Edward A. Thibodeau

Peroral Famciclovir in the Treatment of Experimental Ultraviolet Radiation-Induced Herpes Simplex Labialis: A Double-Blind, Dose-Ranging, Placebo-Controlled, Multicenter Trial

Three doses of famciclovir were tested for treatment of experimental ultraviolet radiation (UVR)-induced herpes labialis. Patients received 125, 250, or 500 mg of famciclovir or placebo 3 times a day for 5 days beginning 48 h after UVR exposure, a model of early episodic intervention. Of 248 patients irradiated, 102 developed lesions while on treatment. There were no significant differences between groups in the number of lesions. The mean maximal lesion size was reduced in a dose-proportional manner: 139, 105, 77, and 55 mm2 for the placebo and 125-, 250-, and 500-mg famciclovir groups, respectively (P=.040, linear regression). Median time to healing was faster in the 500-mg famciclovir group than in the placebo group, both by investigator (4 vs. 6 days, 33% reduction, P=.010) and patient assessment (3.0 vs. 5.8 days, 48% reduction, P=.008) analyses. These findings suggest that evaluation of higher drug doses for herpes labialis treatment is warranted.

Salivary Mutans Streptococci and Incidence of Caries in Preschool Children

The aim of this study was to assess the relationship between salivary mutans streptococcus (SMS) levels and the prevalence and incidence of dental caries in 148 children (mean baseline age 3.8 years) of low socioeconomic status. Caries data (dmfs) and semiquantitative SMS counts were obtained at baseline and annually for 2 years. The children were classified during each of the 3 years as low (0 colony-forming units; CFU), moderate (1-50 CFU), or high (> 50 CFU) caries risk based on total SMS counts. The results indicated that the prevalence of dental caries increased with SMS levels at baseline and generally in both assessment years. At baseline the mean dmfs of the children classified as low, moderate, or high caries risk was 0.15, 1.44, and 3.36, respectively, while the mean dmfs of the same children at year 2 was 1.18, 3.10, and 7.87, respectively. The mean dmfs of the high-caries-risk group increased by 79% between baseline and year 1 and by 30% between year 1 and year 2. At year 2, 50% of the children in the low- and 47% in the moderate-caries-risk groups were caries free as compared with 11% in the high-caries-risk group. Thirty-three percent of the children examined remained in the same caries risk category from baseline to year 2; the incidence (delta dmfs) of dental caries in those children designated as low, moderate, and high caries risk during this period was 1.44, 3.36, and 10.07, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Survey of the medical history questionnaire

The purpose of this study was to examine and to compare the type of information requested on representative health history questionnaires commonly used by the dental profession. Samples of medical history questionnaires were obtained from American and Canadian dental schools, commercial vendors, and the American Dental Association. Results indicated that more than 140 questions have been included on questionnaires and more than 92% of these appeared in some type of yes-or-no format. The number of questions per form ranged from 32 to 88, with an average of 58 items. Although there was wide variation in the range of information requested, the 25 most frequently asked questions occurred in 70% of the forms. The majority of questions focused on noninfectious disease conditions that affect the cardiovascular system and major organ functions, allergies, and blood disorders; infectious diseases such as hepatitis, tuberculosis, mumps, and venereal disease; and health care status and special treatment considerations.

Prenatal nutrition intervention to reduce mutans streptococci among low‐income women

OBJECTIVES The objective of this study is to assess the effectiveness of a prenatal nutrition intervention to reduce sugar intake and mutans streptococci (mutans) among low-income women. METHODS Pregnant women were recruited from the obstetrics service at a community health center in Connecticut. Inclusion criteria were ≥18 years of age; mutans levels >10, 000 colony forming units/ml as determined by Dentocult SM® kits (Orion Diagnostica Oy, Espoo, Finland); and >3 months pregnant. Women were randomized to receive education alone [education intervention (EI)] or education and a 1-hour nutrition group session at 9 months and 6 weeks postpartum [education and nutrition intervention (EIN)]. Mutans and questionnaire data were collected at baseline, 9 months, 6 weeks, and 3 months postpartum. One hundred twenty completed the baseline visit and 93 (77%) completed all four visits. Sugar intake was assessed by the Food Frequency Questionnaire and clinical information was abstracted from medical charts. RESULTS Mean age was 26.3 years [standard deviation (SD)= 6], 73% were Hispanic, 29% had lived in the United States < 6 years; 48% completed high school; 27% were married; mean total sugar intake at baseline was 149g (SD = 85). Repeated measures analysis of variance showed that mutans levels declined significantly in both groups, but that the EI group had significantly lower mutans levels at the final assessment compared with EIN. Sugar intake also declined significantly, but there were no significant differences between groups. CONCLUSIONS The study demonstrated the following: a) the feasibility of conducting the intervention at community health center sites among low-income pregnant women; b) the effectiveness of education to reduce mutans/sugar intake; and c) the need to improve the nutrition intervention to obtain additional gains in mutans reduction.