Heikki Murtomaa

Dental erosion and upper gastrointestinal disorders

The orodental status, particularly dental erosions, of 109 patients with upper gastrointestinal symptoms was examined. In 44 patients, the underlying pathosis was associated with increased acid output in the stomach (reflux esophagitis or duodenal ulcer), while in 48 patients who underwent cholecystectomy, the duodenogastric reflux was alkaline. In 17 patients with gastric ulcer, the gastric secretion was usually normal. The diagnoses were made with gastroscopy. Seven patients with dental erosion were found, and they all came from the group of 35 dental patients with reflux esophagitis or duodenal ulcer. No erosions were seen in the other diagnostic groups (F = 0.02). Thus, gastrointestinal disorders with increased output of gastric acid may be linked with dental erosions. The finding emphasizes the need for accurate diagnosis and appropriate treatment of patients with upper gastrointestinal symptoms in order to avoid irreversible lesions in the teeth.

Salivary pH and glucose after consuming various beverages, including sugar-containing drinks.

Dental erosion is often seen on the lingual tooth surfaces. For this reason tongue pH after consuming orange juice, Coca-Cola (old and new formula), Coca-Cola Light, Jaffa orange beverage, Hart-Sport

A simultaneous reduction of caries and gingivitis in a group of schoolchildren receiving chlorhexidine-fluoride applications. Results after 2 years.

A total of 164 schoolchildren, aged 11–15 years with high DMF scores was divided into 4 groups. Subjects of the CXF group brushed their teeth after school lunch and rinsed their mouths with a solution containing 0.05% chlorhexidine gluconate + 0.044% NaF in succinic acid/NaOH buffer, pH 5.9. The F group had 0.044% NaF in the buffer. The PI group used a placebo solution and the C group served as the basic control. Respective nonabrasive toothpaste preparations were used in the evenings and twice a day during weekends and the holidays. After 2 years, the mean DMFS increments in the C, Pl, F and CXF groups were 6.3, 5.1, 4.3 and 2.9, respectively. The percentage of subjects with bleeding vestibular gingival units examined in different groups had changed from initial to final value as follows: C, 40–63; PI, 50–49; F, 71–47 and CXF, 63–14.

Clinical follow-up study of third molar eruption from ages 20 to 26 years

The development of 412 upper and lower third molars was clinically followed up for 6 years in 120 students, starting at the age of 20 years. Clinical and radiographic examinations carried out at baseline and 6 years later showed that during the follow-up period almost half the third molars originally recorded as partially erupted had erupted. When the lower third molars were initially invisible, only 9% of them had erupted by age 26 years whereas 29% remained invisible. When third molars had been already erupted at baseline, only a few were extracted during the 6-year follow-up period. It was concluded that a certain proportion of third molars erupt relatively late, and therefore the need for surgical interventions may decrease with age during early adulthood.

Work-Related Complaints of Dentists and Dental Assistants

SummaryOccupational health problems of dental teams were investigated in 68 dentists and 90 dental assistants of Helsinki Health Centre. A pre-tested, self-administered questionnaire was used. Diagnosed diseases or discomforts of occupational origin were reported by 38% of the dentists and 12% of the dental assistants. Thirty-one percent of the dentists and 10% of the assistants reported having been on sick-leave during the 2 years prior to the survey because of some kind of occupational problem. As a consequence of years in the dental profession, musculoskeletal disorders of back and neck and stress were most frequently experienced by the dentists and rash or allergic reactions and respiratory infection by the assistants. Only 1% of both professional groups reported no aches while practising dentistry during the 6 months preceding the survey. The vast majority of subjects took regular physical exercise but practice of muscular relaxation or gymnastics at the place of work was unusual. The results indicate that dental teams need functionally designed dental equipment and proper training in ergonomic methods.

Third molars as an acute problem in Finnish university students

The study was carried out to determine the risk of acute disease of third molars in young adult patients. The subjects in this case-control study were 100 consecutive university students who complained of third molar problems when making an appointment. The third molars were mostly mandibular, partly erupted, and distoangularly oriented. Severity of discomfort and interference with daily activities were graded by the patients on average as 5.0 (SD +/- 2.7) and 3.6 (SD +/- 2.9), on a scale from 0 through 10. Distoangular lower third molars caused the most discomfort and interfered most with activities of patients. The risk of acute disease in patients with distoangularly oriented third molars was 3.6 times that in other patients. Bivariate analysis showed that if the follicle of a distoangular third molar were enlarged, the risk of acquiring acute disease was 44 times that in other patients. It was concluded that early removal of partially erupted and distoangularly oriented lower third molars is recommended, especially when they are associated with an enlarged follicle.

Study motives and career choices of Iranian dental students.

Objectives: To investigate the study motives and career choices of Iranian senior dental students in relation to their background factors. Subjects and Methods: During the spring term 2005, a questionnaire survey was administered to 327 senior dental students in seven randomly selected state dental schools in Iran. The questionnaire requested information on age, gender, parents’ employment in dentistry, previous education and employment in dental hygiene, study motives, and career choices. Statistical analyses were made using independent sample t test, factor analysis, and binary logistic regression model. Results: Based on the factor analysis, which explained 73% of the total variance, five motive dimensions were identified: altruism and intellectual challenges, characteristics of the profession, social status and security, other person’s recommendation, and failure to be admitted to other study programmes. The mean for the ‘characteristics of the profession’ dimension was lower among the students with at least one parent employed in dentistry (p = 0.03). The ‘altruism and intellectual challenges’ dimension was reported to be more influential by the students with background in dental hygiene (32 students) compared to the others (p < 0.001). Engaging in postgraduate studies was the first career preference of 189 (70%) of the respondents. Those with a background in dental hygiene were less inclined to enter postgraduate courses (p < 0.001), but more eager to be employed in either the public or the private sector (p < 0.001), and to enter the community oral health and research field (p < 0.001) than the others. Conclusion: Personal characteristics and motives of the students play a major role in shaping their career preferences.

Interrelation between obesity, oral health and life-style factors among Turkish school children.

Obesity, dental caries and periodontal diseases are among major public health concerns which may affect children’s growth and development. This study seeks any clustering between obesity, oral health and life-style factors among school children in Istanbul, Turkey. A cross-sectional study of children, 10- to 12-year-olds, from a public and a private school was undertaken with questionnaires for children and their mothers and child oral health data, in Istanbul (n = 611). DMFS (number of decayed, missing and filled surfaces of permanent teeth), CPI (Community Periodontal Index), body mass index (BMI) and life-style factors (tooth-brushing frequency, milk consumption at breakfast and bedtimes on school nights) of children were examined. Data analysis included factor analysis, Student’s t test and Chi-square tests by cross-tabulation. Public school children were more dentally diseased but less obese than were those in private school (P < 0.001). They more frequently had calculus (62%) and reported non-recommended tooth-brushing (68%) than did those in private school (37%, 56%; P < 0.05). Principal component analysis revealed that DMFS, CPI and BMI shared the same cluster among all children. A need exists for addressing obesity, oral health and nutrition jointly in health promotion strategies to improve children’s well-being and empower good life-style factors.

Malignant oral tumors in iran: ten-year analysis on patient and tumor characteristics of 1042 patients in Tehran.

This study analyzed characteristics of oral cancer patients from Tehran, Iran, and their tumors. Data came from the patient records of 30 major hospitals in Tehran. Patients (n = 1042), diagnosed with invasive oral cancer in 1993-2003, were classified by primary tumor site according to ICD-10 (C00-C10). Data were analyzed separately for lip, oral cavity and salivary gland tumors. Statistical evaluation included &khgr;2 and t-test. Of all cases, 59% were male. Age for all cases ranged from 6-103 years, mean age was 58.8 years (SD 16; median 62); 89% were older than 40. Tumor site breakdown was 65% oral cavity, 21% major salivary glands and 14% lip. A clear gender difference (P < 0.001) appeared regarding the primary tumor sites: women dominated in oral cavity cancers and men in lip cancers. The most common cancer site was the tongue (32%), accounting for 50% of the oral cavity cancers. Histologically, 88% of all oral cavity and lip cancers were squamous cell carcinomas, 10% of those were in age ≤40, 42% in ages 41-64 and 48% ≥ age 65. At the time of diagnosis, 59% of oral cavity cancers and 29% of lip cancers were at stage III or IV (P < 0.001). The results emphasize an urgent need for a national program focusing on early detection of oral cancers, including educational information addressed to oral health professionals.

Oral Health among 35- to 44-Year-Old Iranians

Objective: To investigate the oral health status of 35- to 44-year-old Iranians in relation to gender, place of residence and education. Subjects and Methods: In 2002, data (n = 8,301) were collected as part of a national survey using WHO criteria for sampling and clinical diagnoses across 28 provinces by 33 calibrated examiners who performed examinations under a dental light with a WHO probe. The study sample was 8,301; male: 3,625 and female: 4,676; urban: 4,854 and rural: 3,447. Oral health status was assessed by number of decayed (DT), filled (FT) and missing (MT) teeth and by DMFT and need for periodontal treatment [community periodontal index for treatment needs (CPITN)] indices. Gender, age, place of residence and level of education served as socio-demographic information. Estimates were adjusted for the 35- to 44-year-old provincial population. ANOVA, χ2 test and logistic regression analysis with odds ratios (OR) and their 95% confidence intervals (CI) were the methods of statistical evaluation used. Results: The mean number of teeth was 21.5 ± 6.2, with DMFT: 11.0 ± 6.4, DT: 2.6 ± 2.7, and FT: 1.8 ± 3.2. DT existed in 6,080 (73%) of the subjects and FT in 3,209 (41%). The mean number of FT was greater (p < 0.001) among urban residents, women and those with a higher level of education. Only 1% had a CPITN of 0; 6% exhibited bleeding, 40% had calculus, 43% shallow and 10% deep pockets. Illiterate subjects were more likely to have DT (OR = 1.6, 95% CI = 1.4–1.8) and calculus or periodontal pockets (OR = 6.3, 95% CI = 5.1–7.8). Conclusion: The findings indicate an impaired oral health status in Iranian adults, particularly those of low social status and educational level.