Treatment responses to tooth whitening in twins.

The aim of this study was to determine heritability estimates of treatment responses to a 10% hydrogen peroxide strip-based whitening system in twins. Eighty-five twin pairs were randomly assigned to 10% hydrogen peroxide whitening strips or placebo strips without peroxide. Both twins (monozygotic or dizygotic) received the same treatment. Maxillary teeth were treated for 30 minutes twice daily for 7 days. Efficacy was measured objectively as L* (light-dark), a* (red-green), and b* (yellow-blue) color change from digital images at baseline (∆) and day 8. Heritability estimates for tooth whitening treatment responses for changes from day 8 to baseline were obtained using variance-component methodologies. Whitening treatment responses were highly heritable (h(2) = 71.0) for ∆b* and ∆a*(p < .0001), but not for ∆L* (h(2) = 27.0), which was essentially modulated by environmental factors. This study has demonstrated that both genetic and environmental factors significantly contributed to seven-day whitening treatment responses achieved with 10% hydrogen peroxide strips.

An evaluation of 10 percent and 20 percent benzocaine gels in patients with acute toothaches: efficacy, tolerability and compliance with label dose administration directions.

BACKGROUND: The authors evaluated the efficacy and tolerability of 10 percent and 20 percent benzocaine gels compared with those of a vehicle (placebo) gel for the temporary relief of toothache pain. They also assessed the compliance with the label dose administration directions on the part of participants with toothache pain. METHODS: Under double-masked conditions, 576 participants self-applied study gel to an open tooth cavity and surrounding oral tissues. Participants evaluated their pain intensity and pain relief for 120 minutes. The authors determined the amount of gel the participants applied. RESULTS: The responders' rates (the primary efficacy parameter), defined as the percentage of participants who had an improvement in pain intensity as exhibited by a pain score reduction of at least one unit on the dental pain scale from baseline for two consecutive assessments any time between the five- and 20-minute points, were 87.3 percent, 80.7 percent and 70.4 percent, respectively, for 20 percent benzocaine gel, 10 percent benzocaine gel and vehicle gel. Both benzocaine gels were significantly (P ≤ .05) better than vehicle gel; the 20 percent benzocaine gel also was significantly (P ≤ .05) better than the 10 percent benzocaine gel. The mean amount of gel applied was 235.6 milligrams, with 88.2 percent of participants applying 400 mg or less. CONCLUSIONS: Both 10 percent and 20 percent benzocaine gels were more efficacious than the vehicle gel, and the 20 percent benzocaine gel was more efficacious than the 10 percent benzocaine gel. All treatments were well tolerated by participants. Practical Implications. Patients can use 10 percent and 20 percent benzocaine gels to temporarily treat toothache pain safely.

Treatment outcomes of dental flossing in twins: molecular analysis of the interproximal microflora.

BACKGROUND: The purpose of this study was to assess the effects of dental flossing on the microbial composition of interproximal plaque samples in matched twins. METHODS: The study was a two-treatment, examiner-masked, randomized, parallel-group, controlled study. Fifty-one twin pairs between 12 and 21 years of age were randomized to a 2-week supervised and unsupervised treatment regimen consisting of tongue brushing and toothbrushing or tongue brushing and toothbrushing plus flossing. The reverse-capture checkerboard hybridization assay was used to assess levels (abundance) of 26 microbial species in interproximal plaque samples collected from six sites per subject. An integrative computational predictive model estimated average changes in microbial abundance patterns of selected bacterial species from baseline to 2 weeks by comparing treatment groups. RESULTS: After the 2-week study period, putative periodontal pathogens and cariogenic bacteria were overabundant in the group that did not floss compared to the group that performed flossing. Those included Treponema denticola, Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), Prevotella intermedia, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), and Streptococcus mutans. Microbial species that are not consistent with the development of periodontal disease or dental caries were overabundant in the group that did floss compared to the non-flossing group. CONCLUSION: In a well-matched twin cohort, tooth and tongue brushing plus flossing significantly decreased the abundance of microbial species associated with periodontal disease and dental caries after a 2-week program.

Heritability estimates for dental caries and sucrose sweetness preference.

OBJECTIVE: The aim of this study was to determine heritability estimates for dental caries traits and sucrose sweetness preference. DESIGN: Participants included 115 pairs of twins 4-7-years-old. Caries exams followed NIDCR criteria where the severity of the lesion was also determined. Twins ranked their preference for five concentrations of sucrose/grape juice solutions (0.15-1.17M) with a Face Scale. Variables submitted to analysis: (1) surface-based caries prevalence rate (SBCPR); (2) lesion severity index (LSI); (3) sucrose sweetness preference score (SSPS). Heritability analyses were performed with the SOLAR software package. RESULTS: Heritability estimates adjusted for age and gender were: SBCPR-h(2)=64.6 (p<.00001), LSI-h(2)=61.7 (p<.00001) and SSPS-h(2)=55.2 (p<.00001). Treating SPSS as a covariate in the SBCPR and LSI models did not alter heritability estimates. CONCLUSIONS: These results suggest that variation in dental caries traits and sucrose sweetness preference have a significant genetic contribution that is mediated independently.

Compliance with Xylitol and Sorbitol Chewing Gum Regimens in Clinical Trials.

OBJECTIVE: The purpose of this study was to investigate compliance of long-term xylitol and sorbitol chewing gum regimens in adult women participating in a double-blind randomized controlled clinical trial. DESIGN: The participants included 122 mothers (age range: 16-35 years) residing in the city of Bauru, São Paulo, Brazil. Compliance with the xylitol and sorbitol chewing gum regimens was assessed by weighing, with a precision balance, all used gums returned in zip-lock bags during the study period of 33 months. The total number of returned bags in both chewing gum groups was computed and the differences between groups were determined by one-way ANOVA. Compliance was further categorized into excellent, good, fair or poor based on the distribution of the combined data for both groups by quartiles. These distributions for the xylitol and sorbitol groups were subjected to chi-square analysis. RESULTS: Compliance was always superior for the xylitol group in all categories. These distributions were, however, not significantly different in statistical terms. Average compliance in the xylitol chewing gum group was significantly higher when compared to the sorbitol chewing gum group (p=0.0481). CONCLUSIONS: The results suggest that compliance, and possibly acceptance in this population, was superior for xylitol chewing gum than for sorbitol chewing gum.

On the Acquisition of Periodontopathic Bacteria by Children from Mothers: A Randomized Double-Masked Placebo-Controlled Trial in Bauru, Brazil.

OBJECTIVE: The purpose of this study was two-fold: 1) to determine the effects of mechanical and chemical modalities treatments on periodontal clinical and microbiological parameters of mothers; and 2) to determine the subsequent colonization of periodontal pathogens in tongue samples from their infants. DESIGN: A total of 168 mothers met inclusion criteria to participate in a randomized double-masked placebo-controlled clinical trial. Of those, 121 mothers (and their infants) of 158 seen at baseline provided complete data during study protocols from when their infants were 3 months old until the infants were about 2 years old. Treatments consisted of a combination of xylitol chewing gum, fluoride and chlorhexidine varnishes. The control/placebo group received sorbitol chewing gum and placebo varnishes. The effect of these treatments on periodontal clinical and microbiological parameters of mothers and on microbiological parameters of their infants was assessed by generalized estimating equation models. RESULTS: Microbiological outcomes using the BANA Test were lower for the majority of the visits in the test group when compared to the control/placebo group. These differences, however, were not statistically significant. Similarly, mean PBS results were lower for all follow-up visits for test-group mothers when compared to the control/placebo group's mothers, but of no statistical significance. Colonization of the tongue in infants by periodontal pathogens as measured by the BANA Test showed no distinct patterns concerning the stability of colonization of periodontal pathogens throughout the study period, albeit slightly superior for the test group. CONCLUSIONS: We have demonstrated that a combined chemical modalities treatment consisting of xylitol chewing gum, fluoride varnish and chlorhexidine varnish was moderately superior to control/placebo treatments on periodontal clinical and microbiological parameters of mothers throughout the study period, but of no statistical significance. Similar results were found for the infants in the test group when compared to infants of the control/placebo groups.