The impact of brushing teeth on carbon-14 urea breath test results.
OBJECTIVE: The 14C urea breath test noninvasively detects the presence of the urease-producing bacteria Helicobacter pylori in the stomach. Several sources of errors have been identified to cause false or indeterminate results on the test. The objective of this study was to identify whether brushing teeth affects the test results. METHODS: We performed the 14C urea breath test on 168 patients, with breath samples counted at 10 and 20 min after oral administration of 2 microCi (74 kBq) 14C urea. Ninety-four patients brushed their teeth before the test while 74 did not. RESULTS: Thirty-six of the 74 patients (49%) who did not brush their teeth had positive results at 10 min, which became negative at 20 min. None of the 94 patients who brushed their teeth before testing showed this pattern with agreement of results at 10 and 20 min. CONCLUSION: We recommend brushing teeth before the 14C urea breath test since it significantly decreased the ambiguous results of the test in our laboratory. (+info)
Don't forget your toothbrush!
Patients with rectally inserted foreign bodies can present to accident and emergency departments or general medical practitioners. Rarely dentally related objects are inserted because of their ready availability in the domestic environment. There are many reasons given for their presence in the rectum, most commonly accidental insertion, assault, and psychosexual motives. This case is the first reported incident of a patient using a toothbrush to relieve his pruritus ani and subsequently losing it up into the rectum. (+info)
Clinical evaluation of an electron-ionizing toothbrush with a tooth paste containing stannous fluoride in treatment of dentine hypersensitivity following periodontal surgery.
The purpose of this study was to examine the effect of an electro-ionizing toothbrush with stannous fluoride in the treatment of dentin hypersensitivity following periodontal surgery. Thirty-two volunteers with dentin hypersensitivity were divided in two equal groups each using different methods: (Group I) stannous fluoride dentifrice and hyG Brnde ionizing brush without a battery and (Group II) stannous fluoride dentifrice and hyG Brnde ionizing brush with a battery. The volunteers brushed their teeth for 3 minutes twice a day for 12 weeks following one either of the test protocols. Mechanical (No 23 dental explorer), chemical (lemon juice) and thermal (dental air-water syringe) tests were used for the evaluation of the degree of dentin hypersensitivity. A subjective assessment of the degree of hypersensitivity for each stimulus was recorded. The evaluations were repeated at 4, 8 and 12 weeks after surgical treatment. The second group showed significantly less sensitivity than the first group. The findings appear to suggest that the ionizing brush may be an effective adjunct for the treatment of dentin hypersensitivity in post-periodontal surgery. (+info)
Socioeconomic status and selected behavioral determinants as risk factors for dental caries.
The purpose of this review is to summarize a systematic review evaluating the evidence regarding the association between the incidence and prevalence of dental caries and: 1) socioeconomic status; 2) tooth-brushing; and 3) the use of the baby bottle. Literature was drawn from two databases, Medline and EmBase. Because of limited resources, we did not conduct hand-searching or search unpublished studies. Three thousand one hundred thirty-eight abstracts were identified, 358 reviewed, and 272 papers included in the systematic review. There is fairly strong evidence for an inverse relationship between SES and the prevalence of caries among children less than twelve years of age. The evidence for this relationship is weaker for older children and for adults because of the relatively small number of studies and methodological limitations. There is weak evidence that tooth-brushing prevents dental caries, but it is uncertain whether the effects of tooth-brushing are due to use of a fluoride dentifrice or from mechanical removal of plaque. Finally, the evidence for the relationship between prolonged use of the baby bottle and dental caries is weak. More studies directly aimed at analyzing the relationship between SES and dental caries are needed to identify factors associated with SES that contribute to dental caries risk. Tooth-brushing should continue to be recommended as a measure to prevent dental caries, particularly using a fluoride dentifrice. Recommendations regarding bottle use should continue until clear evidence about the relationship between prolonged bottle use and dental caries can be obtained. (+info)
Topical fluorides in caries prevention and management: a North American perspective.
A review of evidence-based literature indicates incomplete evidence for the efficacy of most measures currently used for caries prevention, with the exception of fluoride varnishes and the use of fluoride-based interventions for patients with hyposalivation. Not all fluoride agents and treatments are equal. Different fluoride compounds, different vehicles, and vastly different concentrations have been used with different frequencies and durations of application. These variables can influence the clinical outcome with respect to caries prevention and management. The efficacy of topical fluoride in caries prevention depends on a) the concentration of fluoride used, b) the frequency and duration of application, and to a certain extent, c) the specific fluoride compound used. The more concentrated the fluoride and the greater the frequency of application, the greater the caries reduction. Factors besides efficacy, such as practicality, cost, and compliance, influence the clinician's choice of preventive therapy. For noncavitated smooth surface carious lesions in a moderate caries-risk patient, the appropriate fluoride regimen would be semiannual professional topical application of a fluoride varnish containing 5 percent NaF (22,600 ppm of fluoride). In addition, the patient should use twice or thrice daily for at least one minute a fluoridated dentifrice containing NaF, MFP, or SnF2 (1,000-1,500 ppm of fluoride), and once daily for one minute a fluoride mouthrinse containing .05 percent NaF (230 ppm of fluoride). If the noncavitated carious lesion involves a pit or fissure, the application of an occlusal sealant would be the most appropriate preventive therapy. The management of the high caries-risk patient requires the use of several preventive interventions and behavioral modification, besides the use of topical fluorides. For children over six years of age and adults, both office and self-applied topical fluoride treatments are recommended. For office fluoride therapy at the initial visit, a high-concentration agent, either a 1.23 percent F APF gel (12,300 ppm of fluoride) for four minutes in a tray or a 5 percent NaF varnish (22,600 ppm of fluoride), should be applied directly to the teeth four times per year. Self-applied fluoride therapy should consist of the daily five-minute application of 1.1 percent NaF or APF gel (5,000 ppm of fluoride) in a custom-fitted tray. For those who cannot tolerate a tray delivery owing to gagging or nausea, a daily 0.05 percent NaF rinse (230 ppm of fluoride) for 1 minute is a less effective alternative. In addition, the patient should use twice or thrice daily for at least 1 minute a fluoridated dentifrice as described above for treatment of noncavitated carious lesions. In order to avoid unintentional ingestion and the risk of fluorosis in children under six years of age, fluoride rinses and gels should not be used at home. Furthermore, when using a fluoride dentifrice, such children should apply only a pea-size portion on the brush, should be instructed not to eat or swallow the paste, and should expectorate thoroughly after brushing. Toothbrushing should be done under parental supervision. To avoid etching of porcelain crowns and facings, neutral NaF is indicated in preference to APF gels for those patients who have such restorations and are applying the gel daily. The rationale for these recommendations is discussed. Important deficiencies in our knowledge that require further research on topical fluoride therapy in populations with specific needs are identified. (+info)
The impact of behavioral technology on dental caries.
Models of self-regulation of patient adherence to specific health promotion recommendations by professionals are available and have been shown effective in changing behavior. However, it is a fundamental misspecification of the caries prevention problem to look to techniques that affect the regulation of individual behavior to directly impact dental caries. Behavioral techniques are used to enhance the probability an individual will initiate, increase, or maintain the use of established caries reduction/control strategies or cease or decrease behaviors that increase caries. Behavioral techniques can also be used to affect parental behavior in a cascade of effects that can eventually lead to healthier children. Studies are needed where behaviorally oriented caries prevention actions are thought of as manipulating self-regulatory behavior and the focus of action is either on the individual or on another, such as a parent. A third category of studies should center on provider competency. Studies are recommended in each of these areas. (+info)
Training mentally retarded adolescents to brush their teeth.
The need for self-care by retarded individuals in behaviors such as brushing teeth led to the development and evaluation of a comprehensive toothbrushing program that included a task analysis and training procedure specific to each component of the task analysis. Eight mentally retarded adolescents, in two groups, individually received acquisition training that included scheduled opportunities for independent performances, verbal instruction, modelling, demonstration, and physical assistance. The first group of four subjects received token plus social reinforcement; the second received only social reinforcement. All eight subjects showed improved toothbrushing behaviors when compared to baseline. Six of the eight subjects correctly performed all toothbrushing steps in two of three consecutive sessions. The study emphasizes the need for systematic program development and evaluation. (+info)
Microstructural analysis of demineralized primary enamel after in vitro toothbrushing.
The aim of this study was to investigate, in vitro, the morphological characteristics of demineralized primary enamel subjected to brushing with a dentifrice with or without fluoride. In order to do so, 32 enamel blocks were divided in 4 different groups containing 8 blocks each. They were separately immersed in artificial saliva for 15 days. The experimental groups were: C - control; E - submitted to etching with 37% phosphoric acid gel (30 s); EB - submitted to etching and brushing 3 times a day with a non-fluoridated dentifrice; EBF = submitted to etching and brushing 3 times a day with a fluoridated dentifrice. The toothbrushing force was standardized at 0.2 kgf and 15 double strokes were performed on each block. After the experimental period, the samples were prepared and examined under SEM. The control group (C) showed a smooth surface, presenting scratches caused by habitual toothbrushing. The etched samples (E) exhibited different degrees of surface disintegration, but the pattern of acid etching was predominantly the type II dissolution. The brushed surfaces were smooth, with elevations which corresponded to the exposure of Tomes' process pits and depressions which corresponded to interrod enamel. Particles resembling calcium carbonate were found in the most protected parts of the grooves. No morphological differences were observed between brushing with fluoridated (EBF) and non-fluoridated (EB) dentifrice. The results suggest that the mechanical abrasion caused by brushing demineralized enamel with dentifrice smoothes the rough etched surface, and the presence of fluoride does not cause morphological modifications in this pattern. (+info)