PURPOSE: To evaluate the clinical performance of Helioseal-F, a fluoride-containing fissure sealant, in school children at caries risk. MATERIALS AND METHODS: A caries risk assessment based on past caries experience, saliva microbial tests, buffer capacity and frequency of sugar intake was carried out in 204 healthy children, 6-7 years of age. Children exhibiting one or more risk factors were considered at caries risk (n = 121) and their permanent molars were sealed with a fluoride-containing fissure sealant, thus forming a fissure sealant group (FSG). The remaining 83 children with low caries risk received no fissure sealants and constituted a reference group (RG). Both groups were followed for 2 years. From 15 children of both groups, unstimulated whole saliva was collected 1 month after sealant placement in order to determine fluoride levels. In another 20 children, a split-mouth study design was utilized to compare the colonization of mutans streptococci adjacent to and on F-containing sealants and conventional controls. The sealants were placed by dental hygienists according to the manufacturers' instructions. RESULTS: A total of 431 fissure sealants were placed at baseline. Complete retention was found in 76.6% during the study period while 22.0% were partially lost. Six sealants (1.4%) were completely lost. The enamel caries incidence was 45% lower (P
Recently, we have shown positive correlations between high salivary calcium content and periodontitis, and between high salivary calcium level and the number of intact teeth in selected groups of subjects. The aim of our present study was to determine whether these correlations could be seen in a randomized group of healthy adults. A thorough oral examination including orthopantomograms was carried out for a total of 137 healthy subjects, 63 men (35.4+/-5.6 years) and 74 women (33.2+/-4.7 years). Paraffin-stimulated saliva was collected from the subjects and salivary flow (ml/min), buffering capacity, calcium (mMol/l) and microbial variables including lactobacilli, yeasts, mutans streptococci, total streptococci, total number of aerobes, and anaerobes were determined. The calcium level of whole saliva had a median of 1.23 mMol/l. Subjects with calcium level below the median were categorized as 'low', while those with higher values formed the 'high' salivary calcium group. There were more men than women in the 'High' salivary calcium group (p=0.025). Subjects in the 'high' calcium group showed more bleeding on probing (p=0.026), had more intact teeth (p=0.045), and lower DMF-scores (p=0.025) than their counterparts. No other differences were found between the two groups. We found clear associations between the level of salivary calcium and factors reflecting gingival health on one hand, and dental health on the other in a randomly selected group of healthy subjects, and conclude that salivary calcium may be important with regard to both dental and gingival health.
The effect of smoking on salivary microbe levels was studied in 780 subjects by multivariate analysis, taking into account some confounding factors. Lactobacilli, mutans streptococci and yeasts were detected with Dentocult-LB, Dentocult-SM and Oricult-N tests. The explanatory variables considered were gender, presence of natural teeth, presence of removable denture, presence of decayed teeth, toothbrushing frequency, use of sugar in coffee or tea, consumption frequency of sugary products, secretion rate of stimulated and unstimulated saliva, buffering capacity of saliva, pH of saliva, oral hygiene and tobacco smoking habits. Smoking was strongly associated with higher lactobacilli counts and presence of yeasts, independently of oral status, hygiene or salivary factors. The relation between smoking and mutans streptococci was weaker. The overall associations of lactobacilli and yeasts with the study variables followed a very similar pattern.
OBJECTIVE: The aim of this study was to investigate the effect of a fixed daily dose of xylitol on mutans streptococci in saliva and the amount of visible dental plaque. A second aim was to explore if the possible effects differed between children with and without caries experience. METHODS: The study was designed as a double-blind randomized controlled trial with two parallel arms. All pupils (n=149) in grades 1-6 in a comprehensive school in northern Sweden were invited, and 128 children (mean age=12.7 years) consented to participate. The children were stratified as having caries experience (DMFS/dmfs>or=1) or not before the random allocation to a test or control group. The control group (A) was given two pellets containing sorbitol and maltitol three times daily for 4 weeks, and the test group (B) received corresponding pellets with xylitol as single sweetener (total dose=6.18 g day). Clinical scoring and saliva samples were collected at baseline and immediately after the test period. The outcome measures were visible plaque index, salivary mutans streptococci counts and salivary lactic acid production. RESULTS: The amount of visible plaque was significantly reduced in both groups after 4 weeks (P
OBJECTIVES: To examine the effect of operative and restorative treatment of dental caries on the levels of caries associated microorganisms in saliva and to relate alterations to the type and extent of treatment. DESIGN: Longitudinal. SETTING: Paediatric Dentistry Department at a central hospital in Sweden. SUBJECTS AND METHODS: One hundred and eight pre-school children with severe dental caries scheduled for treatment under general anaesthesia. Chair-side tests were used to estimate the levels of salivary mutans streptococci, lactobacilli and buffer capacity before the surgery and at recall appointments 1 and 6 months after treatment. Caries were assessed according to WHO guidelines and the number of extracted teeth and filled surfaces during surgery were recorded. RESULTS: The results demonstrate that the post-treatment levels of mutans streptococci and lactobacilli were significantly reduced (P
To determine whether hyperglycemia in IDDM (insulin-dependent diabetes mellitus) could interfere with salivary secretion rates, salivary glucose levels, and salivary microbial counts, we studied salivary factors in two groups of children and adolescents with IDDM. One study group included 14 children with newly diagnosed IDDM )mean age 11 years, SD +/- 2.4 years). Samples of saliva were collected on admission to hospital and after 2 weeks on insulin treatment. The other study group were 50 IDDM children (mean age 14.4 years, SD +/- 1.7 years, mean duration of diabetes 6.2 years, SD +/- 1.4 years) visiting the outpatient diabetic clinic. Samples of saliva were collected during two visits, approximately 3 months apart. In the newly diagnosed IDDM cases, mean salivary glucose level decreased from 54.1 +/- 31.7 mg/l to 35.2 +/- 29.5 mg/l (P = 0.096) after beginning insulin treatment. During hyperglycemia, salivary glucose levels correlated with mean blood glucose levels for the day concerned (r = 0.65, P
In several human studies, scientists have sought to elucidate the connection between caries activity, high levels of lactobacilli, low buffer capacity and a low salivary flow rate, separately or in combinations. The aims of the study were to investigate if there was a difference in caries activity among adults in optimal versus low fluoride areas. It was further investigated if this difference was related to high lactobacilli levels, low buffer capacity and low salivary flow rate, separately or in combination. Finally, it was analysed if the lactobacilli levels were lower in an area with optimal fluoride water concentration. The study is based on clinical examinations of 30-40 year olds who all their lives had drunk water with a fluoride concentration representative for the community. 260 individuals living in the optimal fluoride area and 236 from the low fluoride area are included in the study. The results show a caries activity significantly lower among those in the optimal fluoride area. It is also shown that these differences can not be explained by differences in lactobacilli levels, buffer capacity and salivary flow, neither separately nor in combination. The fluoride concentration in the drinking water is wholly decisive. No difference in lactobacilli levels between optimal and low fluoride areas were demonstrable in this study.