Pål Arneberg

Oral hygiene and caries: A review

On the basis of existing literature, efficient oral hygiene was found to have a caries preventive effect. The quality of the cleaning appears to be more important than the frequency of its performance. Professional tooth cleaning at regular intervals may inhibit caries on all tooth surfaces. The effect of self-performed oral hygiene has been demonstrated mainly on free smooth surfaces and on front teeth.

Dental Fluorosis and Nutritional Status of 6– to 11–Year–Old Children Living in Rural Areas of Paraíba, Brazil

The aim of this study was to investigate the relationship between nutritional status and dental fluorosis in areas with fluoride in the drinking water in Paraíba, Brazil. Rural villages of comparable low socio–economic status and stable water fluoride levels were selected. Lifelong residents (6–11 years old, n = 650) were examined for nutritional status (height–for–age index; WHO methods) and dental fluorosis of central incisors and first molars (TF index). The sample was divided into three groups according to fluoride levels in the drinking water: low (below 0.7 ppm F, n = 164), medium (between 0.7 and 1.0 ppm F, n = 360) and high (above 1.0 ppm F, n = 126). Dental fluorosis was observed in 30.5, 61.1 and 71.4% of the children in these F groups, respectively. The prevalence was significantly related to the water F concentrations (χ2 = 59.93, d.f. = 2, p<0.001). The severity of dental fluorosis ranged from TF 1 to 3 in the low F group and up to 7 in the others. Malnutrition prevalence was approximately 20% in all F groups, but was unrelated to dental fluorosis. The fairly high prevalence of dental fluorosis observed suggests that other factors may be operating.

Fingernail Fluoride: A Method for Monitoring Fluoride Exposure

This work was based on the hypothesis that fingernail clippings can be used as a biomarker for the subchronic exposure to fluoride. The results provide data on factors that may affect the concentration of fluoride in fingernail clippings as determined with the electrode following HMDS–facilitated diffusion. The following variables had only minor or no effects on the concentrations: (1) the surface area of the clippings (intact, minced or filed into powder) that were placed into the diffusion dishes; (2) soaking in deionized water for up to 6 h; (3) soaking in fluoridated water (1.0 ppm) for 2 h, and (4) removal of the organic material of nails by dry ashing. Fingernail fluoride concentrations were approximately 50% higher than those in toenails. A 1–month period of increased fluoride intake by one of the authors resulted in significant increases in fingernail fluoride concentrations after a lag time of approximately 3.5 months. The fluoride concentrations in fingernail clippings obtained from three groups of Brazilian children were directly related to the concentrations in the drinking water (0.1, 1.6 or 2.3 ppm). The results indicate that: (1) HMDS–facilitated diffusion completely separates fluoride from intact nail clippings, so the need for ashing or other preparative methods is obviated; (2) fingernail fluoride is derived mainly from the systemic circulation, and (3) fluoride intake is reflected by the concentrations in fingernails.

Selection of Streptococcus mutans and Lactobacilli in an Intra-oral Human Caries Model

Microbiologic changes during caries development underneath a plaque-retaining band were investigated by the use of selective media for streptococci, Streptococcus mutans, and lactobacilli. The final four-week plaque samples on 16 experimental teeth in six young subjects were assessed. Seven experimental teeth in three other subjects were sampled at baseline and after one, two, and four weeks. All 23 experimental teeth developed a white spot lesion. In the final four-week plaque samples on the lesions, S. mutans accounted for 8% and lactobacilli 0.1% of the total CFU, both being significantly higher than in plaque from unbanded control surfaces. All experimental teeth sampled during lesion formation showed consistently elevated plaque levels of S. mutans and lactobacilli in comparison with baseline and control values at weeks one, two, and four. The results demonstrated a cariogenic environment in the human mouth associated with rapid selection of aciduric bacterial species such as S. mutans and lactobacilli.

Microbial composition, pH-depressing capacity and acidogenicity of 3-week smooth surface plaque developed on sucrose-regulated diets in man

The effect of 3 weeks dietary supplementation, respectively restriction, of sucrose on gingival smooth surface plaque was assessed in 4 caries-inactive adults. Plaque samples collected from discrete t

Caries prevalence and oral hygiene in Lithuanian children and adolescents

Contrary to what is observed in many Western societies, the caries prevalence among children and adolescents in the Baltic States remains high. The aims of the present study were to describe the caries prevalence and oral hygiene among 7-, 12-, and 15-year-old Lithuanians and to correlate the caries prevalence with fluoride content in the drinking water, oral hygiene, gender, ethnicity, and pattern of sugar consumption. The investigation was based on cluster samples, and the clinical investigation was performed in accordance with criteria defined by WHO. High DMFT values were registered (mean DMFT = 1.3 among 7-year-olds; DMFT = 4.9 among 12-year-olds and 7.0 among 15-year-olds) and were associated with low fluoride content in the drinking water and poor oral hygiene. Girls showed higher DMFT values than boys. No correlation between pattern of sugar consumption and caries prevalence could be disclosed.

Bacterial growth on dental restorative materials in mucosal contact

Test specimens of amalgam, gold, porcelain, heat-cured acrylic resin, and human enamel were made to fit into cavities prepared in acrylic pontics of maxillary bridges. One side of the specimen was in close contact with the mucosa. Plaque was allowed to accumulate on the specimens for 27 to 48 days, and adherent bacteria were then quantified by cultivation on selective and non-selective media. The inflammatory status of the mucosa overlying the specimens were monitored by exudation measurements. Lower total numbers of bacteria were recovered from acrylic specimens than from the other materials used, including enamel. There were also significant subject differences in bacterial recovery. Test specimens in contact with inflamed mucosa yielded less total numbers of bacteria, but higher numbers of Streptococcus mutans, than did specimens exposed to mucosa with no or negligible exudation.

Basic, proline-rich glycoproteins in the submandibular gland secretion of the Cercopithecus aethiops

Abstract 1. 1. Salivary glycoproteins from Cercopithecus aethiops were obtained by tissue culture. 2. 2. Isoelectric focusation and gel filtration data showed basic fractions (pI ≈ 10 and ≈ 11) in the submandibular secretion parallel to those produced by parotid gland tissue. 3. 3. Amino acid and carbohydrate analyses indicated that the submandibular glycoproteins of pI ≈ 10 were similar to the corresponding parotid ones, whereas distinct differences were present in the more basic group.

Fluoride tablet programs in healthy elderly subjects: distribution of fluoride in saliva and plaque with tablets in different sites

Based on root caries data and oral sugar clearance pattern, vestibular surfaces of upper incisors and lower molars may be regarded as risk areas along with the proximal surfaces. The aim of the present study was to use this information in improving fluoride tablet programs for the elderly. Six healthy elderly males with full dental arches took part. Flavored and unflavored tablets dissolved passively either under the tongue or in the vestibule close to the root caries risk areas. Salivary fluoride was determined at five to six intra-oral sites with a micro-sampling technique at intervals up to 10 min tablet use. Plaque samples were collected from single tooth surfaces before and after tablet use, and analyzed for total fluoride and total protein by micro-techniques. Salivary fluoride exposure to root caries risk areas was strongly increased when fluoride tablets were placed in the vestibule in these areas. The unflavored tablet gave higher fluoride retention in saliva than did the flavored brand. Plaque fluoride levels tended to be above baseline in the first couple of hours after tablet use, and then to decline. In the caries risk areas, at vestibular surfaces of lower posterior and upper incisor teeth, most of the fluoride taken up in plaque had been lost after 5 h and a bread meal, whereas in the non-risk areas it was largely retained. The study demonstrated that fluoride exposures to the vestibular caries risk areas can be strongly increased by placing fluoride tablets close to them. An unflavored tablet seemed to give higher exposures than a flavored one. The rapid loss of fluoride from plaque in slow clearance risk areas indicates that more than one daily treatment would be required for elderly caries risk subjects.

Changes in plaque fluoride levels by school-based fluoride rinsing and tablet programs in Bangladesh

The aim of this study was to evaluate the effects of school-based fluoride rinsing and tablet programs on plaque fluoride levels. A total of 42 children (8-9 years) were selected from two neighboring schools in Dhaka, Bangladesh. After caries recordings, vestibular plaque samples from the maxillary central incisors and mandibular first molars were collected and frozen on day 0 (baseline). The subjects of one school (rinsing group, n = 15) rinsed with 0.05% NaF, while those from the other school (tablet group, n = 16) used a 0.5 mg F tablet on the 5 school days during a 3-week period. The surfaces were sampled on the first and last school day every week. The fluoride and protein contents of each sample were analyzed using micro-techniques. The median plaque fluoride levels were 9.1 ppm at baseline in the rinsing group and 2.5 ppm in the tablet group (P < 0.05). This difference could in part be related to reported fluoride toothpaste usage. After 4 days on the fluoride programs, plaque fluoride levels in the rinsing group increased to 27.3, 24.5 and 14.2 ppm in the 3 consecutive weeks. The corresponding values after tablet usage were 8.0, 6.5 and 7.1 ppm, respectively. After 3 days without fluoride during the weekends, levels declined towards baseline values in both groups. Hence, the plaque fluoride levels in 8 to 9-year-old Bangladeshi children were increased by both rinsing and tablet programs, but the effect was not detectable 3 days later.