The effects of toothpastes on the residual microbial contamination of toothbrushes.

BACKGROUND: Contaminated toothbrushes have been shown to harbor and transmit viruses and bacteria. The authors conducted a study to evaluate the effect of a triclosan-containing toothpaste on the residual anaerobic microbial contamination of toothbrushes. METHODS: Twenty patients who had Type III or Type IV periodontitis participated in this study. One side of each of their mouths served as a control (no toothpaste). The teeth on the other side were brushed with a regular toothpaste or a triclosan-containing toothpaste. After the toothbrushes were allowed to dry in air for four hours, the authors placed the toothbrush heads in solution, dislodged the microbes from the brushes by vortexing and plated them in culture dishes. The authors anerobically incubated the culture dishes and determined the presence or absence of Prevotella species or Ps; Porphyromonas gingivalis, or Pg; and Actinobacillus actinomycetemcomitans, or Aa. RESULTS: The authors detected Aa and Pg on the control toothbrushes more frequently than they did Ps. This variation in isolation frequency was statistically significant by chi 2 analysis (P < .001). The authors compared the isolation frequency of the three test organisms between the control and regular-toothpaste groups, between the control and triclosan-containing--toothpaste groups, and between the triclosan-containing--toothpaste and regular-toothpaste groups. They found no significant intergroup differences in the isolation frequencies after using chi 2 analysis. CONCLUSIONS: Toothpaste use reduced the residual microbial contamination for two of three test organisms, but the lower isolation frequencies were not statistically significant. Further study in this area is indicated. CLINICAL IMPLICATIONS: Dental professionals should advise patients who have systemic, localized or oral inflammatory diseases to disinfect or frequently replace their toothbrushes.

Effect of topical fluoride on retention of pit and fissure sealants.

PURPOSE: The purpose of this study was to evaluate the clinical effect of topical fluoride on retention of light-cured (CLC) and self-cured (CSC) pit and fissure sealants. METHODS: CLC and CSC sealants were placed in vivo on opposite sides of the arch before and after fluoride treatment. A total of 122 sealants were placed on virgin permanent molars and premolars of 16 dental hygiene students enrolled in a two-year program. Sealant retention in both fluoridated and non-fluoridated teeth was evaluated at 6, 12, and 18 month intervals. RESULTS: Overall sealant retention for both fluoridated and non-fluoridated teeth at 6, 12 and 18 months was 68%, 48%, and 49%, respectively. There was a significant difference (p < 0.001) when fluoridated vs. non-fluoridated teeth were compared. Retention was greater on the fluoridated teeth, with respect to the sealant material (CLC-fluoride). Significant differences (p < 0.001) were found when CLC-fluoride and CLC-no fluoride treatment groups were compared. However, no significant differences were found in retention when CSC-fluoride and CSC-no fluoride groups were compared, or when CLC was compared to CSC irrespective of fluoridation. Significant differences (p < 0.0001) were found when sealant retention on molars was compared to premolars--retention of sealants was greater on premolars. CONCLUSION: This study suggests that sealant retention may not be adversely affected by a topical fluoride treatment applied immediately prior to placement.

Effects of fluoride varnish on color of esthetic restorative material.

PURPOSE: This study determined the color stability of a compomer, hybrid ionomer, and composite after staining with three fluoride varnishes. MATERIALS AND METHODS: Five disks (10 mm in diameter, 2 mm thick) of each material were prepared in a mold and incubated at 100% relative humidity at 37 degrees C for 24 hours. Duraphat, Duraflor, FluorProtector, and water (control) were applied to the disks, which were subsequently brushed with a soft toothbrush and dentifrice. Color was measured at baseline, after staining, and after brushing using CIE L*a*b* (source C) against white background on a reflection spectrophotometer, and color change (delta E*) was calculated. Means (n = 5) and standard deviations were calculated and compared using a repeated-measures analysis of variance (ANOVA). Tukey-Kramer intervals (p = .05) were calculated to compare means. RESULTS: Varnishes Duraflor and Duraphat caused perceptible color changes (delta E* > 3.3) in compomer, hybrid ionomer, and composite after application; however, FluorProtector did not affect the color of the materials. After brushing, none of the materials exhibited perceptible values of delta E*, except the composite with Duraflor (delta E* = 5.4).

Dental hygienist and patient comparisons of fluoride varnishes to fluoride gels.

PURPOSE: The purpose of this study was to evaluate a fluoride varnish and compare it to fluoride gels in categories including taste, comfort, efficiency, discoloration, moisture control, safety, and ease of application. METHODS: Methods. Twenty-five licensed dental hygienists and 148 patients completed questionnaires comparing fluoride varnish to fluoride gel for the following categories: taste, comfort, efficiency, discoloration, moisture control, and safety. Responses were analyzed using descriptive statistics and a chi-square test. RESULTS: The 25 dental hygienists rated fluoride varnish (Duraphat) superior to fluoride gels in all categories. Eighty-three (56.5%) of the 148 patients reported the varnish application to be more comfortable than gel while 29 (20%) found it the same. In taste comparison, 90 (71.4%) preferred the varnish, while 16 (12.7%) rated it the same. The time required was reported as better for the varnish technique by 59 (50.4%) and equal to the gels by 32 (20.3%). Discoloration of the teeth by the varnish was found not noticeable or not objectionable by 66 (49.3%) and somewhat objectionable or too noticeable for comfort in public by 68 (50.7%). However, 85 (64.3%) reported that they would choose to have the varnish treatment while 33 (25%) would not. Dental hygienist responses on questions 1-4 relative to the number of years in practice were not found to be significantly different. CONCLUSION: The patients and dental hygienists in this study preferred fluoride varnishes to gels. However, since some patients objected to the temporary discoloration, varnishes may not be suitable for everyone.

Intensity of curing lights affected by barriers.

PURPOSE: Infection control with the use of curing lights is a problem for many oral health care offices. The purpose of this study was to determine if the use of protective barriers with curing light tips would affect the intensity of the light output of commercial light curing units as measured by a commercial radiometer. METHODS: Four different disposable barriers were tested on four light curing units to determine light intensity output (mW/cm2). Three readings of light output for each light source were obtained in each case and means and standard deviations were calculated. Means comparison was performed using analysis of variance and Tukey-Kramer intervals at the .05 significance level. RESULTS: The factors of barrier (p = .001) and light curing unit (p = .0001) were significant. The interaction (p = .54) was not significant. Light intensity output decreased significantly with addition of every barrier, except for the Sani-Shield barrier with all the light units tested, and Protectop barrier with the Coltolux 4 unit. The greatest reductions occurred with the addition of the All Purpose Adhesive Covering barrier to all light units except the Dentsply (glass tip), and with the Protectop barrier to the Dentsply light unit (glass tip). CONCLUSIONS: Barrier protection can be used with curing light tips only after determination that the emitted light intensity output is adequate.

Operating air pressure of disposable angles.

PURPOSE: This study was conducted to determine if air pressure of 20 pounds per square inch (psi) was sufficient to operate disposable prophylaxis angles smoothly and efficiently without stalling. METHOD: Five specimens of 15 types of disposable angles were evaluated by four dental hygienists to determine the minimum speed required for smooth operation. A fifth person operated the rheostat and increased the air pressure psi until signaled by the operators to stop once reaching a sufficient air pressure for operating the angle without stalling. Air pressure values were recorded for each test. Means and standard deviations were calculated for all raters for each angle. Data were analyzed using a two-way analysis of variance. Since there were no significant trends among raters, data for raters were combined for each angle and analyzed by a one-way analysis of variance. The Tukey-Kramer interval at a 0.05 significance level for comparisons among angles was determined. RESULTS: Study results showed that air pressure to achieve minimum speed required for smooth operation varied among the angles from 16.8 psi to 28.8 psi. The mean air pressure was 23.0 psi for angles with firm cups, 20.3 psi with soft cups, and 18.0 psi with regular cups. Some soft cup angles required air pressure greater than 20 psi while some firm cup angles required less than 20 psi. The regular flexibility of cup angles tested required less air pressure than 20 psi. CONCLUSION: The minimum air pressure psi required for smooth operation of disposable angles varied. Generally, air pressure greater than 20 psi was required to operate angles with firm cups, while less than 20 psi was required to operate angles with soft or regular cups.

Topical fluorides: efficacy, administration, and safety.

Fluoride's role in decreasing dental caries has been recognized for decades. The professional fluoride treatment has recently been augmented with home-use fluoride products. The introduction of many attractive products makes it difficult for dental professionals to know which are effective. Both professional and home-use products are described, as are proven techniques for their use. Recognition of fluoride toxicity, and its prevention and treatment, are also discussed.

Use of in-office fluorides in the Greater Houston area.

The purpose of this study was to determine the types of fluorides and techniques used for the application of in-office fluorides in the Houston area. A telephone survey was conducted using a stratified random sample of 262 dentists. Approximately 39% of the offices contacted chose to respond to the survey. Only one of the 101 dental offices responding was using an ADA approved professional fluoride product and technique: 1.23% APF for 4 minutes. While 41.6% or 42 of the respondents were using 1.23% APF, they were administering the fluoride for 2 minutes or less with the majority (38 out of 42) administering for only 1 minute. The second most number of respondents (35.6%) reported using a dual rinse type product consisting of 0.31% APF and 1.64% SnF2. Of the 101 respondents, 12.8% reported the use of sodium fluoride gels and rinses. Of these 13 respondents, 9 were using 2.0% NaF but for less than the recommended 4 minute application time. The other 4 were using 2.0% rinse which is more appropriate as a weekly-use rinse. The remaining respondents (9.8%) reported the use of a stannous fluoride containing less fluoride than the approved 8.0%. Of these 10 respondents, 3 were using 0.63% SnF2 and 7 were using 0.4% SnF2. One office reported the use of a non-fluoride containing mouthrinse used as an in-office fluoride treatment. This response is not included in the data as it does not qualify as a type of fluoride product.

Juvenile diabetics' oral health and locus of control. A pilot study.

The purpose of this pilot study program was to evaluate the effects of a one-year dental health education program on the oral health status and locus of control of juvenile diabetic children. Thirty subjects with juvenile diabetes mellitus were allocated to control and experimental treatment groups so that group frequencies (age, sex, race, duration of diabetes) were similar. Both groups had a Silness and Loe Plaque Index (PLI) and a Ramfjord Periodontal Disease Index (PDI) performed, and received an oral prophylaxis three times over the one-year period. Locus of control was measured at baseline and one year using the Children's Health Locus of Control Scale. In addition, the experimental group received an extensive dental health education program which emphasized the effects of dental disease on diabetes control. Twenty-five subjects completed the study. Pre- and post-locus of control measures were analyzed using the Wilcoxon Matched Pairs Signed Rank test. The Mann Whitney U Test was used to analyze differences between the groups. Indexes were compared using nonparametric two-factor repeated measures analysis of variance. Analysis revealed no statistically significant differences between groups or in locus of control scores over time. However, PDI and PLI scores improved in both groups, particularly from baseline to six months (p less than .01). Although not statistically significant, both groups exhibited a high internal locus of control. While the dental health education program resulted in only minor improvements in mean group scores, the intervention of preventive treatment produced significant improvement in measured indexes.