A model for estimating hearing aid coverage world-wide using historical data on hearing aid sales.

OBJECTIVE: To estimate the hearing aid coverage for people with disabling hearing loss using data on hearing aid sales. DESIGN: Data on prevalence of disabling hearing loss from WHO and on hearing loss from moderate to severe from the Global Burden of Disease enterprise are used to estimate the number of people with hearing loss. Data on hearing aid sales from the European Hearing Instrument Manufacturers Association (EHIMA) are used to estimate the number of people using hearing aids. STUDY SAMPLE: From 2009 to 2018, the worldwide sales of hearing aids by the EHIMA members were 124 million units. RESULTS: The world-wide hearing aid coverage is 10-11% depending on the prevalence of data source. For all low- to middle-income regions that make up 85% of the world population, the coverage ranges from 1.5% to 12%. In the group of high-income countries as defined by WHO, the coverage is 57%. CONCLUSIONS: Data on hearing aid sales can be used to estimate hearing aid coverage regionally, and world-wide. Globally, there is a huge unmet need for hearing instruments since less than 11% of people with a disabling hearing loss are hearing aid users.

[Pilot Project for Occupational Dental Prevention]. / Pilotprojekt zur betrieblichen zahnmedizinischen Prävention.

AIM OF THE STUDY: To investigate the feasibility and effectiveness of a low-threshold disease prevention offer in a pilot project for employees Methodology: Employees of a company working in office or on production (n=144; 90 women, 54 men) with an average age of 39.25 (StA 11.5) years were interviewed and clinically examined using a questionnaire on habits and knowledge in the prevention of dental diseases. The oral hygiene indices Papillae Bleeding Index (PBI) and the modified Approximal Plaque Index (mAPI) as well as exploratory depth measurements (STM) were collected. Subsequently, a training in dental disease prevention was carried out with a specially produced video as well as the provision of sugar-free chewing gum and mouthwash solutions for twice daily use for a period of one year. After one year, the questionnaire was again issued and the clinical parameters were collected. The study was approved by the UW/H Ethics Committee. Statistical analysis was carried out with SPSS 26. RESULTS: 85 patients with an average age of 39.23 (StD 11.3) years could be examined after one year (59 women, 26 men). The analysis of the questionnaire showed a significant improvement in oral health behavior. The corresponding total score improved from 10.68 (1.93) to 9.97 (1.60) (p<0.05). The PBI improved from 0.43 (0.40) to 0.31 (0.36) (p<0.05), the mAPI from 1.54 (0.51) to 1.35 (0.39) (p<0.01). The STM was reduced from 1.83 (0.39) to 1.56 (0.36) (p<0.001). CONCLUSION: The dental disease prevention program for employees appears suitable for implementation at workplace and has shown significant improvements in oral health behavior as well as in clinical parameters.

How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement.

AIM: To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. METHODS: A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. RESULTS: Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient's individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual.

How to Intervene in the Caries Process in Children: A Joint ORCA and EFCD Expert Delphi Consensus Statement.

This paper provides recommendations for dentists for the treatment of dental caries in children, with an emphasis on early childhood caries (ECC), primary teeth, and occlusal surfaces in permanent teeth. A consensus workshop followed by an e-Delphi consensus process was conducted with an expert panel nominated by the European Organization for Caries Research (ORCA) and European Federation of Conservative Dentistry (EFCD)/German Association of Conservative Dentistry (DGZ) boards. Based on 3 systematic reviews and a nonsystematic literature search, recommendations were developed. The caries decline has led to a more polarized disease distribution in children and adolescents along social gradients which should be taken into account when managing the caries process at all levels, such as the individual, the group, or a population. The control or reduction of caries activity is the basis for successful caries management. In children, caries management requires adequate daily oral hygiene and fluoride application via toothpaste, ensured by caregivers, and especially for ECC prevention an emphasis on sugar intake reduction is needed. These noninvasive interventions are also suitable to arrest or control initial or even cavitated dentine caries lesions in the absence of irreversible pulpitis. Fluoride varnish or silver diammine fluoride can be added as supplementary agents. In pits and fissures, composite resin materials can be used as preventive sealants and for defect-oriented minimally invasive restorations. In primary molars, preformed metal crowns are more successful than multisurface fillings, especially in caries-active patients. With persisting high caries activity, multiple lesions, and limited cooperation, caries control should consist of robust measures with high success rates, even including extraction in selected cases. This applies especially to treatments performed under general anesthesia.

How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement.

OBJECTIVES: To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. METHODS: Based on two systematic reviews, a consensus conference and followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegates. RESULTS: Managing an individual's caries risk using non-invasive means (oral hygiene measures including flossing/interdental brushes, fluoride application) is recommended, as both proximal and secondary carious lesions may be prevented or their activity reduced. For proximal lesions, only cavitated lesions (confirmed by visual-tactile, or radiographically extending into the middle/inner dentine third) should be treated invasively/restoratively. Non-cavitated lesions may be successfully arrested using non-invasive measures in low-risk individuals or if radiographically confined to the enamel. In high-risk individuals or if radiographically extended into dentine, for these lesions, additional micro-invasive (lesion sealing and infiltration) treatment should be considered. For restoring proximal lesions, adhesive direct restorations allow minimally invasive, tooth-preserving preparations. Amalgams come with a lower risk of secondary lesions and may be preferable in more clinically complex scenarios, dependent on specific national guidelines. In structurally compromised (especially endodontically treated) teeth, indirect cuspal coverage restorations may be indicated. Detection methods for secondary lesions should be tailored according to the individual's caries risk. Avoiding false positive detection and over-treatment is a priority. Bitewing radiographs should be combined with visual-tactile assessment to confirm secondary caries detections. Review/refurbishing/resealing/repairing instead of replacing partially defective restorations should be considered for managing secondary caries, if possible. CONCLUSIONS: An individualized and lesion-specific approach is recommended for intervening in the caries process in adults. CLINICAL SIGNIFICANCE: Dental clinicians have an increasing number of interventions available for the management of dental caries. Many of them are grounded in the growing understanding of the disease. The best evidence, patients' expectations, clinicians' expertise, and the individual clinical scenario all need to be considered during the decision-making process.

Elevating the use of sugar-free chewing gum in Germany: cost saving and caries prevention.

OBJECTIVE: To analyse the lifetime monetary and health related effects of the consumption of sugar-free chewing gum. MATERIAL AND METHODS: Using a Markov model we assumed that the German consumption of sugar-free chewing gum (111 gums/year) could be elevated to the level of Finland (202 gums/year). The calculation was based on a model patient representing the development of oral health from the age of 12 to 74 years and clinical data on the effectiveness of chewing sugar-free gum. Lifetime and yearly costs for the 'Finland-scenario' were determined and compared with the actual German expenses of the statutory health insurance companies for dental health. RESULTS: The actual total lifetime expenditures of the statutory health insurance companies are 17,199.96€ per capita and would be 12,188.94€ in the scenario with elevated consumption of sugar-free chewing gum in Germany. Thus, 5011.02€ per capita could be saved in a lifetime and 80.82€ per year. CONCLUSIONS: On a national scale, the elevation of the consumption of sugar-free chewing gum in Germany to the level of Finland would lead to a considerable benefit for cost saving and oral health for the statutory health insurance companies.

Caries-Preventive Effect of Salt Fluoridation in Preschool Children in The Gambia: A Prospective, Controlled, Interventional Study.

The aim of this study was to investigate the anticaries effect of fluoridated salt in a communal feeding program for preschool children. In the Gambian city of Brikama, drinking water had a low fluoride content (0.1 mg F-/L) and young children did not use toothpaste for oral hygiene. Its 2 preschools served as clusters for the trial. Random allocation of the kindergartens was performed by one person not involved in the study, and the clinical examinations were carried out using the envelope method. Meals were prepared with fluoridated salt (250 mg F-/kg salt) in the intervention group but not in the control group. According to the inclusion criteria (complete primary dentition and informed consent from legal guardian), 441 children aged 3-5 years were enrolled. The children were examined by calibrated persons according to WHO criteria, allowing the calculation of d3mft scores. The primary end point was the mean difference in the incidence of caries cavities (Δd3/4mft) after 12 months. After 12 months, the mean caries incidence per person was 1.29 d3/4mf teeth (95% CI: 0.96; 1.62) in the test group (n = 304 children) and 3.83 d3/4mf teeth (95% CI: 2.94; 4.72) in the control group (n = 137 children). Thus, the caries-prevented fraction was 66.3%. No signs of harm due to the intervention were observed. The use of fluoridated salt in a communal feeding program and in an environment with negligible availability of fluoride from other sources yields a considerable caries-preventive effect.

A global approach to assess the economic benefits of increased consumption of sugar-free chewing gum.

PURPOSE: To analyze the influence of increasing the average consumption of sugar-free gum (SFG) in 25 industrialized countries on dental expenditures due to caries by the national health care systems. It was assumed that large cost savings were possible, because the regular consumption of SFG significantly reduces the relative risk of caries and therefore, improves dental health, which reduces expenditures on dental treatments. METHODS: A budget impact analysis (BIA) was performed to model the decrease in the relative risk of caries and the subsequent cost savings for dental care. Annual consumption of SFG, dental expenditures due to caries, chewing frequencies by age groups and the relative risk reduction for caries due to the consumption of SFG were identified and used as model parameters. Three different scenarios for the increase in the number of SFG were calculated. Besides overall results for all countries together, analyses were conducted for countries grouped by regions and the Human Development Index (HDI). RESULTS: For the entity of all 25 analyzed countries together, possible annual cost savings range from US$805.77 M in the scenario with the lowest increase of SFG consumption up to US$18,248 billion in the scenario with the biggest increase of SFG consumption. Europe and the USA show potential cost savings of US$1,061 billion and US$2,071 billion per year, respectively, if all chewers increase their consumption of SFG by 1 piece per day. The analysis showed the potential cost savings in dental expenditures due to caries that can be achieved by only slightly increasing the consumption of SFG. The regular consumption of SFG cannot replace good dental hygiene like tooth brushing, but can have a significant impact on dental health, which can lead to increased cost savings for health care systems worldwide. CLINICAL SIGNIFICANCE: Based on the fact that a regular consumption of sugar-free chewing gum has the beneficial effect of reducing caries prevalence, an increased consumption may not only lead to improved dental health but significant cost savings in expenditures for dental treatment worldwide.

Anterior Open Bite In 27 Months Old Children after Use of a Novel Pacifier - A Cohort Study.

OBJECTIVES: The aim of the present cohort study was to evaluate the influence of a novel pacifier on the first formation of malocclusion, the anterior open bite in children. STUDY DESIGN: 129 newborn children whose parents had decided to use pacifiers were randomly attributed to two experimental groups (D=Dentistar, n=56, Novatex, Pattensen, Germany; N=NUK, n=73, Mapa, Zeven, Germany). Children (n=42) who did not use a pacifier were not randomized and served as reference (C). Primary outcome was the presence of anterior open bite. It was hypothesized that D would result in lower incidence when compared to N. At the age of 27 months the children were examined with respect to anterior open bite. Fisher's exact test served to detect significant differences between groups D and N (SPSS 22.0). RESULTS: 121 children with a mean age of 26.7 months were included in the final analysis (D: n=45; N: n=42; C: n=34). In group D three children (6.7%) showed an anterior open bite. The respective values were 21 (50.0%) for N and 0 for C. The results for group D compared to N were significantly different (chi(2)-test, p<0.001). CONCLUSION: In comparison to a commonly used pacifier the novel one causes significantly less anterior open bites.

A case-control study on oral health-related quality of life in kidney disease patients undergoing haemodialysis.

OBJECTIVE: The study aims to assess the influence of oral health status and socio-behavioural variables on oral health-related quality of life (OHRQoL) in a sample of Iranian haemodialysis (HD) patients. MATERIALS AND METHODS: The present case-control study included 512 patients undergoing HD and 255 healthy controls from Iran. A self-reported questionnaire was used to record socio-demographic variables. In addition, laboratory and clinical variables of each patient were extracted from clinical and patient's electronic records. A closed-ended questionnaire was framed in order to assess oral health knowledge, attitudes and behaviour of each subject. The Short Form Health Survey (SF-36) and Oral Health Impact Profile-14 (OHIP-14) were used respectively to assess general health-related quality of life (GHRQoL) and OHRQoL. All subjects were clinically examined by two trained and experienced dentists for caries by decayed, missing and filled teeth index (DMFT), dental plaque by visible plaque index (VPI), gingival status by Loe and Silness gingival index (GI) and periodontal status by community periodontal index (CPI). RESULTS: Statistically significant differences were found between HD patients and control subjects for all oral health indices. Patients had significantly (p < 0.001) higher mean DMFT, VPI and GI values than controls. Periodontal pockets deeper than 4 mm were more frequently diagnosed in HD patients (p < 0.001). HD patients reported significantly poorer GHRQoL and also a higher impact of oral health (i.e. poorer OHRQoL) in comparison with the healthy controls (p < 0.01). CONCLUSIONS: Oral health status, clinical variables, socio-behavioural factors and GHRQoL were significant predictors of OHRQoL in Iranian HD patients. CLINICAL RELEVANCE: The study findings support the assumption that patient-reported measures can be used to predict treatment need since the objective clinical variables were significantly related to subjective self-reported quality of life in HD patients.

The Fifth German Oral Health Study (Fünfte Deutsche Mundgesundheitsstudie, DMS V) - rationale, design, and methods.

BACKGROUND: Oral diseases rank among the most prevalent non-communicable diseases in modern societies. In Germany, oral epidemiological data show that both dental caries and periodontal diseases are highly prevalent, though significant improvements in oral health has been taking in the population within the last decades, particularly in children. It is, therefore, the aim of the Fifth German Oral Health Study (DMS V) to actualize the data on current oral health status and to gather information on oral health behavior and risk factors. In addition to current oral health monitoring, the study will also permit conclusions about trends in the development of oral health in Germany between 1989 and 2014. METHODS/DESIGN: DMS V is a cross-sectional, multi-center, nationwide representative, socio-epidemiological study to investigate the oral health status und behavior of the German resident population in four age cohorts. Study participants are children (12-year-olds), adults (35- to 44-year-olds), young olds (65- to 74-year-olds), and old olds (75- to 100-year-olds) who are drawn from local residents' registration offices. Social-science investigation parameters concern subjective perceptions and attitudes regarding oral health and nutrition, sense of coherence, and socio-demographic data. Clinical oral parameters are tooth loss, caries and periodontitis, prosthodontic status, further developmental and acquired dental hard tissue and mucosal lesions. To ensure reproducibility, the dental investigators are trained and calibrated by experts and multiple reliability checks are performed throughout the field phase. Statistical analyses are calculated according to a detailed statistical analysis plan. DISCUSSION: The DMS studies first performed in 1989, 1992 and repeated in 1997 and 2005 are the only cross-sectional oral health studies conducted in Germany on a population-based national representative level. Updated prevalence and trend analyses of key oral diseases are, therefore, of major epidemiological and health services research interest. TRIAL REGISTRATION: German Health Services Research Data Bank VfD_DMSV_13_002152.

Reduction of discrepancies between students and instructors in the assessment of practical tasks through structured evaluation sheets and peer feedback.

The aim of this study was to reduce discrepancies between students and instructors in a preclinical dental course by employing structured peer feedback based on a detailed evaluation sheet. In a crossover study of dental students (n = 32), which compared peer feedback using an evaluation sheet (test) with the traditional method (control), participants completed tasks involving cavity and partial crown preparation. The practical tasks were scored numerically on a scale ranging from one (excellent) to six (failure). The amount of feedback provided by the instructor was also recorded. Statistical analysis was conducted using Wilcoxon signed-rank tests (p < 0.05). Regarding cavity preparation, no statistically significant difference was observed (median (25th-75th percentile)) between the grades received by the test (2.00 (1.50-3.00)) and control groups (2.25 (2.00-3.00)). However, the grades pertaining to partial crown preparation exhibited a statistically significant difference between the test (2.25 (2.00-2.50)) and control (2.50 (2.00-3.00)) groups. LimeSurvey and five-finger feedback were used to assess satisfaction with the new method, revealing that most students found the evaluation sheet and peer feedback to be effective. Within the limitations of this study, structured peer feedback using the evaluation sheet positively impacted grades pertaining to partial crown preparation, requiring less instructor feedback.

Orthodontic findings and treatment need in patients with amelogenesis imperfecta: a descriptive analysis.

INTRODUCTION: Amelogenesis imperfecta (AI) is a genetically determined, non-syndromic enamel dysplasia that may manifest as hypoplasia, hypomaturation, or hypocalcification and can commonly be classified into four primary groups. In this retrospective analysis, specific orofacial characteristics are described and associated with each of the AI types based on a patient cohort from Witten/Herdecke University, Germany. METHODS: Data from 19 patients (ten male and nine female, mean age 12.27 ± 4.06 years) with AI who presented at the Department of Orthodontics between July 2011 and December 2023 were analyzed. Baseline skeletal and dental conditions were assessed, including the presence of hypodontia, displacements, and taurodontism. AI was classified into classes I-IV based on phenotype. Treatment needs were evaluated according to the main findings following the German KIG classification, while the radiological enamel situation was determined using panoramic radiographs. RESULTS: An approximately equal distribution between classes II and III was found and a slight inclination toward a dolichofacial configuration (ΔML-NSL: 5.07 ± 9.23°, ΔML-NL: 4.24 ± 8.04°). Regarding orthodontic findings, disturbance in tooth eruption as well as open bite were the most prevalent issues (both 36.8%, n = 7). The most common AI classes were type I and II, which show an almost even distribution about the skeletal classes in sagittal dimension, while dolichofacial configuration was found most frequently in vertical dimension. CONCLUSION: Both clinical and radiological orthodontic findings in context with AI are subject to extensive distribution. It seems that no specific orofacial findings can be confirmed in association with AI with regard to the common simple classes I-IV. It may be more appropriate to differentiate the many subtypes according to their genetic aspects to identify possible associated orthodontic findings.

Quantitative Analysis of the Acceptance and Learning Success Instead of Flipped Classroom Teaching in a Caries Diagnosis Course for Undergraduate Students.

This pilot study aimed to investigate the effectiveness of a flipped classroom for undergraduate students in dentistry. The main objective was to compare the knowledge level of students before and after lectures and practice. All second-year dental students (n = 44) at Witten/Herdecke University participated in this pilot study. They took four knowledge assessments, i.e., T0: the baseline, T2a: after the online lecture (two weeks after T0), T2b: immediately after the face-to-face session, and T3: after the practical session (three weeks after T2). The students' satisfaction and self-assessment of their abilities were determined immediately after the practical session in an anonymous online questionnaire using LimeSurvey. To assess the level of knowledge, we used the Friedman and Wilcoxon-signed-rank tests with the Bonferroni correction to analyze the correct answer by comparing the results from different sessions. The students' satisfaction and self-assessment of their abilities were determined descriptively, presenting the mean and standard deviation. A significance level of p ≤ 0.05 was applied. Data from thirty-nine students regarding the level of knowledge were analyzed. There were statistically significant differences in the level of knowledge of the students at different times (p = 0.001). A total of 19.5% of students reported a problem with the flipped classroom method, and 80.5% reported no problem with this educational method. Ninety-four percent of students would like further flipped classrooms in dental education. Within the limitations of this pilot study, the results suggest that dental students benefit from the flipped classroom method and that this mode of education can be effective in introducing caries diagnosis education for undergraduate students.

In-vitro influence of the use of an erythritol powder through air polishing on the surface roughness and abrasiveness of various restorative materials.

The aim of this in-vitro study is to compare the prophylaxis powder Airflow® Plus to a conventional prophylaxis paste with regards to surface abrasion and roughness on four different restorative materials. A total of 80 samples were fabricated, including 20 of each investigated material. Among those were a nanocomposite (Ceram X Spectra™ ST, Dentsply), a glass ionomer cement (Ketac Fill™, 3M™), a cast metal alloy (Bio Maingold SG®, Heraeus Kulzer) and a ceramic (HeraCeram® Saphir, Heraeus Kulzer). Of each material, all samples were equally divided into two groups. Samples in one group were treated with AirFlow® Plus using the AirFlow® Prophylaxis Master (EMS, Switzerland) (Group AF) and the ones in the other group with Prophy Paste (Cleanic™, Kerr, Austria) (Group CL) on a rubber cup. Applied force amounted to 1.5 N at 2000 rpm. Under controlled reproduceable conditions, a 10-year interval with 4 application per year, a total of 200 seconds, was simulated. Size of each sample amounted to 6 mm in diameter and 2 mm in height. Half side of each sample were treated. While comparing the treated and untreated area of each sample, surface abrasion and roughness were measured using an optical 3D system. Roughness was measured based on the arithmetic roughness average of the surface (Ra) and root mean square of the surface roughness (Rq). The statistical evaluation of the data was carried out using the non-parametric Mann-Whitney-U-test, Wilcoxon-test and the Kruskal-Wallis test for group comparisons. In conclusion, the use of the rubber cup with Prophy Paste caused a significantly higher abrasion on composite, ceramic and gold compared to the AirFlow® Plus powder (p < 0.05). In group AF, the significant highest values for Ra were determined on GIC, followed by composite, gold and then ceramic in intragroup comparison. Ra on GIC was significantly higher in group AF (p < 0.05).

Total and free fluoride concentrations of African dentifrices marketed in West Africa.

OBJECTIVE: To determine the fluoride concentrations of commercial dentifrices marketed in West Africa. DESIGN: In vitro measurement of the total fluoride concentration by liquid gas chromatography, and of the free fluoride concentration with a fluoride sensitive electrode. SETTING: Collection of fluoride dentifrices in public markets and supermarkets in and around the capital of The Republic of The Gambia, Banjul, after a systematic search. MATERIALS: All commercially available different brands sold in The Gambia and produced locally or in other African countries (Egypt, Morocco, Nigeria and South Africa). OUTCOME MEASURES: Total and free fluoride concentrations of dentifrices in parts per million. RESULTS: Seven different dentifrices were detected with NaMFP as the predominant fluoride source. Four dentifrices showed a total fluoride concentration above 1,000 ppm F-. The products showed - in general - a lower free fluoride concentration. Only one product with NaF as fluoride supplement showed both total and free fluoride concentrations above 1,000 ppm F-. Four products contained calcium-based abrasive additives. CONCLUSION: The measurement of total and free fluoride concentrations of dentifrices available in The Gambia (West Africa) showed inhomogeneities. This was particularly verified where fluoride compounds were combined with calcium-based abrasives. If so, it is recommended that the total fluoride content should be measured by gas chromatography. Periodic quality control of dentifrices should be introduced in areas with an under-developed consumer-counselling infrastructure.

Efficacy of a novel pacifier in the prevention of anterior open bite.

PURPOSE: The purpose of this study was to test a novel pacifier (Dentistar) regarding the development of anterior open bite in infants. METHODS: One hundred twenty-nine newborn children were randomly assigned to 2 experimental groups: NUK (N; N =73); and Dentistar (D; N=56. Children (N=42) who did not use a pacifier served as the control (C). At 10- to 26-months old, the children were re-examined (via a blind operator) regarding the existence of an anterior open bite. RESULTS: One hundred twenty-one toddlers (66 females, 55 males) were included in the final analysis (N: N=42; D: N=43; C: N=36). The mean age was 15.9 (±3.9 SD) months. In Group N, 16 children (38%) showed an anterior open bite, 2 (5%) in Group D, and 0 in Group C. The incidence of open bites was significantly less in Groups D and C vs N (chi-square test, P<.001). No significant difference was found between D and C. CONCLUSION: Pacifier use may promote open bites in 16-month-old infants. Compared to a commonly used pacifier, the Dentistar caused almost no anterior open bites and, therefore, can be recommended for children younger than 16 months old.

Comparative in vitro study of the cleaning efficacy of AirFloss ultra and I-Prox Sulcus brushes in an orthodontic phantom model.

Preventing biofilm-related risks such as gingivitis and white spot lesions during orthodontic treatments is very challenging. The cleaning efficiencies of AirFloss Ultra and I-Prox P sulcus brushes were evaluated using an orthodontic phantom model. After attaching brackets onto black-coated maxillary KaVo teeth, a plaque substitute was applied. The evaluated tooth surfaces were divided into two areas. Cleaning was performed with an AirFloss Ultra with two (A-2) or four (A-4) sprays or an I-Prox P for two (I-2) or four (I-4) seconds. Images before and after cleaning were digitally subtracted, and the percentage of fully cleaned surfaces was determined (Adobe Photoshop CS5, ImageJ). Statistical analysis was performed by ANOVA and post hoc tests with Bonferroni correction (SPSS 25, p < 0.05). The mean values of total cleaning efficacy were 26.87% for I-2, 43.73% for I-4, 34.93%, for A-2 and 56.78% for A-4. The efficacy was significantly higher for A-4 than for A-2, I-4, and I-2. There were significant differences between the four groups. Repeated cleaning led to an improved result. Within the study limitations, the AirFloss Ultra with four sprays proved to be more efficient than the sulcus brush I-Prox P for cleaning.

Performance of atraumatic restorative treatment (ART) depending on operator-experience.

OBJECTIVES: Oral health care is not of major interest in developing countries because of lack of infrastructure and professional manpower. Therefore, atraumatic restorative treatment (ART) was introduced by the World Health Organization to be performed by dental auxiliary personnel. The aim of this study was to evaluate the performance of ART depending on operator-experience in The Republic of The Gambia. METHODS: One hundred twenty-eight newly inserted restorations were followed up for 12 months using the clinical ART index in a prospective and blinded study design. The patients were randomly assigned to operators. The clinical performance was compared among three groups: trainees, experienced Community Oral Health Workers (COHW), and professional dentists. The difference in success rates was calculated at a 95 percent confidence interval. RESULTS: There was a statistically significant difference between trainees and dentists in performing leakage/gap-free one-surface restorations (P < 0.05). No significant differences were found between the two groups of auxiliaries (trainees versus experienced COHWs, P > 0.05). Finally, both groups--experienced COHWs and dentists--performed restorations not showing statistically significant differences (P > 0.05). CONCLUSIONS: For The Republic of The Gambia--especially for areas with underdeveloped medical infrastructure--training and assignment to perform ART can be recommended for auxiliary dental staff of Community Oral Health Workers.

Association between oral health-related and general health-related quality of life in subjects attending dental offices in Germany.

OBJECTIVES: To evaluate the GHRQoL and OHRQoL of patients attending dental offices in Germany and to determine correlation coefficients between SF (Short Form)-12 and OHIP (Oral Health Impact Profile)-14 scores. METHODS: A total of 10,342 dental offices were randomly selected. Each of the 1,113 that consented to participate received 20 questionnaires to be filled in by a convenience sample of the patients. The questionnaire included the OHIP-14-form for OHRQoL as well as the SF-12-form for GHRQoL. RESULTS: A total of 12,392 completed questionnaires were analyzed. The mean age of the participants (64.9 percent female, 35.1 percent male) was 44.25 years. The mean summary score of OHIP-14 was 6.30 (SD 7.46). The mean physical component summary scale (PCS) of the SF-12 was 51.15 (SD 7.23) and the mental component summary scale (MCS) was 50.17 (SD 8.55). The variance of PCS and MCS could be explained to 10 percent each by oral health-related quality of life (r2 = 0.095 and 0.101, P < 0.001). CONCLUSION: OHRQoL is considerably related to GHRQoL.