Role of matrix vesicles and crystal ghosts in bio-mineralization.

Matrix vesicles (MVs) are extracellular membrane-bound vesicles of about ~ 50-200 nm in diameter that play a role in the bio-mineralization process of hard tissue formation. The present review is based on the empirical phenomenon of primary mineralization process via matrix vesicle-mediated mechanism with special reference to crystal ghosts as well as the mechanism on the organic-inorganic relationship between matrix vesicles and crystal ghosts, and the transformation that these structures undergo during bio-mineralization.

Salivary fluoride concentration and retention after rinsing with 0.05 and 0.2% sodium fluoride (NaF) compared with a new high F rinse containing 0.32% NaF.

OBJECTIVE: To compare salivary fluoride (F) concentration and F retention after rinsing with a new 0.32% sodium fluoride (NaF) rinse and conventional 0.05 and 0.2% NaF rinses. METHODS: Seventeen subjects (aged 22-26 years), with normal salivary secretion rates, participated in a double blind, cross-over study. In three separate sessions with a minimum washout period of 48 h, they rinsed for 1 min with 10 ml of 0.05, 0.2 or 0.32% NaF mouthrinse. Unstimulated whole saliva was collected before (baseline: 0 min) and after 1, 3, 5, 10, 20, 30, 45 and 60 min. The F concentration was plotted against time, and the area under the curve (AUC) calculated. Salivary F concentration and F retention for the three mouthrinses were compared by a randomized block test, followed by Tukey's test and a paired 2-tailed test. RESULTS: There was a clear dose-response for AUC 3-60 min; 0.32% > 0.2% > 0.05% (p < .05). The mean F retention was 0.25 mg for 0.05% NaF, 0.86 mg F for 0.2% Na and 1.31 mg F for 0.32% NaF, (p < .05). CONCLUSIONS: The higher salivary F concentration over time and the higher F retention after rinsing with an 0.32% NaF solution suggests a potential application in prevention of caries and dental erosion.

Self-reported oral and general health related to xerostomia, hyposalivation, and quality of life among caries active younger adults.

Objective: The aim was to study prevalence of xerostomia, hyposalivation and quality of life among caries active younger adults.Materials and methods: A questionnaire regarding oral and general health, xerostomia and quality of life was mailed to 134 caries active (CA) and 40 caries inactive (CI) patients, 25-50 years of age (mean age 39.9 ± 6.2 years) treated at a Swedish Public Dental Service clinic, regarding oral and general health, xerostomia and quality of life. Caries data and unstimulated whole salivary flow rates were obtained from dental records.Results: The overall response rate was 69%. Dental records confirmed that CA patients had more decayed teeth over time than CI patients (p < .001). The CA group reported worse oral health (p < .001) and general health (p < .01), more xerostomia (p < .001) and lower salivary flow rate (p < .01) compared to CI patients. Xerostomia was inversely related to unstimulated whole salivary flow rates as well as to oral and general health (p < .01). There were no differences between groups in quality of life.Conclusion: Younger caries active adult patients reported significantly more xerostomia and hyposalivation compared to caries inactive patients. Xerostomia and hyposalivation were inversely related to perceptions of oral and general health, but not to quality of life.

Cytokine levels in gingival crevicular fluid during orthodontic treatment with aligners compared to conventional labial fixed appliances: a 3-week clinical study.

Objective: To test the hypothesis that the levels of IL-1ß and TNF-α increased more and IL-1α, IL-2, IL-6, IL-8 increased less, after 3 weeks of treatment with conventional labial fixed appliance and with aligners. Material and methods: Forty patients who were treated either with labial brackets (n = 20) or aligners (n = 20). Gingival crevicular fluid (GCF) samples were collected at baseline and after 21 days. Cytokine levels were evaluated by enzyme-linked immune sorbent assay (ELISA). Plaque index (PI), gingival index (GI), and bleeding on probing (POB) were also examined. Results: The levels of IL-1α, IL-1ß, IL-2, IL-6, IL-8 and TNF-α in the GCF were significantly increased in both groups. The levels of IL-2, IL-6, IL-8 increased more in patients treated with aligners compared to those treated by labial fixed appliances. There was a statistically significant difference in change of the mean cytokine levels of IL-1α, IL-2, IL-6, IL-8 and TNF-α compared to labial fixed appliances and aligners. Conclusions: The levels of the six studied cytokines in GCF (IL-1α, IL-1ß, IL-2, IL-6, IL-8 and TNF-α) increased after 3 weeks both after treatment with conventional labial fixed appliance and with aligners. IL-1ß and TNF-α showed a prominent increase compared to the other cytokines in the GCF of teeth by both the labial fixed appliance and aligners. However, there were only minor differences in the changes of the cytokine levels from baseline to 3 weeks between the two groups. There were no differences between the groups regarding PI, GI or POB.

Adjunctive use of fluoride rinsing and brush-on gel increased incipient caries-like lesion remineralization compared with fluoride toothpaste alone in situ.

Objective: The objective of this study was to compare the remineralizing effect of sodium fluoride (NaF) mouth rinse or NaF gel as an adjunct to NaF dentifrice on incipient caries-like lesions in an in situ cross-over design study, with three sessions of 30 days each. Materials and methods: Orthodontic brackets with artificial demineralized enamel slabs were attached to the upper first molars of 12 participants. A set of 3 test specimens from the same tooth was randomly assigned to each participant and allocated into three 30-day sessions: 1) brushing with 0.22% NaF dentifrice 2 times/day (F dentifrice), 2) brushing with 0.22% NaF dentifrice 2 times/day+ rinsing with 0.05% NaF before bedtime (F mouth rinse), 3) brushing with 0.22% NaF dentifrice 2 times/day + brushing with 1.1% NaF gel before bedtime (F brush-on gel). The mineral gain and lesion depth of the specimens were evaluated by micro-computed tomography. Results: The mean mineral gain from the NaF mouth rinse and the NaF brush-on gel was similar, but greater than that from the NaF dentifrice (p < .05). The NaF brush-on gel yielded the greatest mean depth of remineralization (168 µm), followed by the NaF mouth rinse (144 µm). Both depths were significantly greater than that of the NaF dentifrice (84 µm) (p < .05). Conclusions: Both 0.05% NaF mouth rinse and 1.1% NaF brush-on gel, used at bedtime, increased incipient caries-like lesion remineralization in situ in combination with brushing with NaF dentifrice twice a day.

Dental Caries and Risk Factors in Swedish Adolescents about to Start Orthodontic Treatment with Fixed Appliances.

AIM: The aim of this study is to investigate the caries situation in a group of Swedish adolescents, who were scheduled for orthodontic treatment with fixed appliances. MATERIALS AND METHODS: An age- and gender-matched control group was selected from the same city (Malmö, Sweden). Caries and fillings on smooth surfaces and fillings on occlusal surfaces were diagnosed clinically and caries and fillings on approximal surfaces by bitewings. Numbers of mutans streptococci (MS) and lactobacilli (LB) were analyzed in saliva. RESULTS: There were no significant differences regarding manifest caries lesions and fillings on smooth surfaces. Numbers of occlusal-filled surfaces (FS) and approximal decayed and filled surfaces were around 10%, but did not differ between the groups. However, 53% had approximal enamel caries lesions in the test group and 46% in the control group. The prevalence of approximal decayed surfaces (DS) and FS was low in both groups, 0.57 ± 1.41 in the test group and 0.65 ± 1.38 in the control group (p > 0.05), i.e., somewhat more DS in the control group (p < 0.05). Most individuals had low/medium counts of cariogenic bacteria in their saliva and less than 10% high counts in both groups. CONCLUSION: Most Swedish adolescents who have been scheduled for treatment with fixed appliances appear to have a low-to-medium caries risk nowadays. However, around 10% of all approximal tooth surfaces of premolars/molars had enamel caries and one-third of the individuals had medium/high counts of cariogenic bacteria in their saliva, which may be risk factors for future caries during orthodontic treatment. CLINICAL SIGNIFICANCE: Bitewing radiographs are important before starting orthodontic treatment and approximal caries and many cariogenic bacteria may be risk factors for orthodontic treatment.

Interaction between chlorhexidine and fluoride in a mouthrinse solution-a 4-day and 6-week randomized clinical pilot study.

OBJECTIVE: The aim of the present investigation was to study if there is a reduced clinical effect and fluoride retention of a mouthrinse solution containing both chlorhexidine (CHX) and sodium fluoride (NaF). MATERIAL AND METHODS: Two clinical trials were designed as double-blind, randomized, cross-over studies. In study I, 16 healthy subjects were asked to rinse twice daily for 1 min during 4 days of no tooth brushing with four solutions: (1) 0.12% CHX + 0.2% NaF, (2) 0.2% NaF, (3) 0.12% CHX, and (4) placebo. In study II, another 16 healthy subjects rinsed with the same four solutions twice daily after tooth brushing during a 6-week period. Plaque formation, gingivitis, and microbiological samples from plaque and saliva, as well as fluoride retention, were analyzed. RESULTS: Both studies showed that both CHX + NaF and CHX mouthrinses had the same clinical effect with regards to plaque formation and microflora in plaque and saliva. Similarly, fluoride retention was not altered by the CHX + NaF mouthrinse compared to the NaF solution. CONCLUSION: The combination of CHX and NaF in a mouthrinse showed the same clinical effect as the CHX solution. The retention of fluoride in the oral cavity was not affected by the combination of NaF and CHX. CLINICAL RELEVANCE: A mouthrinse solution containing a mixture of CHX and NaF may be an interesting product for risk patients for caries and periodontal disease. However, this should be verified in further long-term clinical studies.

Attitudes and behavioural factors relating to toothbrushing and the use of fluoride toothpaste among caries-active Swedish adolescents - a questionnaire study.

OBJECTIVE: The aim of this study was to identify attitudes and behaviour relating to fluoride toothpaste and toothbrushing habits among caries-active Swedish adolescents. MATERIALS AND METHODS: This cross-sectional study is based on an earlier clinical, two-year toothpaste intervention study. At the last appointment, 206 adolescents (of 211) answered a questionnaire comprising nine semi-closed questions. RESULTS: The majority (93%) brushed their teeth every day, while 7% did so only occasionally. Most participants (77%) brushed twice a day, while 12% brushed just once a day. About half of those brushing just once a day forgot to brush in the evening. Similarly, more than half of the adolescents (53%) used 1 cm of toothpaste or less on their toothbrush. Moreover, 49% brushed for less than 2 min, 41% brushed for 2 min and 10% for more than 2 min. The majority (73%) rinsed with water after toothbrushing. A difference between boys and girls was also observed; 87% of the girls brushed twice a day, whereas only 67% of the boys did so and boys more frequently forgot in the evening. CONCLUSIONS: Attitudes and behaviour relating to fluoride toothpaste and toothbrushing habits among caries-active Swedish adolescents are still inadequate after two years of toothpaste intervention. There are several areas where improvements can be made, such as frequency of brushing, brushing time, amount of toothpaste and post-brushing procedures. The majority (81%) included 'fresh breath' as a reason for performing oral hygiene and this aspect can be used by dental staff in health promotion.

Profiling of smokers and snuffers among young Finnish men - cross-sectional epidemiological study.

OBJECTIVE: The purpose of this study was to get new information from several sources about the background factors of Finnish smokers, snuffers, and dual users. Profiles of young smokers and snuffers were investigated in association with restorative treatment need, oral hygiene, eating habits, physical activity, body mass index (BMI), psychological and socioeconomic factors. MATERIAL AND METHODS: The study group comprised 3420 conscripts. The data were collected from four different sources: a health examination including an oral health screening, a computer-based questionnaire for investigating individual background factors, a psychological test assessing cognitive skills, and the Cooper test. Statistical analyses comprised cross tabulation and binary logistic regression modelling. RESULTS: The odds for smoking were the greatest among those who had DT (Decayed teeth) > 0, used energy drinks or alcohol regularly, or whose parents were divorced. A score of ≥2900 m in the Cooper test, a higher physical exercise level, a higher own education level, and using sports drinks decreased the odds for smoking. The odds for snuffing were higher among those who ran >2500 m in the Cooper test, had a BMI of ≥25, used sports/energy drinks, or exercised regularly, and lower among those who achieved good results in the cognitive test. Using energy/sports drinks or alcohol was positively and a higher education level was negatively associated with dual use. CONCLUSIONS: Along with increasing prevalence of snuffing, heterogeneity is likely among snuffers. Good cognitive skills may prevent from smoking and snuffing.

Patient-reported negative experiences related to caries and its treatment among Swedish adult patients.

BACKGROUND: It has been suggested that dental caries should be regarded as a chronic disease as many individuals repeatedly develop new caries lesions. How this is perceived by caries active patients is unclear. The aim of this study was to measure patient-reported attitudes and negative experiences related to caries and dental treatment. METHODS: A questionnaire was mailed to 134 caries active (CA) and 40 caries inactive (CI) adult patients treated at a Swedish public dental service clinic. The questionnaire included items regarding patient-reported oral health; attitudes towards caries and efforts to prevent them; and negative experiences related to caries and dental treatment. Questionnaire data were supplemented with data on caries and caries prophylaxis from patients' dental records. Exploratory factor analysis was conducted on items related to patients' perceptions of problems to see whether scales could be created. Experiences, perceptions and dental records of CA and CI patients were compared. RESULTS: The overall response rate was 69%. Dental records confirmed that CA patients had significantly more decayed teeth per year and a longer period of caries-active time than CI patients. Factor analysis resulted in 3 distinct scales measuring problems related to caries; 1) caries-related information; 2) negative experiences; and 3) negative treatment/staff attitudes. A fourth scale measuring perceived problems related to caries was also created. The CA group reported significantly more problems related to caries and dental treatment, received significantly more caries-related information, and reported significantly more negative treatment experiences compared to CI patients. CONCLUSIONS: Caries prophylaxis methods need to be improved in order to better meet the needs of caries active patients and to create a more positive experience with dental care.

Comparison of Fluoridated Miswak and Toothbrushing with Fluoridated Toothpaste on Plaque Removal and Fluoride Release.

INTRODUCTION: Dental caries and periodontal diseases are all induced by oral biofilm (dental plaque). This study was conducted to evaluate if fluoride-impregnated miswak is as effective in plaque removal and fluoride release as toothbrushing with fluoride toothpaste. MATERIALS AND METHODS: This single-blind, randomized, crossover study was conducted at the Department of Cariology, University of Gothenburg, Gothenburg, Sweden, from February 2010 to January 2011. Fifteen healthy subjects participated in this study. The participants were instructed to use the following: (1) 0.5% NaF-impregnated miswak, (2) nonfluoridated miswak, (3) toothbrush with nonfluoride toothpaste, and (4) toothbrush with 1450 ppm fluoride toothpaste. Each method was used twice a day for 1 week after which plaque amount and fluoride concentration in resting saliva were measured. There was a 1-week washout period between each method. RESULTS: No significant difference between miswak and tooth-brushing was found regarding plaque removal on buccal and lingual surfaces. A somewhat higher fluoride concentration in resting saliva was found after using impregnated miswak when compared with toothbrushing with fluoride toothpaste (p < 0.05). CONCLUSION: Miswak and toothbrushing showed the same plaque removing effect on buccal and lingual surfaces. Miswak impregnated with 0.5% NaF resulted in a higher concentration of fluoride in saliva than brushing with 1450 ppm fluoride toothpaste. CLINICAL SIGNIFICANCE: Miswak impregnated with 0.5% NaF and toothbrushing results in comparable plaque removal and about the same fluoride concentration in saliva even it was somewhat higher for impregnated miswak.

BMI, eating habits and sleep in relation to salivary counts of mutans streptococci in children - the IDEFICS Sweden study.

OBJECTIVE: The objective of the present study was to investigate the association between salivary counts of mutans streptococci (MS) and children's weight status, while considering associated covariates. MS ferments carbohydrates from the diet and contributes to caries by lowering the pH in dental plaque. In adults, high counts of MS in saliva have been associated with overweight, but this has not been shown in children. DESIGN: Cross-sectional study investigating salivary counts of MS, BMI Z-score, waist circumference, meal frequency, sugar propensity and sleep duration, in children. SETTING: West Sweden. SUBJECTS: Children (n 271) aged 4-11 years. RESULTS: Medium-high counts of MS were positively associated with higher BMI Z-score (OR=1·6; 95% CI 1·1, 2·3). Positive associations were also found between medium-high counts of MS and more frequent meals per day (OR=1·5; 95% CI 1·1, 2·2), greater percentage of sugar-rich foods consumed (OR=1·1; 95% CI 1·0, 1·3) and female sex (OR=2·4; 95% CI 1·1, 5·4). A negative association was found between medium-high counts of MS and longer sleep duration (OR=0·5; 95% CI 0·3, 1·0). CONCLUSIONS: BMI Z-score was associated with counts of MS. Promoting adequate sleep duration and limiting the intake frequency of sugar-rich foods and beverages could provide multiple benefits in public health interventions aimed at reducing dental caries and childhood overweight.

Prevalence of maxillary lateral incisor agenesis and associated skeletal characteristics in an orthodontic patient population.

OBJECTIVES: This study was aimed to investigate the prevalence of maxillary lateral incisor agenesis and associated skeletal characteristics in an orthodontic patient population. MATERIALS AND METHODS: The records of the 1066 patients seeking orthodontic treatment were screened for maxillary lateral incisor agenesis (MLIA). The following data were recorded for each subject: age; gender; unilateral or bilateral agenesis of MLI and side. The lateral cephalogram of each subject with MLIA was digitally traced. The data were compared to age-matched control orthodontic patients with skeletal Class I. RESULTS: The prevalence of maxillary lateral incisor agenesis was 4.9% (52 patients) in which 63.5% were females. There was a significant difference between MLIA patients and controls in sagittal relationships (ANB, Wits, AB plane, angle of convexity and Co-A/Co-Gn differential analyses) p < 0.05. CONCLUSIONS: Patients with maxillary lateral incisor agenesis showed a significant tendency for skeletal Class III compared with the Class I control. This could be attributed to maxillary hypoplasia/retrognathia.

Patient-reported outcomes of caries prophylaxis among Swedish caries active adults in a long-term perspective.

The aim of this study was to measure patient-reported outcomes of caries prophylaxis and to compare them with previously documented efforts in dental offices. A questionnaire was mailed to 134 caries active (CA) and 40 caries inactive (CI) adult patients treated at a Swedish public dental service clinic. The overall response rate was 69%. The questionnaire included items regarding patient perceived caries prophylaxis in relation to: 1) treatment and recommendations given by the dental personnel, 2) performed self-care and 3) perceived and expected effects.The responses were studied for their association to clinical data, extracted retrospectively from the patients' dental records.The mean follow up time was > 16 years. Information about caries prophylaxis (p = 0.01) and recommendations for self-care (p = 0.04) were given more often to the CA group than to the CI group. Supplementary examinations and recommendations of self-care risk treatments were more frequent in the CA group (p < 0.001). CA patients also made more frequent extra efforts at home to avoid caries by changing their eating habits (p < 0.001), improving their oral hygiene (p = 0.04) and using extra fluoride (p = 0.001). In the CA group, 60% did not considerthat the extra prophylaxis efforts had made them caries inactive, and 40% were not satisfied with the outcome. Most patients (> 90%) hoped that the outcome of caries prophylactics would be a reduced number of cavities.The patient-perceived experiences of caries prophylaxis-were in concordance with dental records. Both the dentists and the caries active middle-aged Swedish adults were aware of the need for extra prophylaxis.The caries active patients perceived having made extra home care efforts, but had not experienced that they had become free from caries.

Dental nurses' experiences of performing a school-based fluoride varnish programme for children and adolescents in Sweden.

In many parts of Sweden today, school-based fluoride varnish programmes (FVP) are perfor- med by dental nurses. Studies have shown that the dental personnel are largely responsible for creating the atmosphere related to children's and adolescents'experiences of the program- mes. Knowledge of dental nurses'experiences of performing FVP is therefore crucial in order to develop and improve these programmes and the dental health of children and adolescents.The aim of this study was to describe dental nurses'experiences of performing FVP for children and adolescents in Sweden. Fifteen female dental nurses, strategically chosen, aged 40-63, from the Public Dental Service in the Vistra Gtaland Region, Sweden, were individually interviewed.The interviews were transcribed verbatim and analysed according to the phenomenographic ap- proach.Three themes with a total of 11 categories, all describing the dental nurses' conceptions of performing FVP, emerged in the analysis. The main conclusions were that in overall terms, performing an FVP was found to be a positive experience for the dental nurses, as it meant mee- ting children and adolescents in a context in which the children and adolescents are comforta- ble and relaxed.The opportunity to identify children and adolescents with poor dental health or poor health and to be able to offer them assistance was regarded as a major advantage. In addition,the participants described a feeling of professional development originatingfrom the challenges associated with working in an arena outside the dental clinic.

Self-reported changes in using fluoride toothpaste among older adults in Sweden: an intervention study.

OBJECTIVE: The aim of the study was to investigate the possibility of increasing knowledge about the caries-reducing effects of fluoride (F) toothpaste and to increase the use of F toothpaste among older adults through an intervention. MATERIALS AND METHODS: 63-67-year-olds in Sweden, who 2 years earlier had answered a questionnaire about their knowledge of F toothpaste, toothbrushing and toothpaste habits and who had shown less favourable habits with regard to toothpaste use, were invited to participate. The 20-min intervention, performed at a Public Dental Clinic, was implemented by a dental hygienist (author OJ) and consisted of individual information and instruction on the use of F toothpaste. The questionnaire was repeated 4 months after the intervention and a population in another city in Sweden served as control. RESULTS: In the intervention group, 68 individuals responded and 151 in the control group. Knowledge of the benefits of F toothpaste in the intervention group had improved between the times of the first and second questionnaires, but the same effect was also noted in the control group. After the intervention, a clear improvement concerning the use of F toothpaste was reported: the individuals brushed for a longer time, used more toothpaste and used less water during and after brushing. In the control group, there were no changes of habits between the first and second occasions. CONCLUSION: Individually-based interventions performed by a dental hygienist had a positive effect on changing the way older adults used F toothpaste.

Dental hygienists working in schools - a two-year oral health intervention programme in swedish secondary schools.

PURPOSE: To investigate the possibility of influencing adolescents' caries incidence, knowledge and attitudes to oral health and tobacco through a school-based oral health intervention programme. MATERIALS AND METHODS: Four schools in a county in Sweden were randomised to one intervention and one control group. At the intervention schools, two dental hygienists worked 4 h every week for two years. Health education and preventive measures, such as fluoride varnish treatments every 6 months, were performed. The control group had no intervention. The study included a total of 534 participants aged 12-16 years. Outcome variables of the study were 1) caries incidence assessed on bite-wing radiographs and 2) knowledge and attitudes measured through questionnaires. RESULTS: The intervention programme impacted on the incidence of enamel caries, while no effect on dentin caries could be seen. Data from the questionnaires showed that the adolescents considered their teeth as important. Adolescents in the intervention group had better knowledge about oral health and oral hygiene compared to the control group after the two years, but no impact on attitudes toward tobacco could be seen. A majority of the adolescents were positive to the education about oral health and tobacco and they believed that the dental hygienists would help them improve their oral health. CONCLUSIONS: Although the effects of the intervention as regards to caries incidence, knowledge and attitudes were limited, the presence of dental hygienists in school was appreciated by the adolescents and seemed to increase their interest in their oral health.

Salivary secretion and drug treatment in four 70-year-old Swedish cohorts during a period of 30 years.

OBJECTIVE: The aim was to examine the association between drug treatment and unstimulated and stimulated whole saliva in four 70-year-old Swedish cohorts, between 1971 and 2001. BACKGROUND: Both diseases and their medication can affect the salivary secretion rate. MATERIALS AND METHODS: The study was based on selected samples of four cohorts born in 1901/1902, 1906/1907, 1911/1912 and 1930/1931, respectively, a total of 1072 individuals. The response rate varied between 65% and 85%. RESULTS: The mean value for the stimulated salivary secretion rate was higher in men (1.3 ± 0.8 ml/min) than in women (1.0 ± 0.7 ml/min) (p < 0.001)). There was a significant association between the salivary secretion rate and the number of drugs among both women (p < 0.01) and men (p < 0.001). This influence was most pronounced in participants who were treated with cardiovascular drugs, mainly diuretics and non-selective ß-adrenoceptor blockers, but also with antipsychotics and antidepressants, even when adjusted for cohort, gender, number of teeth and other drugs. There was an increase in treatment with medicines during the three decades. CONCLUSION: In these four groups of 70-year-old participants, high drug consumption was associated with lower salivary flow. Unstimulated secretion was only affected in women and then, when taking four or more drugs. Pronounced hyposalivation was, however, uncommon. Cardiovascular drugs, antidepressants and antipsychotics were associated with low salivary secretion. In this age group, the frequently observed association between polypharmacy and a lower saliva secretion rate represents a risk of impaired dental health.

Dental caries and associated factors in a group of Swedish snus users.

The aim of this study was to investigate the effects of the Swedish moist powder tobacco product known as "snus" on dental caries and to measure the pH fall in dental plaque. The subjects comprised male and female adults between 26 and 62 years of age (n = 102), all habitual snus users for ≥ 10 years. The control group (n = 101) consisted of similar individuals in terms of gender, age and educational level but with no tobacco use for ≥ 10 years. A clinical and radiographic examination and a questionnaire were completed. The pH fall after a sucrose rinse was estimated in situ in 10 randomly selected subjects per group. The salivary secretion rate was higher in snus users than non-users (2.5 vs 2.2 ml/min, p = 0.005).There was no statistically significant difference regarding salivary buffer capacity. No differences were found between the two groups in terms of the plaque index, primary or secondary enamel and dentine caries, DFS and salivary counts of mutans streptococci or lactobacilli. The pH fall was somewhat more pronounced among non-users compared with snus users (NS). Snus users had a lower intake of snacks between meals and a less frequent intake of cookies (p = 0.000). Furthermore, snus users had a mean gingival index (± SD) for the whole dentition of 20.4 ± 18.2, while the index for non-users was 14.4 ± 13.9 (p = 0.09); the corresponding values for teeth 13-23 were 14.9 ± 20.6 and 7.7 ± 11.9 respectively (p = 0.003). To conclude, this clinical study revealed no statistically significant differences in caries prevalence between snus users and non-users and only minor differences regarding different caries associated factors.

Metabolic Syndrome, Lifestyle, and Dental Caries in Japanese School Children.

The number of children with Metabolic Syndrome (MetS) has recently been increasing in Japan. Few studies have investigated the relationship between MetS and oral health. The aim of this study was to investigate the association between MetS, lifestyle, and oral health status in school children. Our goal is to utilize these results in health education aimed at preventing the onset of MetS in school children and adults. A total of 689 Japanese children (365 boys and 324 girls) aged between 10 and 13 years were examined and waist circumference (WC), ratio of WC to height, blood pressure, fasting blood sugar (FBS), high density lipoprotein-cholesterol, and triglyceride values determined together with oral health status, including dental caries experience (DMFT). The results revealed that 6.5% of the children fell under the health board recognized "MetS or high risk of MetS" (MetS/HR) classification. A total of 140 (20%) children had a high Streptococcus mutans count. The mean WC, FBS, and DMFT values were significantly greater in children with a high salivary S. mutans count (p<0.05). Multiple logistic regression analysis revealed a statistically significance association between MetS/HR, non-breakfast eaters (odds ratio (OR): 2.70), no regular exercise (OR: 2.60), and a high salivary S. mutans count (≥10(5) CFU/ml; OR: 2.18; p<0.05). The present results indicate that lifestyle and salivary S. mutans count could be useful in screening children for MetS/HR. These variables may be useful in targeting interventions aimed at preventing MetS in school children.