Assessing caries, dental plaque and salivary flow in asthmatic adolescents using inhaled corticosteroids

Background: A number of studies have reported that inhaled corticosteroids may cause a greater incidence of caries, reduced salivary flow, changes in saliva composition and an increased frequency of dental plaque, probably through alterations in the oral microbiota. The objective was to compare the frequency of caries, dental plaque and non-stimulated salivary flow rate among asthmatic adolescents using inhaled corticosteroids and non-asthmatic adolescents, as well as the salivary biochemical parameters (pH and leucocytes) in both groups. Methods: This research has a descriptive cross-sectional design to compare dental health of 40asthmatics on inhaled corticosteroids and 40 non-asthmatic adolescents (median age 13 years).Results: The findings were a higher number of tooth surfaces affected by dental caries (median4 versus 1.5), and more dental plaques (median 70.5 versus 60.7) among asthmatic adolescents. They also had a significantly higher frequency of salivary leucocytes. The non-stimulated salivary flow was similar in both groups. Conclusions: The results suggest an association between the use of inhaled corticosteroids and an increased risk of dental caries and bacterial plaque, which calls for special attention of these patients by doctors and dental health professionals(AU)

Assessing caries, dental plaque and salivary flow in asthmatic adolescents using inhaled corticosteroids.

BACKGROUND: A number of studies have reported that inhaled corticosteroids may cause a greater incidence of caries, reduced salivary flow, changes in saliva composition and an increased frequency of dental plaque, probably through alterations in the oral microbiota. The objective was to compare the frequency of caries, dental plaque and non-stimulated salivary flow rate among asthmatic adolescents using inhaled corticosteroids and non-asthmatic adolescents, as well as the salivary biochemical parameters (pH and leucocytes) in both groups. METHODS: This research has a descriptive cross-sectional design to compare dental health of 40 asthmatics on inhaled corticosteroids and 40 non-asthmatic adolescents (median age 13 years). RESULTS: The findings were a higher number of tooth surfaces affected by dental caries (median 4 versus 1.5), and more dental plaques (median 70.5 versus 60.7) among asthmatic adolescents. They also had a significantly higher frequency of salivary leucocytes. The non-stimulated salivary flow was similar in both groups. CONCLUSIONS: The results suggest an association between the use of inhaled corticosteroids and an increased risk of dental caries and bacterial plaque, which calls for special attention of these patients by doctors and dental health professionals.

Effect of external tooth bleaching on dental plaque accumulation and tooth discoloration.

OBJECTIVES: Treatment of dental discolorations with external bleaching is becoming very common in dentistry, however, possible irreversible alterations on enamel surface due to bleaching procedures is a topic of discussion. The aim of this study was to evaluate the clinical effects of bleaching by measuring the dental plaque accumulation on human enamel and tooth discoloration in vivo. STUDY DESIGN: Forty-four teeth in eleven patients not revealing any restorations or periodontal problems were enrolled in this study. Bleaching agent applied only to labial surfaces of incisors using commercial 35% hydrogen peroxide gel. Dental plaque and tooth color measured in the same group of participants, at the end of non-brushing periods lasting 3 and 5 days, respectively, before and after bleaching. RESULTS: The results of the comparison of pre- and post-bleaching measurements showed that, after a non-brushing period lasting 3 day, discoloration scores and plaque accumulation scores for bleached surfaces were lower than the non-bleached surface scores. However, at the end of a non-brushing period lasting 5 day, even the color measurement score in post-bleaching period was lower than the pre-bleaching counterpart, plaque index measurements showed higher plaque accumulation scores in the bleached group. CONCLUSIONS: According to these results, bleaching with 35% hydrogen peroxide seem to favor plaque accumulation after non-brushing period lasting 5 day and tooth discoloration after bleaching is not in correlation with the amount of plaque accumulation.

Efeito antimicrobiano do extrato da lippia sidoides Cham. sobre microrganismos cariogênicos / Antimicrobial effect of the lippia sidoides Cham. extract on cariogenic microorganisms

É fato comprovado que a maior parte das doenças que acomete a cavidade bucal é de origem infecciosa. Várias categorias de agentes químicos têm sido utilizadas no controle químico de biofilme dental, através de estratégias que visem a redução da adesão bacteriana, inibição do crescimento e proliferação dos microrganismos na superfície do dente. A Lippia sidoides Cham. (alecrim-pimenta) é uma planta do Nordeste do Brasil, cujo óleo essencial confere a esta planta forte ação anti-séptica contra fungos e bactérias. A presente pesquisa objetivou avaliar a atividade antimicrobiana in vitro do extrato da folha da Lippia sidoides Cham. sobre microrganismos do biofilme dental. Diante dos resultados alcançados, podemos afirmar que: o extrato da Lippia sidoides Cham. possui atividade antimicrobiana frente aos microrganismos testados.

The effects of combination treatment with a long-acting beta2-agonist and a corticosteroid on salivary flow rate, secretory immunoglobulin A, and oral health in children and adolescents with moderate asthma: a 1-month, single-blind clinical study.

BACKGROUND: Asthma is a common chronic disorder of childhood, and it is frequently accompanied by dental and other oral abnormalities. As such, oral and dental effects of asthma medications have been investigated in several studies. However, the effect of combination therapy with a long-acting beta(2)-agonist and a corticosteroid on oral health in children and adolescents has not been reported in the literature. OBJECTIVE: The aim of this study was to examine whether combination treatment with a long-acting beta(2)-agonist (salmeterol) and a corticosteroid (fluticasone propionate) administered by dry powder inhaler (DPI) affects oral health in children and adolescents with moderate asthma. METHODS: This 1-month, single-blind clinical study was conducted at the Department of Periodontology, Ondokuz Mayis University Faculty of Dentistry, Samsun, Turkey. Male and female children and adolescents aged 7 to 17 years with moderate persistent asthma, as classified by the Global Initiative for Asthma guidelines, were studied before and after 1 month of treatment with combination salmeterol 50 microg and fluticasone propionate 100 mug administered by DPI BID. Salivary flow rate and secretory immunoglobulin A (sIgA) level were measured, and periodontal health was assessed by gingival and dental plaque indices for buccal surfaces and periodontal pocket depth. RESULTS: The study enrolled 15 children and adolescents (8 girls, 7 boys; mean [SD] age, 11 years [45 months]; median age, 13 years; [range, 7-17 years]). At 1 month, mean sIgA, gingival index, buccal surface index, gingival index, dental plaque index, and periodontal pocket depth were not changed significantly from baseline, whereas mean (SD) salivary flow rate was significantly decreased (from 153.21 [39.29] to 113.16 [46.99] microL/5 s; P = 0.015) and dental plaque index on the buccal surface was significantly increased (from 1.43 [0.63] to 1.61 [0.67]; P = 0.01). CONCLUSIONS: In this small study, combination treatment with salmeterol 50 microg and fluticasone propionate 100 microg inhaled twice daily was associated with changes in oral health among these children and adolescents with moderate asthma. Regular follow-up of oral health status may be warranted in children and adolescents during long-term use of a long-acting beta2-agonist and a corticosteroid.

An evaluation of the acidogenic potential of asthma inhalers.

AIM: The aims of the present study were firstly to investigate the inherent pH and titratable acidity of commercially available paediatric asthma inhalers in the United Kingdom and secondly to assess their in vivo acidogenic potential (saliva pH and plaque pH (PpH) tests) in a group of healthy adult volunteers. MATERIALS AND METHODS: Manually actuated metered dose inhaler (MDI) and dry powder inhaler (DPI) formulations of all available preventor (glucocorticoids, disodium chromoglycate), reliever (beta(2) agonists) and combination asthma medication were investigated. The inherent pH and titratable acidity of 18 inhalers were determined and analysed using t-tests, ANOVA and post hoc Tukey's tests. Following this the oral pH responses after inhaler use were assessed in 14 healthy adult volunteers (complying with the FNDH criteria, 1985) who participated in a random blind study to determine both the salivary pH (SpH) and plaque pH following inhaler use. Non-parametric tests of significance (Mann-Whitney and Wilcoxon Signed-Ranked Tests) were used to analyse pH responses according to vehicle of delivery (MDI/DPI), lactose content and generic drug. RESULTS: The inherent pH of the DPIs (n=8, mean pH=5.06) was significantly lower (P<0.005) than that of the MDIs (n=10, mean pH=6.45) and the titratable acidity of the lactose-based DPIs was twice that of the non-lactose-based DPIs (P<0.000). Lactose-based DPIs produced significantly lower salivary pH and plaque pH readings, greater maximum pH drops from baseline pH and larger areas below baseline pH in comparison with that of all other inhalers tested (P<0.05). All inhalers, however, failed to depress plaque pH below pH 6. CONCLUSIONS: Although none of the inhalers were able to demonstrate an acidogenic response below the "critical" pH, the substantial pH drops observed with the lactose-based DPIs may be an important consideration for enamel demineralisation.

Dental and metabolic effects of lactitol in the diet of laboratory rats.

1. Because so little is known about the properties of lactitol as a possible alternative bulk sweetener to sucrose, it was tested in two large-scale experiments in laboratory rats. Matched groups of caries-active Osborne-Mendel rats were fed on uniform diets containing lactitol and compared with a sucrose control in both experiments, plus a xylitol control in the first experiment. 2. In the early stages of the experiments weight gains and food utilization were better on the sucrose than on the lactitol regimens. Body-fat storage was higher on the sucrose than on the polyol regimens. 3. At the end of 8 weeks the mandibular molars were examined for dental plaque accumulation and dental caries. The dental caries scores when 160 g sucrose/kg in the diet was replaced by lactitol were lower by a highly significant margin, bringing them down to the same low level as those on a 160 g xylitol/kg regimen. 4. Testing lactitol in a manufactured food product, shortbread biscuits, in comparison with ordinary sucrose biscuits, showed differences in plaque scores (significant) and caries levels (highly significant), with 60% fewer lesions on the lactitol regimen. 5. The results confirm the low cariogenic potential of lactitol, but show metabolic differences compared with sucrose.

The nutrition significance of sucrose consumption, 1970-1980.

Sucrose consumption is a controversial issue. Part of the difficulty arises because of inadequate knowledge about the actual consumption of populations, as well as individuals within a population. Data on the sucrose content of foods are lacking. This review presents information published in the 1970s on these topics as well as current research and thinking about possible relationships of sucrose consumption to dental caries, cardiovascular disease, diabetes, obesity, and other disease conditions. Current attitudes toward recommendations concerning sugar consumption in the U.S. Dietary Goals are examined, as are data on the use of sugar as a fortification vehicle.

Relation between medicines sweetened with sucrose and dental disease.

The teeth of 44 children aged under 6 years who had been taking syrup medicines regularly for at least six months were compared with those of a control group of 47 children of similar ages. Dental disease was assessed by measuring dental caries, dental plaque, and gingivitis. The children who were receiving sucrose-based medicines had significantly more carious teeth and gingivitis. It is concluded that sucrose-based medicines continuously administered to children cause dental caries and gingivitis. Liquid medicines for children should be either unsweetened or sweetened with non-cariogenic substances.

Comparison of different measurements of development of plaque and gingivitis in man.

The purpose of the present study was to compare efficiency of measurements commonly used to study the development of plaque and gingivitis in short-term clinical trials. Data from a recent experiment on the effect of mutanase on accumulation of plaque and development of gingivitis were used. Efficiency was compared using 1) level of significance and 2) minimum number of individuals necessary to obtain a statistically significant result at a given level of significance and with a given power of the test. Of all the measurements used, the gingival exudate measurement was the most efficient. Among the nonparametric indices, Plaque Index was the most efficient, especially on proximal surfaces in the mandible. Reduction of the scales for the nonparametric indices from a four-point scale to a two-point (dichotomous) scale slightly reduced experimental efficiency.

[The effect of various front tooth filling materials on the in vitro growth of Streptococcus mutans]. / Der Einfluss verschiedener Frontzahnfüllungsmaterialien auf das In-vitro-Wachstum von Streptococcus mutans.

While silicate cement inhibits bacterial growth, resin materials promote it immediately after mixing. Toxic tissue reactions may be induced by bacterial plaque accumulation. Our testing method complements existing in-vitro tests for recording chemo-toxic activities.