Pro-inflammatory, pleiotropic, and anti-inflammatory TNF-alpha, IL-6, and IL-10 in experimental porcine intervertebral disk degeneration.

The aim of this study was to check the balance between tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-10 (IL-10) in well-developed end-stage disk disease in the disk itself as well as in paradiskal spine. In 6 domestic pigs the cranial bony end plate of the L4 vertebra was perforated to the nucleus pulposus. At 3 months the degenerated experimental and contiguous control disks, together with the adjoining bony and cartilaginous vertebral end plates, bone marrow, and spinal ligaments, were excised and used for immunohistochemical analysis. In general, there were more TNF-alpha and in particular IL-10 positive cells in the degenerated disks than in the control disks, whereas the number of IL-6 labeled cells did not differ among sites or between control and experimental intervertebral disks. These results suggest that TNF-alpha and IL-10 are involved in the late reparatory phases of the experimental disk lesion. Use of an experimental model showed that strictly disk-directed manipulation and degeneration are also reflected in the contiguous vertebrae, including adjoining cartilage, bone, marrow, and ligaments.

Taste thresholds, taste preferences, and dental caries in 15-year-olds.

In two groups of 15-year-olds--50 with a high and 50 with a low caries experience--recognition thresholds were determined for sweet, salty, sour, and bitter tastes and preferences for sweet taste, using a full-mouth technique. No statistically significant difference in thresholds could be found between the groups. No correlation between threshold values and preferences for sucrose could be established.

Dental health in a group of Swedish 8-year-olds followed since the age of 3.

A study was made of the dental health of a group of 8-year-old children studied earlier as 3-, 4- and 5-year-olds, including examination of caries, gingivitis and occlusion, as well as certain data on oral habits and fluoride prophylaxis. Caries was found in 92% of the children. The mean DMFS-value was 3.1 and the mean defs-value 8.8. A statistically significant correlation was demonstrated between caries indices at 3 and 8 years of age in the group as a whole. Children with a defs-value higher than the mean defs-value at the age of 3, had a higher mean DMFS-value at the age of 8 than the rest of the group. Sagittal relationships remained largely unchanged between 3 and 8 years of age, while the number of children with an anterior open bite decreased from 51% to 4% during the same time, probably due to a decrease in sucking habits.

Effect of fluoride varnish (Duraphat) in preschool children.

The caries-preventive effect of semiannual applications of a fluoride varnish (Duraphat) was tested for 2 years in 225 3-year-old children; 113 children served as a control group. At the baseline examination, 69% of the children in the test group and 75% in the control group were caries-free. The results after 2 years showed an average caries increment of 2.1 surfaces in the test group and 3.7 in the control group. The difference is statistically significant. Thirty-eight percent of the children in the test group and 27% in the control group were still caries-free. The caries reduction was 44%.

A longitudinal study of dental health in Swedish children aged 3-5 years.

This paper presents data concerning caries, gingivitis, interdental spacing, occlusion and oral habits obtained in a longitudinal investigation of 177 children at the ages of 3, 4 and 5 years. It was found that between 3 and 5 years of age, deft increased from 2.01 to 4.05 and defs from 2.69 to 5.98. The occlusal surfaces of the primary second molars and the occlusal and distal surfaces of the primary first molars were the ones most often affected. The mean Gingival Index decreased from 3 to 5 years (P less than 0.05) and also the number of children with a score of 2 from 4 to 5 years (P less than 0.05). The sagittal and transversal relationship between the jaws remained unchanged in most of the children, while the vertical relationship varied with changes in sucking habits. Dummy sucking was initially more than three times as common as finger sucking, but decreased markedly with increasing age. The children with the habit of finger sucking tended to keep this habit. Nocturnal grinding of the teeth was reported by the parents of 13 % of the children. Dental treatment was needed by 61 % at the age of 3, by 71 % at the age of 4 and by 68 % at the age of 5, as they had caries and/or gingivitis with a gingival score of 2. Futhermor, there was a need for orthodontic supervision including treatment. Caries prophylactic treatment was necessary in all age groups.

Oral health in 5-year-old Swedish children.

The purpose of the study was to investigate the oral health of a group of 5-year-old children who had previously been examined in this respect at 3 and 4 years of age. The results were compared with those in an aged-matched reference group. The study included examination of caries and gingivitis, occlusion, presence of lactobacilli and C. albicans in plaque samples, flow rate, pH and buffer effect of stimulated saliva, and certain data on past prophylaxis and oral habits. Caries was found in 76% of the children in the study group (S-group) and in 78% in the reference group (R-group). No significant differences were found in caries or gingival indices, in oral habits or prophylactic measures between the two groups. Buffer effect and pH of stimulated saliva were negatively correlated with deft and defs. Lactobacilli were demonstrated in 37% and C. albicans in 12% of the plaque samples. Various sucking habits were still present in 25% of the S-group and 22% of the R-group. Forty-nine and 46% respectively had been given a daily supply of fluoride tablets by their parents for at least 2 years.

Allocation of dental caries prevention in Swedish teenagers.

In this study, the hypothesis that teenagers with high caries activity on proximal surfaces receive more preventive care in the Swedish Public Dental Health Service than those with lower caries activity on these surfaces, was tested in an audit study. Dental records and bitewing radiographs from 1987 and 1991 were used to assess caries progression in 406 teenagers from the age of 13 to the age of 17. The time allocated to prevention during the period was also registered. Caries progression as a measure of disease activity was tested. The results showed that the hypothesis could not be verified. The Odds ratio was 1.35, indicating that the chance to get more than 15 min preventive time during 4 yr was only 1.35 times higher if you were highly caries active than if you were less caries active. Although the reproducibility of the method to use caries progression as a measure of disease activity was not high, it was considered a better indicator of active disease than the number of DMF surfaces.

Amelogenesis imperfecta: prevalence and incidence in a northern Swedish county.

The aim of the study was to establish the prevalence and incidence of amelogenesis imperfecta (AI) in the county of Västerbotten, northern Sweden using the criteria of Witkop & Sauk (1976). The diagnoses were based upon clinical and radiographic evidence. The study-population consisted of all 3-19-yr-olds born in the county from 1963 to 1979. AI was diagnosed in 79 children, 41 girls and 38 boys, giving a prevalence of 1.4:1000. The mean incidence 1963-79 was 1.3:1000. Half of the children with AI had brothers or sisters in the group. The hypoplastic form was the most common (58 children) followed by the hypomaturation form (16 children). Only five children had the hypomineralization form.

Enamel mineralization disturbances in 12-year-old children with known early exposure to fluorides.

Enamel changes and caries experience were studied in 134 12-year-old children with a known early exposure to fluoride tablets and/or fluoride containing toothpaste. The influence of birth weight and breast-feeding period was also analyzed. A clinical intact enamel was found in 32% of the children. Enamel fluorosis was found in 45% and localized opacities or hypoplasias in 40%. Children who had consumed fluoride tablets for a period of at least 12 months from the age of 6 months ran a 5.4 times greater risk of developing enamel fluorosis than children with no such consumption. No such risk could be shown in children who at 6 or 12 months of age started to use fluoride toothpaste. There was no statistically significant reduction in the prevalence of smooth surface caries or fillings in children with an exposure to fluoride tablets.

Reduction of caries in 8-year-old Swedish children between 1967 and 1979.

In this paper, the caries prevalence of groups of 8-year-old children in Umeå, Sweden, examined in 1967, 1971, 1975 and 1979 is described. A reduction of caries of 45% in the permanent teeth and 54% in the primary teeth is shown between 1967 and 1979. During the same period there has been a gradual extension of dental care for children and adolescents, and there has been an increasing emphasis on preventive dentistry. The reduction in caries does not, however, continue at the same rapid rate. Further preventive efforts therefore ought to be focused on those individuals with the highest caries indices.

Dental health and parental attitudes in Finnish immigrant preschoolchildren in the north of Sweden.

The aim of the present study was to investigate the dental health of 100 Finnish 4-6-year-old children in Luleå, in the north of Sweden, and to compare data with those from a matched control group of Swedish children of the same age, sex and social background. The study also included attitudes to dental health among the parents. The clinical examination included registration of decayed, extracted and filled teeth and surfaces (deft and defs), gingival bleeding points (GBI) and presence of open bite or crossbite. Posterior bitewings were taken. Data concerning among other things oral habits, dietary habits and fluoride prophylaxis were taken. A questionnaire about the parents' attitudes to their own and their children's dental health as well as their opinion about the dental care received by their children was filled in. The results showed that the average defs in the Finnish group was 12.2 compared to 6.4 in the Swedish group. The percentage of children with a defs greater than 12 was 43% in the Finnish group and 19% in the Swedish. The mean GBI% was 11.2% in the Finnish and 8.2% in the Swedish group. The results showed a statistically significant difference in tooth brushing frequencies between the groups, and a tendency to better dietary habits in the Swedish group. There were no differences in the use of fluoride tablets or fluoridated toothpaste. Forty-seven percent of the Finnish parents were denture wearers compared to 10% of the Swedish. The attitudes to dental health among the Finnish parents differed from those in the Swedish group. This difference in attitudes together with language problems were the factors found that could explain the difference in dental health between the immigrant group and the Swedish group.

Nutrition and health in childhood: causal and quantitative interpretations of dental caries.

The aim of the present study was to suggest a causal model of dental caries and to discuss some quantitative interpretations of this model. Three age groups of children (4, 8 and 13 yr) from three different areas in Sweden were included. The caries status of the children was examined. A 7-day record (4-and 8-yr-olds) and a dietary history (13-yr-olds) were used to estimate food intake. Sociodemographic data and data of caries preventive measures were obtained from parents/children. A causal model of dental caries is suggested and some quantitative interpretations are made by means of path analyses. Hypothetical examples of results of changes in caries determinants are given.

Caries in the preschool child: international trends.

Most studies on the prevalence and incidence of dental caries are carried out on schoolchildren and data on preschool children are comparably few. In most of the developing countries in South East Asia, children have a high prevalence of dental caries in the primary dentition, often in contrast to the situation in the permanent dentition. The reasons for this difference are not obvious, but may be linked to differences in diet. In Africa, dental caries prevalence in the preschool child seems to be increasing somewhat in countries or parts of countries where there is an increase in sugar intake, while it stays low in countries where a poor economy restricts sugar intake. The prevalence does not seem to be as high as in South East Asia. In most industrialized countries in northern Europe, in North America, in Australia and New Zealand, dental caries is decreasing, often linked to an increasing use of fluorides, to various types of dental health education programmes, etc. In many European countries, the prevalence in preschool children is, however, still high and caries in primary teeth is often left untreated. In Scandinavia, where all preschool children are included in an organized dental care programme, dental caries has been decreasing markedly during the 1970s and at the beginning of the 1980s. While the mean values for d.m.f.t. at present appear to be largely unchanged, there seems to be a change in the distribution of the disease. More and more children are totally free of the disease, while the group with high d.m.f. values has a tendency to increase.

Education and diet in the prevention of caries in the preschool child.

Caries prevalence studies of preschool children today show that caries is increasing in many of the developing countries. This is often blamed on a situation where confectionary, soft drinks and refined sugar-containing snacks have become easily available. Studies in Sweden in 1980 on 4 year olds showed a high sucrose consumption, and an increasing proportion of the daily energy intake coming from snacks. Recent studies from Norway have confirmed that the dietary pattern is established in early infancy during the period of primary socialization. In Sweden, nearly all children are taken regularly by their parents to child health centres for regular check-ups and vaccinations. In these centres dental health education is given when the child is about 6 months and 18 months of age. Children of refugees and immigrants in Sweden have a considerably higher prevalence of dental caries than Swedish children. A dental health education programme at the child health centre to Finnish immigrant parents has been carried out and evaluated. The information was given on three separate occasions in Finnish to one test group of Finnish parents, and in Swedish to another test group of Finnish parents. A third Finnish group was given information twice in Swedish. When the children were 3 years of age, the dental health of the group where the parents had been given information three times in Finnish was equally as good as the dental health of matched Swedish 3 year olds.

Distribution of caries in 12-year-old children in Sweden. Social and oral health-related behavioural patterns.

OBJECTIVE: To describe the distribution of caries in 12-year-old children in Sweden according to socio-demographic and oral health related behaviour. PARTICIPANTS: The study group consisted of 3,373 12-year-old children residing in catchments of 26 different public dental health clinics in Sweden, geographically well represented. METHOD: The clinical examination for dental caries was performed by 28 calibrated dentists. A questionnaire on lifestyle was distributed to the children with questions on ethnicity, socio-economic level and oral health as well as overall health attitudes. RESULTS: The proportion of 12-year-old children with no experience of dentine caries was 47% and 35% were completely free from all caries. Intraoral distribution of caries showed most lesions on the first molar mesial surface, with 80% enamel and 20% dentine caries. Almost all children brushed their teeth twice a day and a third of the children had an extra intake of fluoride. Decayed surfaces including enamel caries (DeS) was chosen as a measure of ongoing caries and used when dividing children into three caries groups; caries free (50%), 1-3 lesions (40%) and the high caries group (10%) with more than 3 lesions. These groups showed distribution differences. More non-Swedish children, children from workers' homes, and children who brushed their teeth less than twice a day were found in the high caries group. More children from workers' homes living in big cities and snacking more than once a week were also found in the high caries group. This could not be shown for other social groups. Also children who had an extra intake of fluoride were classified in the high caries group.

Dental caries prevalence and related factors in 5-year-old children in Hong Kong.

One thousand five Hong Kong kindergarten children with a mean age of 5.75 +/- 0.46 years were sampled for caries prevalence and related factors. Samples were drawn from a total population of approximately 9,000 5-year-old children. Caries examination was conducted after the teeth were cleaned professionally using a sickle probe (Ash #54) and diagnostic criteria of the World Health Organization. Thirty-seven percent of children were caries-free and the mean dmft of all children was 3.2 +/- 3.92. The components of the dmft were dt = 2.93, mt = 0.04 and ft = 0.23. The dmfs was 5.10 +/- 7.80 with ds = 4.67, ms = 0.12, and fs = 0.31. The caries distribution was skewed, 18% with more than 10 dmfs and the most severely affected child having 54 decayed surfaces. Seventy-two per cent had never visited a dentist. A statistically significant positive correlation was found between the father's profession and caries prevalence. The age of the child at the first visit and the frequency of visits to the dentist were related directly to parental income. The primary mandibular first molar ranked highest among the teeth that needed treatment, mostly extraction. (Pediatr Dent 15: 116-19, 1993).

Dental health and dental health behaviour in 8-year-old Finnish immigrant children in the north of Sweden.

The aim was to investigate whether the observed difference in dental health between Finnish immigrant children and Swedish children at ages 4-6 persisted at the age of eight. The study also included knowledge of dental health and dental health behaviour. Dmft, dmfs, DMFT, DMFS and GBI were recorded in 70 Finnish and 97 Swedish children included in an earlier study. The children were interviewed about toothbrushing frequency, use of fluoride and dietary habits. Questions about knowledge of dental health were included. Dmfs and DFS averaged 13.1 and 3.8 for the Finnish children and 8.9 and 2.6 for the Swedish. Only 19% of the Finnish and 28% of the Swedish children had cariesfree permanent teeth. The mean GBI was 7.9% in the Finnish and 5.9% in the Swedish group. More Finnish children had bad or poor dietary habits, with more frequent between-meal eating of sucrose containing products than the Swedish children. There were no statistically significant differences in the use of fluorides or in individual prophylaxis within the last 36 months.

Dental health in 13-year-olds in Västerbotten County, Sweden. Changes over twenty years.

An epidemiological study of the prevalence of dental caries and gingivitis in 13-year-olds was carried out in the county of Västerbotten, Sweden, in 1987. Besides providing information on the dental health of this age group, prevalence data were compared with data from earlier surveys of the same age group carried out in 1967 and 1977, covering the same areas and applying the same diagnostic criteria and methods. The results showed a marked decrease in the prevalence of caries and gingivitis. The mean number of DMF surfaces was 4.6, compared to 9.0 in 1977 and 19.0 in 1967. The mean GBI% was reduced from 33% to 21% between 1977 and 1987. In contrast to the results from 1967 and 1977 the differences in mean DMF values between the three areas were nonsignificant in 1987. The decline in dental caries is most probably due to an extended regular dental care with a strong preventive approach. Only slight differences in dental health were found between the three areas in 1987 in contrast to in 1977 and 1967. The most likely reason was probably that larger resources had been allocated to preventive programmes in the rural areas than in the city of Umeå.

Dental caries in Swedish 4-year-old children. Changes between 1967 and 1987.

The aim of the study was to examine the prevalence of dental caries in 4-year-olds in the town of Umeå in 1987, and compare that data with data from 4-year-olds examined in 1967, 1971, 1976 and 1980/81, using the same diagnostic methods and criteria. The reduction in the mean dmfs value amounting to 75% between 1967 and 1980/81 did not continue up to 1987, but there was an increase in the number of children without caries from 50% in 1980/81 to 58% in 1987. There was also an increase in the proportion of children with 10 or more dmf-surfaces during the same period. The mean value for dmfs remained the same in these years. An analysis was made of the correlation between the frequency of tooth-brushing, use of fluoride toothpaste, snack consumption and the dmfs-value in 1987. A statistically significant difference in mean values for dmfs was found between children who had their teeth brushed greater than or equal to 2/day and less than or equal to 1/day. When fluoride toothpaste was used, the difference was less pronounced. There was no statistically significant difference in the mean intake frequency of snack products among children with and without caries, but a higher proportion of caries-free children was found among those with a low intake frequency of such products.

Costs for prevention of dental caries in a group of Swedish teenagers.

The aim of this study was to analyse the costs for 4 years of prevention of dental caries in 92 Swedish adolescents. Using records, the total time allocated to prevention between 1987 and 1991 was calculated. Costs for prevention was assessed from the total cost for dental service at the clinic. The cost for one hour of dental service was SEK 860, 80 pounds. The total cost for prevention in the study group during 4 years was SEK 40,162, 3,744 pounds. The amount spent on prevention in the low or average caries active group of adolescents during 4 years was less than half the sum spent in the high caries active group.