Periodontal disease in cats: back to basics--with an eye on the future.

PRACTICAL RELEVANCE: Periodontal disease is commonly encountered in feline practice. Gingivitis, followed by inflammation of the rest of the periodontal tissues, can lead to chronic oral infection, bacteraemia, pain and ultimately tooth loss. Given adequate plaque control and thorough, consistent dental home care, gingivitis is a reversible and controllable condition. Periodontitis, however, is an essentially irreversible and progressive condition. Treatment aims to control tissue inflammation, returning the gingiva to clinical health and preventing destruction of the periodontium in other parts of the mouth. CLINICAL CHALLENGES: Diagnosis must be established using a combination of oral examination under anaesthesia and dental radiography. Periodontitis leads to tooth attachment loss, and given the short length of most cat teeth, probing depths of 1 mm or more should alert the clinician to the presence of periodontitis. The decision of whether to extract or preserve affected teeth needs careful consideration. In practice, as periodontitis is often associated with type 1 tooth resorption, extraction is often required, but the slender and delicate nature of feline tooth roots, compounded by the destructive nature of tooth resorption, can frustrate extraction attempts. As highlighted in this article, iatrogenic damage to teeth is also a real risk if periodontal therapy procedures (including scaling and polishing) are not performed carefully. The challenges of providing home care in the cat are additionally discussed. EVIDENCE BASE: The authors have drawn upon, wherever possible, an evidence base relating strictly to the feline patient. Where there is a lack of published research, evidence from canine and human studies is assessed.

Promoción de la salud bucodental / Dental health promotion

Los tres factores principales implicados en la caries son las bacterias, los azúcares y la susceptibilidad del huésped, mientras que los procedimientos más útiles como profilácticos de la misma son el empleo de flúor, las medidas dietéticas, la higiene dental y el tratamiento de las lesiones activas. El flúor más efectivo para la prevención de la caries es el tópico administrado de forma continua. Este dato, junto con el conocimiento de que el exceso de flúor sistémico en la fase preeruptiva se asocia con la fluorosis dental hace que el cepillado dental con una pasta que contenga flúor es actualmente la medida más recomendable para la prevención de la caries. Es más importante la minuciosidad del cepillado dental que el tipo de técnica empleada. Solamente se recomiendan suplementos de fluoruro si se pertenece a un grupo de riesgo de caries dental y la cantidad que debe administrarse está en función de la concentración de ion flúor del agua de consumo, ya que los alimentos no constituyen una fuente importante de flúor. Los colutorios de fluoruro que se emplean para realizar enjuagues bucales diarios o semanales, deben recomendarse a partir de los seis años para asegurar que el niño no ingerirá el líquido. La cariogenicidad de los azúcares depende más del tipo de hidrato de carbono y del tiempo de retención bucal que de la cantidad consumida, por lo que se desaconseja especialmente la ingesta de biberones durante el sueño (AU)

The three main factors involved in dental caries are bacteria, sugars and host predisposition whereas the most effective proceedings to prevent caries are fluoride supplements, dietetic measures, teeth brushing and the restoration of active lesions. The most effective fluoride to prevent dental caries is topic continuous-administered fluoride. This statement together with the knowledge that excessive systemic fluoride in the pre-eruptive phase is associated to dental fluorosis, makes dental brushing with fluoridated toothpaste the most advisable preventive measure against caries. A thorough brushing is more important than the brushing technique itself. Fluoride supplements are only recommended to caries risk groups and their amount must be related to tap water fluoride concentration due to the fact that food is not a relevant fluoride source. Fluoride mouthwashes used daily or weekly should be recommended for children over 6 years old to make sure that they will not swallow them. Sugar cariogenicity depends more on the kind of carbohydrate and of the time spent in the mouth than on the amount of it. That is why it is especially recommended not to offer bottle feeding while sleeping (AU)

Conocimiento sobre enfermedad periodontal y práctica de hábitos de higiene oral de pacientes del Programa Nacional de Diabetes del Ministerio de Salud Pública y Bienestar Social - Año 2010 / Periodontal disease knowledge and practice of oral hygiene of patients in the Diabetes National Ministry of Health and Welfare - Year 2010

La diabetes es una enfermedad que afecta a millones de personas en el mundo, en Paraguay afecta al 6,5% de la población adulta dándose en estos la mayor susceptibilidad a infecciones. Su relación con la enfermedad periodontal ha sido ampliamente estudiada, se considera a la prevención como el mejor tratamiento y a la educación, como pilar de la misma. Con el objetivo de determinar el conocimiento sobre Enfermedad Periodontal de pacientes diabéticos que concurrieron al Programa Nacional de Diabetes del Ministerio de Salud Pública y Bienestar Social en el período comprendido entre los meses de setiembre a diciembre del 2010, se planteó la realización de un estudio observacional descriptivo de corte transversal, con componente analítico en 83 pacientes a los que se les aplicó un cuestionario autoadministrado, que además de los datos demográficos contenía preguntas sobre signos, síntomas de la enfermedad periodontal, y su relación con la diabetes, además de hábitos de higiene oral. Los datos fueron procesados y analizados utilizando estadística descriptiva mediante el programa informático Excel 2007. Para relacionar el conocimiento y práctica con sexo, edad y nivel educativo se utilizaron la prueba del Chi cuadrado y test exacto de Fischer. Se observó que la mayor parte de la población afectada era del sexo femenino; el 63 % de de los encuestados considera que existe relación entre la diabetes y la enfermedad periodontal, solo el 37% utiliza hilo dental como medio auxiliar de higiene y el 45% de los pacientes no acuden al odontólogo por alto costo del servicio. Se concluyó que el conocimiento y práctica de la población es insuficiente. Estos datos servirán de base para otros estudios y para la promoción de un programa de salud oral en estos pacientes .

Bacteriemia secundaria a procedimientos odontológicos periodontales / Bacteremia after periodontal procedures

Introducción. La bacteriemia ocurre con frecuenciadespués de la cirugía oral y de los procedimientos odontológicos.La periodontitis puede afectar a la incidencia y el espectrobacteriano de la bacteriemia. La enfermedad periodontalpuede ser un factor de riesgo significativo en eldesarrollo de enfermedades sistémicas. El objetivo del presenteestudio es evaluar la frecuencia de aparición de bacteriasaerobias y anaerobias en muestras de sangre despuésdel raspado y alisado radicular.Material y métodos. Fueron estudiados 13 pacientescon enfermedad periodontal crónica generalizada. Se tomarondos muestras de sangre para cultivo en diferentes momentos:pretratamiento e inmediatamente después del tratamientoodontológico.Resultados. En ninguno de los 13 pacientes se detectóbacteriemia previa al tratamiento. Después del raspado yalisado radicular la bacteriemia ocurrió en 10/13 (76,9%)pacientes con enfermedad periodontal. Predominaron lasbacterias anaerobias (Prevotella spp., Micromonas micros yFusobacterium nucleatum).Conclusiones. Nuestros hallazgos sugieren que los procedimientosperiodontales inducen bacteriemia y puedenrepresentar un riesgo para el desarrollo de complicacionessistémicas. El empleo de profilaxis antibiótica resulta crucialpara su prevención (AU)

Introduction. Bacteremia frequently occurs afteroral surgery and odontology procedures. Periodontitismay affect the incidence and bacterial spectrum of bacteremia.Periodontal disease may be a significant riskfactor for the development of certain systemic diseases.This study has aimed to evaluate the frequency of aerobicand anaerobic bacteria in the bloodstream followingscaling and root planing.Material and methods. Thirteen patients with generalizedchronic periodontitis were included in the study.Two samples of peripheral blood were drawn for cultureat different times: pre-treatment and immediately afterodontology treatment (full-mouth scaling).Results. None of the 13 patients had bacteremia beforethe procedures. Bacteremia after scaling occurred in10/13 (76.9 %) of periodontitis patients. The anaerobicbacteria (Prevotella spp., Micromonas micros and Fusobacteriumnucleatum) were the most predominant microorganism.Conclusions. Our findings suggest that periodontalprocedures induce bacteremia and may represent risk ofdeveloping systemic complications. The use of antibioticprophylaxis is crucial for its prevention (AU)

Hallazgos orales en el síndrome de Rubinstein-Taybi: a propósito de dos casos / Oral findings in the Rubinstein-Taybi syndrome: concerning two cases

El síndrome de Rubinstein-Taybi es una alteración multisistémica genética que cursa con dismorfia facial, y retraso mental y del crecimiento. Este síndrome se caracteriza por tener los primeros dedos de los pies anchos, anomalías cráneo faciales con una nariz aguileña, estatura baja y retraso mental y motor, con diagnóstico radiológico y clínico. La prevalencia es desconocida y es relativamente raro. Las cúspides en garra aparecen con frecuencia localizadas en los incisivos. No hay un patrón hereditario definido y la recurrencia es bastante improbable. Se encontró que la causa es genética, mutaciones en el cromosoma 16p13 (AU)

The Rubinstein-Taybi syndrome is a genetic multisystemicdisorder that involves facial dysmorphosisand mental and growth retardation. This syndromeis characterised by having broad first toes,craniofacial anomalies with an aquiline nose, shortstature and mental and motor retardation, withradiological and clinical diagnosis. The prevalenceis unknown and is relatively rare. The talon cuspsappear frequently located on the incisors. There isno defined hereditary pattern and the recurrenceis quite improbable. The genetic cause was found, mutations in the chromosome 16p13 (AU)

Estudio sobre la prevención quimioterapéutica de la caries dental con barnices de clorhexidina y timol, en niños de 5-8 años de edad, con riesgo alto de caries. Un reporte preliminar / Study on the chemotherapeutic prevention of the caries with chlorhexidine/thymol varnish in children of 5-8 years old, with high caries risk. A preliminary report

Objetivos: el propósito de este estudio fue evaluar la posibilidad de reducir la caries de fisura en las caras oclusales de los primeros molares permanentes, a través de barnices antimicrobianos, en escolares con alta incidencia de caries. Se ha realizado un ensayo clínico aleatorio a doble ciego. Sujetos: 35 niños saludables con edades comprendidas entre los 6 y 8 años, con alto riesgo de caries, fueron seleccionados en un colegio de Madrid. Para ser incluidos en el estudio cada niño debería tener como mínimo dos primeros molares permanentes sanos, y presentar caries en dentina en sus molares temporales. Métodos: después de la profilaxis dental, el grupo de estudio se le aplicaba un barniz de clorhexidina 1 por ciento y timol 1 por ciento (Cervitec), y al grupo control un barniz de placebo. El barniz era colocado sobre todos los dientes (dentición temporal y permanente) cada tres meses (al inicio a los 3, 6 y 9 meses) y el incremento de caries era comparado a los 12 meses. Resultados: al inicio del estudio no habían diferencias entre los grupos. Al año existía una diferencia significativa entre el grupo de estudio y el de control, en CAO-D P=0,001, CAO-S P=0,000 (en los primeros molares permanentes) . Conclusión: la aplicación de Cervitec cada 3 meses, es efectiva previniendo la caries en los primeros molares permanentes de escolares con alta actividad de caries (AU)

Objective: the purpose of this study, was to evaluate the possibility of reducing occlusal fissures caries development, in permanent first molars, using an antimicrobial varnish, in schoolchildren with high caries activity. Randomised, a double-blind clinical trial was developed. Subjects: 35 healthy children aged 6-8 years with high caries risk, were selected from a schools in Madrid. To be included in the study, each child had to have least 2 sound permanent molars and primary molars with carious lesions in dentin. Methods: after prophylaxis, test groups received 1% chlorhexidine and 1% thymol varnish (Cervitec) application, the control group received a placebo varnish. The varnish was reapplied in all the teeth (primary and permanent dentitions) every 3 months (initially and after 3,6 and 9 months), and the caries increments were compared at 12 months. Results: no differences between groups were seen at baseline. At year there was a significant difference between test group and control in DMFf P=0.001 DMFS P= 0.000, (in permanent first molars). Conclusion: the application of Cervitec every 3 months, is effective in preventing caries in permanent first molars, in schoolchildren with high caries activity (AU)

Diagnostic and preventive service trends in private general practice: 1983-1984 to 1998-1999.

BACKGROUND: Aggregate trends have indicated increases in the provision of diagnostic and preventive services but there have been few reports based on their component sub-categories. The aims of this study were to investigate time trends in the provision of sub-categories of diagnostic an preventive services across a 15-year period. METHODS: A random sample of Australian dentists was surveyed by mailed questionnaire in 1983-1984, 1988-1989, 1993-1994 and 1998-1999 (response rates 71-75 per cent). Data were weighted to provide representative estimates for the age by sex distribution of private general practitioners in 1983, 1988, 1993 and 1998. RESULTS: Rates per visit were higher, Poisson regression, P<0.05, in 1998-1999 compared to baseline for examinations, radiographs, prophylaxis and topical fluoride. Diagnostic and preventive service rates varied by age of patient: compared to patients aged 65+ years, examinations were higher among children aged <5 years to adults aged 25-44 years, radiographs were lower among children <5 years and 5-11 years but higher among adults aged from 18-24 years to 45-64 years, prophylaxis services were lower among children <5 years but higher among adolescents 12-17 years to adults aged 45-64 years, while topical fluoride was higher among children 5-11 years and adolescents 12-17 years. CONCLUSIONS: Examination, radiograph, prophylaxis, and topical fluoride rates increased over the study period. While examination rates increased for both children and adults, and prophylaxis rates increased for adolescents and adults, rates for radiographs and topical fluoride only increased for adults. Age-specific changes in service rates over time indicate the effect of changing oral health status and population demographics on service provision.

Dental hygienists in Korea.

The purpose of this paper is to give basic information about the status of dental hygienists in Korea. This paper examines the changing process of the dental hygiene education system in Korea, from its start in 1965 until the present, 2003, the composition of dental personnel in Korea, the specialised areas and roles of dental hygienists after they receive their licenses, employment of dental hygienists, dental hygiene-related organisations, and the status and direction of dental hygienists in Korea. This paper shows the organisational, educational, governmental and individual efforts to increase the level of professionalism, education and quality of care delivered to Korean citizens nationwide.

Prioritization of the National Dental Hygiene Research Agenda.

The profession of dental hygiene has made considerable progress over the past 30 years toward developing a unique body of knowledge for guiding education, practice, and research. The 1993-1994 American Dental Hygienists' Association Council on Research published the first national dental hygiene research agenda in 1994. The 1994 research agenda focused dental hygienists' research efforts; however, publication of two national reports--the Surgeon General's Report on Oral Health, and Healthy People 2010--have made it necessary to revisit the research agenda. After considering input from participants in the Fourth National Dental Hygiene Research Conference and evaluating the Surgeon General's Report, the 2000-2001 Council on Research has established recommendations for the prioritization of the 1993-1994 research agenda. This report outlines for readers the rationale for the proposed recommendations.

Dental hygiene: challenges and opportunities for the millennium.

This paper was originally presented as the Keynote Speech at the ODHA Annual Spring Meeting, Toronto, May 1, 1997. The author has drawn on her lengthy involvement with the dental hygiene profession, including as a clinician, educator, researcher, and president of the Canadian and Ontario Dental Hygienists' Associations and the International Federation of Dental Hygienists.

[Future outlook for dental prophylaxis from the perspective of statutory sickness insurance]. / Zukunftsperspektiven der zahnmedizinischen Prophylaxe aus Sicht der Krankenkassen.

Recent legislation in dental health care in Germany calls for a substantial expansion of prevention. The statutory sickness funds start from the assumption that group prophylaxis in core settings of children like kindergartens and schools should be the focus of combined efforts. The departments of dental health care in local public health offices could integrate the relevant services for children and adolescents. However, in the pluralistic system between providers, purchasers and underlying legislation these must come to an agreement regarding new financial solutions for this important preventive task.

[Preventive dental care from a sociological viewpoint]. / Zahnmedizinische Prävention aus soziologischer Sicht.

In this essay the question is examined: Are there tendencies to "medicalisation" in the actual programmes of oral prevention? Medicalisation is interpreted as a subordination of the daily behaviour of clients under control of the medical system. Two possibilities of implementation of oral prophylaxis are discussed: Alternation of a concept of strict supervision and a concept of "oral self-care" emphasising more elements of behavioural self-control and empowerment.