Jindra Šmejkalová

Smoking Related Systemic and Oral Diseases

This article reviewed smoking related systemic diseases and oral diseases. Smoking is related to lung cancer, cardiovascular diseases and many other systemic diseases. Cigarette smoke affects the oral cavity first, so it is evident that smoking has many negative influences on oral cavity, for example, staining of teeth and dental restorations, wound healing, reduction of the ability to smell and taste, and development of oral diseases such as oral cancer, periodontitis, smokers palate, smokers melanosis, hairy tongue, leukoplakia, oral candidiasis and implant survival rate. The article also discusses the relationship between smoking and dental caries in detail.

THE INFLUENCE OF CIGARETTE SMOKING ON VARIOUS ASPECTS OF PERIODONTAL HEALTH

Tobacco is one of the most important risk factors for oral diseases, including oral cancer, oral mucosal lesions and periodontal diseases. There is substantial evidence suggesting that the risk of oral diseases increases with frequent use of tobacco and that quitting smoking results in reduced risk. In this article, the influence of cigarette smoking on the periodontium will be discussed, giving importance to the effects on immune responses, alveolar bone loss, periodontal pathogens and briefly outlining the negative effects of smoking on wound healing and periodontal treatment procedures.

Urinary mutagenicity and genotoxic risk in children with psoriasis after therapeutic exposure to polycyclic aromatic hydrocarbons and ultraviolet radiation

The Goeckerman regimen (GR) for the treatment of psoriasis comprises dermal application of crude coal tar (polycyclic aromatic hydrocarbons, PAHs) and exposure to ultraviolet radiation (UVR). PAHs and UVR are mutagenic and carcinogenic agents. We evaluated dermal absorption of PAHs as well as the mutagenic and genotoxic effects of GR in 16 children with psoriasis, by determining levels of 1-hydroxypyrene (1-OHP), 1-,2-,3-,4-hydroxyphenanthrene, (1-OHPhe, 2-OHPhe, 3-OHPhe, and 4-OHPhe), urinary mutagenicity (Salmonella mutagenicity assay, Ames test) and numbers of chromosomal aberrations in peripheral lymphocytes (CA), in urine and/or blood, before and after GR. The Psoriasis Area and Severity Index (PASI) score was used to evaluate clinical efficacy of GR. Compared with pre-treatment levels, there were significant increases in urinary concentrations of 1-OHP (p<0.001), 1-OHPhe (p<0.001), 2-OHPhe (p<0.001), 3-OHPhe (p<0.001), and 4-OHPhe (p<0.01), indicating a high degree of dermal absorption of PAHs. There were also significantly increased numbers of revertants in the Ames test in two different strains (YG1041-S9, p<0.01; YG1041+S9, p<0.001; TA98+S9, p<0.01), which demonstrates urinary mutagenicity. We also found a significant increase in the number of CA (p<0.001) and significantly decreased number of CA (p<0.01) at 81 days post-treatment, suggesting that GR has a temporary genotoxic effect. The PASI scores were significantly decreased after GR (p<0.001), confirming the clinical benefit of GR. In conclusion, our results demonstrate mutagenic and temporary genotoxic effects of GR in the group of 16 treated child patients.

Self-reported risk factors related to the most frequent musculoskeletal complaints among Czech dentists

The purpose of the study was to describe the occurrence of the most common complaints related to MSDs in Czech dentists and to assess the risk factors affecting them. A questionnaire survey of 581 Czech dentists (the response rate 72.6%) was conducted in 2011. The questionnaire ascertained general information about the respondents, their work habits and environment along with the occurrence of musculoskeletal disorders. The respondents filled out the questionnaires during the educational events organized by the Czech Dental Chamber. At least mild difficulties associated with the motoric system were reported by 96.9% of the respondents, with 66.3% of respondents reporting moderate or major difficulties. Back and neck pain followed by shoulder pain and headache were the most common complaints in our sample. According to our data: age, gender, length of practice, a history of serious MSDs, the occurrence of MSDs in blood relatives, the perception of work as psychologically demanding, and especially a perceived moderate/bad general health were significantly associated with the four most common musculoskeletal complaints. Some of the factors were found as protective. This study suggests that MSDs represent a significant burden for Czech dentists and further research is needed to elucidate this issue.

Experience of Czech Children with Alcohol Consumption in Relation to Selected Family Indicators

OBJECTIVE The aim of this study is to monitor and analyze the influence of chosen family indicators related to alcohol consumption and experience of drunkenness in a representative sample of Czech children. METHODS Data for our work were obtained from the Health Behaviour in School Aged Children (HBSC) study - a World Health Organization (WHO) cross national study. The sample consisted of 4,293 children aged 11, 13 and 15 years. Data collection was conducted in June 2010 in 88 randomly selected schools in the Czech Republic using standardized questionnaires. Statistical analysis was performed in the program NCSS 9, methods of descriptive statistics, χ2 test of independence in the contingency tables and logistic regression analysis were used. RESULTS Regular alcohol consumption (at least weekly) was reported by 7.4% of children aged eleven, 19.3% of children aged thirteen and 38.4% of children aged fifteen years. Drunkenness at least twice in their life was admitted by 3% of children aged eleven, 15% of children aged thirteen and 43% of children aged fifteen years. Both alcohol consumption and drunkenness were significantly associated (p<0.001) with age and gender. Formal structure of family was found to have significant effect on the experience of drunkenness, but no effect on alcohol consumption was recorded. Based on our results, neither the amount of time spent together, nor the children communication with parents had a statistically significant influence on alcohol consumption or drunkenness experience within each family type. However, statistically significant differences were observed between different family types (p<0.001). CONCLUSIONS These findings indicate a high degree of liberalism of Czech society towards alcohol. It appears that alcohol consumption will remain a serious problem in Czech society, therefore, more attention should be paid to this phenomenon in the future.

The Influence of Smoking on Dental and Periodontal Status

Tobacco is one of the major toxic agents in our civilization. It’s use is considered as one of the most common cause of mortality and morbidity in both developed and developing countries in present times. Of 260 million deaths which occurred in the developing world between 1950 and 2000, it is estimated that 50 million were due to smoking. Globally, smoking related mortality is set to rise from 3 million annually (1995 estimate) to 10 million annually by 2030, with 70 % of these deaths occurring in developing countries (Fagerstrom, 2002). Since 1970, smoking prevalence among men has slightly decreased, but among women, teenagers and children, smoking has increased dramatically. Sixty percent of children are exposed to Environmental Tobacco Smoke (ETS) at their homes (Mackay & Amos, 2003). Tobacco is one of the most important risk factor for oral diseases including oral cancer, oral mucosal lesions, periodontal diseases, wound healing failure, dental implants failure, gingival inflammation, acute necrotizing ulcerative gingivitis and apthous ulcers (Vellappally et al., 2007; Jacob et al., 2007). There is substantial evidence suggesting that the risk of oral diseases increase with frequent use of tobacco and that quitting smoking results in reduced risk (Winn, 2001).

Tabacco use in smokeless and smoking forms and its effect on periodontal health in India

The aim of the present study was to establish the relationship between tobacco use and periodontal health in an adult sample in India. A cross-sectional population-based study was conducted in a province of southern India. A total of 805 subjects between the ages of 30 and 69 years were interviewed, and clinical examinations were made by three cooperating dentists. The examiners recorded oral mucosal findings, gingivitis, and the Community Periodontal Index of Treatment Needs index using a WHO-621 Trinity probe. Among the 805 participants, 72% were males and 28% were females. Among regular smokers, 98% were males and 2% were females. In the studied population, 64.6% visited the dentist only when they had some dental problems. Oral mucosal findings were present more in of the regular smokers and chewing tobacco users than in the non-consumers. The maximum findings from six sextants indicate that non-consumers exhibited higher rates of healthy periodontium and bleeding on probing but lower rates of pockets than tobacco consumers. The present analysis shows that tobacco use exerts a strong and chronic effect on periodontium and oral mucosa and reduces bleeding on probing.

Assessment of work-related stress by using salivary cortisol level examination among early morning shift workers

OBJECTIVE Early morning shifts have a negative effect on the hypothalamic-pituitary-adrenal axis. The aim of this study was to comprehensively assess the extent of occupational stress in early shift workers of the car industry by using salivary cortisol as an objective marker during a workday and on a day off. METHODS For this cross-sectional epidemiological type of study, a survey included 55 suitable volunteers from the car industry. Five saliva samples were collected according to the following schedule: during one work day in the morning, during the morning shift from 6 a.m. - 2 p.m., then after the shift was completed, 3 hours after work and in the evening before going to sleep. Control samples were taken from the same participants on a day off. Radioimmunoanalysis was used as the main analytical method, and the effect of factors and between-factor interactions on the levels of salivary cortisol during the workday were assessed using an ANOVA model. RESULTS The cortisol diurnal rhythm was as expected, with the highest values in the morning and declining to the lowest values in the evening hours. Concentrations of salivary cortisol showed higher values during the workday, especially higher concentrations of evening cortisol and attenuated cortisol slope. Based on the results, irregular shift work has a greater increase in cortisol excretion after waking in the morning and a slower progressive recovery of the organism during the workday. In addition, cortisol levels were significantly higher in older women than in older men but did not differ in younger subjects. CONCLUSIONS Salivary cortisol levels are a suitable objective marker of stress and can be used as a good predictor of occupational stress by public health services for the purposes of primary prevention.