Mucosal microflora in head and neck cancer patients.

OBJECTIVE: To analyse the tongue and buccal microflora prospectively in head and neck cancer patients treated with radiation therapy (RT). METHODS: In 33 dentate patients, microbial samples from the tongue and buccal mucosa were collected pretreatment, during treatment, and 6 months, 1 year and 2 years post-treatment. Microorganisms associated with oral health and oral disorders were analysed using cultivation technique. Oral mucositis was scored at the appointment during treatment. RESULTS: Compared with pretreatment, lactobacilli and Candida increased on the tongue, while streptococci and Neisseria decreased during treatment. Two years post-treatment, Neisseria and Prevotella were decreased and Candida increased. On the buccal mucosa, an increased growth of lactobacilli and increased detection frequencies of the opportunistic bacteria Staphylococcus aureus, Gram-negative enteric rods and enterococci were seen during treatment compared with pretreatment. Seventy per cent showed severe mucositis during treatment. Two years post-treatment the total count as well as streptococci, Neisseria and Fusobacterium nucleatum were decreased and lactobacilli increased compared with pretreatment. CONCLUSION: Despite improvements in treatment for cancer in the head and neck region, microorganisms associated with oral health decrease during treatment and mucosal pathogens increase. Two years post-treatment, levels of acid-tolerant (lactobacilli and Candida) were increased, while acid-sensitive microorganisms (Neisseria and F. nucleatum) were decreased, plausibly due to persisting decreased salivary secretion rate.

Explorative study on mucosal and major salivary secretion rates, caries and plaque microflora in head and neck cancer patients.

OBJECTIVE: To analyse mucosal and major salivary secretion rates, caries and plaque microflora in connection with treatment for cancer in the head and neck region. METHODS: Thirty-three patients were included and the number of teeth, filled surfaces and caries lesions registered. The labial and buccal gland secretion and stimulated whole salivary secretion rates were determined. Supragingival plaque microflora was analysed using cultivation technique. Data were collected pretreatment, during treatment and 6 months, 1 year and 2 years post-treatment. RESULTS: Two years post-treatment, 36% had new caries lesions, which had been restored. The labial secretion was comparable with pretreatment, while the buccal secretion was lower (P < .001). The stimulated secretion rate was lower compared with pretreatment (P < .001) and was ≤0.7 mL/minute for 50%. Growth of lactobacilli increased during treatment (P < .001) and remained increased (P < .001), while growth of mutans streptococci was decreased (P < .01) 2 years post-treatment. Growth of Candida increased over time and was higher 2 years post-treatment compared with pretreatment (P < .001) while growth of Prevotella was lower (P < .01). CONCLUSIONS: Two years post-treatment, the stimulated salivary secretion rate was substantially decreased, acid-tolerant lactobacilli and Candida increased, acid-sensitive microorganisms decreased, and the caries prevalence was low.

Relationship between plaque pH and different caries-associated variables in a group of adolescents with varying caries prevalence.

The pH response of the dental biofilm after a sugar challenge can be considered to mirror the acidogenic potential and thereby the caries risk of an individual. The aim of this cross-sectional study was to evaluate the relationship between plaque pH and different caries variables in adolescents with varying caries prevalence. One hundred individuals, aged 14-15 years, were examined regarding different caries-related variables: (i) caries score (DSm, DSi, DSm + i, DTm), (ii) salivary secretion rate and buffer capacity, (iii) oral microflora of plaque and saliva, (iv) plaque amount, (v) plaque pH and (vi) dietary intake, oral hygiene habits and fluoride use. Plaque pH was assessed using the microtouch method before and after a 1-min mouthrinse with 10 ml 10% sucrose. Depending on the minimum pH, the participants were divided into three groups: low pH (≤5.3), medium pH (>5.3-6.3) and high pH (>6.3). Statistically significant differences between the three groups (p < 0.01) were found for initial caries (DSi) and combined manifest and initial caries (DSm + i). A statistically significant difference was also found in the log values for salivary lactobacilli (p = 0.02) within the three groups, and for the total number of bacteria in plaque (p = 0.04); for both variables, the low-pH group had the highest values. The only covariate significantly associated was the Cariogram score in the medium-pH group (p < 0.01) and the number of meals per day in the high-pH group (p = 0.02). To conclude, plaque pH measured by the microtouch method is a method that can be used for discriminating between individuals with varying caries prevalence.

Patterns of carbohydrate intake--a study of typology, associations and changes over time in an elderly Swedish population.

BACKGROUND: Patterns may explain part of the dietary variation between subjects. OBJECTIVE: To create a typology of carbohydrate intake among the elderly and to analyse whether it seems valuable or not. DESIGN: Factor and cluster-analyses of dietary interviews from two elderly cohorts of free-living elderly people in Göteborg, Sweden. SUBJECTS AND METHODS: Three hundred and thirty seven women and three hundred and twenty three men aged 70-79 was studied cross-sectionally and longitudinally. The altogether 917 dietary interviews were based on the dietary history method. Cluster analysis, based on factor scores, was used to create the typology. RESULTS: Seven clusters were identified: 1) Small eaters (high relative intake of starch and a low energy intake), 2) Lean and green eaters (high intake of dietary fibre), 3) Fruit eaters (high intake of monosaccharides), 4) Sweet tooth eaters (high intake of sucrose), 5) Gourmands (high absolute intake of starch, dietary fibre and energy), 6) Milk drinkers (high intake of lactose) and 7) Fat eaters (high intake of fat and low intake of carbohydrates). The different patterns were associated with different food consumption, different intake of micronutrients and different social and physiological factors. There were also changes over time of the proportion of subject within the clusters. CONCLUSIONS: The typology found by using cluster analysis, seems to be valid and was related to all analysed dimensions. Therefore, the methods may be valuable for describing and analysing the dietary intake among elderly.

Perception of malocclusion in 11-year-old children: a comparison between personal and parental awareness.

In orthodontic counselling an understanding of how individuals perceive their occlusal features is important to ensure effective communication and for provision of adequate advice on treatment need. The purpose of the present study was to assess personal and parental awareness of malocclusion in children, and to examine whether agreement existed between children and their parents on assessments of malocclusion traits. Of 104 randomly selected fourth-grade children 99 presented themselves at a public dental clinic. Ninety-three accompanying parents attended. Awareness was assessed by comparing the opinion of parents and children on the presence or absence of anterior malocclusion with direct measurements on dental study casts. The subjects' abilities to identify a polaroid of the child's dentition in a panel of 17 alternative photographs were also used as a measure of awareness. The findings revealed a moderate level of awareness among both the children and their parents. About half of the children and the parents identified the child's photograph on the first attempt. About three-quarters of the traits recorded as marked/severe malocclusion and about half of the mild/moderate traits were recognized. A significant association existed between the number of correct reports on traits given by the children and the parents. However, agreement across professional, child, and parental assessments varied for the different traits. The results indicated that the individual's comprehension of professional terms may be unclear and that professionally defined cut-off points often do not coincide with norms existing within the actual family unit.