Joanna Baginska

Index of clinical consequences of untreated dental caries (pufa) in primary dentition of children from north-east Poland

PURPOSE The purpose of this study was to evaluate the prevalence and experience of clinical consequences of untreated dental caries in primary dentition in 5 and 7 year-old children from north-east Poland and to find whether there is a correlation between dmft and pufa indices. MATERIAL/METHODS Two hundred fifteen children aged 5 and 7 years living in the Podlaskie region were examined in the course of the Polish National Oral Health Survey 2011. Caries prevalence and experience in primary dentition was evaluated according to WHO criteria (dmft index). The clinical consequences of untreated dental caries were assessed by pufa index. RESULTS The dmft index was 5.56 ± 4.45 in 5-years-old children and 6.69 ± 3.14 in 7-years-olds. The prevalence/experience of pufa index was 43.4%/2.20 ± 3.43 and 72.4%/2.44 ± 2.22, respectively. Children living in rural areas presented a worse dental condition. A statistical analysis revealed a strong relation between dmft and pufa in both age groups. CONCLUSION The present study revealed negligence in the dental treatment of children from north-east Poland resulting in the high prevalence and experience of the pufa index in primary dentition. This index is a valuable measurement tool to record the clinical consequences of untreated dental caries.

Dental caries in primary and permanent molars in 7-8-year-old schoolchildren evaluated with Caries Assessment Spectrum and Treatment (CAST) index

BackgroundNo reports on a caries pattern covering the full spectrum of the disease could be found in the literature. The aim of this study was to evaluate caries in primary and first permanent molars of 7-8-year-old Polish children by the Caries Assessment Spectrum and Treatment (CAST) index and to find whether there was any correlation between the caries stages in such teeth.MethodsThe study covered 284 7-8-year-old children from randomly selected schools in the Bialystok District, Poland. The prevalence of CAST categories was evaluated with regard to the first and second primary, and first permanent, molars. The Spearman’s rank correlation coefficient was used to explore the correlation of the distribution of CAST codes among the evaluated teeth. The level of statistical significance was established at p < 0.05. The intra-examiner reliability was determined by the unweighted kappa coefficient.ResultsWith regard to the permanent molars, caries was observed in 14.8% to 17.3% of the molar and most lesions were scored at the non-cavitation level. Caries in primary molars was most often recorded at the stage of cavitated dentine lesion. Teeth with pulpal involvement, sepsis and extracted due to caries were found to be more prevalent in first, and then in second primary molars. A strong correlation was found between the status of teeth from the right and left sides of the oral cavity. The correlation of the status of first and second primary teeth was stronger for the left than for the right side of the mouth, r was 0.627 and 0.472 in maxilla and 0.513 and 0.483 in mandible (p < 0.001), respectively. For the neighbouring primary and permanent molars the correlation was assessed to be weak. With regard to the teeth situated in opposite jaws the study revealed that the correlations were moderate - r between 0.33 and 0.49. The intra-examiner reliability was established at 0.96 for the primary dentition and at 0.878 for permanent molars.ConclusionThe strongest correlation found in the evaluated population concerned the distribution of caries in primary molars on the left side of the mouth. The study proved the usefulness of the CAST index in epidemiological surveys.

Hepatocyte Growth Factor in Saliva of Patients with Renal Failure and Periodontal Disease

Background: Hepatocyte growth factor (HGF), endogenous cytokine with pleiotropic repairing and regeneration properties in relation to most tissues and organs, contributes to the progression of periodontal disease (PD). Furthermore, PD is a significant health problem in patients with chronic renal failure (CRF). The role of HGF in the development of PD in this specific population was not a subject of research so far. Material and methods: The following groups were enrolled in the study: (1) 26 chronic hemodialysis (HD) subjects, (2) 26 patients treated by continuous ambulatory peritoneal dialysis (CAPD), (3) 28 predialysis CRF patients, (4) 26 subjects with advanced PD (without coexisting diseases), and (5) 20 healthy subjects without PDs. HGF level in saliva was measured using the immunoenzymatic method. Gingival index, papillary bleeding index, plaque index, and the loss of clinical attachment level were evaluated. Results: The HGF level in saliva of HD patients was twice higher than in that of subjects with healthy periodontium. Direct relationships between proper HGF level in saliva and the indices GI, PBI, and PI in CAPD-treated patients and with more severe PD were shown. It was found that PD is most advanced in HD patients, moderately in CAPD-treated patients and to the smallest extent in predialysis CRF patients. Conclusions: The HGF level in mixed saliva is the index of PD progression in subjects without renal failure and in CAPD-treated patients. PD is common in renal failure patients and is a significant problem concerning general health status.

Is xerostomia a risk factor for cardiovascular morbidity and mortality in maintenance hemodialysis patients

Xerostomia resulting mostly from hyposalivation and alkaline salivary pH is a frequent but often underappreciated symptom in the diseased population of maintenance hemodialysis (HD) patients. We reviewed also other xerostomia-predisposing factors, its specific dental and oral clinical signs and features, as well as plausibly detrimental dialysis-specific pro-atherosclerotic and cardiovascular consequences. In view of increasing multidisciplinary importance of xerostomia, its general, pharmacological and emerging treatment methods were presented. Special attention was paid to the untoward and often neglected pro-xerostomic effects of multiple common medications and substances; they were listed and described in more detail. The combined therapeutic approach of dentists and nephrologists may effectively alleviate xerostomia and support general health condition of maintenance hemodialysis patients.

First-Aid Algorithms in Dental Avulsion.

Almost one fourth of traumatic dental injuries occur at schools or in their surroundings. Prevalence of tooth avulsion varies from 0.5% to 16% of all cases of dental trauma. Children with dental avulsion may seek help from school nurses so they should be able to provide first-aid treatment. However, many studies showed that the general level of knowledge of medical staff concerning tooth avulsion is unsatisfactory and that it could be improved by educational activities. This article attempts to give short algorithms of first-aid management of avulsed tooth.

Oral health-related quality of life in patients undergoing chronic hemodialysis

Aims The aims of the study were to determine oral health-related quality of life (OHRQoL) in chronic hemodialysis (HD) patients and to estimate which scale describing OHRQoL, Oral Health Impact Profile (OHIP-14) or Geriatric/General Oral Health Assessment Index (GOHAI), was more useful in this particular group. Methods This was a cross-sectional study conducted by means of a census survey. The Polish versions of OHIP-14 and GOHAI were used to assess OHRQoL. The oral examination included decayed, missing and filled teeth (DMF-T) Index; Oral Hygiene Index simplified; Plaque Index and Gingival Index. In the statistical analysis, the Kruskal–Wallis test, Mann–Whitney U test, Pearson’s χ2 test and Spearman’s rank correlation coefficients were used as appropriate. Results The final sample consisted of 72 patients (mean age 63.2±15.2 years). The mean duration of HD treatment was 43.8 months. The mean number of teeth was 10.9. The majority of participants (81.9%) were dentate; only 22.2% of the respondents had >20 teeth. Among the dentate subjects, 44.1% wore removable dental prostheses (60.7% women). The most prevalent items for GOHAI (mean 14.71; SD 7.21) were uncomfortable to swallow, discomfort when eating and unhappy with appearance. The most prevalent items for OHIP-14 (mean 8.87; SD 10.95) were uncomfortable to eat foods, and diet has been unsatisfactory. The internal reliability (Cronbach’s alpha) was 0.637 for GOHAI and 0.918 for OHIP-14. Chewing problems were significantly related to GOHAI (p=0.001) and OHIP-14 (p<0.001) scales. Higher OHIP-14 scores were significantly associated with dental treatment needs (p=0.029) and poor self-rated oral status (p=0.001). Conclusion The HD patients had an unsatisfactory oral status, but using only OHRQoL scale was insufficient to capture all their oral health problems. The scales did not fully reflect poor oral health in HD patients. The oral problems were not a major concern for this group of patients, which could indicate the adaptation to impaired oral health or a change in health priorities. Regular dental examinations together with the assessment of OHRQoL in HD patients are required for a comprehensive patients’ state. In our study, more variables were significantly related to the OHIP-14 scale than to the GOHAI scale. Thus, the OHIP-14 scale may be more useful in assessing OHRQoL in HD patients.