Harald M. Eriksen

Isolation of Enterococcus faecalis in previously root-filled canals in a Lithuanian population.

The occurrence of Enterococcus faecalis in root canals of previously root filled teeth with apical periodontitis requiring retreatment was studied in Lithuanian patients. Twenty-five asymptomatic teeth were included in the study. Avoiding contamination microbiological samples were taken from the canals before and after preparation and irrigation with sodium hypochlorite and EDTA. Microbes were isolated from 20 of 25 teeth. E. faecalis was isolated from 14 of those 20 culture positive teeth, usually in pure culture or as a major component of the flora. Second samples taken after preparation revealed growth in 7 of the 20 teeth. Five of the seven cases were E. faecalis in pure culture. Isolation of E. faecalis was not related to the use of any particular root filling material in the original root filling. The results indicate that, rather than previous chemical treatment, it is the ecological conditions present in the incompletely filled root canal that are important for the presence of E. faecalis in these teeth.

A comparison of the plaque-inhibiting effect of stannous fluoride and chlorhexidine

A double blind clinical trial was undertaken in order to compare the plaque inhibiting effect of SnF2 (0.2% and 0.3%) with chlorhexidine (0.1%) applied as mouthrinses in a test panel of 12 dental hygienist students. The experimental series were performed in periods of four days. The mean Plaque Index values were 0.35 and 0.2 when employing SnF2 and 0.1 when chlorhexidine was used, whereas distilled water resulted in a mean value close to 1.0. The long-term effect of a 0.3% SnF2 solution was tested in another group of five students for a period of three weeks. The two trials confirmed previous reports claiming that SnF2 is effective as a plaque inhibitor and, furthermore, that this effect could be maintained for a period of at least three weeks. The staining problem was less than in similar studies using chlorhexidine.

Oral health behavior and attitudes of adults in Lithuania

In Lithuania, the oral health system is currently in transition and systematic data are needed for public oral health care planning. The objectives of this study were (i) to describe the self-assessment of oral health status in Lithuanian adults, the oral hygiene practices, and dental visiting habits; (ii) to assess the attitudes towards teeth and oral health, dental care and oral health services; (iii) to determine whether oral health attitudes and behavior are affected by socio-economic factors; and (iv) to analyse the association between self-care practices and use of oral health services. The study comprised random samples of 35-44-year-olds (n = 381) and 65-74-year-olds (n = 302). Data were collected during 1997-98 by means of self-administered questionnaires and the response rate was 53%. Nearly all persons of ages 35-44 had natural teeth, whereas 14% of 65-74-year-olds were edentulous. Among the dentate persons, 45% of the young adults against 36% of the elderly claimed having poor teeth, and 66% and 55%, respectively, had experience of pain from teeth or mouth during the past year. At ages 35-44, 33% of participants reported toothbrushing at least twice a day and this was the case for 21% of 65-74-year-olds. Dental visits within the past year were indicated by 60% of young adults and 43% of the elderly; 83% of all participants reported that their last visit to the dentist was due to acute oral symptoms. In general, the participants had positive dental knowledge and attitudes; however, 56% were unaware of any effect of fluoride. The bivariate analyses showed that perceived oral health status and oral self-care practices were related to use of dental services. The multivariate analyses of dental visiting habits revealed the effects of gender, urbanization, presence of natural teeth, experience of dental problems, attitudes to dental care and dentists, and education. In conclusion, preventive dental services should be introduced and the establishment of community-based oral health promotion programs is urgently needed for Lithuania.

Pulpal Response of Monkeys to a Composite Resin Cement

A composite resin cement is shown to be stronger and less soluble than the cementing materials that are commonly used today. The acidic cavity cleanser that is recommended to improve the adhesive properties of this resin cement considerably enhanced the pulpal response to the cement.

Occurrence, Population Structure, and Antimicrobial Resistance of Enterococci in Marginal and Apical Periodontitis

ABSTRACT Subgingival plaque samples and root canal samples were collected from 2,839 marginal periodontitis (MP) patients and 21 apical periodontitis (AP) patients. Enterococcus species were identified by a series of phenotypic and genotypic tests. Antimicrobial susceptibility assays were performed by an agar disk diffusion test. Multilocus sequence typing (MLST), eBURST, and minimum spanning tree were used for enterococcal genetic clustering and population analysis. Enterococcus faecalis was recovered from 3.7% MP patients and 9.5% AP patients, and Enterococcus faecium was recovered from 0.04% MP patients. Enterococci were detected more often in older male patients. E. faecalis isolates of MP were found resistant to tetracycline (49.1%), erythromycin (8.5%), trimethoprim (2.8%), and gentamicin (1.9%), while one AP isolate was resistant to tetracycline. A total of 40 sequence types (STs) were resolved in 108 E. faecalis isolates. Comparison with E. faecalis international MLST database revealed that 27 STs were previously found, 13 STs were novel, and several major clonal complexes in the database were also found in MP isolates. The tetracycline-resistant isolates distributed mainly in the major clonal complexes and singletons, whereas the erythromycin-resistant isolates were more dispersed. Although the rate of occurrence of enterococci recovered in the MP and AP samples was low, 50% of these isolates are resistant to at least one antimicrobial agent, which is most often tetracycline. This implies that subgingival E. faecalis might represent a reservoir of resistance to tetracycline and erythromycin. The subgingival E. faecalis isolates show high genetic diversity but are grouped, in general, with the known isolates from the international database.

Dental caries in adult Lithuanians

There are few data on the incidence of dental caries in Lithuanian adults. The aim of the present study was to describe caries and treatment experience among 35-44 and 65-74-year-olds, and to relate this to certain selected independent variables (gender, urban/rural residence, drinking water fluoride levels, and years of education). A total of 680 subjects selected based on a stratified random sampling procedure (response rate 52%) were examined by one examiner. Dental caries was recorded as DMFT following the WHO recommendations. The results showed that the median DMFT scores were 18 for the 35-44-year-olds (n = 380) with median DT = 2, MT = 5, FT = 7. For the 65-74-year-olds (n = 300) the median DMFT was 24, with DT = 1, MT = 18, FT = 2, respectively. One percent of all 35-44-year-olds and 11% of 65-74-year-olds were edentulous. In the younger age group, statistically significant differences in the DMFT scores were related to gender, urbanization and drinking water fluoride levels. Participants from areas with high fluoride content in the drinking water (>1.5 ppm F/l) had lower DT, MT, and FT values. Females and participants from urban areas had higher numbers of FT. Participants with more years of education had lower DT, MT, and higher FT values. In the elderly, DMFT scores were related to water fluoride levels and years of education. Individuals with more years of education had higher numbers of FT and lower MT values in this age group. Poor oral hygiene was associated with high numbers of DT in both age groups. The data indicate that dental caries is widespread among adult Lithuanians.

Changes in caries experience among 35-year-old Oslo citizens, 1973–2003

Objective. The aims of the present study were to describe caries experience among 35-year-olds in Oslo in 2003 and to assess changes in caries experience during the past 30 years using data from cross-sectional studies performed in 1973, 1984, and 1993. Material and Methods. The dental status of 149 randomly selected 35-year-olds in Oslo was examined in 2003 (response rate 64%) and the data were compared with available data from earlier studies. Dental caries was registered clinically and radiographically at the surface level, applying the same criteria as used in previous studies, and recorded as DMFS/T. Results. The results indicate a gradual decrease in the mean DMFS scores by 62% from 68.2 in 1973 to 26.1 in 2003. There was an 83% decrease in the mean number of DS, a 73% decrease in the mean number of MS, and a 56% decrease in the mean number of FS during this 30-year period. The proportion of individuals with DS = 0 gradually increased from 5% in 1973 to 54% in 2003. There was also a significant decrease in the prevalence of recurrent caries from 2.8% in 1984 to 1.2% in 2003. While a statistically significant reduction in the number of decayed, missing, and filled surfaces was observed during the period 1984–1993, in the past decade (1993–2003) a significant decrease appeared only in the case of the filled surfaces. Conclusions. The results indicate that dental health among 35-year-olds in Oslo, measured as a reduction in caries experience, has improved substantially from 1973 to 2003.

Evaluation of a dental outreach teaching programme

Dental health care is largely based on primary care. It is therefore logical to train students in external dental clinics in addition to university facilities. Consequently, the new dental curriculum at The University of Tromsø in Northern Norway has implemented outreach teaching and training as an extensive part of their curriculum. The overall opinion is that the external training has been very valuable both regarding volume and diversity of treatment experiences and has contributed substantially to the clinical maturity of the students. Educating the tutors is considered to be an essential part of the programme.

Chemical Plaque Control and Prevention of Extrinsic Tooth Discoloration in Vivo

Extrinsic discoloration of teeth has frequently been observed in connection with the use of chemical plaque-preventive agents. Preliminary investigations have indicated that oxidizing peroxymonosulfate may effectively reduce this discoloration without interfering with the plaque-preventive capacity of chlorhexidine. In the present experiment a 0.2% chlorhexidine and a 1% peroxymonosulfate solution were used for oral rinsing in a group of 50 military recruits. A double-blind experimental design was followed. The plaque-preventive capacity of chlorhexidine was maintained, and a marked reduction in extrinsic tooth discoloration could be observed.

Dental health and disease determinants among 35-year-olds in Oslo, Norway

Objective. The aim of the present study was to identify non-biological determinants associated with the number of sound teeth (ST) and presence of decayed surfaces (DS) among 35-year-old Oslo citizens. Material and methods. Randomly selected participants (n=149, response rate 64%) completed a self-administered questionnaire and were examined clinically and radiographically. Dental caries was registered clinically following World Health Organization (WHO) diagnostic criteria for caries registration, and the findings were combined with radiographic caries recordings. The number of sound teeth and the presence of two or more dentine caries lesions (D3S≥2) were selected as dependent variables. Associations between selected dependent variables and possible determinants were assessed by linear and logistic regression analyses, taking into account the hierarchical relationships between the independent variables. Results. On average, 35-year-olds had 17.1 (SD=5.6) ST. Half of the participants had no DS and 26% had D3S≥2. Non-Western region of birth, being single, and having a university education were significantly associated with higher numbers of ST. Low family income, presently a smoker, and irregular dental visits were significantly associated with the presence of dentine caries. Conclusions. The results of this study indicate that several non-biological determinants operating at different levels are important for health and disease in this adult population.