Bánóczy J

Collaborative WHO xylitol field studies in Hungary I. Three-year caries activity in institutionalized children

The aim of this 3-year field study was to assess the value of partial substitution of sucrose with peroral xylitol (14-20 g/day) as a caries-preventive measure (X group) in comparison with systemic administration of fluoride (F group) and restorative treatment procedures solely (C group). An F dentifrice was used unsupervised in the X and F groups, the former containing 10% xylitol. The C group used customary, predominantly F-free dentifrices distributed by the local health authorities. The final material consisted of 689 institutionalized children (6-11 years). Caries was scored yearly in duplicate by two continuously calibrated teams. At base line the X group had a significantly higher caries prevalence than the F and C groups. The 3-year DMFS increment was 4.2 in the X group, 6.5 in the F group, and 7.7 in the C group. The corresponding ratio (RS) between caries incidence and the tooth surface population at risk was RSx, 4.9; RSF, 6.6; and RSC, 8.6. It is concluded that dietary xylitol in solid sweets resulted in a lower increment of caries than obtained in the F and C groups (p less than 0.001, covariance analysis, with base-line prevalence, number of permanent teeth, and visible plaque index as covariants).

ASSOCIATIONS BETWEEN MICROBIOLOGICAL AND SALIVARY CARIES ACTIVITY TESTS AND CARIES EXPERIENCE IN HUNGARIAN ADOLESCENTS

The aim of the study was to assess caries prevalence in connection with salivary caries–related findings in 349 14– to 16–year–old Hungarian adolescents living in two different cities. DMFT, DMFS means, stimulated salivary flow, buffer capacity, mutans streptococci, lactobacilli and candida counts in saliva were determined. The ratio of caries–free adolescents was 4.6% in the total population sample, DMFT mean values were 7.24±4.86, DMFS means 10.50±8.35. Mean secretion rate of stimulated saliva was 0.84±0.50; a low buffer capacity was found in 6.3% of the examined children. The ratio of carriers of mutans streptococci, lactobacilli and yeasts in saliva was 89.7, 73.9 and 47.7%, respectively. DMFT and DMFS values as well as mutans streptococci and candida counts were lower in the capital than in the other city. Statistically significant correlations were found between DMFT, DMFS mean values, and salivary microbiological counts.

Effect of fluoride toothpastes on enamel demineralization

BackgroundIt was the aim of this study to investigate the effect of four different toothpastes with differing fluoride compounds on enamel remineralization.MethodsA 3 × 3 mm window on the enamel surface of 90 human premolars was demineralized in a hydroxyethylcellulose solution at pH 4.8. The teeth were divided into 6 groups and the lower half of the window was covered with varnish serving as control. The teeth were immersed in a toothpaste slurry containing: placebo tooth paste (group 1); remineralization solution (group 2); Elmex Anticaries (group 3); Elmex Sensitive (group 4); Blend-a-med Complete (group 5) and Colgate GRF (group 6). Ten teeth of each group were used for the determination of the F- content in the superficial enamel layer and acid solubility of enamel expressed in soluble phosphorus. Of 6 teeth of each group serial sections were cut and investigated with polarization light microscopy (PLM) and quantitative energy dispersive X-ray analysis (EDX).ResultsThe PLM results showed an increased remineralization of the lesion body in the Elmex Anticaries, Elmex Sensitive and Colgate GRF group but not in the Blend-a-med group. A statistically significant higher Ca content was found in the Elmex Anticaries group. The fluoride content in the superficial enamel layer was significantly increased in both Elmex groups and the Blend-a-med group. Phosphorus solubility was significantly decreased in both Elmex groups and the Blend-a-med group.ConclusionIt can be concluded that amine fluoride compounds in toothpastes result in a clearly marked remineralization of caries like enamel lesions followed by sodium fluoride and sodium monofluorophosphate formulations.

Effect of Amine Fluoride/Stannous Fluoride-Containing Toothpaste and Mouthrinsings on Dental Plaque, Gingivitis, Plaque and Enamel F–– Accumulation

The aim of the study was to assess the effect of an amine fluoride/stannous fluoride toothpaste and mouthwash on dental plaque and gingivitis, plaque F- accumulation, F- content and acid solubility of dental enamel. Participants in the 12-week double-blind study were 92 schoolchildren, with a mean age of 12.4 years, randomly distributed to four groups: (1) AmF/SnF2 toothpaste, (2) placebo toothpaste, (3) AmF/SnF2 toothpaste plus AmF/SnF2 mouthwash, (4) placebo toothpaste plus AmF/SnF2 mouthwash. Analyzing the results, the mean values of dental plaque (Silness-Löe index) and of the sulcus bleeding index decreased statistically significantly in all groups except the placebo toothpaste users. Plaque F- and enamel F- content increased considerably only in the two groups using the AmF/SnF2 toothpaste. A decrease in acid solubility was significant only in the group of both test toothpaste and test mouthwash users. Thus the clinical efficacy of the tested AmF/SnF2 toothpaste might be increased by the combined use of mouthrinsings containing the same substances.

Milk fluoridation for the prevention of dental caries

UNLABELLED The aim of this review is to give an overview of 55 years experience of milk fluoridation and draw conclusions about the applicability of the method. Fluoridated milk was first investigated in the early 1950s, almost simultaneously in Switzerland, the USA and Japan. Stimulated by the favourable results obtained from these early studies, the establishment of The Borrow Dental Milk Foundation (subsequently The Borrow Foundation) in England gave an excellent opportunity for further research, both clinical and non-clinical, and a productive collaboration with the World Health Organization which began in the early 1980s. Numerous peer-reviewed publications in international journals showed clearly the bioavailability of fluoride in various types of milk. Clinical trials were initiated in the 1980s - some of these can be classed as randomised controlled trials, while most of the clinical studies were community preventive programmes. CONCLUSION These evaluations showed clearly that the optimal daily intake of fluoride in milk is effective in preventing dental caries. The amount of fluoride added to milk depends on background fluoride exposure and age of the children: commonly in the range 0.5 to 1.0 mg per day. An advantage of the method is that a precise amount of fluoride can be delivered under controlled conditions. The cost of milk fluoridation programmes is low, about € 2 to 3 per child per year. Fluoridation of milk can be recommended as a caries preventive measure where the fluoride concentration in drinking water is suboptimal, caries experience in children is significant, and there is an existing school milk programme.

Effect of fluoridated milk on caries: 5 year results

THE AIM OF the study was to assess the caries- preventive effect of fluoridated milk after 4- and 5 years of consumption in 165 institutionalized chil ren aged 6- to 12 years. The children consumed 200 ml of milk daily, fluoridated with 0.4 mg-, or 0.75 mg F- according to age. The data were compared with those of 122 home children without preventive measures. Analysis of the data showed a considerable increase in the ratio of caries-free children, aged 7-10 years, after 5 years of fluoridated milk consumption. The caries pre valence in the test group showed statistically significant reduction both in the primary and permanent dentition, in the latter between 60- to 67% . The caries reduction of the first permanent molars in the age-group of 7 years old was 85%. In children aged 9-12 years, after 4 years of fluoridated milk consumption, only small reductions could be observed. Milk-fluoridated thus seems to be effective in home children; early starting-age increases the protective effect considerably.

Effect of Amine Fluoride Toothpaste and Gel in High Risk Groups of Hungarian Adolescents: Results of a Longitudinal Study

The aim of the study was to establish a preventive program with the combined use of amine fluoride toothpaste and gel in groups of adolescents living in different locations in Hungary. Caries and oral hygiene examinations were performed at the beginning of the study and repeated after 1 and 2 years. The adolescents were divided into 3 groups: 1 control and 2 test groups. The control group continued its usual oral care habits. One of the test groups received Elmex toothpaste for unsupervised home use daily and Elmex gel for use once a week, and the other test group received Elmex toothpaste and only placebo gel. The combined use of amine fluoride-containing toothpaste and gel provided a significant reduction in DMFS mean values (38% including white spot lesions, 34% not including white spot lesions, p < 0.05) and in visible plaque index values (18%, p < 0.05) compared to the control group.

SALIVARY SECRETION RATE, pH, LACTOBACILLI AND YEAST COUNTS IN DIABETIC WOMEN

SummarySaliva samples of 29 type I (insulin-dependent) diabetic women and 30 healthy women were analyzed and compared. Saliva secretion rate and mean pH were statistically significantly lower in diabetics.Lactobacillus counts were almost the same in the two groups, while theCandida albicans count was higher in diabetic women. In the diabetic group PI and OHI-S indices showed higher values as compared to the healthy control group, the difference being statistically significant (p<0.01). Studying the relation between the various salivary parameters, it was found that higher salivary secretion rate was associated with higher pH values and with a higher proportion ofCandida-negative cases, while lower salivary secretion rate coincided with higher OHI-S and PI index values.

Collaborative WHO xylitol field studies in Hungary VII. Two-year caries incidence in 976 institutionalized children

The aim was to assess caries increment as influenced by partial substitution of sucrose by xylitol (X group) over a 2-year period in comparison with systemic fluoride (F group) and restorative treatment only (C group). The study differed from the 3-year field study of the same series primarily in that existing base-line differences were eliminated because the protocol required that all the new subjects entering the institutions in the 1st year were to be included for a 2-year trial. During this period the number of dropouts was 243 (19.9% of all subjects), the final material consisting of 976 children (6-12 years old). The 2-year DMFS increment was 3.8 in the X group, 4.8 in the F group, and 6.0 in the C group. The corresponding ratio (RS) between caries incidence and the tooth surface population at risk was RSX, 4.5; RSF, 5.5; and RSC, 7.5. The xylitol regimen resulted in a lower increment of caries than measured in the F and C groups (p less than 0.001; convariance analysis, with base-line prevalence, number of permanent teeth, and visible plaque index as covariants.

Effect of pH of amine fluoride containing toothpastes on enamel remineralization in vitro.

BackgroundOne of the important factors of the demineralization and remineralization equilibrium of enamel is the pH of the surrounding solutions. Effort has been laid in the formulation of different fluoride compounds and the fluoride content in toothpastes but much less is known about the influence of the pH of the toothpastes on their effectiveness. It was therefore the aim of this study to investigate the influence of different pH levels on enamel remineralization in an in vitro experiment using polarization light microscopy and EDX quantitative element analysis.MethodsA 5 × 5 mm window on the enamel surface of 40 caries free extracted human premolars was demineralized in a hydroxyethylcellulose solution at pH 4.8. The teeth were divided into 8 groups and the lower half of the window was covered with varnish serving as control. Each group was then immersed in toothpaste slurry containing amine fluoride (1400 ppm) at pH 4.1, 4.5, 5.1 and 6.9 or control toothpaste slurry without fluoride at pH 4.3, 4.7, 5.3 and 7.0. Serial sections were cut through the lesions and investigated with polarization light microscopy and quantitative EDX element analysis.ResultsThe PLM results showed a decreased porous volume of the body of the lesion after incubation with fluoridated toothpaste at pH 4.53 and 5.16. No differences between the experimental window and the control window were found in the other groups. The quantitative element analysis showed no differences in the element content of any of the groups.ConclusionFrom the results it can be concluded that slightly acidified fluoridated dentifrices may have a certain positive effect on enamel remineralization.