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1.
Med Hypotheses ; 121: 160-163, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30396472

RESUMEN

Municipal fluoridation was a mid-twentieth century innovation based on the medical hypothesis that consuming low doses of fluoride when young provided protection against cavities with only a small risk of mild dental fluorosis, a cosmetic effect. In the 21st century, more than half of American teens are afflicted by dental fluorosis with approximately one in five having moderate to severe dental fluorosis in at least two teeth. Scientific literature since the 1990s has found that even low doses of fluoride adversely affect cognitive-behavioral development and that deficits are correlated with the severity of dental fluorosis in afflicted individuals. Evidence of neurotoxic impact from low dose systemic exposure to fluoride prompted an investigation by a branch of the governmental agency that has promoted fluoridation policy since its 1940's inception. This review identifies ten significant flaws in the design of an animal experiment conducted by the U.S. National Toxicology Program as part of that investigation into the neurotoxic impact of systemic prenatal and postnatal fluoride exposure. The authors hypothesize that organizational bias can and does compromise the integrity of fluoride research.


Asunto(s)
Fluoruros/análisis , Salud Pública/métodos , Toxicología/métodos , Toxicología/normas , Adolescente , Animales , Niño , Caries Dental/prevención & control , Agua Potable , Femenino , Fluoruración , Fluorosis Dental/prevención & control , Humanos , Pruebas de Inteligencia , Neurotoxinas/análisis , Embarazo , Ratas , Ratas Long-Evans , Proyectos de Investigación , Riesgo , Estados Unidos
2.
Community Dent Oral Epidemiol ; 45(6): 496-502, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-28994462

RESUMEN

A paper published in this journal, "Measuring the short-term impact of fluoridation cessation on dental caries in Grade 2 children using tooth surface indices," by McLaren et al had shortcomings in study design and interpretation of results, and did not include important pertinent data. Its pre-post cross-sectional design relied on comparison of decay rates in two cities: Calgary, which ceased fluoridation, and Edmonton, which maintained fluoridation. Dental health surveys conducted in both cities about 6.5 years prior to fluoridation cessation in Calgary provided the baseline. They were compared to decay rates determined about 2.5 years after cessation in a second set of surveys in both cities. A key shortcoming was the failure to use data from a Calgary dental health survey conducted about 1.5 years prior to cessation. When this third data set is considered, the rate of increase of decay in Calgary is found to be the same before and after cessation of fluoridation, thus contradicting the main conclusion of the paper that cessation was associated with an adverse effect on oral health. Furthermore, the study design is vulnerable to confounding by caries risk factors other than fluoridation: The two cities differed substantially in baseline decay rates, other health indicators, and demographic characteristics associated with caries risk, and these risk factors were not shown to shift in parallel in Edmonton and Calgary through time. An additional weakness was low participation rates in the dental surveys and lack of analysis to check whether this may have resulted in selection biases. Owing to these weaknesses, the study has limited ability to assess whether fluoridation cessation caused an increase in decay. The study's findings, when considered with the additional information from the third Calgary survey, more strongly support the conclusion that cessation of fluoridation had no effect on decay rate. Consideration of the limitations of this study can stimulate improvement in the quality of future fluoridation effectiveness studies.


Asunto(s)
Caries Dental , Fluoruración , Alberta , Niño , Ciudades , Estudios Transversales , Humanos
3.
J Environ Public Health ; 2017: 5120504, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28713433

RESUMEN

In countries with fluoridation of public water, it is imperative to determine other dietary sources of fluoride intake to reduce the public health risk of chronic exposure. New Zealand has one of the highest per capita consumption rates of black tea internationally and is one of the few countries to artificially fluoridate public water; yet no information is available to consumers on the fluoride levels in tea products. In this study, we determined the contribution of black tea as a source of dietary fluoride intake by measuring the fluoride content in 18 brands of commercially available products in New Zealand. Fluoride concentrations were measured by potentiometric method with a fluoride ion-selective electrode and the contribution of black tea to Adequate Intake (AI) and Tolerable Upper Intake Level (UL) was calculated for a range of consumption scenarios. We examined factors that influence the fluoride content in manufactured tea and tea infusions, as well as temporal changes in fluoride exposure from black tea. We review the international evidence regarding chronic fluoride intake and its association with chronic pain, arthritic disease, and musculoskeletal disorders and provide insights into possible association between fluoride intake and the high prevalence of these disorders in New Zealand.


Asunto(s)
Fluoruros/análisis , Salud Pública , Té/química , Artritis/inducido químicamente , Dolor Crónico/inducido químicamente , Dieta , Fluoruros/efectos adversos , Enfermedades Musculoesqueléticas/inducido químicamente , Nueva Zelanda , Medición de Riesgo
4.
Artículo en Inglés | MEDLINE | ID: mdl-26927146

RESUMEN

The Republic of Ireland (RoI) is the only European Country with a mandatory national legislation requiring artificial fluoridation of drinking water and has the highest per capita consumption of black tea in the world. Tea is a hyperaccumulator of fluoride and chronic fluoride intake is associated with multiple negative health outcomes. In this study, fifty four brands of the commercially available black tea bag products were purchased and the fluoride level in tea infusions tested by an ion-selective electrode method. The fluoride content in all brands tested ranged from 1.6 to 6.1 mg/L, with a mean value of 3.3 mg/L. According to our risk assessment it is evident that the general population in the RoI is at a high risk of chronic fluoride exposure and associated adverse health effects based on established reference values. We conclude that the culture of habitual tea drinking in the RoI indicates that the total cumulative dietary fluoride intake in the general population could readily exceed the levels known to cause chronic fluoride intoxication. Evidence suggests that excessive fluoride intake may be contributing to a wide range of adverse health effects. Therefore from a public health perspective, it would seem prudent and sensible that risk reduction measures be implemented to reduce the total body burden of fluoride in the population.


Asunto(s)
Exposición a Riesgos Ambientales/efectos adversos , Fluoruración/legislación & jurisprudencia , Fluoruros/efectos adversos , Política de Salud/legislación & jurisprudencia , Salud Pública , Té/química , Adulto , Niño , Preescolar , Exposición a Riesgos Ambientales/legislación & jurisprudencia , Exposición a Riesgos Ambientales/prevención & control , Femenino , Fluoruración/efectos adversos , Fluoruros/análisis , Humanos , Lactante , Recién Nacido , Electrodos de Ion-Selectivo , Irlanda/epidemiología , Embarazo , Salud Pública/legislación & jurisprudencia , Medición de Riesgo
6.
J Mich Dent Assoc ; 95(5): 34-8, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23767220

RESUMEN

The key environmental factor involved in caries incidence is fermentable carbohydrates. Because of the high costs of caries treatment, researchers continue to explore dietary control as a promising preventive method. While dietary change has been demonstrated to reduce Streptococcus mutans, a preventive role is expected for "functional foods" and dietary habit alterations. The authors consider how recent advances in the understanding of caries pathology can reveal dietary control as a valuable method in promoting a healthy dentition.

7.
Spec Care Dentist ; 32(6): 242-50, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23095067

RESUMEN

This study assessed the efficacy of oral care education among nursing home staff members to improve the oral health of residents. Nursing home support staff members (NHSSMs) in the study group received oral care education at baseline between a pretest and posttest. NHSSMs' oral care knowledge was measured using a 20-item knowledge test at baseline, posteducation, and at a 6-month follow-up. Residents' oral health was assessed at baseline and again at a 6-month follow-up using the Modified Plaque Index (PI) and Modified Gingival Index (GI). Among staff members who received the oral care education (n = 32), posttest knowledge statistically significantly increased from the pretest level (p < .05). Thirty-nine control residents of the nursing homes and 41 study residents participated. Among residents in the study group, PI decreased at 6 months compared to baseline (p < .05), but there was no statistically significant difference in their GI measurements between baseline and 6-month follow-up (p= .07).


Asunto(s)
Educación en Salud Dental , Cuidados a Largo Plazo , Casas de Salud , Personal de Enfermería/educación , Salud Bucal/educación , Adulto , Anciano , Anciano de 80 o más Años , Actitud Frente a la Salud , Cuidadores/educación , Índice de Placa Dental , Femenino , Estudios de Seguimiento , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud , Humanos , Masculino , Persona de Mediana Edad , Higiene Bucal/educación , Índice Periodontal , Fotografía Dental , Recursos Humanos , Adulto Joven
8.
J Calif Dent Assoc ; 40(10): 799-804, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23316561

RESUMEN

The key environmental factor involved in caries incidence is fermentable carbohydrates. Because of the high costs of caries treatment, researchers continue to explore dietary control as a promising preventive method. While dietary change has been demonstrated to reduce Streptococcus mutans, a preventive role is expected for "functional foods" and dietary habit alterations. The authors consider how recent advances in the understanding of caries pathology can reveal dietary control as a valuable method in promoting a healthy dentition.


Asunto(s)
Caries Dental/prevención & control , Dieta , Ciencias de la Nutrición , Caries Dental/dietoterapia , Carbohidratos de la Dieta/administración & dosificación , Conducta Alimentaria , Alimentos Funcionales , Humanos , Probióticos/uso terapéutico , Streptococcus mutans/crecimiento & desarrollo
9.
Rev. bras. promoç. saúde (Impr.) ; 24(4)out.-dez. 2011. graf, tab
Artículo en Portugués | LILACS | ID: lil-621775

RESUMEN

Objective: To determine the relationship between dental fluorosis (DF) severity and fluoride [F] concentration in tooth and water in DF endemic areas. Methods: Life-long residents from two DF endemic communities were studied. Forty-five extracted teeth were collected and analyzed for DF severity and tooth [F]. Thylstrup-Ferjeskov Index (TFI) was used to measure DF severity and instrumental neutron activation analysis (INAA) for tooth [F] concentration. Water from regional wells was also collected (n=9) and analyzed for F content using specific ion F electrode. Results: Water [F] varied between 0.2ppm and 4.7ppm. TFI scores ranged from 0 to 6; [F] from 120ppm to 2,140ppm in enamel and 304ppm to 4,800ppm in dentin. No correlation was found between DF severity and [F] in enamel (rs=0.22,p=0.15) and dentin (rs=-0.19,p=0.20), nor between water [F] and [F] in enamel (rs=-0.09,p=0.65) and dentin (rs=-0.11,p=0.56). Weak correlation between DF severity and water [F] (rs=0.38,p=0.04) was found. Linear regression analysis showed that TFI couldn?t be predicted from a linear combination of the independent variables (age, enamel and dentin [F]). When enamel, dentin and water [F] were used as independent variables in the linear regression (predict DF severity), only water [F] showed influence in DF severity (p=0.013;t=2.67). Conclusion: Even in areas of endemic DF, tooth [F] didn?t correlate with DF severity and the relationship between water [F] and DF severity was very weak. Therefore, tooth [F] may not be a good predictor/indicator of DF severity.


Objetivo: Determinar a relação entre severidade de fluorose dental (FD), e concentração de flúor [F] no dente e água em áreas endêmicas de FD. Métodos: Residentes de duas comunidades endêmicas de FD foram estudados. 45 dentes foram coletados e analisados para severidade de FD e concentração de flúor. O índice de Thylstrup-Ferjeskov (TFI) foi utilizado para medir a severidade de FD e análise por ativação com nêutrons (AAN) para concentração de [F] dental. Águas de poços da região foram coletadas (n=9) e analisadas para [F], utilizando eletrodo específico de flúor. Resultados: Concentração de [F] da água variou entre 0,2 e 4,7ppm. Os escores do TFI variaram entre 0 e 6; [F] no esmalte entre 120 e 2140ppm e na dentina entre 304 e 4800ppm. Não se observou correlação entre severidade de DF e [F] no esmalte (rs=0,22,p=0,15) e dentina (rs=-0,11,p=0,56). Encontrou-se correlação fraca entre FD e [F] na água (rs=0,38,p=0,04). Análise de regressão linear demonstrou que TFI não podia ser predito por uma combinação linear das variáveis (idade, e concentração de flúor no esmalte e dentina). Quando a concentração de flúor no esmalte, dentina e água foram analisadas de forma independente na regressão linear, apenas flúor na águademonstrou influência na severidade de FD (p=0,013;t=2,67). Conclusão: Mesmo em áreas endêmicas de FD, concentração de flúor dental não se correlaciona com severidade de FD, e a relação entre este e a concentração de flúor nas águas foi fraca. Assim, concentração de flúor dental pode não ser um bom preditor/indicador de severidade de FD.


Asunto(s)
Esmalte Dental , Dentina , Flúor , Fluorosis Dental , Agua
10.
Cochrane Database Syst Rev ; (11): CD007095, 2011 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-22071833

RESUMEN

BACKGROUND: Acute otitis media (AOM) is the most common bacterial infection among young children in the United States with limitations and concerns over its treatment with antibiotics and surgery. Therefore, effective preventative measures are attractive. A potential preventative measure is xylitol, a natural sugar substitute that reduces the risk for dental decay. Xylitol can reduce the adherence of Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) to nasopharyngeal cells in vitro. OBJECTIVES: To assess the efficacy and safety of xylitol to prevent AOM in children up to 12 years old. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3) which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1950 to August Week 1, 2011), EMBASE (1974 to August 2011), CINAHL (1982 to August 2011), Health and Psychosocial Instruments (1985 to August 2011), Healthstar (OVID) (1966 to August 2011) and International Pharmaceutical Abstracts (2000 to August 2011). SELECTION CRITERIA: Randomised controlled trials (RCTs) or quasi-RCTs of children aged 12 years or younger where xylitol supplementation was compared to placebo or no treatment to prevent AOM. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials from search results, assessed and rated study quality and extracted relevant data for inclusion in the review. We contacted trial authors to request missing data. We noted data on any adverse events of xylitol. We extracted data on relevant outcomes and estimated the effect size by calculating risk ratio (RR), risk difference (RD) and associated 95% confidence intervals (CI). MAIN RESULTS: We identified four studies of adequate methodological quality that met our eligibility criteria. In three RCTs with a total of 1826 healthy Finnish children attending day care, there was a reduced risk of occurrence of AOM in the xylitol group (in any form) compared to the control group (RR 0.75; 95% CI 0.65 to 0.88). The fourth RCT included 1277 Finnish day care children with a respiratory infection and found no effect of xylitol on reducing the occurrence of AOM (RR 1.13; 95% CI 0.83 to 1.53). Xylitol chewing gum was superior to xylitol syrup in preventing AOM among healthy children (RR 0.59; 95% CI 0.39 to 0.89) but not during respiratory infection (RR 0.68; 95% CI 0.43 to 1.07). There was no difference between xylitol lozenges and xylitol syrups in preventing AOM among healthy children (RR 0.77; 95% CI 0.53 to 1.11) or among children during respiratory infection (RR 0.74; 95% CI 0.47 to 1.14). Similarly, no difference was noted between xylitol chewing gum and xylitol lozenges in preventing AOM among healthy children (RR 0.73; 95% CI 0.47 to 1.13) or among children during respiratory infection (RR 0.92; 95% CI 0.59 to 1.46). Among the reasons for drop-outs, there were no significant differences in abdominal discomfort and rash between the xylitol and the control groups. AUTHORS' CONCLUSIONS: There is fair evidence that the prophylactic administration of xylitol among healthy children attending day care centres reduces the occurrence of AOM by 25%. This meta-analysis is limited since the data arise from a small number of studies, mainly from the same research group.


Asunto(s)
Otitis Media/prevención & control , Edulcorantes/uso terapéutico , Xilitol/uso terapéutico , Enfermedad Aguda , Goma de Mascar , Niño , Preescolar , Femenino , Geles/uso terapéutico , Humanos , Lactante , Recién Nacido , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Edulcorantes/efectos adversos , Xilitol/efectos adversos
11.
J Mich Dent Assoc ; 93(10): 42-6, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22073722

RESUMEN

Celiac disease (gluten sensitive enteropathy) is a common disorder affecting both children and adults. As many people with celiac disease do not present with the classic malabsorptive syndrome, delays in diagnosis are common. Dental enamel defects and recurrent aphthous ulcers, which may occur in patients with celiac disease, may be the only manifestation of this disorder. When dentists encounter these features, they should enquire about other clinical symptoms, associated disorders and family history of celiac disease. In suspected cases, the patient or family physician should be advised to obtain serologic screening for celiac disease and, if positive, confirmation of the diagnosis by intestinal biopsy. Dentists can play on important role in identifying people who may have unrecognized celiac disease. Appropriate referral and a timely diagnosis can help prevent serious complications of this disorder.

12.
J Can Dent Assoc ; 77: b39, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21507289

RESUMEN

Celiac disease (gluten sensitive enteropathy) is a common disorder affecting both children and adults. As many people with celiac disease do not present with the classic malabsorptive syndrome, delays in diagnosis are common. Dental enamel defects and recurrent aphthous ulcers, which may occur in patients with celiac disease, may be the only manifestation of this disorder. When dentists encounter these features, they should enquire about other clinical symptoms, associated disorders and family history of celiac disease. In suspected cases, the patient or family physician should be advised to obtain serologic screening for celiac disease and, if positive, confirmation of the diagnosis by intestinal biopsy. Dentists can play an important role in identifying people who may have unrecognized celiac disease. Appropriate referral and a timely diagnosis can help prevent serious complications of this disorder.


Asunto(s)
Enfermedad Celíaca/complicaciones , Enfermedades de la Boca/etiología , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/fisiopatología , Esmalte Dental/anomalías , Diagnóstico Diferencial , Humanos , Estomatitis Aftosa/etiología
13.
Community Dent Oral Epidemiol ; 37(5): 451-62, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19740249

RESUMEN

OBJECTIVES: To develop and validate an instrument to measure the functional oral health literacy of adults. METHODS: For the generation of items different dental patient educational materials and text types were selected that had reading levels similar to materials used for the Test of Functional Health Literacy in Adults (TOFHLA) which was the model for our Oral Health Literacy Instrument (OHLI). The OHLI contains reading comprehension and numeracy sections. The reading comprehension section is a 38-item test with words omitted from one passage on dental caries and another on periodontal disease. The numeracy section has 19 items to test comprehension of directions for taking common prescriptions associated with dental treatment, postextraction instructions and dental appointments. We also developed a 17-item oral health knowledge test. The OHLI, the TOFHLA, the oral health knowledge test and a brief questionnaire were administered to a convenience sample of 100 patients. Internal reliability of OHLI was assessed with Cronbach's alpha. Test-retest reliability was examined by intra-class correlation coefficient (ICC). Concurrent validity was tested by comparing OHLI scores across categories of education level and frequency of dental visits. Construct validity was assessed by correlating OHLI scores with TOFHLA scores and with the oral health knowledge scores using Spearman's rho (rho) and multiple linear regression. RESULTS: Participants averaged 39 years (SD = 12.4); 73% were female; 64% had college/university education; 40% visited a dentist every 3-6 months. Total OHLI and TOFHLA weighted mean scores were 87.2 and 91.7, respectively (possible range 0-100). The Cronbach's alpha values were high (>0.7) for OHLI and its components. The ICC values indicated good agreement between the test and retest results for OHLI and the oral health knowledge test. Patients visiting a dentist every 3-6 months had significantly higher levels of oral health literacy than those visiting only when they felt pain. The association between OHLI and education level was not significant. OHLI scores were significantly correlated with the scores on the TOFHLA (rho = 0.613) and the test of oral health knowledge (rho = 0.573). These associations remained significant in multiple regression models. CONCLUSION: Initial testing of OHLI suggested that it is a valid and reliable instrument to evaluate oral health literacy among adults, although additional work is needed to investigate the instrument's predictive validity and sensitivity to change using oral health outcomes with population groups known to be at high risk of low functional oral health literacy.


Asunto(s)
Evaluación Educacional , Conocimientos, Actitudes y Práctica en Salud , Salud Bucal , Adulto , Anciano , Evaluación Educacional/normas , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Salud Bucal/normas , Análisis de Regresión , Reproducibilidad de los Resultados , Factores Sexuales , Adulto Joven
14.
J Endod ; 35(1): 1-9, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19084115

RESUMEN

The aim of this study was to evaluate the effect of an ozone delivery system (HealOzone; KaVo, Biberach, Germany) in reducing dentin hypersensitivity. An 8-week, 3-visit, triple-blinded, randomized controlled clinical trial with 2 HealOzone machines (ozone/air) involving 44 subjects was conducted. The pain in response to tactile stimulus or desiccation was assessed by using a 100-mm visual analogue scale. Also, the global subjects' perception of sensitivity was assessed at each visit by using the visual analogue scale. No subjects reported an increase in pain or any adverse effect. All subjects reported a clinically significant reduction of pain at each follow-up relative to baseline; however, the difference between the study groups was not statistically significant. The effect of treatment of hypersensitive teeth with ozone reduces the pain sensation, but this effect cannot be distinguished from the placebo treatment. There was a large placebo effect that narrowed the range over which to detect treatment differences.


Asunto(s)
Sensibilidad de la Dentina/terapia , Sistemas de Liberación de Medicamentos/instrumentación , Oxidantes Fotoquímicos/administración & dosificación , Ozono/administración & dosificación , Adulto , Método Doble Ciego , Femenino , Humanos , Masculino , Dimensión del Dolor , Efecto Placebo , Resultado del Tratamiento , Vacio
15.
J Am Dent Assoc ; 139(7): 915-24; quiz 994-5, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18594077

RESUMEN

BACKGROUND: The objective of this article was to review systematically the clinical trials of casein derivatives (specifically casein phosphopeptide-amorphous calcium phosphate [CPP-ACP] complex) used in dentistry. TYPES OF STUDIES REVIEWED: The authors included clinical studies that examined the efficacy of casein derivatives in dentistry. They excluded in vitro studies, case series, case reports, letters to editors (not containing primary data), editorials, review articles and commentaries, but read them to identify any potential studies. RESULTS: The authors searched 98 articles for relevance, determined according to title, abstract and full text, resulting in a yield of 12 original studies. Nine were clinical trials that focused on caries prevention, seven of which showed that CPP-ACP (as found in sugar-free pellet or slab chewing gum, lozenges, milk or mouthrinse) was effective in preventing dental caries by remineralizing subsurface carious lesions in situ in a dose-response fashion. One was a clinical trial with conflicting results regarding the effect of CPP-ACP on the regression of white-spot lesions; one was a survey of the relief of dry-mouth symptoms; and one was an uncontrolled clinical study that showed the lack of effectiveness and lack of short-term therapeutic effect in treating dentin hypersensitivity. CLINICAL IMPLICATIONS: The quantity and quality of clinical trial evidence are insufficient to make conclusions regarding the long-term effectiveness of casein derivatives, specifically CPP-ACP, in preventing caries in vivo and treating dentin hypersensitivity or dry mouth.


Asunto(s)
Cariostáticos/uso terapéutico , Caseínas/uso terapéutico , Quelantes/uso terapéutico , Ensayos Clínicos como Asunto , Caries Dental/prevención & control , Humanos , Remineralización Dental
16.
J Dent ; 36(2): 104-16, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18166260

RESUMEN

OBJECTIVES: (1) To systematically review the clinical application and remineralization potentials of ozone in dentistry; (2) To summarize the available in vitro applications of ozone in dentistry. SOURCES: Ovid MEDLINE, CINAHL, etc. (up to April 2007). STUDY SELECTION: In vitro or in vivo English language publications, original studies, and reviews were included. Conference papers, abstracts, and posters were excluded. RESULTS: In vitro: Good evidence of ozone biocompatibility with human oral epithelial cells, gingival fibroblast, and periodontal cells; Conflicting evidence of antimicrobial efficacy of ozone but some evidence that ozone is effective in removing the microorganisms from dental unit water lines, the oral cavity, and dentures; Conflicting evidence for the application of ozone in endodontics; Insufficient evidence for the application of ozone in oral surgery and implantology; Good evidence of the prophylactic application of ozone in restorative dentistry prior to etching and the placement of dental sealants and restorations. In vivo: Despite the promising in vitro evidence, the clinical application of ozone in dentistry (so far in management of dental and root caries) has not achieved a strong level of efficacy and cost-effectiveness. CONCLUSIONS: While laboratory studies suggest a promising potential of ozone in dentistry, this has not been fully realised in clinical studies to date. More well designed and conducted double-blind randomised clinical trials with adequate sample size, limited or no loss to follow up, and carefully standardised methods of measurement and analyses are needed to evaluate the possible use of ozone as a treatment modality in dentistry.


Asunto(s)
Atención Odontológica , Oxidantes Fotoquímicos/uso terapéutico , Ozono/uso terapéutico , Antiinfecciosos Locales/uso terapéutico , Cariostáticos/uso terapéutico , Caries Dental/terapia , Humanos , Caries Radicular/terapia , Remineralización Dental/métodos
17.
Eur J Oral Sci ; 114 Suppl 1: 123-6; discussion 127-9, 380, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16674673

RESUMEN

Mild-to-moderately severe enamel fluorosis (EF) is an unsightly maturation-phase dental disorder. Despite extensive epidemiological studies on EF, little is known about individual treatment options. This study was carried out to determine whether a simple microabrasion technique is effective in improving the esthetics of EF. Patients with a variety of severities were treated using a water-cooled fine diamond polishing bur at high speed to remove the surface enamel layers. Photographs of the affected teeth before and after treatment were shown by computer to a panel of three judges (two lay and one experienced), who rated the appearance of the teeth using a newly developed visual analog scale. The severity of EF was rated randomly and blind for 52 individual teeth (26 before and 26 after treatment). Reteated-measures analysis of variance was used to analyze the results. The lay judges rated the appearance of the teeth with EF as significantly more objectionable before treatment. All judges found a significant improvement in the severity of EF after treatment. Using a newly developed visual analog scale, our study indicates that EF of an objectionable nature can be significantly improved with a simple microabrasion technique, thus conserving tooth structure and minimizing the cost of treating EF.


Asunto(s)
Esmalte Dental/patología , Microabrasión del Esmalte/métodos , Estética Dental , Fluorosis Dental/terapia , Adolescente , Adulto , Niño , Microabrasión del Esmalte/instrumentación , Femenino , Fluorosis Dental/clasificación , Fluorosis Dental/patología , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Fotografía Dental , Estudios Retrospectivos , Método Simple Ciego
18.
Eur J Oral Sci ; 114(1): 83-8, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16460346

RESUMEN

Despite fluoride (F) use in caries prevention, not much is known about its effects on tooth quality. This study evaluated the effect of tooth F concentration ([F]) on selected dentin structural and mechanical properties. Third molars (n = 136) from Toronto, which has 1 part per million (p.p.m.) water [F], Montreal (0.2 p.p.m. water [F]), and Fortaleza (Brazil) (0.7 p.p.m. water [F]), were analyzed for [F], dental fluorosis (DF) severity, ultrasound velocity, and dentin tubule size and density. The enamel [F] was found to vary between 32 and 940 p.p.m., the dentin [F] was found to vary between 110 and 860 p.p.m., while the DF severity varied between TF0 and TF4. The enamel [F] showed no correlation with dentin [F], DF severity, ultrasound velocity, dentin tubule size or density. The dentin [F] correlated with DF severity, dentin tubule size, and ultrasound velocity. DF severity showed a correlation with dentin [F] and ultrasound velocity. It was concluded that dentin [F] is an indicator of dentin structural properties (dentin tubule size and ultrasound velocity), while DF severity is an indicator of dentin mechanical properties (ultrasound velocity).


Asunto(s)
Dentina/efectos de los fármacos , Dentina/diagnóstico por imagen , Fluoruros/farmacología , Análisis de Varianza , Brasil , Esmalte Dental/química , Esmalte Dental/diagnóstico por imagen , Dentina/química , Dentina/ultraestructura , Elasticidad , Fluoruración , Fluoruros/análisis , Fluorosis Dental/diagnóstico por imagen , Fluorosis Dental/patología , Humanos , Tercer Molar/química , Tercer Molar/diagnóstico por imagen , Tercer Molar/ultraestructura , Análisis de Activación de Neutrones , Ontario , Quebec , Ultrasonografía , Vibración
19.
Paediatr Child Health ; 11(3): 151-7, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19030271

RESUMEN

OBJECTIVES: To assess the knowledge of early childhood caries and to examine the current preventive oral health-related practices and training among Canadian paediatricians and family physicians who provide primary care to children younger than three years. METHODS: A cross-sectional, self-administered survey was mailed to a random sample of 1928 paediatricians and family physicians. RESULTS: A total of 1044 physicians met the study eligibility criteria, and of those, 537 returned completed surveys, resulting in an overall response rate of 51.4% (237 paediatricians and 300 family physicians). Six questions assessed knowledge of early childhood caries; only 1.8% of paediatricians and 0.7% of family physicians answered all of these questions correctly. In total, 73.9% of paediatricians and 52.4% of family physicians reported visually inspecting children's teeth; 60.4% and 44.6%, respectively, reported counselling parents or caregivers regarding teething and dental care; 53.2% and 25.6%, respectively, reported assessing children's risk of developing tooth decay; and 17.9% and 22.3%, respectively, reported receiving no oral health training in medical school or residency. Respondents who felt confident and knowledgeable and who considered their role in promoting oral health as "very important" were significantly more likely to carry out oral health-related practices. CONCLUSION: Although the majority of paediatricians and family physicians reported including aspects of oral health in children's well visits, a reported lack of dental knowledge and training appeared to pose barriers, limiting these physicians from playing a more active role in promoting the oral health of children in their practices.

20.
J Am Dent Assoc ; 136(7): 895-901, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16060470

RESUMEN

BACKGROUND: To date, no continuous scale exists for measuring the severity of dental fluorosis (DF). OBJECTIVES: The authors developed and validated a visual analog scale (VAS) for DF. They tested the scale in clinical (DF-endemic area) and laboratory settings. METHODS: Dentists and nondentists (23 per group) were asked to grade the DF severity in photographs of 23 anterior teeth with different DF levels (using a 100-millimeter VAS) to create a VAS for DF. Statistical analysis was performed to validate the new scale. The authors used clinical and laboratory (unerupted third molars) analyses to assess the usefulness of the VAS. RESULTS: The authors used an intraclass correlation coefficient (ICC) to assess the interexaminer (ICC = .79: good agreement) and intraexaminer (.88 < ICC < .97: excellent agreement) reliability during creation of the scale. They used the Spearman rank correlation (r(s)) to validate the VAS against the gold standards (that is, the Thylstrup-Fejerskov index [TFI] and Dean's index [DI]) (the results showed excellent or good correlation for 45 examiners). Two dentist examiners clinically tested the new VAS, and the results showed excellent (r(s) = .922, P < .001) correlation and excellent ICC between the examiners (ICC = .96), as well as good ICC between the TFI and the VAS for DF (ICC = .6). The laboratory study showed better correlation between fluoride concentration and the VAS for DF than between fluoride concentration and the TFI. CONCLUSION: Because of its simplicity, precision and utility in statistical applications, the VAS for DF can be useful in DF studies.


Asunto(s)
Fluorosis Dental/clasificación , Adolescente , Niño , Preescolar , Esmalte Dental/química , Dentina/química , Enfermedades Endémicas , Femenino , Fluoruros/análisis , Humanos , Masculino , Tercer Molar/patología , Variaciones Dependientes del Observador , Fotografía Dental , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Anomalías Dentarias/clasificación , Decoloración de Dientes/clasificación , Diente no Erupcionado/patología
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