Comparison of biochemical markers of bone metabolism between conventional labial and lingual fixed orthodontic appliances.

OBJECTIVES: The applied orthodontic force causes remodeling of the periodontium through the selective release of cytokines causing resorption of bone, enabling controlled movement of the tooth. This study compared the cytokine profile between patients treated with conventional labial and lingual fixed orthodontic appliances. PATIENTS AND METHODS: The study included 80 patients in need of orthodontic treatment, out of which 40 patients were treated by the labial fixed appliance and 40 by the lingual fixed appliance. Gingival crevicular fluid (GCF) specimens were gathered from both the groups using a microcapillary pipette. The samples were collected at the beginning of the treatment and after 21 days. Enzyme-linked immunosorbent assay was performed to evaluate the cytokine levels. RESULTS: Interleukin (IL)-1α, 1ß, 2, 8, and tumor necrosis factor-alpha (TNF-α) levels were significantly high (P < 0.001) in GCF of participants treated with conventional labial fixed appliance. IL-1α, 1ß, 2, 6, 8, and TNF-α levels were significantly high (P < 0.001) in GCF of participants treated by the lingual fixed appliance. The concentrations of TNF-α and IL-1ß were increased higher than other cytokines in both the treatment groups. CONCLUSION: Overall, the lingual fixed appliance had higher cytokine levels than a labial fixed appliance. Analyzing the GCF cytokine levels during orthodontic treatment could provide an ideal platform for monitoring the progress of the treatment.

Relationship between plaque pH and different caries-associated variables in a group of adolescents with varying caries prevalence.

The pH response of the dental biofilm after a sugar challenge can be considered to mirror the acidogenic potential and thereby the caries risk of an individual. The aim of this cross-sectional study was to evaluate the relationship between plaque pH and different caries variables in adolescents with varying caries prevalence. One hundred individuals, aged 14-15 years, were examined regarding different caries-related variables: (i) caries score (DSm, DSi, DSm + i, DTm), (ii) salivary secretion rate and buffer capacity, (iii) oral microflora of plaque and saliva, (iv) plaque amount, (v) plaque pH and (vi) dietary intake, oral hygiene habits and fluoride use. Plaque pH was assessed using the microtouch method before and after a 1-min mouthrinse with 10 ml 10% sucrose. Depending on the minimum pH, the participants were divided into three groups: low pH (≤5.3), medium pH (>5.3-6.3) and high pH (>6.3). Statistically significant differences between the three groups (p < 0.01) were found for initial caries (DSi) and combined manifest and initial caries (DSm + i). A statistically significant difference was also found in the log values for salivary lactobacilli (p = 0.02) within the three groups, and for the total number of bacteria in plaque (p = 0.04); for both variables, the low-pH group had the highest values. The only covariate significantly associated was the Cariogram score in the medium-pH group (p < 0.01) and the number of meals per day in the high-pH group (p = 0.02). To conclude, plaque pH measured by the microtouch method is a method that can be used for discriminating between individuals with varying caries prevalence.

Oral administration of Lactobacillus reuteri during the first year of life reduces caries prevalence in the primary dentition at 9 years of age.

The aim of this study was to evaluate the effect on oral health, at age 9 years, of daily oral supplementation with the probiotic Lactobacillus reuteri, strain ATCC 55730, to mothers during the last month of gestation and to children through the first year of life. The study was a single-blind, placebo-controlled, multicenter trial involving 113 children: 60 in the probiotic and 53 in the placebo group. The subjects underwent clinical and radiographic examination of the primary dentition and carious lesions, plaque and gingivitis were recorded. Saliva and plaque were sampled for determination of mutans streptococci (MS) and lactobacilli (LB) in saliva and plaque as well as salivary secretory IgA (SIgA). Forty-nine (82%) children in the probiotic group and 31 (58%) in the placebo group were caries-free (p < 0.01). The prevalence of approximal caries lesions was lower in the probiotic group (0.67 ± 1.61 vs. 1.53 ± 2.64; p < 0.05) and there were fewer sites with gingivitis compared to the placebo group (p < 0.05). There were no significant differences between the groups with respect to frequency of toothbrushing, plaque and dietary habits, but to intake of fluoride supplements (p < 0.05). There were no intergroup differences with respect to L. reuteri, MS, LB or SIgA in saliva. Within the limitation of this study it seems that daily supplementation with L. reuteri from birth and during the first year of life is associated with reduced caries prevalence and gingivitis score in the primary dentition at 9 years of age.

'I take for granted that patients know' - oral health professionals' strategies, considerations and methods when teaching patients how to use fluoride toothpaste.

OBJECTIVES: The aim of this study was to explore the oral health professionals' (OHPs') perspectives regarding their strategies, considerations and methods when teaching their patients the most effective way of toothbrushing with fluoride (F) toothpaste. METHODS: A qualitative research method was used to collect data. To stimulate interactivity among the participants, interviews were performed in focus groups. Five groups of OHPs, including dentists, dental hygienists and dental nurses, were interviewed a total of 23 individuals. The interviews were analysed using manifest and latent qualitative content analysis. Data were systematically condensed and coded to the relevant phrases that identified their content. RESULTS: Three categories were identified in the manifest and latent content analysis: (i) strategies and intentions, (ii) providing oral hygiene information and instruction and (iii) barriers to optimal oral healthcare education. Health promotion and seeing to the patients' best interest were driving forces among the OHPs as well as personal success in their preventive work. They focused on toothbrushing techniques more than on how to use F toothpaste. Barriers to oral health information were cost to the patients and, to some extent, the opinion of the OHPs that some patients were impossible to motivate or that patients already know what to do. CONCLUSION: The OHPs described toothbrushing with F toothpaste as very important, although the plaque removal perspective dominated. They did not focus on how to use F toothpaste, because they believed that knowledge about and appropriate behaviour concerning F toothpaste were already familiar to their patients.

Caries prevalence in Swedish 20-year-olds in relation to their previous caries experience.

BACKGROUND/AIM: There are few studies of caries development and caries-related factors from early age to young adulthood. The aim of the present study is to analyse caries prevalence in 20-year-olds in relation to their previous caries experience. METHOD: Oral health from 3 to 20 years of age was followed longitudinally in a cohort of 499 individuals. The clinical and radiographic incidence of caries and restorations in 494 20-year-olds was related to caries data at 3, 6 and 15 years of age. RESULTS: Twenty-six per cent of the 20-year-olds were caries-free. The mean number of initial and manifest lesions and restorations (Di + mFS) was 5.8. Initial lesions comprised 40% of the Di + mFS. Of the occlusal surfaces of molars and premolars, 12 and 4%, respectively, had manifest caries or restorations. Compared with individuals who had been caries-free during childhood (primary dentition) and adolescence, those with a history of caries activity while growing up had statistically significantly more approximal lesions at the age of 20 (DmFSa 0.6 vs. DmFSa 4.6, respectively). Those with manifest caries during childhood but caries-free at 15 years had a low caries prevalence at 20 years of age (DmFSa 1.3). Few new lesions developed after age 15. However, 50% of initial lesions at this age had progressed to manifest lesions at age 20. CONCLUSION: There is a relationship between caries prevalence at age 20 and early caries experience.

Adolescents' experiences of a two-year oral health intervention programme in two Swedish secondary schools.

OBJECTIVES: To describe adolescents' experiences of participating in a school-based oral health intervention programme for 2 years containing education about oral health and fluoride varnish treatment at the school clinic. METHODS: Sixteen adolescents aged 13-16 were interviewed in three focus group sessions. A phenomenographic approach was used for analysis. RESULTS: The results are presented as three themes and seven descriptive categories. The three themes were 'Seeing the dental hygienist', 'Treatments at the dental hygiene clinic' and 'Education about oral health in class'. The results demonstrate satisfaction with the intervention, such as accessibility, time gain and expanding knowledge. On the other hand, feelings of vulnerability in the treatment sessions were expressed. The fluoride varnish treatment was given both positive and negative reviews. The contact between the participants and the dental hygienist was important, and the opportunity to ask questions about oral health issues was emphasized. CONCLUSIONS: Both positive and negative experiences of the programme were found. Adolescence is a transitional period of life, and for this reason, it is important to create a good working alliance between students and the dental hygienist in future school-based oral health interventions.

Effect of post-brushing mouthwash solutions on salivary fluoride retention--study 2.

OBJECTIVE: This study evaluated the effects of three post-brushing mouthwashes containing 0 ppm F, 225 ppm F, and 500 ppm F, respectively, on salivary fluoride retention after brushing with 1450 ppm fluoride (as NaF) toothpaste and rinsing with water immediately after brushing. METHODS: In this three-phase, randomized, cross-over study, an ion-specific electrode was used to measure salivary F levels in thirty trial participants before brushing (Time 0), and after brushing, rinsing with water, and then rinsing with one of the three mouthwashes. Time points evaluated after brushing were one, three, five, 10, 20, 30, 45, and 60 minutes. For saliva sample collections, subjects were asked to pool saliva in their mouths for 10 seconds before spitting out into a container for each of the time points. RESULTS: The AUC0-60 means for F in saliva were 554, 252, and 20 for the 500, 225, and 0 ppm F mouthwash groups, respectively. The 500 ppm F mouthwash resulted in a 2660% increase in total fluoride salivary retention over 60 minutes when compared with the 0 ppm F group, and a 120% increase when compared with the 225 ppm F group. A significant difference (p < 0.001) in the AUC0-60 means between the three groups was observed using analysis of variance (ANOVA). Paired t-tests also showed significant differences in the mean fluoride retention over 60 minutes for all three pair-wise group comparisons (p < 0.001). CONCLUSION: Use of a fluoride mouthwash containing 225 ppm F or 500 ppm F produced a significant increase in salivary fluoride retention following brushing with a 1450 ppm F toothpaste and rinsing with water compared to rinsing without fluoride. The use of the 500 ppm F mouthwash may be of particular benefit to those at high caries risk.

The effect of a modified fluoride toothpaste technique on buccal enamel caries in adults with high caries prevalence: a 2-year clinical trial.

OBJECTIVE: To evaluate the preventive effect of a "modified fluoride (F) toothpaste technique" on the incidence and progression of buccal/ lingual enamel caries among Saudi adults with high caries prevalence. METHOD: Adults were randomly assigned to test and control groups. Test group patients were instructed to use the provided F toothpaste twice a day as follows: 1, use 2cm toothpaste; 2, brush for 2 min; 3, swish the toothpaste slurry around the teeth for about half a minute before spitting it out; and 4, no post-brushing water rinsing and no eating/drinking for 2hr. The patients in the control group (n = 57) were instructed to continue using their regular F toothpaste twice a day without any further instructions. The patients' compliance in the test group was assessed after 2 years. RESULTS: Of 175 adults, 113 completed the study. The test group (n = 56) had a lower enamel mean caries incidence 0.56 (sd 1.04) than the control group (n = 57), 1.01 (1.00) (p < 0.05), with a preventive fraction of 44%. There was no difference regarding enamel caries progression or arrested caries. The caries incidence in the test group was higher in the subgroup of patients who rinsed with water post-brushing and who only brushed once a day (p < 0.05). CONCLUSION: The "modified fluoride toothpaste technique", as practised over the 2 years in a Saudi population with high caries prevalence, had a preventive effect on the incidence of buccal/lingual enamel caries but not on the progression.

Preventive effect of high-fluoride dentifrice (5,000 ppm) in caries-active adolescents: a 2-year clinical trial.

There is a lack of clinical studies comparing dentifrices with high fluoride (F) concentration. The aim was to evaluate a dentifrice containing 5,000 ppm F compared to a dentifrice containing 1,450 ppm F in caries-active adolescents. The design was a 2-year, single-blind randomized controlled trial and 211 adolescents of 279 (76%) completed the trial. The subjects were divided into two groups and were given one of the assigned F dentifrices for daily unsupervised toothbrushing: (1) Duraphat 5,000 ppm F and (2) Pepsodent Superfluor 1,450 ppm F, both as NaF. The outcome variables were caries incidence and progression of proximal and occlusal caries. The subjects were asked to fill in a questionnaire to evaluate their compliance and they were divided into two subgroups: subgroup A, excellent compliance, and subgroup B, poor compliance. The latter group (28%) comprised the subjects who did not brush twice a day or did not use the dentifrice regularly. Adolescents using 5,000 ppm F toothpaste had significantly lower progression of caries compared to those using 1,450 ppm F toothpaste (A: p < 0.01, B: p < 0.001), with a prevented fraction of 40%. Subjects using 5,000 ppm F toothpaste had significantly lower caries incidence for compliance B compared to those using 1,450 ppm F toothpaste (p < 0.05); the prevented fraction was 42%. This may indicate that 5,000 ppm F toothpaste has a greater impact on individuals who do not use toothpaste regularly or do not brush twice a day. Thus, 5,000 ppm F toothpaste appears to be an important vehicle for caries prevention and treatment of adolescents with a high caries risk.

Caries prevalence, caries-related factors and plaque pH in adolescents with long-term asthma.

The aim of the present case-control study was to investigate dental caries, various caries-related factors as well as gingival condition, in 12- to 16-year-olds with long-term asthma (n = 20) and a matched healthy control group (n = 20). Data on dietary and oral hygiene habits, numbers of mutans streptococci and lactobacilli in saliva were also obtained. The plaque pH drop after a sucrose rinse was measured up to 40 min at 2 approximal tooth sites. A lower salivary flow rate was found in the asthma group compared to the control group (p < 0.05). The mean (± SD) of DFS, including manifest and initial caries, was 4.9 ± 5.5 in the asthma and 1.4 ± 2.3 (p < 0.01) in the control group. Only 1 adolescent in the asthma group was caries free compared to 13 in the control group. Concerning pH in plaque, adolescents with asthma had a lower initial value (p < 0.01) and final pH (p < 0.05) than the control group. The Cariogram data showed that 55% of the subjects in the control group had 'a high chance of avoiding caries' compared to 10% in the asthma group (p < 0.01). The asthmatic adolescents had higher numbers of sites with gingival bleeding (p < 0.01). To conclude, adolescents with long-term asthma had a higher total DFS and caries risk (according to Cariogram), decreased salivary rate, more gingival bleeding and lower plaque pH than adolescents without asthma.

Effect on de novo plaque formation of rinsing with toothpaste slurries and water solutions with a high fluoride concentration (5,000 ppm).

The aim of this study was to evaluate the effect, on de novo plaque formation, of rinsing with toothpaste slurries and water solutions containing a high concentration of fluoride (F). Sixteen subjects rinsed three times per day for 4 d with dentifrice slurries containing 5,000, 1,500, and 500 ppm F, while 12 subjects rinsed with water solutions containing 5,000, 1,500, 500, and 0 ppm F, and 1.5% sodium lauryl sulphate (SLS). Plaque was scored [using the Quigley & Hein index (QHI)] after each 4-d period. Plaque samples for F analysis were collected. Significantly less plaque was scored for the dentifrice slurry containing 5,000 ppm F (buccal and all surfaces) and for 1.5% SLS (buccal surfaces). The differences in plaque scores between dentifrice containing 5,000 and 1,500 ppm F were 19% for all surfaces and 33% for buccal surfaces. The difference between the water solutions containing 1.5% SLS and 1,500 ppm F for buccal surfaces was 23%; the corresponding difference for 5,000 ppm F was 17%. The dentifrice slurry containing 5,000 ppm F accumulated 56% more F in plaque. The combination of high levels of F and SLS in dentifrice reduces de novo plaque formation and increases the accumulation of F in plaque after 4 d.

Fluoride retention in proximal plaque and saliva using two NaF dentifrices containing 5,000 and 1,450 ppm F with and without water rinsing.

A total of 26 healthy volunteers participated in this randomized 4-leg crossover study designed to measure fluoride (F) retention in interdental plaque and saliva. Two NaF dentifrices (5,000 and 1,450 ppm F) were used, with and without postbrushing water rinsing. The 4 tooth brushing methods were carried out twice a day during 2 weeks. Interdental plaque was collected from all proximal sites after each method, using dental floss. Immediately after the plaque sampling, the subjects were asked to brush their teeth with the same toothpaste and use the postbrushing water rinsing procedure as previously. Proximal saliva was collected from 4 interdental sites, using small paper points, before and up to 60 min after the brushing. The present study showed that the 5,000 ppm F toothpaste without postbrushing water rinsing resulted in the highest F concentration in both plaque and saliva and the 1,450 ppm F toothpaste with water rinsing in the lowest. The difference in the area under the curve of saliva F concentration versus time between the 2 methods was 4.2 times (p<0.001). The corresponding difference in F concentration per unit weight of plaque (n=16) was 2.75 times (p<0.05). Water rinsing immediately after tooth brushing with 5,000 ppm reduced the F concentration in saliva by 2.4 times (p<0.001). The difference in F values in saliva between 5,000/rinsing and 1,450/no rinsing was minor and not significant. The increase of F in both proximal saliva and plaque, using a dentifrice with 5,000 ppm F without postbrushing water rinsing, may be of clinical importance.

Tobacco use in relation to socioeconomic factors and dental care habits among Swedish individuals 15-70 years of age, 1983-2003.

OBJECTIVES: The aim of this study was to describe the use of tobacco and changes in its use over time among individuals living in Jönköping, Sweden, and to analyse tobacco habits in relation to socioeconomic conditions, personality aspects and dental care habits. METHODS: This study comprised three epidemiological cross-sectional studies, involving a random selection of individuals aged between 15 and 70 years, and was conducted in 1983, 1993 and 2003. The participants were asked to complete a questionnaire. RESULTS: The results revealed a statistically significant reduction from 34% tobacco users in 1983 to 27% in 1993 and 28% in 2003. The main decrease was seen among smokers. At the same time, the number of users of snuff increased in all the age groups between 20 and 60 years of age. The use of tobacco was therefore largely unchanged in 1993 and 2003. In 2003, there was a statistically significant difference between users and non-tobacco users when it came to the frequency of dental visits; more tobacco users than non-tobacco users did not visit a dentist at all or did not visit a dentist regularly. In 1993, non-tobacco users brushed their teeth more frequently than tobacco users and this difference was statistically significant. CONCLUSIONS: During the 20-year study, there was a reduction in the number of smokers and an increase in the number of snuff users. There was a difference between tobacco users and non-tobacco users when it came to the frequency of dental visits and oral hygiene habits.

Approximal fluoride concentration using different fluoridated products alone or in combination.

The aim of the present investigation was to measure the approximal fluoride (F) concentration after using different F-containing products, either alone or in combination. Ten subjects participated on a total of 17 occasions, which were randomized, distributed and divided into two trials (called trial I and trial II). The F concentration was studied after treatment with toothpicks, dental flosses, an interdental brush dipped in 0.2 or 0.32% F gels, brushing with toothpaste containing 0.32% F and a mouthrinse with 0.2% NaF solution. The results of trial I revealed that the rinsing solution resulted in the highest approximal F values, followed by toothpicks and brushing. When brushing was combined with either flossing or toothpick, the sequence order of the two methods had less influence. However, when combined with rinsing it appeared to be better to use the floss or the toothpicks first, prior to the mouthrinse. In trial II, treatment with the gels alone, and in combination with brushing, resulted in higher approximal F concentrations compared with brushing alone. The data indicate that the order of usage when combining products may be of importance when it comes to obtaining high F levels at the approximal sites and that an interdental brush with F gel after toothbrushing may be a suitable method, called 'Inter Dental Brush Gel Method', to produce elevated F concentrations at approximal sites.

Fluoride retention of a mucosa adhesive paste compared with other home-care fluoride products.

Home-care use of fluoride (F) requires a motivated individual and several F products rely on a person's ability to follow instructions and to cooperate with the treatment. The aim of this crossover study was to investigate concentrations, distribution in the oral cavity and duration of the elevated F concentrations after using four F products: (1) a mucosa adhesive paste with 0.1% F, (2) a mouth rinsing solution with 0.2% NaF, (3) toothpaste containing 0.5% F and (4) a tablet with 0.75 mg F. Fourteen subjects used the four products in randomized order either during the daytime or just before going to bed. The F concentration was measured both in saliva and at interproximal sites. After 6 h of sleep, the F concentration after using the mucosa adhesive paste and the mouth rinse solution was high in saliva. In the interproximal area, the adhesive paste showed the highest values. During daytime use, all the products increased the F concentration, but only the mucosa adhesive paste and the rinsing solution elevated F in saliva for up to 2 h. In the interproximal area, the paste increased the F concentration most. In conclusion, this study showed that the mucosa adhesive paste and the mouth rinse solution led to higher F concentrations and for a longer time than tablets and toothpaste. For patients who are unable to comply with traditional F treatment, an F-containing adhesive paste therefore has the potential to be a useful vehicle. For individuals who are able to cooperate, a mouth rinse with an F solution is a simple, efficient and well-known method for preventing dental caries.

Uptake and release of fluoride from fluoride-impregnated chewing sticks (miswaks) in vitro and in vivo.

The purpose was to investigate the uptake and release of fluoride (F) from F-impregnated chewing sticks (miswaks). In the first series, 3-cm-long pieces were impregnated in 1, 2, 3 and 4% NaF solutions for 3 h, 1 day and 3 days (10 pieces/test). There was a dose-response effect with respect to both impregnation time and the concentration of the F solution. In the second and third series, totally 40 miswak pieces were impregnated in 3% NaF for 1 day and 3 days; the outer layer (bark) was separated from the inner spongy part (pulp) and analyzed separately. F was released from both parts, but somewhat more was released from the bark than from the pulp; a plateau was reached at around 30 min. In vivo, 9 healthy subjects used three products for 2 min in a crossover design: (1) a miswak impregnated in 3% NaF for 1 day, (2) a miswak impregnated in 3% NaF for 3 days, and (3) 1 g of F toothpaste (containing 1,450 ppm F as NaF) on a toothbrush. The highest F concentration at the approximal area was obtained after using the miswak impregnated in 3% NaF for 3 days compared with the other products (p < 0.05 or p < 0.01). To conclude, NaF-impregnated miswaks produced a rapid release of F in vitro as well as in vivo and may be an interesting vehicle for home care use for caries prevention in countries where they are used regularly.

Oral hygiene and parent-related factors during early childhood in relation to approximal caries at 15 years of age.

The aim was to investigate whether oral hygiene habits and parent-related factors, recorded in early childhood, have a predictive value in relation to approximal caries experience (including initial caries lesions) at the age of 15 years (n = 568). Data were selected from examinations, interviews and questionnaires at 1 and 3 years and bitewing radiographs at 15 years. Four levels of cut-off points for the statistical analysis were used: DFa = 0, > 0, > or = 4 and > or = 8. In the final logistic regression analyses, mother's self-estimation of her oral health care being less good remained statistically significant and predicted a caries experience of DFa > 0 at 15 years. The following four variables predicted DFa > or = 4: (1) female gender, (2) plaque on maxillary incisors at 1 year, (3) mother's self-estimation of her oral health care being less good and (4) father being less satisfied with his social situation. Two variables predicted DFa > or = 8: (1) toothbrushing with fluoride toothpaste just once a day, and (2) father being less satisfied with his social situation. Furthermore, children who failed to attend the examination at 1 year of age had 6.95 +/- 5.36 (mean +/- SD) DFa at 15 years compared with 3.10 +/- 3.85 for children who were examined at 1 year of age (p < 0.01). To conclude, factors explaining good dental health at 15 years of age pertained to both children and parents. Thus, it seems that good oral hygiene habits, established in early childhood, provide a foundation for a low experience of approximal caries in adolescents.

The healthcare system and the provision of oral healthcare in European Union member states. Part 9: Sweden.

Equally accessible and affordable dental services for all population groups have been a political goal in Sweden for almost a century. All political parties have shared the idea that a person's social background should not have consequences for his or her dental status. Strategic tools to achieve this ambitious goal have been the wide use of publicly provided oral healthcare services, covering even sparsely populated areas, focusing on preventive care and significant subsidies for necessary treatments. Besides free care for children and young adults, oral healthcare is reimbursed from public funds. The public subsidy was particularly generous in 1975-1999 when a 'full clearance' of adults' dentitions was undertaken both by the public and private providers under fixed prices and high reimbursement levels for all treatment measures. Today, preventive oral healthcare for the elderly is given higher priority as most Swedes have been able to keep their natural teeth.

Prevalence of approximal caries in posterior teeth in 15-year-old Swedish teenagers in relation to their caries experience at 3 years of age.

The aim of the present investigation was to study the prevalence of approximal caries lesions and fillings in posterior teeth at 15 years of age in a prospectively followed Swedish population (n = 568), with special reference to their caries experience at the age of 3 years. Only approximal surfaces were recorded, since all children in the Community of Jönköping have had fissure sealing performed on all caries-free permanent molars. At 15 years of age, the mean number of approximal tooth surfaces with initial caries lesions (D(i)a), manifest caries lesions and fillings (D(m)Fa) and total caries experience and fillings (D(i + m)Fa)--recorded on bitewing radiographs--was 2.78 , 0.45 and 3.23, respectively. One third of the adolescents had no approximal caries or fillings; the D(i)a constituted 86% of the D(i + m)Fa. Children with manifest caries at 3 years of age had a higher risk of developing approximal caries in their permanent teeth than caries-free children at the same age (41 vs. 17%). Furthermore, children who were caries-free at 3 years of age were more likely to remain caries-free at 15 years of age compared to children with manifest caries (37 vs. 17%). All these differences were statistically significant (p < 0.001). Additionally, early childhood caries experience (developed before 3 years of age) had a greater predictive value than late childhood caries experience (developed between 3 and 6 years of age) concerning approximal caries at 15 years of age.

Patterns of carbohydrate intake--a study of typology, associations and changes over time in an elderly Swedish population.

BACKGROUND: Patterns may explain part of the dietary variation between subjects. OBJECTIVE: To create a typology of carbohydrate intake among the elderly and to analyse whether it seems valuable or not. DESIGN: Factor and cluster-analyses of dietary interviews from two elderly cohorts of free-living elderly people in Göteborg, Sweden. SUBJECTS AND METHODS: Three hundred and thirty seven women and three hundred and twenty three men aged 70-79 was studied cross-sectionally and longitudinally. The altogether 917 dietary interviews were based on the dietary history method. Cluster analysis, based on factor scores, was used to create the typology. RESULTS: Seven clusters were identified: 1) Small eaters (high relative intake of starch and a low energy intake), 2) Lean and green eaters (high intake of dietary fibre), 3) Fruit eaters (high intake of monosaccharides), 4) Sweet tooth eaters (high intake of sucrose), 5) Gourmands (high absolute intake of starch, dietary fibre and energy), 6) Milk drinkers (high intake of lactose) and 7) Fat eaters (high intake of fat and low intake of carbohydrates). The different patterns were associated with different food consumption, different intake of micronutrients and different social and physiological factors. There were also changes over time of the proportion of subject within the clusters. CONCLUSIONS: The typology found by using cluster analysis, seems to be valid and was related to all analysed dimensions. Therefore, the methods may be valuable for describing and analysing the dietary intake among elderly.