Relative contribution of caries and periodontal disease in adult tooth loss among patients reporting to the Institute of Dental Sciences,Belgaum, India

Objectives: To examine the reasons for tooth loss in an adult population. Methods: Patients who reported to the department of prosthodontics in Institute of Dental Sciences, Belgaum, located in the north‐western part of the state of Karnataka, in the southern region of India over a period of 2 months, with at least one missing tooth (excluding third molars) constituted the sample size. There were a total of 365 patients (185 females and 180 males) within the age group of 16–84 years (mean age 51.06 ± 16.47 years) who fulfilled this criterion. Socio‐demographic profile was recorded along with a clinical examination for assessing the number and pattern of tooth loss. The reasons for tooth loss were recorded according to the history reported by the patient. Results: In the present study of 365 patients, 58.9% of the patients were completely edentulous, 41% were partially dentate, of which 20.8% had lost their teeth from caries, 11% from periodontal disease and 9.3% from a combination of reasons. More females had lost their teeth because of dental caries whereas more males had lost their teeth because of periodontal disease, this being statistically significant. (χ² = 16.53, p = 0.001). Highly significant results were obtained for age and reasons for tooth loss. (χ² = 150.39, p < 0.001). Irrespective of the socio‐economic status, dental caries was the most common cause for tooth loss in partially dentate patients though it was not statistically significant (χ² = 13.62, p = 0.325). Mandibular first molars were the teeth most frequently lost due to dental caries. The maxillary left central incisor was most frequently lost due to periodontal disease, followed by the maxillary right central incisor. Conclusions: Since both dental caries and periodontal disease contributed to tooth loss at different ages, risk indicators need to be identified.     

Preliminary assessment of safety and effectiveness in humans of ProBiora3 ™, a probiotic mouthwash

Aims:  To conduct a pilot human clinical trial to assess the safety and to test the ability of a probiotic mouthwash, ProBiora³, to affect the levels of Streptococcus mutans and certain known periodontal pathogens in the mouth when administered twice daily over a period of 4 weeks.
Methods and Results:  The mouthwash contained three specific strains of naturally occurring oral bacteria and was tested at two dose levels: 10⁶ and 10⁸ colony forming units each of Strep. oralis strain KJ3sm, Strep. uberis strain KJ2sm, and the spontaneous lactic acid-deficient variant of Strep. rattus , strain JH145. Substantial decreases in the levels of the marker bacteria were observed. No safety issues were noted with the twice daily application of this mouthwash.
Conclusions:  Despite the small number of subjects and the use of young, orally healthy adults, along with the inherent variability in the microbiological measurements, the probiotic mouthwash was able to substantially affect the levels of dental pathogens in saliva and periodontal pathogens in subgingival plaque.
Significance and Impact of the Study:  The results of this pilot human study suggest that the probiotic mouthwash product may be safe for daily use as an aid in maintaining both dental and periodontal health.     

A longitudinal study of the relationship between diet intake and dental caries and periodontal disease in elderly Japanese subjects

Objective: We hypothesise that a difference in nutrition influences dental caries and periodontal disease. There are few previous studies especially longitudinal ones which have evaluated this hypothesis. This study investigated the relationship between nutritional intake, including milk and milk products (MMP), and dental disease, controlling for several confounding factors. Material and methods: A group of 600 subjects aged 70, randomly selected for this study, included approximately the same number of male and female subjects. The number of teeth on which root caries had occurred or where there was a periodontal event over a 6‐year period was measured. To determine quantitative food intake at baseline, a semi‐quantitative food frequency questionnaire was used during face‐to‐face interviews by dieticians. The stepwise method of multiple linear regression analysis was used to identify independent predictors of the number of root caries or periodontal disease events during the 6 years. Intake of the six food groups includes (i) fish, shellfish, meat, beans and eggs; (ii) MMP; (iii) dark green and yellow vegetables (DYV); (iv) other vegetables and fruits; (v) cereals, nuts and seeds, sugar and sweeteners, confectioneries (CNSC) and (vi) fats and oils. The alcohol, gender and anthropometric evaluation including measurements of weight and height for the calculation of body mass index, educational level, the number of family members and the number of remaining teeth were used as independent variables. Results: According to stepwise multiple regression analysis, two variables (quantity of MMP, and gender) were negatively associated with the number of root caries events during the 6 years. The standardised coefficients were ?0.14 (p = 0.035) and ?0.17 (p = 0.007) respectively. In addition, DYV were negatively, and three other variables (CNSC; alcohol; and the number of remaining teeth at baseline) were positively associated with the number of periodontal disease events during the 6 years. The standardised coefficients were ?0.16 (p = 0.001), 0.11 (p = 0.042), 0.10 (p = 0.041) and 0.58 (p < 0.001) respectively. Conclusion: Our results suggest that the intake of MMP in this elderly population correlated with root caries events. In addition, intake of vegetables negatively correlated, and intake of ‘CNSC’ positively correlated with periodontal disease events.     

牙菌斑生物膜的形成与控制

牙菌斑生物膜是附着于牙釉质表面,由复杂的微生物群落构成的一种聚集体。牙菌斑生物膜的形成与生长对口腔健康有着直接或间接的影响,许多研究证实口腔疾病如龋齿和牙周病都与细菌的积累及牙菌斑的形成有关。在牙菌斑生物膜形态建成过程中,牙齿表面最初的定殖菌对生物膜的微生物组成和结构至关重要,这些初级定殖菌决定了后续与之结合形成共生体的微生物种类和数量。不同的微生物组成可能在与生物膜形成相关的口腔病理状况中发挥不同的作用。因此,本文就牙菌斑生物膜的生长及控制进行综述,介绍其微生物的早期定殖和成熟过程、以及通过物理和化学方法对牙菌斑生物膜的控制,以期为了解牙菌斑生物膜的形成机制及相关口腔疾病的预防和治疗提供有价值的参考。     

Oral status in home-dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease

doi: 10.1111/j.1741‐2358.2011.00507.x Oral status in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease Objectives: The aim of this study was to compare the prevalence of edentulous subjects, caries and periodontal disease among the home‐dwelling elderly with moderate and substantial needs of support for daily living. Materials and method: A sample of 302 randomly selected elderly with moderate or substantial needs of supportive care were examined in Sweden. Several oral clinical variables were registered: number of teeth, dentures, caries, probing pocket depth, gingival bleeding and Eichner’s index. Results: Both in general and in oral health, the differences were small when comparing elderly with moderate and substantial care needs for daily living. Those with substantial needs had more caries lesions (p < 0.01) and more gingival bleeding (p < 0.05), while the number of teeth and prevalence of edentulous subjects did not differ in relation to the need of daily support. The elderly had, on average, 9.8–11.7 teeth, one‐third of whom had no natural teeth. According to Eichner’s index, half of the elderly in both groups had no opposing tooth contacts. Fifty‐five per cent used dentures. Conclusions: Elderly people with needs of supportive care have lost many teeth before they become dependent. Health promotion should be a priority in early ageing populations to prevent oral diseases and tooth loss.     

Antimicrobial Peptides and their Potential as Oral Therapeutic Agents

Dental caries (tooth decay) and periodontal diseases are the most prevalent bacterial infectious diseases of mankind, together affecting almost the entire population of the world. Both diseases are caused by oral bacteria that exist as components of a polymicrobial biofilm, known as dental plaque, on the tooth surface. The control of specific types of bacteria and/or total numbers of bacteria in dental plaque could lead to prevention or resolution of disease. Antimicrobial peptides isolated from a wide range of natural sources have been known for over 30 years yet little progress had been made in the therapeutic application of these peptides. This is due in part to the characteristics, including susceptibility to proteolysis, of the cationic amphipathic antimicrobial peptides that form the majority of peptides discovered to date. Bovine milk is a readily available source of a range of bioactive peptides. We have isolated and characterized a novel anionic antimicrobial peptide, Kappacin, from bovine milk. Antibacterial activity of the peptide is increased when it is complexed with zinc ions. We have demonstrated that a Kappacin:Zn²⁺ preparation is able to suppress the growth of oral cariogenic bacteria in a biofilm. The Kappacin:Zn²⁺ antibacterial complex may have potential as an additive to oral care products and other delivery vehicles for the control of oral disease.     

Oxygen metabolism,oxidative stress and acid-base physiology of dental plaque biofilms

Dental plaque is a natural biofilm which has been a focus of attention for many years because of its known roles in caries and periodontal diseases. Acid production by plaque bacteria leads to the erosion of tooth mineral in caries, and the cariogenicity of plaque is related to population levels of acid-tolerant organisms such as mutants streptococci. However, the biofilm character of plaque allows for survival of a diverse flora, including less acid-tolerant organisms, some of which can produce ammonia from arginine or urea to counter acidification. Plaque is often considered to be relatively anaerobic. However, evidence is presented here that both supragingival and subgingival plaque have active oxygen metabolism and that plaque bacteria, including anaerobes, have developed defenses against oxidative stress. Even in subgingival plaque associated with periodontitis, measured residual oxygen levels are sufficient to allow for oxygen metabolism by organisms considered to be extremely anaerobic such asTreponema denticola, which metabolizes oxygen by means of NADH oxidases and produces the protective enzymes superoxide dismutase and NADH peroxidase. The finding that plaque bacteria produce a variety of protective enzymes is a good indicator that oxidative stress is a part of their everyday life. The biofilm character of plaque allows for population diversity and coexistence of aerobes, anaerobes and microaerophiles. Overall, agents that affect oxidative metabolism offer possibilities for reducing the pathogenic activities of plaque.     

Characterization of polymicrobial biofilms obtained from saliva or carious lesions in dentin

Abstract

This study aimed to compare the formation of polymicrobial biofilms using carious dentin or saliva as inoculum for application in in vitro microbiological studies on caries research. For biofilm growth, combined samples of infected dentin or saliva from three donors were used. The biofilms were grown on glass coverslips, under a regimen of intermittent exposure (6?h day^?1) to 1% sucrose for 4?days. Total bacterial loads, as well as specific aciduric bacteria and mutans streptococci loads were quantified and correlated with biofilm acidogenicity and susceptibility to chlorhexidine. The data were evaluated using the Student’s-t, Mann Whitney and Kruskal-Wallis tests. The two biofilms showed similar microbial loads (total bacteria, aciduric bacteria and mutans streptococci) on day 4, and high acidogenicity after 48?h and were susceptible to chlorhexidine at different time intervals. In conclusion, both dentin and saliva can be used as an inoculum in in vitro studies of processes related to biofilm formation.     

益生元对口腔健康促进作用和机制研究进展

口腔微生物群落的动态平衡是维持口腔健康的关键因素。益生元是一类具有选择性、能够促进体内有益菌代谢增殖从而改善宿主健康的有机物质,主要通过调节口腔微生物生长代谢、抑制口腔菌斑生物膜形成、调节宿主免疫反应、参与硝酸盐-亚硝酸盐-一氧化氮代谢循环通路、调节氧化应激反应等途径调控口腔微生态,从而对口腔常见疾病,如龋齿、牙周病、口腔黏膜病的防治起到积极作用。本文主要就近年来益生元在口腔健康中的作用及相关机制的研究情况进行综述。     

Analysis of socio-demographic and systemic health factors and the normative conditions of oral health care in a population of the Brazilian elderly

doi: 10.1111/j.1741‐2358.2010.00446.x
Analysis of socio‐demographic and systemic health factors and the normative conditions of oral health care in a population of the Brazilian elderly Objective: To investigate the association of socio‐demographic and systemic health factors according to the normative conditions of oral health care (dental caries, edentulism, periodontal disease and oral mucosal lesion) in elderly individuals. Material and methods: A cross‐sectional study was carried out in a group of elderly with access to community health care (n = 200). The normative conditions of oral health were then investigated according to the WHO and the SB Brazil criteria. Bivariate analyses were evaluated by the chi‐square test and Fisher’s exact test. An estimation of prevalence for the covariates was performed using Poisson’s regression models. Results: The prevalence of edentulism and oral mucosal lesions was detected in 58% and 21.5% of elderly patients, respectively. In the dentate subjects, the prevalence of dental caries and periodontal disease was 51.2% and 20.8%, respectively. Older men and individuals from lower‐income groups exhibited a higher prevalence of dental caries. Elderly women, illiterate individuals, and individuals over the age of 65 years exhibited a higher prevalence of edentulism. Elderly 60–64 years old and those who are employed had a significant association with periodontal disease. Conclusion: Socio‐demographic factors were associated with some notable oral diseases in the elderly.     

Self-reported oral hygiene habits among institutionalised elderly and their relationship to the condition of oral tissues in Taubaté, Brazil

Objectives: To record self‐reported hygiene habits, examine the oral conditions of a sample group of institutionalised elderly, and examine possible relationships between these habits and conditions. Design: Cross‐sectional. Setting: All the institutions for the elderly in Taubaté, Brazil. Subjects: The entire population of these institutionalised elderly people (n = 553). Intervention: The subjects were interviewed and underwent an oral examination. Main outcome measures: Oral hygiene habits, oral conditions and statistical relationships between habits and oral conditions were recorded. Results: The average age of the subjects who knew their age (n = 364) was 74.9 years (±12.9), and 64.7% of the sample group were females. Denture‐related stomatitis was found in 19.5%, impaired manual dexterity in 40%, dry mouth sensation in 36.3%, difficulty in performing oral hygiene in 20%, no oral hygiene‐related orientation in 54.1%, no periodic oral examinations in 59.5%, and no tongue cleaning in 68.3% was declared. Among dentate subjects, 73.3% had periodontal disease, 54.7% had caries, 26% reported no toothbrushing, and 7.3% reported flossing. Of the denture wearers, 7% did not brush their dentures. Denture‐related stomatitis showed a statistical relationship with impaired manual dexterity (p = 0.012) and an inverse statistical relationship with denture brushing frequency (p = 0.006). Periodontal disease showed an inverse relationship to flossing (p < 0.001) and tongue cleaning (p = 0.0026). Caries showed an inverse relationship with tooth‐brushing (p = 0.043), flossing (0.022), proper oral hygiene orientation (p = 0.041) and periodical check‐ups (p = 0.007). Conclusion: Oral hygiene practices in this sample group were found to be inadequate, and statistically significant relationships were verified between the lack of good oral hygiene practices and the deleterious oral conditions.     

益生菌与口腔微生态调控的研究进展

口腔疾病的发生和发展与口腔微生物群落的失衡密切相关.益生菌是一类对人体健康有益的活的微生物,主要通过分泌抗菌物质、与致病菌竞争性定殖、调节毒力相关基因表达、调节宿主免疫反应、调节氧化应激反应、参与硝酸盐—亚硝酸盐—一氧化氮代谢循环通路、调整生物膜pH值等过程发挥其益生效能.研究发现,益生菌疗法能够降低龋齿的风险、改善牙...     

Dental effects of diet and coca-leaf chewing on two prehistoric cultures of northern Chile

Two ancient cultures of northern Chile, the Chinchorro (9000-3500 BP) and the Maitas Chiribaya (850-700 BP) were examined for dental pathology in search of possible correlations between dental health, diet, and the cultural practice of coca-leaf chewing. The Chinchorro occupied the river mouth of the Azapa valley, subsisting almost exclusively on a maritime economy. The Maitas Chiribaya, descendants of migrant highlanders, had a rather well-developed agricultural subsistence base. The Chinchorro demonstrated extreme attrition rates and a correspondingly high frequency of periapical abscesses. They were essentially caries-free and enjoyed a moderate antemortem tooth loss frequency. The Maitas Chiribaya suffered light attrition, a high caries frequency, especially at the cementoenamel junction of crown and root, and a remarkably high antemortem tooth loss frequency. The cultural practice of coca-leaf chewing is implicated in the excessive posterior edentulism of the Maitas Chiribaya. © 1996 Wiley-Liss, Inc.     

Purification and characterization of hemolysin from periodontopathogenic bacterium Eikenella corrodens strain 1073

Eikenella corrodens 1073 was found to show hemolytic activity when grown on sheep blood agar. A high and dose-dependent hemolytic activity was detected in the cell envelope fraction, which was further purified by ion-exchange and gel-filtration chromatography. Consequently, a 65-kDa protein with hemolytic activity was obtained, suggesting that this protein might be a hemolysin. Its N-terminal amino acid sequence was nearly identical to that of X-prolyl aminopeptidase from E. corrodens ATCC 23834. To confirm that X-prolyl aminopeptidase functions as a hemolytic factor, we expressed the hlyA gene, encoding X-prolyl aminopeptidase, in Escherichia coli. After induction with isopropyl β-D-1-thiogalactopyranoside, a protein of about 65 kDa was purified on a Ni column, and its hemolytic activity was confirmed. Meanwhile, a strain with a disrupted hlyA gene, which was constructed by homologous recombination, did not show any hemolytic activity. These results suggested that X-prolyl aminopeptidase might function as a hemolysin in E. corrodens.     

Models for irreversible processes,based on cross-sectional data

The analysis of the time dependent behavior of an irreversible all-or-none process on the basis of data from cross sectional surveys requires special methods. Assuming a pure death process three models of different degree of sophistication have been developed, mathematically analyzed and applied to one particular example: the caries attack on the permanent teeth of children.     

甘肃临潭磨沟墓地人骨的牙齿健康状况

本文通过甘肃临潭磨沟齐家文化墓地出土的262例人骨标本的牙病情况尤其是龋病、牙周病、根尖周病以及牙结石情况的统计与分析,得知磨沟墓地古代居民牙齿疾病的基本情况:1)牙病的罹患率性别差异显著,女性龋病和根尖周病的罹患率高于男性,而在牙周病和牙结石的出现率上则是男性高于女性;2)牙病的罹患率随着年龄增长而增高;3)龋病、牙周病及根尖周病多发于臼齿,牙结石多发于门齿;4)重度磨耗牙齿多发牙周病及根尖周病;5)牙病罹患率不仅受到性别、年龄、牙位以及齿冠磨耗程度的影响,而且与磨沟组古代居民农业种植食物和采集食物并重的食物结构有关。