Gerardo Maupomé

In vitro Quantitative Microhardness Assessment of Enamel with Early Salivary Pellicles after Exposure to an Eroding Cola Drink

To assess the erosive effect of a cola drink on enamel incorporating early salivary pellicles, 72 groups of human enamel slabs were immersed in fresh cola, with groups differing in that slabs were (1) incubated in whole or in clarified saliva, (2) under three regimes of frequency intake (1, 5 and 10 times/day); (3) immersed with or without agitation, and (4) the pellicle was incubated for 20 min, 6 or 24 h. Quantitative assessments were done over an 8–day interval using surface microhardness testing. Results for primary enamel showed a sharp decrease from baseline (344.2±32.4 Vickers Units; mean ±SD) to day 1 (268.9±36.8), and reached 155.2±68.6 on day 8. Results for permanent enamel were 350.8±42.2, 315.9±39.2, and 149.8±85.2. Microhardness was affected by agitation, level of intake and type of saliva, but not by the pellicle incubation interval nor the type of enamel. The joint effect of static baths and higher immersion frequency was the most important factor in decreasing hardness.

In vitro Quantitative Assessment of Enamel Microhardness after Exposure to Eroding Immersion in a Cola Drink

Studies assessing the erosive potential of soft drinks have employed long time intervals of immersion that may not accurately depict the impact of frequent soft drink consumption on enamel. This in vitro study assessed the effect of a cola drink on enamel, replicating an actual drinking pattern. Six groups of 4 human enamel slabs were immersed (5 min each bath) in fresh cola drink, with immersions taking place with or without agitation, and under 3 regimes of frequency intake (low intake, 1 immersion/day; medium, 5/day; high, 10/day). Quantitative assessments of surface erosion were done over an 8-day interval using surface microhardness testing (Vickers). Results showed a sharp decrease from baseline (mean value 352.1 Vickers Hardness Number, SD 32.5) to day 1 (269.3, SD 41.0) and then continued decreasing throughout the assay, although less markedly, to reach 204.5, SD 45.4 on day 8. Microhardness decreased regardless of frequency regime, except on day 8, on which slabs from the low intake group were harder (233.2, SD 25.0) than slabs from the high intake group (169.8, SD 49.5; p < 0.05). Results from the ANOVA on the factorial experiment indicated that the role of agitation was statistically significant (d.f. = 1, F = 7.2, p = 0.020) while the level of intake was of borderline significance (d.f. = 2, F = 3.2, p = 0.075). The main effect resulting from the joint roles of agitation and intake indicated that there was an important interaction between the two variables (d.f. = 3, F = 4.5, p = 0.023).

Survey on attitudes toward HIV-infected individuals and infection control practices among dentists in Mexico City

BACKGROUNDnThe teaching of infection control is gradually being introduced at dental schools in Mexico. However, most practicing dentists have limited access to current infection control standards. Deficiencies of knowledge with regard to blood-borne pathogens such as HIV and hepatitis B virus may influence attitudes toward infected individuals and reduce compliance with infection control recommendations.nnnOBJECTIVEnThe purpose of this study was to assess (1) attitudes toward HIV-infected patients and hepatitis B virus-infected patients and (2) infection control knowledge and practices among dental practitioners in Mexico City.nnnMETHODnA total of 196 dentists were interviewed by means of a questionnaire with Likert-type scales and open-ended questions (response rate, 86.1%).nnnRESULTSnMost respondents had no previous social or professional contact with HIV-positive individuals. Nine percent indicated that they had knowingly treated HIV-positive patients. Perceived professional and moral obligations to treat HIV-positive patients were high. Thirty-five percent of the respondents perceived the risk of HIV infection as considerable to very strong. The risk of hepatitis B infection was considered significantly higher than the risk of HIV infection (P <.01); however, 78% of the respondents had not been immunized against hepatitis B. Reported use of personal protective equipment was high. Most respondents used dry heat sterilization. The principal disinfectants used were quaternary ammonium compounds, bleach, and glutaraldehyde. Fifty-four percent of the respondents acknowledged that clinical precautions reduced occupational risks.nnnCONCLUSIONSnThis survey revealed contradictory attitudes toward HIV-positive individuals and limited understanding of infection control recommendations. Educational and regulatory efforts are needed to promote better adherence to current infection control standards.

Prosthodontic profiles relating to economic status, social network, and social support in an elderly population living independently in Canada

STATEMENT OF PROBLEMnPrevious evaluations of life satisfaction and health have not completely explained the impact of social network, social support, and economics on the oral health-related behavior of elderly patients, particularly in relation to missing teeth.nnnPURPOSEnThis study measured the strength of associations between social network/support/class and the use of complete and removable partial dentures in elderly patients living independently.nnnMATERIAL AND METHODSnA multiple stepwise logistic regression was used to contrast data from previous studies relating to the subject and to explore the influence of these social variables.nnnRESULTSnThe results substantiated the links observed in a previous study between some social features and oral fitness. More frequent use of complete dentures was identified among participants who reported higher incomes and among those who thought their incomes were sufficient for their needs. Unreplaced missing anterior teeth were associated more commonly with subjects less willing or able to leave their homes.nnnCONCLUSIONSnSome salient features of prosthodontic care and oral health status were common to 2, comparable social environments. A minority within the elderly population may not see a need to make use of clinical dental services, regardless of how accessible these services are to them. Social network and social support issues may be important determinants in this perceived need to use clinical services.

A comparison of senior dental students and normative standards with regard to caries assessment and treatment decisions to restore occlusal surfaces of permanent teeth

STATEMENT OF PROBLEMnEven though assessments of borderline restorative items in terms of accuracy and interexaminer variation have been reported, no attempt has been made to simultaneously evaluate diagnostic and treatment planning decision using objective normative standards.nnnPURPOSEnThis study established the accuracy of caries presence assessment as compared with gold standards, interexaminer agreement in assessment of caries presence and restorative needs, and influences of perceived caries status and restoration quality on treatment planning in borderline restorative situations.nnnMATERIALS AND METHODSnFifteen senior dental students in Mexico City (66% women; mean age 23.2 years) evaluated predetermined areas in 109 restored and unrestored posterior teeth in an in vitro model. Teeth were subsequently assessed for restoration quality and the presence of enamel and dentinal caries by use of histologic and specific dye techniques. Students t test, Cohens kappa, and Pearsons correlation analyses were used to analyze the data.nnnRESULTSnThere were significant caries misdiagnoses and substantial overtreatment proposed. In a few instances, teeth were left untreated, but usually they were programmed for restoration. Interexaminer agreement varied markedly and was not high. However, performance while correctly detecting lesions was better than in treatment planning.nnnCONCLUSIONnThere was a high correlation between a diagnosis of caries and restorative treatment in unrestored teeth; the correlation was lower for restored teeth, although they were allocated to restorative treatment more often. This difference hinged on perceived quality of the restoration, an important factor in the frequency of proposed re-restoration.

Tooth–Surface Progression and Reversal Changes in Fluoridated and No–Longer– Fluoridated Communities over a 3–Year Period

Objective: To compare permanent tooth surface–specific progression/reversal changes between fluoridation–ended (F–E) and still–fluoridated (S–F) communities in British Columbia, Canada, over a 3–year period. Methods: D1D2MFS examinations were contrasted for 2,964 schoolchildren in 1993/94 (grades 2, 3, 8 and 9) and 1996/97 (grades 5, 6, 11 and 12). Generalized Estimating Equation (GEE) models explored the relation between progression/reversal changes and fluoridation status, age, gender, socioeconomic status, and dietary/fluoride histories. Results: Within a scenario of low levels of caries overall, few children had multiple surfaces progressing. At least one smooth surface progressed in 31.4% of subjects; at least one pit–and–fissure (PF) surface progressed in 43.1% of subjects. At least one smooth surface reverted in 89% of subjects who had reversible stages; at least one PF surface reverted in 23.8% of subjects who had reversible stages. GEE (smooth) indicated that odds ratios of progression were twice as large in the F–E site compared to the S–F site, and slightly increased in older participants and in participants exposed to more fluoride technologies. GEE (PF) also indicated that progression was slightly more common in the F–E site; more frequent snacking and lower parental educational attainment had modest associations with increased progression in PF surfaces. For the two types of surfaces, GEE models demonstrated that unerupted surfaces were less likely to progress than sound surfaces. No associations were found between reversals and independent variables. Conclusion: Progressions were found to be weakly linked to socio–demographic factors; baseline surface statuses were better predictors of progression. Using the current definitions for disease transitions, F–E communities had more frequent progressions than a S–F community.

Perceptions of tooth loss and periodontal problems in an independent elderly population: content-analysis of interview discourse.

Oral health/illness and surrounding socio-demographic and behavioral phenomena are poorly documented in the Mexican elderly. To establish the rationales explaining oral health/illness and tailor a Health Promotion intervention (1995--1997) accordingly, an interview nested in a questionnaire was done at baseline, with the recording of 228 interviews transcribed verbatim. Every transcript was subsequently assessed by content-analysis. Results showed that lack of oral hygiene, inadequate calcium intake and old age were the most common explanations of tooth-loss. Only a few factors were felt to be under control: the same state of relative adaptation that characterized people affected by gum problems. The themes that explained them were lack of oral hygiene, and (non-specific) infections. When interviewees evaluated the impact of good oral health on their lives, many made evaluations pertaining to quality of life, adequate function, and an attractive appearance generally.