Najith Amarasena

Dentine hypersensitivity in a private practice patient population in Australia

Although dentine hypersensitivity (DH) has been widely investigated, studies based on randomly selected general practice populations are scarce. This study aimed to examine the intra-oral distribution of DH and its association with age, sex, symptoms, stimuli, pre-disposing factors and management strategies in a private practice patient population in Australia. A randomly selected sample of 800 Australian private dental practice dentists was invited to participate in a questionnaire-based survey. A log diary about the total number of patients seen during a typical week in practice and the details of patients with DH were recorded. The details included teeth and sites involved with DH and the age and sex of people affected, symptoms, stimuli, pre-disposing factors and management strategies. The prevalence of DH was 9·1% among patients seen over the typical week with 2·3 teeth/person and 1·2 surfaces/tooth affected. Women (60·7%) were more affected than men (39·3%) whilst 30- to 49 -year-olds (48·8%) were the most common among those affected. Premolars (36·5%) and buccal surfaces (54·8%), respectively, were the most commonly affected teeth and tooth sites. Although cold stimulation (80·1%) was the commonest stimulus, dietary acid was the only stimulus that was significantly associated with DH. Gingival recession and erosion emerged as significant pre-disposing factors, whereas using desensitising toothpastes was the most important management strategy. The findings suggested that dietary acid, gingival recession and erosion were significantly associated with DH, while desensitising toothpastes was the key management strategy used for DH in this patient population.

Effect of antimicrobial periodontal treatment and maintenance on serum adiponectin in type 2 diabetes mellitus.

AIMS The aims of this study were to evaluate the effect of mechanical periodontal treatment with local application of minocycline (APT) on serum adiponectin as a marker of insulin resistance improvement in type 2 diabetes mellitus (T2DM) patients and to investigate if effect of APT on serum adiponectin level was sustained by periodontal maintenance (PM). MATERIAL AND METHODS Twenty-seven T2DM patients were randomly assigned into test or control groups. Test received scaling with ultrasonic devices at baseline and APT biweekly for 2 months while control received scaling at baseline and mechanical tooth cleaning (MPT) at the same interval. At 6 months, all patients received mechanical tooth cleaning as PM. Periodontal examination and blood measurements were performed at baseline, 4 and 9 months. RESULTS Adiponectin concentrations in test had significantly increased by 31.4% after APT (p=0.024) and by 30.4% after PM (p=0.002) compared with baseline. The percentage of >or=4 mm probing depths (PD) had shown 8.3% and 9.3% reduction after APT and PM (p=0.046, 0.02) in test while 5.0% reduction after MPT in control group (p=0.031). CONCLUSIONS Our results suggested that APT and PM not only improve periodontal disease but also increase serum adiponectin in T2DM patients.

Association between serum calcium and periodontal disease progression in non‐institutionalized elderly

OBJECTIVE To assess the effect of baseline serum calcium on the progression of periodontal disease in non-institutionalized elderly. BACKGROUND Although a few studies have found some evidence of the role played by dietary calcium in periodontal disease process, there is a paucity of information pertinent to longitudinal assessment of serum calcium-periodontal relationships. MATERIAL AND METHODS Clinical attachment levels of 266 Japanese subjects aged 70 years were recorded at baseline and annually for six consecutive years. Progression of periodontal disease (PPD) was defined as the number of teeth that showed additional attachment loss of > or =3 mm during the 6 years. The number of PPD was calculated for each subject and categorised into four levels, namely, PPD(0), PPD(1), PPD(2) and PPD(3) where the number of teeth with additional attachment loss ranged from 0, 1-10, 11-20 and >20 respectively. The levels of serum calcium, albumin, random blood sugar, immunoglobulin (IgG, IgA and IgM), gender, smoking habits, education, gingival bleeding and the number of teeth present were obtained at baseline. RESULTS Serum calcium, IgA, smoking, gingival bleeding and teeth present were associated with PPD at p < or = 0.10 and were included in a multinomial logistic regression analysis. Serum calcium was the only variable that was significantly associated with PPD with relative risks of 100 at PPD(1) and PPD(2), respectively, and 1000 at PPD(3). CONCLUSION Serum calcium may be considered a risk factor for periodontal disease progression in non-institutionalized elderly.

Influence of Family Structure on Dental Caries Experience of Preschool Children in Sri Lanka

Background: The prevalence of dental caries in preschool children has not been declining in the recent past. A growing body of research suggests that social and behavioural factors may play a considerable role in the aetiology of dental caries. Aims: The objective of this study was to determine the relationship between the family structure and dental caries experience in preschool children. Methods: A descriptive cross-sectional study was carried out in children aged 3–5 years in Wattala Divisional Secretariat area in Colombo district of Sri Lanka. An interviewer-administered questionnaire was used to obtain information from the parents on family structure including the size, birth rank, age spacing between the next oldest and youngest sibling and age of parent at birth of the subject. The dental caries status of the children was assessed using WHO standard criteria for primary teeth. Results: Family size, birth rank, age difference between the subject and next oldest sibling and parent’s age at birth of the subject were significantly associated with the dental caries experience of the preschool children at bivariate level. In a stepwise multiple linear regression analysis family size, birth rank and the parent’s age at birth of the child remained statistically significant. Conclusion: The present findings suggest that family structure might significantly affect the caries experience of preschool children.

Socio-Demographic Risk Indicators for Tooth Mortality in Rural Sri Lankans

To explore the socio-demographic factors associated with tooth loss in rural inhabitants of Sri Lanka, a random sample of 2178 males aged 20-60 years was selected using multistage cluster sampling procedure. The number of missing and present teeth was recorded excluding third molars and the subjects were interviewed to elicit socio-demographic information as well as oral hygiene and tobacco consumption habits. The mean number of teeth lost in the sample was 5.17±5.43. Tooth loss increased significantly with age. Sinhalese had significantly fewer lost teeth (5.05±5.38) compared to Tamils (6.54±6.18) and Muslims (6.02±5.21) whereas education, income, oral hygiene practices and tobacco use were significantly associated with tooth loss in the bivariate analysis. A forward stepwise multiple regression analysis revealed that age, Muslim ethnicity and quantified tobacco use were positively associated with tooth loss while better socio-economic conditions and good oral hygiene habits were negatively linked with tooth mortality independent of other factors. Age, Muslim ethnicity, quantified tobacco use, income, education, brushing frequency and substance used for cleaning had significantly affected tooth loss. Quantified tobacco use and oral hygiene may be regarded as modifiable socio-demographic risk indicators associated with tooth mortality in Sri Lankans. Asia Pac J Public Health 2003; 15(2): 105-110.

Psychological distress and self-rated oral health among a convenience sample of Indigenous Australians

OBJECTIVES This study sought to: a) estimate the frequency of poor self-rated oral health as assessed by a summary measure; b) compare frequency according to sociodemographic, behavioral, and psychological distress factors; and (3) determine if psychological distress was associated with poor self-rated oral health after adjusting for confounding. METHODS Data were from a convenience sample of Indigenous Australian adults (n = 289) residing in Australias Northern Territory. Poor self-rated oral health was defined as reported experience of toothache, poor dental appearance or food avoidance in the last 12 months. A logistic regression model was used to evaluate socio-demographic, behavioral, and psychological distress associations with poor self-rated oral health (SROH). Effects were quantified as odds ratios (OR). RESULTS The frequency of poor SROH was 73.7 percent. High psychological distress, measured by a Kessler-6 score ≥8, was experienced by 33.9 percent of participants. Poor SROH was associated with high levels of psychological distress, being older, being female, and usually visiting a dentist because of a problem. In the multivariable model, factors that were significantly associated with poor SROH after adjustment for other covariates included having a high level of psychological distress (OR 2.74, 95% CI 1.25-6.00), being female (OR 2.22, 95% CI 1.03-4.78), and usually visiting a dentist because of a problem (OR 3.57, 95% CI 1.89-6.76). CONCLUSIONS Poor self-rated oral health and high levels of psychological distress were both highly frequent among this vulnerable population. Psychological distress was significantly associated with poor self-rated oral health after adjustment for confounding.

Factors Associated with Severe Periodontitis in Rural Cambodia

An analytical cross-sectional study was conducted with 812 subjects aged 35-74 years in Prek Russey commune, Cambodia to detect some factors associated with severe periodontitis. Four calibrated examiners employed Community Periodontal Index (CPI) to ascertain periodontal pocket depth (PD) and loss of epithelial attachment (LA). A questionnaire was used to obtain tobacco and alcohol consumption habits. One hundred (12.3%) subjects had one or more sextants with ≥ 4mm PD and ≥ 6mm LA (severe periodontitis). Smoking, tobacco chewing and age were significantly associated with severe periodontitis in bivariate analysis while only age and quantified smoking remained significant in a logistic regression analysis. The impact of quantified smoking on severe periodontitis was almost negligible [OR: 1.0006 (95% CI: 1.0001, 1.001)] compared to that of age [OR ranged from 8.3 at 45-54 years to 22 at 65-74 years (95% CI: 3.1, 62.3)]. Nevertheless, both age and quantified smoking can be considered as factors associated with severe periodontitis in rural Cambodians. Asia Pac J Public Health 2004; 16(1): 50-53.

Oral Stereognostic Ability during Adaptation to New Dentures in Experienced and Non-experienced Complete Denture Wearers

Abstract one of the major concerns of denture wearers is adaptation to new or replacement dentures, regardless of their experience of wearing dentures. The purpose of this study was to investigate the changes in oral stereognosis ability (OSA) that occur with the insertion of a new denture in experienced and non-experienced complete denture wearers. Age and gender-matched 8 experienced and 8 non-experienced complete denture wearers were tested. OSA was assessed by measuring the accuracy of solid object size perception at 3 stages, namely, just before (pre-treatment), 30 min after (30 min post-treatment) and one month after (1 month post-treatment) the insertion of new dentures. Two-way ANOVA with post-hoc Tukeys test was used to analyze the experience factor (experienced vs. non-experienced) and test interval (pre-treatment, 30 min post-treatment and 1 month post-treatment). OSA was influenced by the test interval (F 2,23 =4.3, p =0.04). OSA was significantly increased 1 month post-treatment compared to 30 min post-treatment (Tukeys test p 1,13 =0.76, p =0.41). There was a significant interaction of experience by test interval (F 2,23 =69.44, p

PERIODONTAL STATUS OF RURAL INHABITANTS IN PREK RUSSEY, CAMBODIA

There is a paucity of information pertaining to oral disease patterns including periodontal disease in Cambodia, which is just emerging from a 20-year ruin. A house-to-house survey was conducted to assess the periodontal status of 1948 subjects aged 15-74 years in a rural commune in Cambodia using Community Periodontal Index (CPI) and measuring Attachment Loss (LA). The periodontal status of Cambodians increased with age as indicated by both CPI and LA. Calculus was the most common finding among Cambodians pointing to overall poor oral hygiene levels. Notwithstanding the poor oral hygiene, however, the severe periodontitis as denoted by ≥ 6mm periodontal pockets was rare even in the elderly while edentulousness was not frequently observed until 65 years. Preventive programmes targeting periodontal disease in Cambodia should focus on oral health education and simple oral hygiene instructions while the ubiquitous calculus could be dealt with oral prophylaxis. Asia Pac J Public Health 2002; 14(2): 105-109.

Mastication and Swallowing in Patients with Oral Submucous Fibrosis

Objective: Early stages of oral submucous fibrosis may lead to masticatory and swallowing impairments. This study was, conducted to evaluate the masticatory and swallowing functions in a group of oral submucous fibrosis patients. Patients and Methods: Masticatory and swallowing performance, maximum bite force, oral stereognosis, and surface electromyographic activity of the buccinator muscle were measured in 11 patients with early oral submucous fibrosis and controls matched for age and gender. Results: Statistical analysis revealed that there was no significant difference in maximum bite force between controls and patients with oral submucous fibrosis. However, the masticatory and swallowing performance, integrated surface electromyographic activity during maximum blowing in right buccinator, and oral stereognostic score in the oral submucous fibrosis group were significantly lower than in the control group. Conclusion: These findings suggest that patients with early oral submucous fibrosis may exhibit impaired masticatory and swallowing functions along with reduced oral stereognosis and buccinator muscle activity.