Melinda Madléna

ASSOCIATIONS BETWEEN MICROBIOLOGICAL AND SALIVARY CARIES ACTIVITY TESTS AND CARIES EXPERIENCE IN HUNGARIAN ADOLESCENTS

The aim of the study was to assess caries prevalence in connection with salivary caries–related findings in 349 14– to 16–year–old Hungarian adolescents living in two different cities. DMFT, DMFS means, stimulated salivary flow, buffer capacity, mutans streptococci, lactobacilli and candida counts in saliva were determined. The ratio of caries–free adolescents was 4.6% in the total population sample, DMFT mean values were 7.24±4.86, DMFS means 10.50±8.35. Mean secretion rate of stimulated saliva was 0.84±0.50; a low buffer capacity was found in 6.3% of the examined children. The ratio of carriers of mutans streptococci, lactobacilli and yeasts in saliva was 89.7, 73.9 and 47.7%, respectively. DMFT and DMFS values as well as mutans streptococci and candida counts were lower in the capital than in the other city. Statistically significant correlations were found between DMFT, DMFS mean values, and salivary microbiological counts.

Caries prevalence and tooth loss in Hungarian adult population: results of a national survey

BackgroundOral health is basicly important for the well-being of people. Thus, it is strongly suggested to organize epidemiological surveys in order to gain representative data on oral condition of the given population. The purpose of the cross-sectional study was to determine the results on tooth loss and caries prevalence of Hungarian adults in different age groups.MethodsAltogether 4606 persons (2923 women, 1683 men) participated in the study who were classified into different age groups: 19 [less than or equal to], 20–24, 35–44, 45–64, 65–74, [greater than or equal to]75 year olds. Probands were selected randomly from the population attending the compulsory lung screening examinations. The participants were examined by calibrated dentists, according to the WHO (1997) criteria. In order to produce representative data, the chosen localities for these examinations covered the capital, the largest towns, the villages, and case weights were used for the statistical evaluation.ResultsThe mean values of DMF-T were found between 11.79±5.68 and 21.90±7.61 These values were significantly higher in women compared to men (p < 0.05). In all age groups the values of M were the highest. Except for the women in the groups of 35–44 and 45–64 year olds, these values showed an increasing tendency both in women and men by age (from 5.50±6.49, and 4.70±4.08 to 21.52±9.07 and 18.41±8.89 respectively). The values of D components reached the highest values in 45–64 year olds (4.54±2.12 and 4.22±2.81, by gender, respectively), then in the older age groups there was a high reduction in these values (in 65–74 year olds: 2.72±1.88 and 1.36±2.48; in 75 or more than 75 year olds: 1.05±1.41 and 1.03±1.76 by gender, respectively). The ratio of D and F values was the highest in the age group of 65–74 year olds (2.12), the lowest ratio could be calculated in 20–34 year olds (0.65).Data showed some decrease in caries experience in 35–44 years of age between 2000 and 2004. The prevalence of persons with 21 or more teeth had been increased from 65.6% to 73.1%. This positive tendency has not been occured in prevalence of edentulousness in this age group: the prevalence of edentulous persons changed from 1.4 to 1.9%. In 65–74 year olds the level of edentulousness became lower, from 25.9 to 14.8% and the prevalence of persons with 21 or more teeth is higher (22.6%) than it was in 2000 (13.0%).ConclusionPresent data from Hungary show some slight decrease in caries experience between 35–44 years of age, although this positive tendency has not been occured in prevalence of edentulousness in this age group. A positive tendency could be experienced in the group of 65–74 year olds in edentulousness and in number of teeth, but further efforts are needed to reach a better situation.

Periodontal health of an adult population in Hungary: findings of a national survey.

OBJECTIVES To estimate the levels of periodontal health conditions of Hungarian adults. MATERIAL AND METHODS Periodontal data on 4153 adults in 304 survey locations from all Hungarian regions were analysed. The Community Periodontal Index (CPI) was used to report the occurrence of probing pocket depth, calculus, and gingival inflammation. Age, gender, socioeconomic and health status, oral hygiene and lifestyle habits, dental office attendance, level of education, and fixed partial denture (FPD) treatment were evaluated for their association with periodontal conditions. CPI score as an outcome was dichotomized using an accepted threshold as low (<3) and high (3, 4) for multiple logistic regression modelling. RESULTS CPI2 was the most prevalent score in all age groups. CPI scores were also strongly associated with the independent variables. Approximately 66% of subjects visited a dentist only in the case of an emergency. Lack of periodontal aspects of restorative care was demonstrated by the result of CPI0 among 16% of non-FPD wearers compared with only 9% of individuals treated with FPD. CONCLUSION The present survey indicates that oral hygiene standards and periodontal health conditions need improvement in Hungary. Effective intervention programme for the prevention and control of periodontal disease are recommended at a national level.

Effect of Amine Fluoride Toothpaste and Gel in High Risk Groups of Hungarian Adolescents: Results of a Longitudinal Study

The aim of the study was to establish a preventive program with the combined use of amine fluoride toothpaste and gel in groups of adolescents living in different locations in Hungary. Caries and oral hygiene examinations were performed at the beginning of the study and repeated after 1 and 2 years. The adolescents were divided into 3 groups: 1 control and 2 test groups. The control group continued its usual oral care habits. One of the test groups received Elmex toothpaste for unsupervised home use daily and Elmex gel for use once a week, and the other test group received Elmex toothpaste and only placebo gel. The combined use of amine fluoride-containing toothpaste and gel provided a significant reduction in DMFS mean values (38% including white spot lesions, 34% not including white spot lesions, p < 0.05) and in visible plaque index values (18%, p < 0.05) compared to the control group.

Dental caries experience in a Hungarian police student population.

The aim of this study was to assess the caries experience of Hungarian police students and to evaluate its relationship with nutrition, oral hygiene habits, behavioural and social factors. This representative cross-sectional epidemiological survey was conducted in a dental office of the Miskolc Law Enforcement Secondary School in Hungary in 2008. Altogether 792 Hungarian police student volunteers (male/female ratio was 90.3/9.7%, age: 20.4 ± 1.3 years, mean ± SD) participated in the study. Caries experience was measured using World Health Organization criteria and a validated questionnaire was used to collect social and oral health behaviour data. The DMFT number was 10.3 ± 5.7 (mean ± SD). Significant relationships were found between the DMFT value and the education of fathers, frequency of dental attendance, and use of dental floss (p < 0.05). D and T components of caries prevalence showed significant relationships with the frequency of dental attendance, while from the components the FT value showed statistically significant relationships with the education of fathers and the MT component with the use of dental floss (p < 0.05). Based on the results of this survey, strategies aiming at effective caries-preventive programmes should be established in police student populations ensuring the official basic requirements on their health condition and suitability for subsequent service. The published information can be used as a base for new strategies, and allows the evaluation of the effects of a carefully planned and implemented health care system.

Experiences with amine fluoride containing products in the management of dental hard tissue lesions focusing on Hungarian studies: a review.

UNLABELLED Fluorides play a significant role in the promotion of oral health, fostering remineralization, inhibiting demineralization processes in the enamel, and having antibacterial activity. The effects of fluorides are mostly exerted by their topical effect. The beneficial effect of amine fluorides (AmF) on caries and dental plaque reduction has been known for a long time. The caries reducing and plaque-inhibiting effect of stannous fluoride (SnF2) was also reported. However, the combination of amine fluoride/stannous fluoride has shown a much better inhibition of plaque accumulation then these products alone. There have been several clinical studies with AmF or AmF/ SnF2 products, using toothpaste, gel, combination of toothpaste and gel/fluid, toothpaste and mouth rinse. The aim of this article is to review the clinical experiences with these products based on Hungarian studies. The first Hungarian studies with AmF containing gel were published by Szőke and Kozma (1989) and Dénes and Gábris (1991). Madléna et al. (2002) performed a study with an AmF-containing toothpaste and gel in high risk groups of adolescents. The first Hungarian study with AmF/SnF2 products was published by Bánóczy et al. (1989). Based on the favourable results of these products used in combination for 12 weeks, other studies (Madléna et al. 2004, 2012) assessed the effects of toothpastes and mouth rinse containing AmF/SnF2 on plaque accumulation, within a shorter period of time, in young adults and orthodontic patients. CONCLUSION Regular use of different oral hygienic products containing an AmF and AmF/SnF2 combination contributes to the prevention of plaque accumulation and consequently to the prevention of dental diseases.

Changes in gingival blood flow during orthodontic treatment

The aim of the study was to investigate the changes in gingival blood flow due to orthodontic forces. Eleven volunteers, with the maxillary canine in an ectopic position were tested. A Laser Doppler Flowmeter (LDF) with a gingival probe was used, registering both the blood flow and temperature of the gingivae. After baseline measurement, a fixed orthodontic appliance was bonded. Measurements were repeated monthly, after activation of the appliance. The study lasted 6 months. The baseline value was 338.7 ± 201.56 P.U. [Perfusion Unit (mean ± S.D.)] which decreased to 218.9 ± 74.83 P.U. (p < 0.05) after two months and the final value of 363.9 ± 194.86 P.U was not significantly different from that initially (p > 0.5). The results showed that application of a force of 75 g resulted in a decrease in gingival blood flow up to 50%, but this returned to previous values after a few months. The study supports this measurement technique as a useful tool for monitoring gingival blood flow in long-term studies as well.

Microbiological Changes and Caries-Preventive Effect of an Innovative Varnish Containing Chlorhexidine in Orthodontic Patients

The aim of this study was to investigate the effects of Cervitec Plus® on the level of mutans streptococcus (SM) and lactobacillus (LB) colonies and the development of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Informed consent was obtained from 32 volunteers (age 16.5 ± 2.75 years). At baseline, levels of the bacterial colonies were determined in saliva and plaque using a chairside test (CRT Bacteria, Ivoclar-Vivadent, Schaan, Liechtenstein), and the number of WSLs was registered. After placing the fixed appliance, Cervitec Plus® or placebo varnishes (Ivoclar-Vivadent, Schaan, Liechtenstein) were applied monthly around the brackets and tubes, randomly in the right or left (test and placebo) quadrants of the same dental arch. SM and LB colonies in saliva and the SM colonies in plaque were determined on 11–21, 13–23, 15–25, and 16–26 teeth monthly over a 6-month period. At the sixth month, the number of new WSLs was determined. By the end of the study, compared with baseline, the ratio of saliva samples belonging to the low-risk category was significantly higher (p ≤ 0.01) from the 2nd month regarding the SM (76 vs. 52%) and LB (69 vs. 52%); reduction of SM in plaque was significantly greater on the test than placebo sides (6.69 ± 1.71 and 4.45 ± 1.60, respectively; p ≤ 0.01). The mean number of new WSLs was significantly lower in the test (0.06 ± 1.60) than in the placebo quadrants (1.13 ± 1.50, p ≤ 0.01). Conclusion: Monthly use of Cervitec Plus® could result in a significant improvement in oral health of orthodontic patients.

Links between oral health and personality at a law enforcement school

One of the territories of dental psychosomatics is the link between personality characterisctics and dental status. The aim of the present study was to survey the relationship between temperament and character factors and dental status in police students. It can be hypothesized, that some temperament factors can increase the risk for dental health problems. After dental screening 792 police students completed the Temperament and Character Inventory (TCI) devised by Cloninger. 57.5% of students rated their own teeth as being in good or very good condition, and only 2.8% as bad condition. In persons rating their dental status as “good”, the average DMFT was 9.23±5.01 (mean±S.D.). In students assessing their own oral health as bad, TCI results showed that a higher percentage of students displayed extravagance, impulsiveness, disorderliness than the overall population. Among the students with good self-assessment but bad teeth, there was a higher percentage of students displaying passivity, low assertiveness, and introversion. The temperament and character factors may have negative consequences for students in an institution which exposes them to high stress level. It may be useful to screen these students using subjective health questionnaires in order to permit more effective efforts to positive health behaviour.

Quantitative Analysis of Catecholamines in Human Dental Pulp

Catecholamines are important elements of neuroendocrine regulation, and their concentrations in dental pulp are of interest. Two groups of teeth were used in this study: (i) healthy teeth and (ii) periodontally diseased teeth. After the processing of dental pulp obtained from the extracted teeth, the samples were analyzed in a computer-controlled Merck-Hitachi HPLC system at 280 nm wavelength. The external and internal standard methods of the HPLC Manager Program were used for validation. In healthy teeth the norepinephrine level of dental pulp was 4.86 +/- 0.96 micrograms/g, whereas the epinephrine level was 8.1 +/- 1.18 micrograms/g. In periodontally diseased teeth norepinephrine and epinephrine levels were significantly higher (p < 0.01) at 13.98 +/- 21.13 micrograms/g and 1.42 +/- 0.32 micrograms/g, respectively. Dopamine could not be demonstrated in 87% of the pulps. Summing up we succeeded in demonstrating norepinephrine and epinephrine in human pulp, but in most cases we could not demonstrate dopamine. Further investigations are needed on pulp tissue infected because of caries.