- Email: [email protected]
Caries and fluoridation
Results.—The enamel wear values for groups 1 and 2 and the control group were 1.26, 2.41, and 3.48 mm, respectively (Fig 1). The values for dentin wear for the groups were 2.16, 5.75, and 10.29 mm, respectively. Both enamel and dentin wear values were significantly influenced by the presence of TM with or without CPP-ACP. The mean wear depth for the group 1 specimens was significantly less than that for either group 2 or the control group. Discussion.—TM reduced the erosive tooth wear related to toothbrushing plus acid exposure. It is likely that the mechanism to achieve this effect involved remineralization and lubrication of the eroded tooth surfaces.
Clinical Significance.—TM appears to be an effective substance we can apply to teeth to reduce erosive wear on both the enamel and the dentin. Further studies in real patients should give us more data on which to base any recommendations for its use.
Ranjitkar S, Rodriguez JM, Kaidonis JA, et al: The effect of casein phosphopeptideamorphous calcium phosphate on erosive enamel and dentine wear by toothbrush abrasion. J Dent 37:250254, 2009 Reprints available from DW Bartlett, King’s College London Dental Inst, Flr 25, Guy’s Tower, London Bridge SE1 9RT, UK: fax: þ44 20 7188 1792; e-mail: [email protected]
Public Health Caries and fluoridation
Methods.—The 876 Australian Defence Force (ADF) personnel ranged in age from 17 to 56 years; 11% of the sample were female military personnel. At each mandatory annual dental examination, assessments were made of the number of decayed, missing, and filled teeth (DMFT) using visual, tactile, and radiographic means. Questionnaires were also obtained, noting the participant’s residence(s) each year between 1964 and 2003. Groups were formed according to the percentage of the individual’s lifetime spent drinking fluoridated water, specifically, <10%, 10% to <50%, 50% to <90%, and R90%. These groups were then compared on the basis of their mean DMFT scores, with adjustments for age, gender, years of service, and rank. Results.—Over half of the participants lived 50% or more of their lives in fluoridated areas. Lifetime fluoride exposure and mean DMFT were statistically significantly related, with DMFT scores greatest (7.8) in persons living 10% to <50% of their lives in fluoridated areas and lower in those living <10% of their lives in fluoridated areas (Fig 1). The mean DMFT scores predictably increased significantly as the age group increased. Degree of lifetime exposure
Predicted DMFT for Fl Exposure
Percentage Fl Exposure
Background.—Children and adolescents have shown benefit from the fluoridation of drinking water in the form of fewer caries. The same cannot be said definitively for adults. The fluoridation of drinking water in Australia began in 1953 and has spread, with seven of Australia’s eight capital cities fluoridated by 1977. Thus the lifetime exposure to fluoride in drinking water varies among the adult population of Australia. Whether these variations in lifetime exposure to fluoride are related to the caries experience of Australian military personnel was investigated.
>90%
5.73
50–90%
5.72
6.86
10–50%
7.57
<10%
0
2
4
6
8
10
Predicted DMFT with 95% CI
Fig 1.—Adjusted mean* decayed, missing, and filled teeth (DMFT) by Lifetime fluoridation exposure (LFE). *Adjusted means are from generalized linear model shown in Table 4. (Courtesy of Mahoney G, Slade GD, Kitchener S, et al: Lifetime fluoridation exposure and dental caries experience in a military population. Community Dent Oral Epidemiol 36:485-492, 2008.)
also correlated with age, but no effect was noted for gender. Rank showed a significant correlation with the mean DMFT score and with lifetime fluoride exposure. The difference in mean DMFT score among 17- to 24-year-olds was 20%; that in 25- to 34-year-olds was 38%, and that in 35- to 44-yearolds was 35%. Adjusting for age, the mean DMFTscore of participants who lived in fluoridated areas for >90% of their lives was 1.8 teeth (24%) less than that for participants who had <10% exposure to fluoride. A plateau effect was noted for those living the most time under fluoridated conditions.
Volume 54
Issue 4
2009
219
Discussion.—Dental caries experience and the degree of lifetime exposure to fluoridated water were significantly linked for these adults in the ADF. This parallels the case with children and adolescents and further supports the use of fluoride in drinking water supplies.
Mahoney G, Slade GD, Kitchener S, et al: Lifetime fluoridation exposure and dental caries experience in a military population. Community Dent Oral Epidemiol 36:485-492, 2008 Reprints available from G Mahoney, Gregory Herston Rd, Herston, Brisbane, Qld 4006, Australia; fax: þ61 7 3346 4878; e-mail: [email protected]
Clinical Significance.—Having fluoridated water to drink for at least 90% of your lifetime can lower your DMFT score by 24%. Those with low lifetime exposures to fluoride benefited less. It seems clear that the fluoridation of water is a significant preventive action to take against dental caries.
Saliva Dry mouth and minor salivary glands Background.—Dry mouth is a common complaint among elderly populations but is also seen in those with Sjo ¨ gren’s syndrome, in individuals undergoing irradiation of the head and neck, and in association with certain medications. Some correlation has been noted between the whole saliva secretion rate and feelings of oral dryness, but the findings have not been consistent. Persons with subjective dry mouth may have reduced secretion rates for the minor palatal and labial salivary glands. Saliva that is retained on and moistens the oral surface appears to guard against the discomfort and diminished quality of life related to oral dryness. This film may be largely composed of saliva from the minor glands, which might explain the inconclusive relationship between whole saliva secretion rate and subjective oral dryness. Subjective feelings of oral dryness during the day and at night were investigated in relation to the resting and stimulated salivary secretion rates.
with four reporting these only in the day and 23 only at night. Manifest complaints of dry mouth both during the day and at night were reported by 29 individuals. No difference in VAS scores were related to gender.
Methods.—The 142 participants were between ages 18 and 82 years. All completed separate visual analog scales (VAS) to reflect their feelings of oral dryness at night and during the day. Resting and stimulated whole saliva flow rates were determined; the Periotron method was used to determine the rates specific to the minor palatal, buccal, and labial salivary glands.
Specifically in the normal and low whole saliva groups, greater palatal and labial secretion rates were noted in subjects who no complaints than in those with dry mouth during day and night hours. The secretion rates for each of the minor salivary glands in persons whose dry mouth complaints were only at night did not differ significantly. Subjects with low or normal resting and stimulated whole saliva secretion rates tended to have less labial secretion and complain of nighttime oral dryness. Subjects with normal stimulated whole saliva flow plus reduced resting secretion rates did not have these findings, but the few subjects with low whole saliva flow only did; the rate was not statistically significant.
Results.—Seventeen participants reported no sensation of dry mouth and 86 had dry mouth 25% or less of the time. These returns would indicate minor and less reliable ideations of what a dry mouth felt like. Fifty-six participants had VAS scores over 25% during the day and/or night,
220
Dental Abstracts
Persons with the lowest mean rates of resting and stimulated whole saliva secretion had xerostomia complaints. The ranges of the rates were well above normal secretion rates in all but four who reported dry mouth during the day only. Subjects complaining of dry mouth day and night had secretion rates significantly lower than subjects who had no complaints of dry mouth. Subjects with night dryness only had significantly lower resting whole salivary secretion rates than other subjects. The four subjects with daytime dryness only had significantly lower resting and stimulated saliva secretion rates. The minor mucosal gland secretion rates varied considerably.
Clinical Significance.—TM appears to be an effective substance we can apply to teeth to reduce erosive wear on both the enamel and the dentin. Further studies in real patients should give us more data on which to base any recommendations for its use.
Ranjitkar S, Rodriguez JM, Kaidonis JA, et al: The effect of casein phosphopeptideamorphous calcium phosphate on erosive enamel and dentine wear by toothbrush abrasion. J Dent 37:250254, 2009 Reprints available from DW Bartlett, King’s College London Dental Inst, Flr 25, Guy’s Tower, London Bridge SE1 9RT, UK: fax: þ44 20 7188 1792; e-mail: [email protected]
Public Health Caries and fluoridation
Methods.—The 876 Australian Defence Force (ADF) personnel ranged in age from 17 to 56 years; 11% of the sample were female military personnel. At each mandatory annual dental examination, assessments were made of the number of decayed, missing, and filled teeth (DMFT) using visual, tactile, and radiographic means. Questionnaires were also obtained, noting the participant’s residence(s) each year between 1964 and 2003. Groups were formed according to the percentage of the individual’s lifetime spent drinking fluoridated water, specifically, <10%, 10% to <50%, 50% to <90%, and R90%. These groups were then compared on the basis of their mean DMFT scores, with adjustments for age, gender, years of service, and rank. Results.—Over half of the participants lived 50% or more of their lives in fluoridated areas. Lifetime fluoride exposure and mean DMFT were statistically significantly related, with DMFT scores greatest (7.8) in persons living 10% to <50% of their lives in fluoridated areas and lower in those living <10% of their lives in fluoridated areas (Fig 1). The mean DMFT scores predictably increased significantly as the age group increased. Degree of lifetime exposure
Predicted DMFT for Fl Exposure
Percentage Fl Exposure
Background.—Children and adolescents have shown benefit from the fluoridation of drinking water in the form of fewer caries. The same cannot be said definitively for adults. The fluoridation of drinking water in Australia began in 1953 and has spread, with seven of Australia’s eight capital cities fluoridated by 1977. Thus the lifetime exposure to fluoride in drinking water varies among the adult population of Australia. Whether these variations in lifetime exposure to fluoride are related to the caries experience of Australian military personnel was investigated.
>90%
5.73
50–90%
5.72
6.86
10–50%
7.57
<10%
0
2
4
6
8
10
Predicted DMFT with 95% CI
Fig 1.—Adjusted mean* decayed, missing, and filled teeth (DMFT) by Lifetime fluoridation exposure (LFE). *Adjusted means are from generalized linear model shown in Table 4. (Courtesy of Mahoney G, Slade GD, Kitchener S, et al: Lifetime fluoridation exposure and dental caries experience in a military population. Community Dent Oral Epidemiol 36:485-492, 2008.)
also correlated with age, but no effect was noted for gender. Rank showed a significant correlation with the mean DMFT score and with lifetime fluoride exposure. The difference in mean DMFT score among 17- to 24-year-olds was 20%; that in 25- to 34-year-olds was 38%, and that in 35- to 44-yearolds was 35%. Adjusting for age, the mean DMFTscore of participants who lived in fluoridated areas for >90% of their lives was 1.8 teeth (24%) less than that for participants who had <10% exposure to fluoride. A plateau effect was noted for those living the most time under fluoridated conditions.
Volume 54
Issue 4
2009
219
Discussion.—Dental caries experience and the degree of lifetime exposure to fluoridated water were significantly linked for these adults in the ADF. This parallels the case with children and adolescents and further supports the use of fluoride in drinking water supplies.
Mahoney G, Slade GD, Kitchener S, et al: Lifetime fluoridation exposure and dental caries experience in a military population. Community Dent Oral Epidemiol 36:485-492, 2008 Reprints available from G Mahoney, Gregory Herston Rd, Herston, Brisbane, Qld 4006, Australia; fax: þ61 7 3346 4878; e-mail: [email protected]
Clinical Significance.—Having fluoridated water to drink for at least 90% of your lifetime can lower your DMFT score by 24%. Those with low lifetime exposures to fluoride benefited less. It seems clear that the fluoridation of water is a significant preventive action to take against dental caries.
Saliva Dry mouth and minor salivary glands Background.—Dry mouth is a common complaint among elderly populations but is also seen in those with Sjo ¨ gren’s syndrome, in individuals undergoing irradiation of the head and neck, and in association with certain medications. Some correlation has been noted between the whole saliva secretion rate and feelings of oral dryness, but the findings have not been consistent. Persons with subjective dry mouth may have reduced secretion rates for the minor palatal and labial salivary glands. Saliva that is retained on and moistens the oral surface appears to guard against the discomfort and diminished quality of life related to oral dryness. This film may be largely composed of saliva from the minor glands, which might explain the inconclusive relationship between whole saliva secretion rate and subjective oral dryness. Subjective feelings of oral dryness during the day and at night were investigated in relation to the resting and stimulated salivary secretion rates.
with four reporting these only in the day and 23 only at night. Manifest complaints of dry mouth both during the day and at night were reported by 29 individuals. No difference in VAS scores were related to gender.
Methods.—The 142 participants were between ages 18 and 82 years. All completed separate visual analog scales (VAS) to reflect their feelings of oral dryness at night and during the day. Resting and stimulated whole saliva flow rates were determined; the Periotron method was used to determine the rates specific to the minor palatal, buccal, and labial salivary glands.
Specifically in the normal and low whole saliva groups, greater palatal and labial secretion rates were noted in subjects who no complaints than in those with dry mouth during day and night hours. The secretion rates for each of the minor salivary glands in persons whose dry mouth complaints were only at night did not differ significantly. Subjects with low or normal resting and stimulated whole saliva secretion rates tended to have less labial secretion and complain of nighttime oral dryness. Subjects with normal stimulated whole saliva flow plus reduced resting secretion rates did not have these findings, but the few subjects with low whole saliva flow only did; the rate was not statistically significant.
Results.—Seventeen participants reported no sensation of dry mouth and 86 had dry mouth 25% or less of the time. These returns would indicate minor and less reliable ideations of what a dry mouth felt like. Fifty-six participants had VAS scores over 25% during the day and/or night,
220
Dental Abstracts
Persons with the lowest mean rates of resting and stimulated whole saliva secretion had xerostomia complaints. The ranges of the rates were well above normal secretion rates in all but four who reported dry mouth during the day only. Subjects complaining of dry mouth day and night had secretion rates significantly lower than subjects who had no complaints of dry mouth. Subjects with night dryness only had significantly lower resting whole salivary secretion rates than other subjects. The four subjects with daytime dryness only had significantly lower resting and stimulated saliva secretion rates. The minor mucosal gland secretion rates varied considerably.