Periodontal disease status of an indigenous population of Guatemala, Central America.

OBJECTIVES: This study was designed to determine the periodontal disease status of an indigenous Indian community of rural Central America (San Juan La Laguna, Guatemala), for comparison with results of similar studies in other populations, and with a view to performing future studies to address familial clustering of adult periodontitis. METHODS & RESULTS: An initial screen of 239 subjects aged 12-75 years from extended families suggested a high disease prevalence according to full-mouth pocket probing depths (PPDs), with more than 75% of subjects with one or more pockets of PPD > or =5 mm. A more detailed study was performed in 125 unrelated subjects > or =18 years, recording full-mouth PPDs and clinical attachment levels (CALs). The high prevalence of pocketing was confirmed and 90% of adults > or =35 years had at least one site with CAL > or =6 mm. However, extensive disease was restricted to a small minority, with only 10% of adults > or =35 years having 20% or more sites with CAL > or =6 mm. CONCLUSION: The study results highlight the importance of performing a detailed examination and appropriate analysis. In both studies, tooth retention was high (mean number of teeth recorded was 26.4 and 28.0 respectively), smoking unusual, and families large and localised to the village. This community thus affords several advantages over populations in developed countries when considering familial studies of adult periodontitis.

Helicobacter pylori infection in indigenous families of Central America: serostatus and oral and fingernail carriage.

Helicobacter pylori infection remains one of the most common in humans, but the route of transmission of the bacterium is still uncertain. This study was designed to elucidate possible sources of infection in an isolated, rural population in Guatemala. A total of 242 subjects in family units participated in the study. A medical history, including a history of dyspepsia, was taken by a physician and immunoglobulin G antibodies to H. pylori were detected with the QuickVue (Quidel, San Diego, Calif.) onsite serology test. Overall, 58% of subjects were seropositive, with a positive relationship between mother and child (P = 0.02) and a positive correlation between the serostatuses of siblings (intraclass correlation coefficient = 0.63). There was no association between serostatus and gastric symptoms. Oral H. pylori was detected from periodontal pockets of various depths and the dorsum of the tongue by nested PCR. Eighty-seven percent of subjects had at least one oral site positive for H. pylori, with the majority of subjects having multiple positive sites. There was no association between periodontal pocket depth and the detection of H. pylori. Nested PCR was also used to detect H. pylori from beneath the nail of the index finger of each subject's dominant hand. Overall, 58% of subjects had a positive fingernail result, with a significant positive relationship between fingernail and tongue positivity (P = 0.002). In conclusion, the results of this study suggest that oral carriage of H. pylori may play a role in the transmission of infection and that the hand may be instrumental in transmission.

Safety and efficacy of a novel tartar control dentifrice containing 3.3% pyrophosphate: a controlled six-month clinical trial.

This study was undertaken to establish the tartar control efficacy and long-term safety of a new tartar control dentifrice that was formulated to enhance aesthetics and consumer acceptability. In a partially randomized, examiner-blind clinical trial, the experimental dentifrice, Crest MultiCare with 3.3% pyrophosphate, was compared to two currently marketed control dentifrices, Crest Regular Paste or Crest Tartar Protection Paste with 5.0% pyrophosphate. The eight-month trial model included a two-month pretest period to establish calculus formation after prophylaxis, followed by a six-month test period to evaluate efficacy and safety. Following the pretest period, 456 subjects were allocated to one of the three treatment groups and then monitored for calculus accumulation. After three and six months' test product use, the Crest MultiCare group experienced reductions in calculus accumulation of 28.9% and 32.3%, respectively compared to the regular control dentifrice. Over the six-month observation period, the experimental tartar control and the marketed tartar control dentifrices were comparable on adverse event frequency, type or severity, and no subject discontinued treatment due to an oral soft tissue adverse event. In this partially randomized and controlled six-month clinical trial, this new dentifrice exhibited tartar control efficacy, with a comparable overall safety profile to a marketed tartar control dentifrice.

Anticalculus effect of a dentifrice containing 0.5% zinc citrate trihydrate.

A doubleblind 3-month anticalculus clinical study was conducted to determine the magnitude of the antitartar effect to be derived from use of a 0.5% zinc citrate dentifrice. From a population of 1600 subjects exhibiting calculus, 1210 subjects (age 18 and over) were selected and received a dental prophylaxis. The subjects were initially stratified on the basis of calculus score, age, and sex, then allocated randomly to a 3-month usage period of one of two treatment groups. These were a dentifrice containing 0.5% zinc citrate or a control dentifrice without zinc citrate. Calculus was assessed using the Volpe-Manhold Index. Oral soft tissue status was assessed throughout the course of the study. At the conclusion of the study 964 subjects had completed the trial: 486 using the zinc citrate dentifrice and 478 using the control. The results showed that the mean calculus scores in the group using the dentifrice containing zinc citrate were 13.7% lower than those of the group using the control dentifrice. This finding was statistically significant (P less than 0.05). No adverse effects related to the use of either dentifrice were observed.

The prevalence and incidence of dental calculus in adults.

The occurrence of dental calculus is widespread with various investigators having reported evidence of calculus accumulations in a vast segment of the population. The purpose of this paper is to provide information on both the prevalence and incidence of calculus formation among adults. To determine prevalence, a total of 1,426 adult males and females were graded in Indiana for the presence of calculus using the Volpe-Manhold (VM) Index on the lingual surfaces of the six mandibular teeth. A second panel of 980 subjects was recruited in Texas to determine the incidence of calculus over a six-month period. These latter participants were given a thorough dental prophylaxis, a sufficient supply of a sodium fluoride dentifrice and toothbrushes, and were instructed to use the dentrifrice as they normally do, at least once a day. Six months after the prophylaxis, 804 participants were available and were examined for calculus accumulation using the VM Index. Results from both clinical trials indicate that males have more calculus than females and calculus formation was directly related to age for both sexes. Data are presented regarding the frequency distribution of VM Index scores by sex and age.

Urinary fluoride levels of children residing in communities with naturally occurring fluorides in the drinking water.

The studies by Dean and others in the 1930's established excessive fluorides as the causative agent in the mottling of teeth. Although cultural and dietary patterns have changed during the past half century, this study suggests that the fluoride intake has remained relatively constant and generally proportional to the community's water fluoride level.

A current study of mottled enamel in Texas.

Enamel mottling is strongly associated with the water fluoride level of the community water supply. About 32% of the variation in the mottled enamel scores of subjects aged 7 to 12 was attributable to their community's water fluoride level. Objectionable mottling (moderate mottling) occurred at 2.3 times the currently accepted optimum water fluoride level. Subjects with incomes less than $10,000 have slightly more mottling (mostly moderate mottling) than subjects from higher income families. It should be emphasized that the effect of gender, ethnic group, or family income on enamel mottling is small compared with the effect of water fluoride level. Although many other personal and water supply characteristics were evaluated, virtually none of the remaining variation in mottled enamel scores could be attributed to any of these characteristics.

Influence of alkaline pH on the effectiveness of sodium fluoride dentifrices.

Two similar sodium fluoride dentifrices, one neutral and one alkaline, were compared to a placebo for clinical effectiveness in reducing caries. The neutral dentifrice contained 35% less soluble fluoride than the alkaline dentifrice. Both fluoride dentifrices were significantly effective but were not different from each other.