Liisi Sewón

A prospective study on sucrose consumption, visible plaque and caries in children from 3 to 6 years of age

OBJECTIVES As data on the association of sugar consumption and dental caries in the industrialized countries give mixed results, we prospectively studied this association in 135 healthy Finnish children (71 boys, 64 girls). METHODS The dental health and oral hygiene of the children was first examined at the mean age (+/-SD) of 37.4 (+/-2.1) months and again at 73.7 (+/-2.6) months. On both occasions the parents were interviewed about the childs sweet intake and toothbrushing habits, and sucrose consumption was analyzed using 4-day food diaries. RESULTS The proportion of children with caries experience, enamel and dentin lesions combined, increased from 16% to 40%. Daily sucrose intake of children who developed caries by 6 years of age, whether expressed as absolute (g) or as relative (E%) amounts, was already higher at 3 years of age than that of children who stayed caries-free (P<0.05 and P<0.03, respectively). Furthermore, children who used sweets more than once a week at 3 years of age, consumed more sucrose 3 years later (P<0.01) than those who used sweets once a week or less. The proportion of children with a combination of a sweet intake more than once a week and visible plaque, increased (P<0.05) during the follow-up. The risk ratio of children with the combined risk habit at 3 years of age to develop carious lesions by 6 years of age was 1.7 compared to the rest of the children (95% confidence interval 0.9-3.0). CONCLUSIONS We conclude that the manifestation of dental caries at 6 years of age seemed to be associated with a higher daily sucrose intake that had started already at 3 years of age. Moreover, a combination of sweet intake more than once a week and visible plaque at 3 years of age may be predictive of dental health 3 years later.

The effect of hormone replacement therapy on salivary calcium concentrations in menopausal women.

Hormone replacement therapy in menopausal women is known to affect the general calcium turnover of the body. No information is available about the effects of hormone therapy on salivary electrolytes and on calcium in particular. A group of 16 healthy peri- and postmenopausal women, all recommended to start hormone replacement therapy, were studied longitudinally for 5 months. Paraffin-stimulated whole saliva was collected at baseline, at 3 and at 5 months after the onset of therapy, and analysed for calcium, sodium and potassium concentrations. In response to hormone replacement therapy, calcium concentration decreased (p = 0.037), that of sodium increased (p = 0.019), while no change was observed in the potassium concentrations during the follow-up period.

Long-term physical inactivity and oral health in Finnish adults with intellectual disability

Physical inactivity is prevalent among patients with intellectual disability. Because little is known about the oral effects of poor mobility, we reviewed the medical and dental charts of institutionalized dentate patients (n = 214;40.2 years - 12.1) of the Special Welfare District of Southwestern Finland. The number of decayed, missing, and filled teeth (DMFT), the number of retained teeth, dental treatment visits, and the type of the first treatment visit were recorded. Physical activity was good in 55% and severely reduced or completely absent in 45% of the patients. The degree of intellectual disability was mild or moderate in 40% and severe or profound in 60% of the patients. The walking patients weighed more (64.3 (19.6)versus 44.4 (14.4) kg; P < 0.001), had fewer secondary diagnoses (1.4 (1.3) versus 2.2 (1.4); P < 0.001), fewer daily medications (4.0 (2.1) versus 4.8 (2.4); P < 0.02), higher DMFT scores (18.5 (8.2) versus 14.8 (9.2); P < 0.05), and more dental treatment visits (2.7 (2.4) versus 2.0 (1.3); P < 0.03) than patients with poor physical activity. Periodontal treatment given as the primary type of dental care was more common among subjects with poor mobility than among those with good motor activity (P < 0.002). Poor physical activity was related to better dental health, higher need for periodontal therapy, and fewer dental visits than in patients with good motor activity.

Salivary variables in relation to tobacco smoking and female sex steroid hormone-use in 30 to 59-year-old women.

Several systemic conditions may have an influence on oral health. Hormone replacement therapy (HRT) has a positive effect on alveolar bone of menopausal women and smoking a negative effect. However, little is known about their effect on saliva. The purpose of this study was to examine the effect of hormone-use and tobacco smoking on the composition of saliva, in particular on the inorganic constituents. Salivary samples were collected from a representative study group comprising 1013 women (30-59 years) participating in a pre-screen referral program for osteoporosis. The participants were divided into 2 subgroups according to age. The younger group ( h 45 years) comprised 413 women and the older group ( S 50 years) 600 women. Salivary calcium, magnesium, sodium, potassium, inorganic phosphate, total protein, and flow rate of paraffin-stimulated saliva were measured. In the older age group, female sex steroid users (hormone users) had lower salivary protein concentrations than non-users. Smoking was associated with high salivary calcium, magnesium, and potassium levels in the group of older participants. Neither tobacco smoking nor female sex steroid hormones had any significant effect on the salivary composition in the younger age group. In conclusion, smoking was reflected more clearly than female sex steroid hormone-use in the inorganic composition of saliva in the older age group. The salivary composition was not affected by hormone-use or by smoking among the younger age group.

The limited value of three pathogen species in predicting healing of periodontal pockets.

Baseline level of Actinobacillus actinomycetemcomitans has been suggested as being predictive of periodontal treatment outcome. We analyzed the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in 55 deep periodontal pockets of 29 patients (18 men, 11 women, 37-75 years) before and after periodontal treatment. At baseline and after treatment, 62% and 33%, respectively, of the subjects presented with 1, 2, or a combination of all 3 pathogens. The mean pocket depth of 6.6 mm (0.4 mm) before treatment decreased to 2.2 mm (0.4 mm) in response to treatment (P<0.001). The treatment plan of non-surgical or surgical treatment was based on pocket depths and tooth morphology only. No antimicrobial medications were used during the treatment. Eighty-two percent of the deep pockets healed satisfactorily to < or = 4 mm. The presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, or Prevotella intermedia at baseline was not associated with the outcome of the periodontal therapy. In conclusion, we found that the presence of the 3 periodontopathogen species had little or no value in predicting healing of periodontal pockets.