Beneficial effect of aged garlic extract on periodontitis: a randomized controlled double-blind clinical study.

The purpose of this study is to assess the long-term efficacy of aged garlic extract to improve periodontitis. Two hundred and one participants were randomly stratified and assigned equally to the regimen group or the control group. At the start, 12 month, and 18 month subjects received dental examination and periodontal evaluation. Probing Pocket Depth and Gingival Recession were examined. For each efficacy parameter, the mean value of examination was calculated and assessed using paired-difference t tests. Statistical tests were two-sided using a 5% significance level. The mean value of pocket depth for the aged garlic extract group at 18 month was 1.06 ± 0.49 as compared to the baseline value of 1.89 ± 0.74 (p<0.001) and the corresponding value of 1.50 ± 0.46 for the placebo group (p<0.001), indicating the beneficial effect of aged garlic extract on periodontitis. According to a Multiple linear regression analysis the only three variables which reached statistical significance as predictors of PPD level were the baseline PPD scores (p<0.001), smoking (p = 0.020), and consumption of daily dose of aged garlic extract (p<0.001). These results demonstrated that aged garlic extract is an effective supplement for preventing or improving periodontal disease. The well demonstrated benefits of aged garlic extract for the oral disease may also be used as a means to improve general health because of the close relationship between periodontitis and some systemic diseases such as diabetes, hypertension, atherosclerosis, and others.

The Efficacy of Aged Garlic Extract on Gingivitis - A Randomized Clinical Trial.

OBJECTIVES: To assess gingivitis and gingival bleeding following the consumption of Aged Garlic Extract versus placebo for a period of four months. METHODS: A randomized, controlled, examiner-blind, two-treatment parallel group study was conducted. Participants were stratified and randomly assigned equally to a regimen group using Aged Garlic Extract (AGE) or a control group, based on gender, age, baseline number of bleeding sites, and gingival health status. Assessment was performed at baseline and at one, two, three, and four months. Clinical assessment was conducted by three experienced calibrated examiners. RESULTS: One hundred and fifty-one participants followed the inclusion criteria; 50.3% males, with an average age of 32.7 ± 8.2 years. Only 134 subjects completed the four-month study (11.3% attrition rate). A statistically significant decrease of the Modified Gingival Index and Gingival Bleeding Index scores was shown for the AGE compared to the placebo group, both between and within groups (p < 0.001). CONCLUSIONS: This research demonstrated that daily consumption of AGE benefits oral health by reducing gingival inflammation and gingival bleeding, as compared to a placebo control.

Survival Rates of Amalgam and Composite Resin Restorations from Big Data Real-Life Databases in the Era of Restricted Dental Mercury Use.

Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the cavity left in the tooth, most commonly with amalgam or composite resin. The consequences of filling failure include repeating the filling or performing another treatment such as a root canal or extraction. Dental amalgam contains mercury, and there is a global effort to reduce its use. However, no consensus has been reached regarding whether amalgam or composite resin materials are more durable, and which is the best restorative material, when using randomized clinical trials. To determine which material is superior, we performed a retrospective cohort study using a large database where the members of 58 dental clinics with 440 dental units were treated. The number of failures of the amalgam compared to composite resin restorations between 2014 and 2021 were compared. Our data included information from over 650,000 patients. Between 2014-2021, 260,905 patients were treated. In total, 19,692 out of the first 113,281 amalgam restorations failed (17.49%), whereas significantly fewer composite restorations failed (11.98%) with 65,943 out of 555,671. This study indicates that composite is superior to amalgam and therefore it is reasonable to cease using mercury-containing amalgam.

The effect of cessation of drinking water fluoridation on dental restorations and crowns in children aged 3-5 years in Israel - a retrospective study.

BACKGROUND: Community water fluoridation began in the 1945 as a public health measure to prevent and control caries and was implemented in Israel in 1981. Community water fluoridation reduced caries significantly, but in 2014, the Ministry of Health decided to stop Community water fluoridation in Israel. The aim of our study was to examine the effect of fluoridation cessation on the dental health of children aged 3-5, treated in "Assuta Tel Aviv" dental clinics, under general anesthesia or deep sedation. METHODS: The computerized Maccabi-Dent database provided data for this retrospective study. Records from the years 2014-2019 including treatment codes for procedures relevant to the study, the number of stainless-steel crowns and restorations of all types were examined. Kruskal-Wallis test was performed to compare the results from before and after fluoridation cessation. RESULTS: A statistically significant increase in the mean number of treatments in the years after fluoridation cessation (P < 0.05) was found. There was approximately a two-fold increase in the number of all treatments for all ages. CONCLUSION: The results of the study emphasize the advantages of water fluoridation and are further proof of the need to restore community water fluoridation in Israel.

Prevalence of Occupational Contact Dermatitis Among Dental Personnel Using the Nordic Occupational Skin Questionnaire-2002: A Prospective Cross-Sectional Study.

BACKGROUND: Occupational skin disease (OSD), such as contact dermatitis, is widespread among dental professionals; however, reports regarding its prevalence have inconsistent findings and methodology. Therefore, we conducted a cross-sectional survey using a self-reported questionnaire to estimate the prevalence of work-related and occupational exposure-induced skin diseases. METHODOLOGY: A self-administered questionnaire, based on the validated Nordic Occupational Skin Questionnaire-2002, was distributed to 15 dental clinics in Israel in the first half of 2022. The questionnaire included questions about the occupation, exposure, and history of atopic disease, dry skin, and hand/arm and wrist eczema, as well as participant demographics. RESULTS: Overall, 312 dental professionals completed the questionnaires. Response rate was 80%. The lifetime prevalence of self-reported skin symptoms was 19.23%. Significant risk factors included exposure to metal objects, odds ratio (OR): 2.43, 95% confidence interval (CI): [1.02, 5.78]; p < .05, dry skin (OR: 3.54, 95% CI: [1.93, 6.5]; p < .001), itching when sweating (OR: 2.89, 95% CI: [1.39, 6]; p < .05), contact urticaria (OR: 10.67, 95% CI: [4.46, 25.49]; p < .001), hay fever (OR: 2.25, 95% CI: [1.14, 4.42]; p < .05), allergic symptoms (OR; 2.33, 95% CI: [1.18, 4.58]; p < .05), and asthma (OR: 4.8, 95% CI: [2.17, 10.36]; p < .001). CONCLUSIONS: This is the first study to use the NOSQ-2002 among dental professionals. Our study provides a better understanding of the prevalence and consequences of OSDs among dental personnel by utilizing the validated tool NOSQ-2002.

Caries prevalence and water fluoridation in Israel: a cross-sectional study.

OBJECTIVES: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5,000 individuals was fluoridated. In 2014, CWF in Israel stopped. METHOD AND MATERIALS: Data on 12-year-old children from all areas in Israel from the national cross-sectional epidemiological survey conducted in 2011 to 2012 were stratified by city water fluoridation and by city and school socioeconomic status. Two dependent variables were defined: (1) DMFT index of caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov classification of fluorosis. RESULTS: Data from 2,181 12-year-olds were analyzed. The average DMFT was 1.17 ± 1.72, and 49% were caries-free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs 0.98 in fluoridated cities) and there were more caries-free children in fluoridated cities (56.4% vs 40.6% in nonfluoridated). DMFT was higher in cities with lower socioeconomic status than high socioeconomic status (1.29 vs 1.05, respectively, P < .001) and there were fewer caries-free children in low socioeconomic status cities (44.5% vs 53.0% in high socioeconomic status cities, P < .0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in the Thylstrup-Fejerskov index), had questionable to mild fluorosis (9.3%). CONCLUSIONS: CWF is a cheap, simple method of dental health protection that reaches all socioeconomic levels, and cessation of water fluoridation reduced the health of Israel's children. CLINICAL SIGNIFICANCE: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.

Correlates of Early Dental Implant Failure: A Retrospective Study.

PURPOSE: To examine whether patient-level disease diagnoses, drug treatments, and dental clinical factors are correlates of early implant failure. MATERIALS AND METHODS: This historical, nested case-control study used electronic medical records to retrieve patient-level data on individuals with implant failure occurring up to 6 months after implantation, including demographics, clinical information (number, location, and complicated status of implants), underlying diseases (osteoporosis, diabetes, hypertension, inflammatory bowel disease [IBD], myocardial infarction [MI]), and drug purchases (chemotherapy, bisphosphonates, selective serotonin inhibitors, antihypertensive medications, proton pump inhibitors [PPIs], disease-modifying antirheumatic drugs, corticosteroids, and nonsteroidal anti-inflammatory drugs) among adult members of a large, state-mandated health provider in Israel between 2015 and 2020. Individuals with implant extraction occurring up to 6 months after implantation were matched 1:1 to controls. Univariate and adjusted multivariate conditional logistic regression models were used to examine the odds ratios (ORs) of all dental implant risk factors among the patients. RESULTS: A total of 585 individuals with implant failure (mean age, 53 years [42,62], 51.3% females and 49.7% males) were identified among 29,378 eligible patients. Compared to controls, patients who experienced implant failure (ie, cases) were more likely to have smoked in their lifetime (18% vs 11.5%, P = .009), experienced IBD (1.5% vs 0.02%, P = .059), and consumed PPIs within 6 months of the implant surgery (40.0% vs 32.5%, P = .028). Clinical factors, including the number of implants per person (individuals with two implants, OR = 1.53; individuals with at least four implants, OR = 3.33; P < .01), location of implant (maxilla; OR = 1.59; 95% CI: 1.2-2.04), and smoking (OR = 1.57; 95% CI: 1.09-2.26) were significant correlates of early implant failure among the included cases. Crohn's disease, MI, and osteoporosis were found to be borderline significant correlates of early dental implant failure. CONCLUSIONS: Among the factors examined, the number of implants, the location of implants, and smoking history were significant correlates of early implant failure, while Crohn's disease, MI, and osteoporosis were found to not be significant. Larger patient-level studies are needed to examine the individual and combined effects of diseases, medications, and clinical factors on early implant failure.

Caries prevalence and water fluoridation in Israel: a cross-sectionalstudy.

OBJECTIVES: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5000 individuals was fluoridated. In 2014 CWF in Israel stopped. METHODS: Data on 12-year-old children from all areas in Israel from the national crosssectional epidemiological survey conducted in 2011-2012 were stratified by city water fluoridation and by city and school socio-economic status (SES). Two dependent variables were defined: (1) DMFT index -caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov (TF) classification of fluorosis. RESULTS: Data from 2181, 12-year-olds was analyzed. the average DMFT was 1.17+1.72 and 49% were caries free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs. 0.98 in fluoridated cities) and there were more caries free children 56.4% in fluoridated cities vs. 40.6% in non-fluoridated. DMFT was higher in cities with lower SES than high SES (1.29 vs. 1.05 respectively, p<0.001) and there were less caries free children in low SES (44.5% vs. 53% in high SES cities, p<0.0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in TF index), had questionable to mild fluorosis (9.3%). CONCLUSIONS: CWF is a cheap, simple method of dental health protection that reaches all socio-economic levels and cessation of water fluoridation reduced the health of Israel's children. CLINICAL SIGNIFICANCE: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.

Establishment of "Smiles": an innovative inclusive program for the promotion of oral health among preschool children.

OBJECTIVES: To describe the planning stage and the first year of "Smiles," an innovative, inclusive oral health promotion program among preschool children, ages 3 to 5, encompassing the enhancement of daily toothbrushing skills, engagement of teaching staff and parents, and integration of a supportive environment of supervised toothbrushing in kindergartens. METHOD AND MATERIALS: The major components of the first year of the program included workshops with the teaching staff, working sessions with the preschool children, and workshops with the parents. Program participation, program cooperation, program satisfaction, and kindergarten teachers, kindergarten parents, and dental hygienists' attitudes towards this component of the program were recorded and evaluated. Minor components of the first year of the program included assimilation and integration of daily supervised toothbrushing in some of the kindergartens. Program participation, kindergarten teachers, kindergarten teachers' assistants, and kindergarten parents' attitudes towards this component of the program were recorded and evaluated. RESULTS: In total, 180 kindergartens, in nine locations across Israel, including 5,311 preschool children, their parents, and teaching staff, took part in the first year of the program. High levels of participation (80% and above), cooperation (9.55 to 9.78) and satisfaction (9.62 to 9.81) were recorded in the first year of the program. Kindergarten teachers, parents, and dental hygienists expressed high levels of support for continuing the program beyond its first year (9.86 to 10.00). Regarding the daily supervised toothbrushing model in the kindergartens, high levels of satisfaction (9.50 to 9.75) and willingness to continue the program (9.50-10.00) were recorded among kindergarten teachers, assistants, and parents. CONCLUSION: The "Smiles" program serves as an example of successful collaboration between many partners and stakeholders from different organizations, sectors, and government ministries, local authorities, kindergarten management and staff, parents, and the most important partners, the preschool children. Its adherence to the basic principles of health promotion, and its professional adjustment to early childhood with positive atmosphere of happiness, joy, and shared warmth, contributed to the success of the program.

A 6-month study of the effects of 0.3% triclosan/copolymer dentifrice on dental implants.

AIM: Supportive therapy to maintain dental implants is increasingly important. This study examined the effect of a 0.3% triclosan/2% copolymer dentifrice on oral biofilms and gingival inflammation (GI) on dental implants and peri-implant tissues. MATERIALS AND METHODS: One hundred and twenty adults with a dental implant and contra-lateral tooth were enrolled in this 6 month, double-blind, two-treatment, parallel group study. Sixty subjects were randomly assigned to a triclosan/copolymer dentifrice test group and 60 subjects to a fluoride dentifrice control group and instructed to brush twice daily for 6 months. At baseline, 3, and 6 months, a calibrated dentist assessed dental plaque, GI and collected supragingival dental plaque for microbiological analysis. RESULTS: Subjects in the triclosan/copolymer group demonstrated significantly lower levels of dental plaque, gingivitis, and bleeding on probing at 3 and 6 months at both the implant and contra-lateral tooth compared with the fluoride group (p<0.05). There were significantly fewer Gram-negative anaerobes in the triclosan/copolymer group (p<0.05) including >90% reductions in Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Eubacterium saburreum, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella melaninogenica, Solobacterium moorei, and Tannerella forsythia. CONCLUSIONS: Twice daily use of a triclosan/copolymer dentifrice may enhance dental implant maintenance by reducing dental plaque and GI.

Perceptions and Attitudes Toward the Use of a Mobile Health App for Remote Monitoring of Gingivitis and Willingness to Pay for Mobile Health Apps (Part 3): Mixed Methods Study.

BACKGROUND: Gum infection, known as gingivitis, is a global issue. Gingivitis does not cause pain; however, if left untreated, it can worsen, leading to bad breath, bleeding gums, and even tooth loss, as the problem spreads to the underlying structures anchoring the teeth in the jaws. The asymptomatic nature of gingivitis leads people to postpone dental appointments until clinical signs are obvious or pain is evident. The COVID-19 pandemic has necessitated social distancing, which has caused many people to postpone dental visits and neglect gingival health. iGAM is a dental mobile health (mHealth) app that remotely monitors gum health, and an observational study demonstrated the ability of iGAM to reduce gingivitis. We found that a weekly dental selfie using the iGAM app reduced the signs of gingivitis and promoted oral health in a home-based setting. OBJECTIVE: The aim of this mixed methods study is to assess perceptions, attitudes, willingness to pay, and willingness to use an mHealth app. METHODS: The first qualitative phase of the study included eight semistructured interviews, and the second quantitative phase included data collected from responses to 121 questionnaires. RESULTS: There was a consensus among all interviewees that apps dealing with health-related issues (mHealth apps) can improve health. Three themes emerged from the interviews: the iGAM app is capable of improving health, the lack of use of medical apps, and a contradiction between the objective state of health and the self-definition of being healthy. Participants were grouped according to how they responded to the question about whether they believed that mHealth apps could improve their health. Participants who believed that mHealth apps can enhance health (mean 1.96, SD 1.01) had a higher willingness to pay for the service (depending on price) than those who did not believe in app efficacy (mean 1.31, SD 0.87; t119=-2417; P=.02). A significant positive correlation was found between the amount a participant was willing to pay and the benefits offered by the app (rs=0.185; P=.04). CONCLUSIONS: Potential mHealth users will be willing to pay for app use depending on their perception of the app's ability to help them personally, provided they define themselves as currently unhealthy.

Periodontal disease and its prevention, by traditional and new avenues.

One of the most prevalent diseases affecting humans are those which affect the oral cavity. Several diseases can affect the mouth, such as oral cancer, dental caries, Lichen Planus and, of course, periodontal disease with its variants. This review discusses gingivitis, periodontitis and peri-implantitis with a brief focus on the different primary prevention aids, such as mechanical, chemical and the new generation of potential products to be used in the future dental market, products that are prepared from natural sources, the general trend worldwide. In this review, not all new inventions will be mentioned, yet, the role of aged garlic extract (AGE) will be described in addition to a new toothpaste which originates from the Dead Sea and the Purecare dental which produces the Ozone (H3) for the prevention of periodontal disease.

Influence of solvation and the structure of adsorbates on the kinetics and mechanism of dimerization-induced compositional changes of mixed monolayers on TiO(2).

Mixed monolayers of thiol-terminated (T) and methyl-terminated (Me) carboxylic acids on nanocrystalline TiO(2) films underwent dimerization-induced compositional changes. At short reaction times, the compositions of mixed monolayers were kinetically controlled and mirrored the compositions of coadsorption solutions. On time scales up to several hours, well after the establishment of saturation surface coverages, the monolayers relaxed to thermodynamically controlled compositions through the displacement of Me by T. Equilibration was driven by the formation of intermolecular disulfide bonds between thiol groups of adsorbed T, which yielded polydentate dimeric adsorbates that were bound more strongly than monomeric adsorbates to TiO(2). The rate of compositional changes increased with decreasing solvent viscosity and decreasing alkyl chain length of T, suggesting that the rate of adsorption of T to TiO(2) strongly influenced the overall kinetics under certain conditions. Steric bulk within adsorbates and the strength of surface-attachment interactions also influenced the rate of compositional changes. A kinetic model, derived on the basis of Langmuir adsorption and desorption kinetics, accounts for key aspects of the mixed-monolayer compositional changes. The rate-determining step in the overall mechanism involved either the adsorption of T or the formation of disulfide bonds, depending on the conditions under which monolayers were prepared. Our findings illustrate that dimerization and other intermolecular interactions between adsorbates may dramatically influence the composition and terminal functionalization of mixed monolayers.

Comparison of a dentifrice containing 0.243% sodium fluoride, 0.3% triclosan, and 2.0% copolymer in a silica base, and a dentifrice containing 0.243% sodium fluoride in a silica base: a three-year clinical trial of root caries and dental crowns among adults.

OBJECTIVE: Colgate Total toothpaste has been demonstrated to be highly effective in plaque and gingivitis control. The effect of triclosan on root caries and on the survival of dental crowns (fixed dental prosthetic treatment) has not been evaluated. In order to examine these important variables, a randomized controlled clinical trial was conducted comparing Colgate Total toothpaste with triclosan, and an identical fluoride toothpaste without triclosan. METHODS: Adult subjects were randomly assigned to a test group using Colgate Total plus Whitening toothpaste with triclosan, and a control group using Colgate sodium fluoride toothpaste without triclosan. By the end of the study, following three years of product use, an evaluation was performed to compare baseline data to the three-year data for root caries and dental crown survival. Clinical root caries was evaluated by the Katz RCI- Root Caries Index. Within-treatment analysis for each dentifrice was conducted using a paired t-test. Between-treatment analysis was performed using Analysis of Covariance (ANCOVA). For fixed dental prosthetic treatment evaluation, dental crowns were dichotomized for success and failure at the end of the study. Within-treatment analysis for each dentifrice was conducted using a paired t-test. Between-treatment analysis was performed using the Bonferroni test. RESULTS: One-thousand, three-hundred, and fifty-seven subjects (1,357) completed the study. Regarding root caries, at termination of the study the Colgate Total group presented a mean score of 1.14 +/- 1.75 and a +5.6% change from baseline, while the sodium fluoride toothpaste presented a mean of 1.25 +/- 1.88 and a +43.2% change from baseline (p < 0.001). The adjusted mean root caries increment was 0.07 +/- 0.03 for the Colgate Total group, and 0.38 +/- 0.03 for the sodium fluoride toothpaste group (p < 0.001). Regarding crowns, at termination of the study the Colgate Total group presented a mean score of 5.38 +/- 3.70 and a +1.1% change from baseline, while the sodium fluoride toothpaste without triclosan presented a mean of 5.75 +/- 3.86 and a +3.8% change from baseline (p < 0.001). The mean (adjusted for multiple comparisons) dental crowns failure increment was 0.09 +/- 0.03 for the Colgate Total group, and 0.31 +/- 0.02 for the sodium fluoride toothpaste group (p < 0.001). CONCLUSION: A comparison between the two study groups revealed a statistically significant difference for root caries and dental crown failure scores, both favoring the triclosan toothpaste (Colgate Total). The significantly lower root caries and observed dental crown failure scores among the Colgate Total toothpaste users indicate an effect of the triclosan and the copolymer system. These results are important and could provide a strong and valuable public health measure.

Changing dental caries and periodontal disease patterns among a cohort of Ethiopian immigrants to Israel: 1999-2005.

BACKGROUND: Dental epidemiology has indicated that immigrants and minority ethnic groups should be regarded as high risk populations on the verge of oral health deterioration. The objectives of this study were to measure the changing pattern of dental caries, periodontal health status and tooth cleaning behaviour among a cohort of Ethiopian immigrants to Israel between the years 1999-2005. METHODS: Increment of dental caries and periodontal health status was recorded among a cohort of 672 Ethiopian immigrants, utilizing the DMFT and CPI indices. Data were gathered during 1999-2000 and five years later, during 2004-2005. Participants were asked about their oral hygiene habits in Ethiopia and in Israel five years since their immigration. RESULTS: Regarding dental caries, at baseline 70.1% of the examinees were caries-free, as compared to 57.3% after five years. DMFT had increased from 1.48 to 2.31. For periodontal health status, at baseline, 94.7% demonstrated no periodontal pockets (CPI scores 0-2) and 5.3% revealed periodontal pockets (CPI scores 3&4), compared to 75.6% and 24.4%, respectively after five years. At baseline, 74% reported cleaning their teeth exclusively utilizing chewing and cleaning sticks common in Ethiopia. After five years, 97% reported cleaning their teeth exclusively utilizing toothbrushes. CONCLUSION: The deterioration in the oral health status, especially the alarming and significant worsening of periodontal health status, among this immigrant group, emphasizes the need for health promotion and maintenance among immigrants and minority groups in changing societies. An "acclimatizing and integrating" model of oral health promotion among minority and immigrant groups is suggested.

Caries Experience among Adults Exposed to Low to Moderate Doses of Ionizing Radiation in Childhood - The Tinea Capitis Cohort.

While the impact of therapeutic levels of ionizing radiation during childhood on dental defects has been documented, the possible effect of low doses on dental health is unknown. The study aim was to assess the association between childhood exposure to low-moderate doses of therapeutic radiation and caries experience among a cohort of adults 50 years following the exposure. The analysis was based on a sample of 253 irradiated (in the treatment of tinea capitis) and 162 non-irradiated subjects. The decayed, missing, and filled teeth (DMFT) index was assessed during a clinical dental examination and questions regarding dental care services utilization, oral hygiene behavior, current self-perceived mouth dryness, socio-demographic parameters, and health behavior variables were obtained through a face-to-face interview. An ordered multivariate logistic regression model was used to assess the association of the main independent variable (irradiation status) and other relevant independent variables on the increase in DMFT. Mean caries experience levels (DMFT) were 18.6 ± 7.5 for irradiated subjects compared to 16.4 ± 7.2 for the non-irradiated (p = 0.002). Controlling for gender, age, education, income, smoking, dental visit in the last year, and brushing teeth behavior, irradiation was associated with a 72% increased risk for higher DMFT level (95% CI: 1.19-2.50). A quantification of the risk by dose absorbed in the salivary gland and in the thyroid gland showed adjusted ORs of 2.21 per 1 Gy (95% CI: 1.40-3.50) and 1.05 per 1 cGy (95% CI: 1.01-1.09), respectively. Childhood exposure to ionizing radiation (0.2-0.4 Gy) might be associated with late outcomes of dental health. In line with the guidelines of the American Dental Association, these results call for caution when using dental radiographs.

Long-Term Effects of Exposure to Ionizing Irradiation on Periodontal Health Status - The Tinea capitis Cohort Study.

Studies among long-term survivors of childhood cancer who had received high-dose irradiation therapy of 4-60 Gy, demonstrated acute and chronic dental effects, including periodontal diseases. However, the possible effects of low to moderate doses of radiation on dental health are sparse. The aim of this study is to investigate the association between childhood exposure to low-moderate doses of ionizing radiation and periodontal health following 50 years since exposure. The study population included 253 irradiated subjects (treated for Tinea capitis in the 1950s) and, 162 non-irradiated subjects. The estimated dose to the teeth was 0.2-0.4 Gy. Dental examination was performed according to the community periodontal index (CPI). Socioeconomic and health behavior variables were obtained through a personal questionnaire. Periodontal disease was operationally defined as "deep periodontal pockets." A multivariate logistic regression model was used for the association of irradiation status and other independent variables with periodontal status. The results showed that among the irradiated subjects, 23%, (95% CI 18-28%) demonstrated complete edentulousness or insufficient teeth for CPI scoring as compared to 13% (95% CI 8-19%) among the non-irradiated subjects (p = 0.01). Periodontal disease was detected among 54% of the irradiated subjects as compared to 40% of the non-irradiated (p = 0.008). Controlling for education and smoking, the ORs for the association between radiation and periodontal disease were 1.61 (95% CI 1.01-2.57) and 1.95 (95% CI 1.1-3.5) for ever never and per 1 Gy absorbed in the salivary gland, respectively. In line with other studies, a protective effect for periodontal diseases among those with high education and an increased risk for ever smokers were observed. In conclusion, childhood exposure to low-moderate doses of ionizing radiation might be associated with later outcomes of dental health. The results add valuable data on the long-term health effects of exposure to ionizing radiation and support the implementation of the ALARA principle in childhood exposure to diagnostic procedure involving radiation.

Past and present geographic location as oral health markers among older adults.

OBJECTIVES: This study evaluated the association between oral health status of community-dwelling elderly adults visiting day health centers in Israel and geographic living location. METHODS: Oral status was assessed through clinical examination, with additional data obtained using a questionnaire addressing demographic characteristics, dental utilization, and perceived oral health needs. RESULTS: A representative sample of 338 subjects was examined. Fifty-four percent of the sample was edentulous. Higher rates of edentulism were found among subjects living in urban areas compared to subjects living in rural areas (P<.01). More edentate subjects were found among European immigrants than among immigrants from North Africa or subjects born in Israel (P<.01). Among dentate subjects, the mean number of remaining teeth was 10.4. The mean periodontal loss of attachment was 5.8 mm. Less than 10 percent had mean attachment loss <4 mm. Among subjects living in rural areas, mean attachment loss was higher than among those living in urban areas (P=.05). The mean DF score was 1.9. Forty-seven percent had at least one tooth with untreated caries. Subjects living in urban areas tended to utilize dental services more than subjects living in rural areas (P<.01). CONCLUSION: Results indicate that present (urban or rural) and past (country of origin) geographic location represented a significant oral health risk marker. The implementation of a comprehensive program for this target population was clearly indicated.

Periodontal health among recent immigrants from Quara, rural Ethiopia and indications for periodontal health care.

OBJECTIVES: To investigate periodontal status and oral hygiene practices among recent new immigrants from Quara, Ethiopia, with the aim to maintain and promote their periodontal health. METHODS: Periodontal status was recorded for a total of 487 participants using the Community Periodontal Index (CPI). Age was grouped into 13-17, 18-24, 25-34, 35-44, and 45-65 years, and its association with 'worst CPI' was tested. Information on oral hygiene behaviour was collected by interview. RESULTS: The percentage of subjects with calculus is most common in all age groups. Low levels of periodontal pockets in the presence of calculus and very low levels of deep pockets were detected. Differences in CPI scores among the various age groups were statistically significant (p<0.0001). Oral hygiene practice is rare among children in Ethiopia, but a considerable proportion (53%) immediately adopted the local common custom and started brushing their teeth in Israel. Among the adults, oral hygiene practice with chewing sticks was common. CONCLUSIONS: Periodontal health promotion of this population should be targeted towards the entire population by enhancement of self-care oral hygiene measures. Periodontal treatment of this population, especially scaling and root planing remains controversial. The presence of inferior oral hygiene and high levels of calculus, together with low levels of periodontal pathology, raises important thoughts regarding the natural history of periodontal disease development.