Oral health status, salivary pH status, and Streptococcus mutans counts in dental plaques and saliva of children with acute lymphoblastic leukemia.

BACKGROUND: Acute lymphoblastic leukemia (ALL), accounting for 23% of all malignancies in children, is the most prevalent pediatric malignancy. This study compared dental caries, oral hygiene status, salivary pH, and Streptococcus mutans counts in dental plaques and saliva of children with leukemia with those of healthy controls. MATERIALS AND METHODS: This case-control cross-sectional study assessed 32 children with ALL and 32 healthy children (4-9-year-old) for gingival bleeding index (GBI), decayed, missing, and filled/decayed, missing, and filled surfaces (DMF/dmfs), and plaque index (PI). Sampling was performed to determine salivary pH and S. mutans counts of the participants. The two groups matched in terms of age, gender, and socioeconomic status. The groups were compared using independent t-test, Mann-Whitney test, Chi-square test, and Spearman's and Pearson's correlation analyses. RESULTS: The mean DMF/dmfs and GBI were significantly higher in the ALL group (PDMF/dmfs= 0.03; PGBI= 0.04). However, the two groups were not significantly different in the mean PI values (P = 0.47). The mean S. mutans counts in dental plaques and saliva of the children with leukemia were significantly lower than the healthy controls (P < 0.01). Moreover, the mean salivary pH was significantly lower in the ALL group compared to the control group (P < 0.01). CONCLUSION: Higher caries and gingival bleeding rates, higher dental plaque accumulation in children with ALL, decreased salivary pH, and cumulative effects of other risk factors highlight the significance of oral hygiene training programs (for the parents of these children) and regular dental examinations for these children.

Effect of Probiotic Yogurt and Xylitol-Containing Chewing Gums on Salivary S Mutans Count.

BACKGROUND AND AIMS: In addition to improving gastrointestinal health and intestinal microflora, probiotic bacteria have been recently suggested to decrease cariogenic agents in the oral cavity. The aim of this study was to investigate the effects of probiotic yogurt and xylitol-containing chewing gums on reducing salivary Streptococcus mutans levels. STUDY DESIGN: This randomized clinical trial recruited 50 female students with over 105 colony forming units S. mutans per milliliter of their saliva. The participants were randomly allocated to two equal groups to receive either probiotic yogurt containing Lactobacillus acidophilus ATCC 4356 andBifidobacteriumbifidum ATCC 29521 (200 g daily) or xylitol-containing chewing gums (two gums three times daily after each meal; total xylitol content: 5.58 g daily) for three weeks. At baseline and one day, two weeks, and four weeks after the interventions, saliva samples were cultured on mitis-salivarius-bacitracin agar and salivary S. mutans counts were determined. Data were analyzed with independent t-tests, analysis of variance, and Fisher's least significant difference test. RESULTS: In both groups, S. mutans counts on the first day, second week, and fourth weeks after the intervention were significantly lower than baseline values (P < 0.05). The greatest level of reduction in both groups was observed in the second week after the intervention. Moreover, although the reduction was greater in probiotic yogurt consumers, the difference between the two groups was not statistically significant. CONCLUSION: Probiotic yogurt and xylitol-containing chewing gums seem to be as effective in reduction of salivary S. mutans levels. Their constant long-term consumption is thus recommended to prevent caries.

Effect of different cavity conditioners on microleakage of glass ionomer cement with a high viscosity in primary teeth.

BACKGROUND: Glass ionomer cement is a common material used in pediatric dentistry. The aim of this study was to evaluate the microleakage of high-viscosity glass ionomer restorations in deciduous teeth after conditioning with four different conditioners. MATERIALS AND METHODS: Fifty intact primary canines were collected. Standard Class V cavities (2 mm × 1.5 mm × 3 mm) were prepared by one operator on all buccal tooth surfaces, including both enamel and dentin. The samples were divided into five groups with different conditioners (no conditioner, 20% acrylic acid, 35% phosphoric acid, 12% citric acid, and 17% ethylenediaminetetraacetic acid [EDTA]). Two-way - ANOVA, Kruskal-Wallis and Mann-Whitney tests were used to compare the means of microleakage between the five groups. The significance level was set at P < 0.05. RESULTS: There was no significant difference between the means of microleakage in incisal (enamel) and gingival (dentin) margins (P = 0.34). Furthermore, there was no significant difference between the means of microleakage in enamel and dentin margins (P = 0.4). There was a significant difference between the means of microleakage in different groups (P = 0.03). CONCLUSION: Within the limitations of this study, it is suggested that 20% acrylic acid and 17% EDTA be used for cavity conditioning which can result in better chemical and micromechanical adhesion.

Effects of Treatment with Various Remineralizing Agents on the Microhardness of Demineralized Enamel Surface.

Background and aims. Remineralization of incipient caries is one of the goals in dental health care. The present study aimed at comparing the effects of casein phosphopeptide-amorphous calcium phosphate complex (CPP-ACP), Remin Pro(®), and 5% sodium fluoride varnish on remineralization of enamel lesions. Materials and methods. In this in vitro study, 60 enamel samples were randomly allocated to six groups of 10. After four days of immersion in demineralizing solution, microhardness of all samples was measured. Afterward, groups 1-3 underwent one-time treatment with fluoride varnish, CPP-ACP, and Remin Pro(®), respectively. Microhardness of groups 4-6 was measured not only after one-month treatment with the above-mentioned materials (for eight hours a day), but also after re-exposing to the demineralizing solution. The results were analyzed by one-way analysis of variance (ANOVA), repeated measures ANOVA, and Fisher's least significant difference (LSD) test. Results . None of the regimens could increase microhardness in groups 1-3. However, one-month treatment regimens in groups 4-6 caused a significant increase in microhardness. The greatest microhardness was detected in the group treated with CPP-ACP (P = 0.001). In addition, although microhardness reduced following re-demineralization in all three groups, the mean reduction was minimum in the CPP-ACP-treated group (P < 0.001). Conclusion. While long-term repeated application of all compounds improved microhardness, the remineralization potential of CPP-ACP was significantly higher than that of Remin Pro(®) and sodium fluoride varnish.

Assessment of intranasal midazolam administration with a dose of 0.5 mg/kg in behavior management of uncooperative children.

AIM: Intranasal midazolam has been used to induce conscious sedation in children with negative and aggressive behavior The main goal of this study was to determine the effectiveness of intranasal administration of midazolam (with a dose of 0.5 mg/kg) in behavior management of uncooperative children. MATERIALS AND METHODS: Thirty healthy, difficult children of 3-5 years were evaluated. At the beginning of each session, ordinary techniques of behavior management to treat patients were applied. In cases of unsatisfactory responses, intranasal midazolam was immediately employed. To determine the efficacy of the drug, child behavior was evaluated before and after administration of midazolam using Houpt rating scale of general behavior. RESULTS: A statistically significant difference was demonstrated in the patients 'behavior before and after administration of intranasal midazolam. CONCLUSIONS: this drug is effective in sedation and reduction of the anxiety of children under treatment.