Oral health of dental assistants and patients receiving maintenance--an investigation based on a district of Thuringia, Germany.

OBJECTIVES: The aim of the study was to assess data for the oral health behaviour and oral health of dental assistants (DAs) and patients (PTs) who regularly received preventive dental care. METHODS: One-hundred DAs (38.8 years) and 100 PTs (44 years) participated in the study conducted in the Unstrut-Hainich region of Thuringia, Germany. A questionnaire established oral hygiene and smoking habits. The dental examination included the caries index DMF-T, evaluation of the periodontal situation (PSI) as well as gingival inflammation [papilla bleeding index (PBI)]. RESULTS: Seventy-seven DAs and 46 PTs used dental floss regularly. Twenty-four DAs and 27 PTs were smokers. The mean DMF-T of DAs was 12.5, which was significantly lower than the DMF-T of PTs (17.0) (P < 0.001). The main reason for this difference was the number of missing teeth (DAs: 0.9, PTs: 4.8; P < 0.001). In both groups, several participants required periodontal treatment. Nevertheless, the number of DAs with PSI scores 3 or 4 was significantly lower (9%) than the corresponding number of PTs (63%) (P < 0.001). The PBI showed a significant difference between the groups (DAs = 0.1, PTs = 0.3; P < 0.01). CONCLUSIONS: Although the oral health of the participating DAs clearly exceeded the results found for PTs, it was concluded that DAs did not avail themselves of their job-related knowledge and skills and so failed to optimize their personal oral health behaviour.

Oral health in adult patients with congenital coagulation disorders--a case control study.

Inflammatory disorders of the periodontium, gingivitis and periodontitis are among the most prevalent diseases worldwide. A few studies have found poorer oral health in patients with congenital coagulation disorders (CCD) like haemophilia and von Willebrand's disease compared with non-affected controls. The aim of this study was to investigate the effect of congenital coagulation disorders on oral health and periodontal (alveolar) bone loss. This is a case control study comparing oral health and periodontal bone loss of patient with congenital coagulation disorders with matched healthy subjects. The examination included dental status (DMF-T), assessment of oral hygiene (modified Quigley-Hein-Index: QHI) and a dental panoramic X-ray for assessment of alveolar bone loss caused by periodontal disease. A total of 15 patients with CCD (Haemophilia A: n = 8, von Willebrand's disease: n =7) were matched with 31 non-affected controls. We observed no clinical relevant difference of oral health (DMF-T, QHI) between patients with CCD and controls despite better oral hygiene (QHI) of patients with CCD. Moreover, there was a statistically significant difference in periodontal bone loss, but the observed difference is not clinically meaningful. Unlike previous studies carried out mainly in children we found no evidence that oral health or periodontal status in adult patients with CCD is worse than that in healthy subjects. However, larger studies and longitudinal studies in adults are needed to confirm our results.

Microbiological findings at tongue piercing sites: implications to oral health.

BACKGROUND: Body piercing enjoys a widespread popularity among juveniles and young people. The tongue is the most commonly pierced oral site. Tongue jewellery, however, can damage the teeth and periodontium and may provide an ideal environment for microorganisms. The aim of this report was to investigate if and in case in which amount periodontopathogenic organisms can be found at tongue piercing sites. METHODS: Patients with tongue piercings visiting the authors' dental office for a dental check-up volunteered. A questionnaire was used to collect data on the type of material used in the piercing, the time the device was in place, oral and piercing hygiene practices and smoking habits. The dental examination included an oral hygiene index and the periodontal screening index. From the surface of the piercing jewellery adjacent to the tongue perforation, microbiological samples were collected and analysed for the presence of 11 periodontopathogenic bacteria. RESULTS: A total of 12 patients with tongue piercing were asked and examined. Their tongue piercings had been in place between 2 and 8 years. The microbiological analysis showed an increased or substantially increased concentration of periodontopathogenic bacteria in all cases. It became obvious that the longer a piercing had been in place, the more pronounced was the shift from bacteria with a moderate periodontopathogenic potential to bacteria with a high periodontopathogenic potential. CONCLUSION: Tongue piercing provides a potential reservoir for periodontopathogenic bacteria.

Tooth brushing and oral health: how frequently and when should tooth brushing be performed?

This review shows that there is consensus in the literature that (meticulous) tooth brushing once per day is sufficient to maintain oral health and to prevent caries and periodontal diseases. Tooth brushing is also regarded as an important vehicle for application of anti-caries agents, such as fluorides. However, most patients are not able to achieve sufficient plaque removal by performing oral hygiene measures at home. Therefore, tooth brushing twice daily is recommended by most of the dentists in order to improve plaque control. This rule is followed by most of the patients taking care for their oral health and has shown to be effective in maintenance of oral health in numerous studies. Study of the literature gives no clear evidence as to the optimal time-point of tooth brushing (before or after meals). However, in order to eliminate food impaction and to shorten the duration of sucrose impact by tooth cleaning after meals seems to be recommendable. Although--with our current knowledge of potential harm due to brushing of erosively altered and softened tooth surfaces--giving advice on a more individual basis is recommended for patients suffering from erosion.

Computer-supported device for histomorphometric investigations on laser-surgery.

A device for quantitative morphometric analysis of tissue alterations caused by laser or electrosurgery was developed. The unit was designed for interactive evaluation of histological specimens obtained by experimental surgery. It consists of a microscope, a stepper-motor driven scanning stage, a digitizing tablet and a PC with software developed for this purpose. The depth of the incision, the width and the area of the coagulation zone can be measured independent of the microscopic magnification. Graphs and data can be exported in standard data-formats (ASCII, HPGL, DXF) for further processing. The application is demonstrated on experimental incisions with a CO2-laser in the oral mucosa of pigs; quantitative data are presented.

[Need for preventive dentistry in adult women: investigation in maternal convalescent homes. 2. Tooth and periodontal findings]. / Zur Notwendigkeit zahnärztlicher Prophylaxe bei erwachsenen Frauen: Eine Untersuchung in Müttergenesungskurheimen. II. Zahn- und Parodontalbefunde.

For this study an extensive oral examination was performed in 111 women between 21 and 48 years of age recreating themselves in special rest homes. A mean DMF-T of 19.1 and a mean DMF-S of 62.5 was found; women with a low education (Sonderschule) showed an especially high DMF-S of 85.0, participants with a secondary education (Abitur) had a DMF-S-Index less by half. The oral hygiene of the women was insufficient (mean QHI 2.6), papilla bleeding was easy to provoke in most of them. 98% of the women needed periodontal treatment, 10.8% showed a probing depth of 6-8 mm. 60.8% of 942 examined restorations needed to be renewed, the reason was mostly marginal leakage.

[Need for dental prophylaxis in grown women: an investigation in maternal rest centers. 1. Information knowledge and or oral hygiene status]. / Zur Notwendigkeit zahnärztlicher Prophylaxe bei erwachsenen Frauen: Eine Untersuchung in Müttergenesungskurheimen. I. Informationsstand und Mundhygieneverhalten.

111 women out of 316 women relaxing in three rest homes volunteered to participate in this study and answered a questionnaire concerning following subjects: daily oral hygiene, knowledge in hygiene procedures, frequency of dental treatment and interest in dental prophylaxis. Oral hygiene behaviour and knowledge were not sufficient. Only half of them knew dental floss and fluorides. Interdental care was practised by 20 women and only 10 used fluorides, they had without exception a secondary education. Most of the participants were educated in dental health care mainly by their parents. 36 women went to see the dentist only in case of necessity. 15 women were very afraid of dental treatment. 60% out of 111 women participated in a lecture on preventive dentistry and prophylaxis.

[Recommendations for training with dental HF surgery apparatus]. / Empfehlungen zum Umgang mit zahnärztlichen HF-Chirurgiegeräten.

A training program for the application of dental electrosurgery is presented. Exercises on muscle tissue and pig jaws are suitable to get informations of the proper adjustment of the units as well as the treatment procedures. The necessity of proper handling is illustrated by the results of wrong manipulations. Better understanding of the facts during electrosurgery enables the dentist to avoid adverse effects in treating his patients.

[Clinical applications of HF-surgery]. / Klinische Anwendungen der HF-Chirurgie.

The advantage of electrosurgery in minor dental surgery is demonstrated with regard to contraindications and especial precautions. In reports of case some indications are presented in combination with the treatment procedure.

[HF surgery vs. laser surgery. Experimental study of use in periodontology]. / HF-Chirurgie vs. Laser-Chirurgie. Experimentelle Untersuchungen zur Anwendbarkeit in der Parodontologie.

The purpose of this study was to evaluate the suitability of CO2 laser and two different electronically controlled electrosurgical units in periodontal surgery; both of the electrosurgical generators were recently designed for application in medicine. The study was performed on freshly butchered pig jaws. In addition to the management of the devices, the macroscopic and histologic effects of laser and high frequency energy on palatal gums, alveolar bone, tooth structures and filling materials were investigated. The handling of the electrosurgical units was efficient and smooth, the incisions showed accurate and reproducible results. In contrast to this the laser was uncomfortable to work with, additional safety arrangements were required and lesions in teeth and alveolar bone occurred easily. While the electronically controlled electrosurgical generators offer interesting aspects in some indications, CO2 laser seems to be unsuitable for periodontal surgery.

[Periodontal-orthodontic treatment possibilities for migrated front teeth. Possibilities and limits of orthodontic therapy]. / Parodontologisch-kieferorthopädische Behandlungsmöglichkeiten sekundär gewanderter oberer Frontzähne. Möglichkeiten und Grenzen der kieferorthopdischen Therapie.

An interdisciplinary approach for the rehabilitation of patients with pathologic tooth movement caused by advanced periodontal disease is presented. The special demands to the orthodontic therapy are illustrated by a case report. The necessity for precise treatment planning and for the use of controlled treatment is demonstrated.

[Importance of oral hygiene in the treatment of capillary hemangioma of the gingiva]. / Zur Bedeutung der Mundhygiene bei der Therapie des kapillären Hämangioms der Gingiva.

This is a case report on two patients, 21 resp. 25 years old, who suffered from recurrent capillary hemangioma of the gingiva. Prior to surgical therapy the hygienic conditions were improved in several sessions with professional preventive treatment and oral hygiene instructions. Post-surgical treatment consisted of efficient plaque control and adequate three-monthly oral prophylaxis sessions. In both cases the hemangioma was not observed to recur up to 2 1/2 resp. 1 1/2 years later.

[Periodontal-orthodontic treatment possibilities for migrated front teeth--case selection and theoretical concept]. / Parodontologisch-kieferorthopädische Behandlungsmöglichkeiten sekundär gewanderter oberer Frontzähne--Fallauswahl und Therapierkonzept.

Migration of maxillary incisors caused by advanced periodontal disease induces functional, periodontal and esthetical problems to the patient. Under certain conditions a combined periodontal-orthodontal treatment should be considered. A successful treatment result depends on the selection of the patients. The presented concept offers good long-term results for a combined periodontal-orthodontal therapy.

[Distribution of oral hygiene aids on air flights]. / Zur Verteilung von Mundhygieneartikeln auf Flugreisen.

The question as to which dental care aids airlines offered their passengers to assist their oral hygiene during their flight was to be answered with the assistance of a questionnaire. 56 replies showed large differences existed varying with the different airlines, the flight time and the passenger class. Toothpicks were offered by almost 90% of the companies. Toothbrushes, toothpaste and mouth hygiene sets were distributed more rarely, primarily in the higher passenger classes and on long haul flights. The use of the aids was estimated by 24 companies as frequent, 12 estimated that the distributed aids were rarely used or mainly had a souvenir value.