A comparison between written, verbal, and videotape oral hygiene instruction for patients with fixed appliances.
The objective of the study was to compare the effectiveness of written, videotape, and one-to-one instruction upon the knowledge, oral hygiene standard, and gingival health of subjects undergoing orthodontic treatment with a lower fixed appliance. Subjects for whom fixed appliances had been fitted recently were divided randomly into three groups of 21, 22, and 22, respectively. Group 1 received written oral hygiene instruction, group 2 a specially made videotape, and group 3 saw a hygienist for one-to-one instruction. Results were assessed in terms of improvement in knowledge concerning oral hygiene procedures, and of plaque and gingival index scores. Analysis of variance revealed no significant main effects or interactions at P = 0.05, although the difference in the plaque index scores before and after instruction was close to significance. (+info)
Periodontal health of London women during early pregnancy.
OBJECTIVES: A descriptive cross-sectional study to determine the severity of periodontal disease in early pregnancy and its relation to demographic variables in a South East London population. METHODS: 2,027 pregnant women attending Guy's Hospital for an ultrasound scan at 10 to 14 weeks gestation were assessed. Data were collected via questionnaire and periodontal examination, including plaque and bleeding scores, pocket probing depth and loss of attachment. RESULTS: Mean age was 29.8 years (sd 5.5). Of these, 61.8% were white, 28.5% black, and 9.7% of other ethnic group. A total of 15% reported smoking during pregnancy. The mean number of teeth present was 28 (sd 2) per subject, mean percentage of sites with plaque present was 60.5% (sd 22.6), mean pocket depth was 2.0 mm (sd 0.4), mean loss of attachment was 0.4 mm (sd 0.3), and the mean percentage of sites bleeding on probing was 20.2% (sd 16.3). Linear regression demonstrated that probing depth was related to age, ethnicity, socioeconomic status and plaque score but not to smoking whereas loss of attachment demonstrated relationships with age, smoking status and plaque score but not ethnicity or socioeconomic status. CONCLUSION: There was a relatively high proportion of subjects with deep periodontal pockets in this pregnant population compared to the Adult Dental Health Survey 1998 but with similar levels of loss of attachment and percentage of sites with plaque present. Several demographic factors were associated with the level of periodontal disease in this population. (+info)
A clinical trial of light cure acrylic resin for orthodontic use.
OBJECTIVE: To ascertain whether or not the less porous surface associated with visible light cure appliances and the absence of free monomer had any measurable affect upon mucosal erythema, and to assess the durability of such appliances in a clinical context. DESIGN: A prospective randomized trial of visible light cure (Triad VLC) and autopolymerizing (Orthoresin) acrylic resin used as orthodontic base plate materials. SETTING: University Dental Hospital and School. SUBJECTS: Fifty subjects from a consecutively enrolled sample of 69 (19 drop outs) for removable appliance therapy (23 VLC, 27 AP). OUTCOME MEASURES: Erythema meter scores and appliance breakages. RESULTS: No statistical difference in mucosal erythema between the two materials was found. Fifty-two per cent of VLC appliances broke during a 6-month period, as opposed to 7 per cent of AP appliances. CONCLUSIONS: VLC appears to have no clinically beneficial effect on the oral mucosa compared with AP. VLC appliances are currently not sufficiently durable to make them a viable alternative to AP appliances. (+info)
The relationship between odontogenic bacteraemia and orthodontic treatment procedures.
The purpose of this research was to estimate the prevalence and intensity of bacteraemia associated with orthodontic treatment procedures. The four procedures investigated were: an upper alginate impression, separator placement, band placement, and adjustment of an archwire on a fixed appliance. Eighty-one children undergoing general anaesthesia (GA) for dento-alveolar surgery related to their orthodontic treatment were randomly allocated to the impression or separator group. A further 61 children, receiving treatment in the Outpatient Department, were included and randomly allocated to the banding or archwire adjustment groups. A cannula was inserted into either the left or right antecubital fossa using an aseptic technique. A baseline 6 ml sample of blood was taken before treatment and a second 6 ml sample was taken 30 seconds after the procedure. There was no significant difference in the number of positive blood cultures between baseline (nine, 23 per cent), and following an upper alginate impression (twelve, 31 per cent); between baseline (twelve, 27 per cent), and placement of a separator (fifteen, 36 per cent); between baseline (nine, 36 per cent), and fitting or placement of a band (eleven, 44 per cent); or between baseline (twelve, 33 per cent), and archwire adjustment (seven, 19.4 per cent). For the separator group only the mean total number of aerobic and anaerobic bacteria combined, isolated from the blood samples (cfu of bacteria per ml of blood), was significantly greater following the placement of a separator (2.2, SD 9.1), compared with baseline (0.9, SD 0.2; P < 0.02). This investigation demonstrates that the only orthodontic treatment procedure that causes a significant bacteraemia is the placement of a separator. (+info)
Intentional use of the Hawthorne effect to improve oral hygiene compliance in orthodontic patients.
The purpose of this study was to evaluate whether the home care of noncompliant adolescent orthodontic patients with "poor" oral hygiene could be improved through the use of a deception strategy designed to intentionally induce the Hawthorne effect. This effect is often cited as being responsible for oral health improvements of control groups that receive placebo treatments. It is thought that participating in and fulfilling the requirements of a study alters subjects' behavior, thereby contributing to the improvement. Forty patients with histories of poor oral hygiene were assigned, in a quasi-random fashion, to two groups. Experimental subjects (n = 20) were presented with a situation that simulated participation in an experiment. These included the use of a consent form; distribution of tubes of toothpaste labeled "experimental"; instructions to brush twice a day for two minutes using a timer; and a request to return unused toothpaste. Control subjects (n = 20) had no knowledge of study participation. Tooth surface area covered with plaque was used as a proxy measure of home care behavior. It was measured at baseline, three months, and six months. Mean percentages of tooth surface covered with plaque for the experimental and control groups were 71 (+/- 11.52) and 74 (+/- 11.46) at baseline; 54 (+/- 13.79) and 78 (+/- 12.18) at three months; and 52 (+/- 13.04) and 79 (+/- 10.76) at six months. No statistically significant difference (p > .05) was obtained between groups at baseline. Statistically significant differences (p < .05) were found between groups at three and six months. Significant differences (p < .05) were also found only for the experimental subjects between baseline and each of the two subsequent observation periods. The efficiency and potential effectiveness of this strategy suggest that additional research be conducted to assess oral health improvements and possible applications to the private practice setting. (+info)
Salivary characteristics of diabetic children.
Salivary components may suffer variations that can be detected by chemical determinations. The aim of this work was to determine physical and biochemical characteristics of the saliva of a group of diabetic children compared to those of a control group. Relation to oral health indices was also determined. Twenty diabetic children (3-15-years-old) and 21 control children (5-12-years-old) were included in this study. Total proteins, sugars and calcium were determined by colorimetric methods, and glucose, urea, alpha-amylase and acid phosphatase by enzymatic methods. Our results demonstrated that acidic pH, diminished salivary flow rate and excess foam are usually present in saliva of diabetic children. Total sugars, glucose, urea and total proteins were greater in diabetic patients than controls, while calcium values were decreased. These differences were confirmed by the discrimination test. Diabetic children have higher DMFT-dmft-deft and DMFS-dmfs-defs values compared to those of the control children despite their lower sugar intake. Some salivary components in addition to the diminished flow rate could be involved in the characterization of the oral health state of diabetic children. (+info)
The effect of cyclosporine with and without nifedipine on gingival overgrowth in renal transplant patients.
PURPOSE: This investigation was performed to evaluate the effect of cyclosporine alone and in combination with nifedipine on gingival overgrowth. METHODS: One hundred and nineteen patients who had undergone renal transplantation at least 12 months previously were selected for the study. The patients were divided into 2 groups according to whether they had received cyclosporine alone (group 1, n = 98) or cyclosporine with nifedipine (group 2, n = 21). Periodontal and pharmacological characteristics were assessed for all patients. RESULTS: Marked gingival overgrowth was seen in 11 (52%) of the patients in group 2 but just 6 (6%) of those in group 1. In addition, the gingival overgrowth index was significantly greater for patients who had received both nifedipine and cyclosporine (Mann-Whitney U-test, p < 0.001). However, there were no significant differences between groups with higher and lower gingival overgrowth index in terms of age, sex, cyclosporine dose, nifedipine dose or level of cyclosporine in the serum. CONCLUSION: The combination of cyclosporine and nifedipine may increase the incidence as well as the severity of gingival overgrowth in renal transplant patients. Among patients who had received both drugs, there was a clear relationship between gingival overgrowth and duration of cyclosporine and nifedipine use. (+info)
Effect of chitosan rinsing on reduction of dental plaque formation.
The purpose of the present study was to investigate whether the use of a chitosan mouthrinse could be efficacious in reducing plaque and saliva mutans streptococci level. A randomized crossover clinical trial was performed to evaluate the effect of a rinse with 0.5% chitosan for 14 days on plaque formation and mutans streptococci counts in saliva. Twenty-four subjects were randomly assigned either the chitosan rinse or a placebo rinse in addition to their usual oral hygiene procedures. Following the baseline examination, each subject was given a prophylaxis. They were instructed to rinse with 20 ml of the mouthrinse twice daily for 30 seconds. Plaque scores were measured after a 14-day rinsing period, and mutans streptococci counts in saliva were also determined at the start and the end of the each rinsing period. The procedures were repeated with the alternate rinse after a 14-day washout period. Rinsing with 0.5% chitosan was significantly more effective in plaque reduction using the Quigley & Hein Index (chitosan: 1.44, placebo: 1.62, p < 0.001) and Plaque Severity Index (chitosan: 0.138, placebo: 0.186, p = 0.003). The mutans streptococci count in saliva was less after the chitosan rinsing (chi 2 cal = 13.51, p = 0.035) than placebo rinsing. In conclusion, the chitosan rinsing was effective in reducing plaque formation and counts of salivary mutans streptococci after a 14-day rinsing period. These results would appear to warrant further investigation into the potential value of chitosan as an effective anti-plaque agent for use in oral hygiene products. (+info)