Tony Axéll

Friction, capacitance and transepidermal water loss (TEWL) in dry atopic and normal skin

The biophysical properties of non‐eczematous skin at three locations in atopics and non‐atopics were characterized using non‐invasive physical methods. Skin friction was measured with a newly developed sliding friction instrument, the degree of hydration with a capacitance meter (Corneometer CM 820), and the transepidermal water loss (TEWL) was determined using an Evaporimeter EP1. The areas examined (dorsum of the hand, volar forearm and lower back) showed lower values of friction and capacitance in the atopic patients than did corresponding sites in the normal controls. In most areas a significant correlation between friction and capacitance was found. The TEWL was increased in atopic skin, but TEWL seems to correlate neither to friction nor to capacitance.

Dry eyes or mouth—An epidemiological study in Swedish adults, with special reference to primary Sjögren's syndrome

The prevalence of dry eyes or dry mouth, and of primary Sjögrens syndrome (primary SS) according to the Copenhagen criteria were established in 705 randomly selected subjects, aged 52-72 years who answered a simple questionnaire, and of whom 247 (35%) reported symptoms. A subgroup with symptoms (n = 77) and a matched asymptomatic control group (n = 32) were examined with the Schimer-1 test (S1t), tear film break-up time (BUT), van Bijsterveld score (vB), unstimulated whole sialometry (Sialo) and, in about 40% of them labial salivary gland (LSG) biopsy and salivary gland scintigraphy. Apart from four cases of keratoconjunctivitis sicca (KCS) among controls, cases of KCS (15), xerostomia (12), autoimmune sialoadenitis (6) and primary SS (6) were exclusively confined to the symtomatic group. The calculated frequencies (with 95% confidence intervals) for the whole population were 14.9 (7.3-22.6)% for KCS, 5.5(3.0-7.9)% for xerostomia and 2.7 (1.0-4.5)% for autoimmune sialoadenitis and primary SS. The serum levels of ANA and RF were similar in the two groups, though those of anti-SS-B/La antibodies were higher in the group with symptoms (P less than 0.01).

Treatment of Candida-infected denture stomatitis with a miconazole lacquer

The efficacy of a topically administered miconazole denture lacquer was compared with that of a placebo lacquer in the treatment of Candida-infected denture stomatitis. The study was a double-blind, randomized, controlled clinical trial with two parallel treatment groups. The lacquer was applied once on the fitting denture surface. Follow-up examinations took place on days 3, 7, 14, 21, 28, and 35. On day 14 the effect of the treatment was assessed. Thirty-six patients were included in the statistical analysis. Eighteen received miconazole and 18 received placebo lacquer. Primary efficacy endpoints were the number of colonies cultured from the palatal mucosa and denture surface on day 14. Thirteen of 16 patients in the miconazole group A showed < 10 colonies on culture medium on day 14 in the specimens from the palatal mucosa as did 5 of 18 patients in the placebo group B (p < 0.05). Corresponding results for the denture surface were 6 of 17 and 3 of 18, respectively (p < 0.05). Reapplication of lacquer was considered necessary (> 100 colonies in at least one sampling site within 14 days) in 35% of the patients from group A and in 83% of the patients from group B. The results indicate that a single application of a miconazole denture lacquer considerably reduces the number of Candida yeasts for a substantial period of time.

Factors affecting commencement and cessation of betel quid chewing behaviour in Malaysian adults.

BackgroundBetel quid chewing is a common habit widely practiced in Southern Asian populations. However, variations are seen in the content of a betel quid across the different countries. Factors associated with commencement and cessation of this habit has been numerously studied. Unfortunately, data on Malaysian population is non-existent. This study aims to determine the factors associated with the inception and also cessation of betel quid chewing behaviour among Malaysian adults.MethodThis study is part of a nationwide survey on oral mucosal lesions carried out among 11,697 adults in all fourteen states in Malaysia. The questionnaire included sociodemographic information and details on betel quid chewing habit such as duration, type and frequency. The Kaplan-Meier estimates were calculated and plotted to compare the rates for the commencement and cessation of betel quid chewing behaviour. Cox proportional hazard regression models were used to calculate the hazard rate ratios for factors related to commencement or cessation of this habit.ResultsOf the total subjects, 8.2% were found to be betel quid chewers. This habit was more prevalent among females and, in terms of ethnicity, among the Indians and the Indigenous people of Sabah and Sarawak. Cessation of this habit was more commonly seen among males and the Chinese. Females were found to be significantly more likely to start (p < 0.0001) and less likely to stop the quid chewing habit. Females, those over 40 years old, Indians and a history of smoking was found to significantly increase the likelihood of developing a quid chewing habit (p < 0.0001). However, those who had stopped smoking were found to be significantly more likely to promote stopping the habit (p = 0.0064). Cessation was also more likely to be seen among those who chewed less than 5 quids per day (p < 0.05) and less likely to be seen among those who included areca nut and tobacco in their quid (p < 0.0001).ConclusionFactors that influence the development and cessation of this behaviour are gender, age, ethnicity, and also history of smoking habit while frequency and type of quid chewed are important factors for cessation of this habit.

Hypersensitivity of the oral mucosa: clinics and pathology

Hypersensitivity reactions of the oral mucosa comprise an array of clinical manifestations. Some of the reactions are difficult to differentiate from toxic reactions. Hypersensitivity reactions of type I, type III, and type IV are well known, although, especially for types I and III, they are rarely encountered. Type-I reactions are most frequently seen related to application of polymers in the oral cavity, such as orthodontic bonding and fissure sealant materials. There may also be systemic manifestations such as urticaria. Type-IV reactions may be seen related to most dental materials used, from amalgam and gold to polymers. These reactions appear as chronic reddening and/or ulceration of the oral mucosa. Lichenoid reactions have histopathological characteristics compatible with type-IV hypersensitivity reactions and are the most prevalent material-adverse reactions seen in the oral cavity. A special variety inside the lips with multiple papules and/or diffuse redness has recently been identified. This lesion comprises a serious treatment challenge. Skin patch tests, applying a series of dental materials in non-toxic concentrations on the skin, have been used to identify sensitization. However, the value of those tests can be questioned. Exacerbation of geographic stomatitis may be another form of hypersensitivity to dental materials.

Dental caries among the elderly in Norway.

Objectives: To describe the occurrence of decayed teeth (DT), missing teeth (MT), filled teeth (FT), and the total sum score DMFT in elderly Norwegian pensioners, 67 years or more. Basic procedures: A representative sample of 582 elderly Norwegians (12.5% receiving social care) participated in a nationwide study (46% men and 54% women). In all, 394 (68%) still had some of their own teeth. A standardized clinical examination was performed by one of the authors (BMH) using well‐defined criteria. Main findings: Mean DT was 0.46, FT was 8.4, and DMFT was 25.4. Mean number of root remnants was 0.11. Mean DT, FT, DMFT, and root remnants for the dentate participants were 0.67, 12.4, 24.1, and 0.17, respectively. Men had significantly higher DT than women. DT decreased with increasing age. Only small differences were found in the prevalence of dentate individuals with caries between gender, age groups, geographical regions, and residence in areas of varying population density. Conclusion: It seems that caries is a minor problem in the Norwegian elderly population. Age and the number of remaining teeth do not have a decisive role in the development of caries. Further, there are no differences in these respects between geographical areas in Norway.

Prevalence of teeth and dentures among elderly in Norway receiving social care

The aim of this study was to estimate the prevalence of teeth and dentures in individuals aged 67 years and over receiving social care in Norway. A representative sample of 2893 individuals was selected from all 19 counties of Norway. In all, 1910 individuals (1358 living in institutions, 552 living at home) could be interviewed and examined by calibrated local dental teams in 1996-97. Overall response rate was 66%. Out of the examined, 1359 (71%) were women and 551 (29%) were men. The mean age was 85.1 years for women and 82.2 years for men. In all, 19.6% had own teeth only, 21% own teeth and dentures, 54% dentures only, and 5.3% neither teeth nor dentures. Previous findings in a random sample of elderly Norwegians from three regions with markedly different dental health were confirmed by using plychotomous logistic regressin. Three regions of Norway could be identified with respect to the occurence of teeth and dentures: region A (South-East counties of Norway including the capital Oslo), region B (West-Central counties), and region C (Northern counties). Significant differences existed between them and non-significant differences between them. A mean number of 12.3 teeth were observed in 773 (40.5%) dentate individuals, 13.4 in reion A, 11.4 in region B, and 9.0 in region C, respectively. In conclusion, there are large geographic disparities with respect to dental/denture status also in individuals receiving social care in Norway. When the data were collected (1996-97), the oral health goal for the year 2000 suggested by WHO/FDI aiming at 50% of people aged 65 years and above having a minimum of 20 remaining functional teeth was not fulfilled for individuals receiving social care in large parts of Norway.

Factors affecting commencement and cessation of smoking behaviour in Malaysian adults

BackgroundTobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs.MethodsData were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios.ResultsMales had a much higher prevalence of the habit (61.7%) as compared to females (5.8%). Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p < 0.0001), while cessation was least likely among Indians, current quid chewers and kretek users (p < 0.01).ConclusionsGender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation.

Evaluation of in vitro properties of films of saliva substitutes in contact with different surfaces A comparative study with instruments for measurements of friction and rheologic properties

An instrument based on friction measurement has been developed to evaluate oral mucosal dryness objectively. The purpose of this study was to compare the friction instrument with instruments measuring in vitro rheologic properties. Measurements were performed against steel and irreversible hydrocolloid after application of different concentrations of aqueous solutions of carboxymethylcellulose and chitosan lactate. The results of the measurements were logical, with inversely proportional values for the friction instrument as compared with values obtained using the instrument measuring rheologic properties; that is, increased viscosity led to decreased friction values.