Denise Bailey

Regression of Post-orthodontic Lesions by a Remineralizing Cream

Orthodontic patients have an increased risk of white-spot lesion formation. A clinical trial was conducted to test whether, in a post-orthodontic population using fluoride toothpastes and receiving supervised fluoride mouthrinses, more lesions would regress in participants using a remineralizing cream containing casein phosphopeptide- amorphous calcium phosphate compared with a placebo. Forty-five participants (aged 12–18 yrs) with 408 white-spot lesions were recruited, with 23 participants randomized to the remineralizing cream and 22 to the placebo. Product was applied twice daily after fluoride toothpaste use for 12 weeks. Clinical assessments were performed according to ICDAS II criteria. Transitions between examinations were coded as progressing, regressing, or stable. Ninety-two percent of lesions were assessed as code 2 or 3. For these lesions, 31% more had regressed with the remineralizing cream than with the placebo (OR = 2.3, P = 0.04) at 12 weeks. Significantly more post-orthodontic white-spot lesions regressed with the remineralizing cream compared with a placebo over 12 weeks.

Molar-incisor hypomineralisation: prevalence and defect characteristics in Iraqi children.

BACKGROUND.  Little prevalence data relating to molar incisor hypomineralisation (MIH) exist for Middle East populations. AIM.  To evaluate the prevalence and the clinical features of MIH in school-aged children residing in Mosul City, Iraq. DESIGN.  A cluster sample of 823 7- to 9-year-old children had their first permanent molars and incisors (index teeth) evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria for MIH. The examinations were conducted at schools by a calibrated examiner. RESULTS.  Of the children examined, 177 (21.5%) had hypomineralisation defects in at least one index tooth, 153 (18.6%) had at least one affected first molar or first molars and incisors and were considered as having MIH. The most commonly affected teeth were maxillary molars. Demarcated creamy white opacities were the most frequent lesion type. Dental restorations and tooth extraction because of MIH were uncommon. Children with three or more affected teeth were 3.7 times more likely to have enamel breakdown when compared with those children having only one or two affected teeth. CONCLUSIONS.  Molar incisor hypomineralisation was common amongst Iraqi children. Demarcated opacities were more prevalent than breakdown. The severity of the lesions increased with the number of affected teeth. The more severe the defect, the greater the involved tooth surface area.

Consumption of milk with added casein phosphopeptide-amorphous calcium phosphate remineralizes enamel subsurface lesions in situ.

BACKGROUND Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is an anticariogenic agent that is suitable to be added to foods. The aim of this double-blind, three-way crossover randomized study was to investigate the capacity of CPP-ACP, when added to bovine milk, to remineralize enamel subsurface lesions in situ. METHODS Ten subjects drank 100 mL of bovine milk containing no added CPP-ACP (control milk), 0.2% (w/v) CPP-ACP or 0.3% (w/v) CPP-ACP, for 30 seconds once daily for 15 days, whilst wearing removable appliances with attached slabs of enamel containing subsurface enamel lesions. After each treatment and a one-week washout period, subjects crossed over to another treatment and this was repeated until they had consumed each of the three milk products. At the completion of each treatment the enamel slabs were removed and remineralization was determined using microradiography. RESULTS The results demonstrated that all three milk samples remineralized enamel subsurface lesions in situ. However, the two milk samples containing added CPP-ACP each produced significantly greater remineralization than the control milk. CONCLUSIONS The remineralizing effect of CPP-ACP in milk was dose-dependent with milk containing 0.2% CPP-ACP and 0.3% CPP-ACP producing an increase in mineral content of 81% and 164%, respectively, relative to the control milk.

Prevalence of demarcated hypomineralisation defects in second primary molars in Iraqi children

BACKGROUND Demarcated hypomineralization lesions are not uncommon in second primary molars. Data on the prevalence of hypomineralized second primary molars (HSPM) are scarce. AIM To investigate the prevalence of HSPM, assess the relationship between HSPM and first permanent molars previously diagnosed with demarcated lesions and to determine the severity of HSPM in relation to dental caries severity. DESIGN A cluster sample of 809, 7- to 9-year-old children was examined. The scoring criteria proposed by the European Academy of Paediatric Dentistry for hypomineralization in permanent dentition were adapted to score HSPMs. The International Caries Detection and Assessment System was used to assess caries status in the second primary molar of the children diagnosed with demarcated defects. The examination was carried out in schools by a calibrated dentist. RESULTS Of the children examined, 53 (6.6%) had hypomineralization defects in at least one second primary molar. Combinations of affected first permanent and second primary molars were reported in 21 (39.6%) of cases. Severe carious lesions were found mostly in teeth with enamel breakdown. CONCLUSIONS The prevalence of HSPM was 6.6%. Over one-third of affected second primary molars were associated with demarcated lesions in the first permanent molars. The chance of severe caries increased with the increase in the demarcated lesion severity.

Risk factors in the occurrence of molar–incisor hypomineralization amongst a group of Iraqi children

BACKGROUND.  Despite the worldwide increasing interest in the prevalence studies of molar-incisor hypomineralization (MIH), there is still insufficient evidence to verify the aetiological factors of this condition. AIMS.  To investigate risk factors involved in the development of MIH in a group of school-aged Iraqi children. DESIGN.  Seven- to nine-year-old school children (823 of 1000 eligible, response rate of 82.3%) had their first permanent molars and incisors evaluated using the European Academy of Paediatric Dentistry evaluation criteria for MIH. Mothers completed a medical history questionnaire-based interview performed in the schools by a trained examiner. RESULTS.  For children with MIH, 6% reported no relevant medical history; the remaining 94% reported various medical conditions putatively associated with MIH compared with 70% for the non-affected group. Post-natal medical conditions (33.3%) were most frequently reported. When data were split into the possible risk effect groups, maternal psychological stress (OR, 3.24), frequent exposure to ultrasonic scans during the last gestational trimester (OR, 2.51) and birth order as a fourth sibling or later (OR, 3.17 and 5.73, respectively) were previously unreported significant risk factors and postulated as contributing to, or causing the defect. CONCLUSIONS.  Children with MIH had experienced a greater number of medical conditions than their unaffected peers with no single health event identified as a risk factor.

The impact of changing dental needs on cost savings from fluoridation

BACKGROUND Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. METHODS Net costs were estimated as Costs((programme)) minus Costs((averted caries).) Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. RESULTS With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from

An in vivo investigation of salivary properties, enamel hypomineralisation, and carious lesion severity in a group of Iraqi schoolchildren

56.41 (1970s) to

Trends of oral health care and dental treatment needs in relation to molar incisor hypomineralisation defects: a study amongst a group of Iraqi schoolchildren

17.75 (1990s) (conventional method) and from

Risk factors of hypomineralised second primary molars in a group of Iraqi schoolchildren

249.45 (1970s) to

Economic evaluation of preventive dental programs: what can they tell us?

69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from