Caries experience and background factors in 4-year-old children: time trends 1967-2002.

In cross-sectional studies conducted in 1967, 1971, 1976, 1980, 1987, 1992, 1997 and 2002, 4-year-old children in Umeå, a city in northern Sweden, were examined for dental caries and background factors such as oral hygiene habits, use of fluorides, and sugar consumption. The same methods and criteria have been used in each of the studies from 1967 to 2002. The number of children with caries had declined from 87% in 1967 to 42% in 1987, but then the decline levelled out. In 2002, 46% of the children had caries with a mean dmfs value of 2.0 +/- 3.6. Six percent of the children had 10 or more dmfs. Immigrant children had a higher caries prevalence (p < 0.01). A significant difference in the dmfs values was found in children according to tooth-brushing frequency (p < 0.01). Although the consumption of sugary products between meals increased between 1987 and 1997, no changes were noted from 1997 to 2002. In conclusion, no important changes in caries prevalence have taken place during the last 15 years. The frequency of tooth-brushing and immigrant background had a significant association with caries prevalence.

Treatment of traumatic dental injuries in a cohort of 16-year-olds in northern Sweden.

The prevalence and yearly incidence of traumatic tooth injury between 1 and 16 years of age have been studied in a cohort of 16-year-olds, born in 1975, and residing in the County of Västerbotten. The study material comprised 3007 dental records from the Public Dental Health Service. Of these, 1040 contained information on dental injuries. Out of 1000 injured primary teeth, 32% were lost, either avulsed at the time of the accident or extracted due to complications. A majority (92%) of the extractions was performed at the first or second follow-up. A total of 690 tooth injury episodes had occurred in the permanent dentition, involving 981 teeth. In 10% of the teeth more than one diagnosis was recorded for the same tooth. 416 restorations were performed due to crown fractures, the majority at the emergency visit. 44% of the patients had to come back one or more times to revise the composite restoration. Complicated fractures or serious luxation injuries constituted only 5% of the total number of injuries in the permanent dentition. 77 (8%) of the traumatised teeth were treated endodontically. Two percent of the teeth with uncomplicated crown fractures required endodontic treatment due to pulp necrosis, while 28% of teeth with a combination of crown fractures and luxation injury were endodontically treated. Out of 6 avulsed incisors, 4 survived after endodontic treatment. A total of 7 incisors were lost as a consequence of the injuries. A specialist treated 4% of the patients.

Dental caries, sugar-eating habits and toothbrushing in groups of 4-year-old children 1967-1997 in the city of Umeå, Sweden.

Four-year-old children in the city of Umeå, northern Sweden, have been the subjects for studies of dental caries at regular intervals between 1967 and 1997. Similar methods and criteria were used in all studies and the children were selected from the same catchment areas. The results of this study signified a shift in the trend towards a declining caries prevalence among 4-year-old children. There was a slight non-significant increase in the number of children with caries as well as in the mean dmft and dmfs values between 1992 and 1997. The mean dmfs value was 7.8 in 1967 and declined to 4.5 in 1971. It was 2.9 in 1976 and 2.0 in 1980 and 1987, 1.8 in 1992 and increased to 2.0 in 1997. Ten percent of the children were immigrant or refugee children in 1997 compared to 6% in 1992 and they had a significantly higher caries prevalence than children with a Swedish background (p<0.001). In 1997, 58% of the children had one or more daily intakes of sugary snacks such as buns, cakes sweets, soft drinks, etc. There was an increasing consumption of sweets and soft drinks between 1987 and 1997.

Risk factors for dental caries in 2-year-old children.

This paper describes risk factors for dental caries identified among 491 2-year-olds in the city of Umeå, Sweden. The study was performed as a risk screening for dental caries according to a method developed for use by dental assistants. The sugar consumption was high, 80% of the 2-year-olds had sweets once a week or more and 25% had sweet beverages once a day or more frequently. In addition, 14% of the children had a meal at night and most common were formula, bovine milk or breastmilk. The majority of the parents brushed the child's teeth at least daily using fluoride toothpaste. Among the children 6% had a chronic somatic disorder and 6% had an intolerance towards specific foods, milk being the most common. The high level of sugar consumption indicates that improved dental health education focusing on the importance of limiting sugar consumption is needed among parents with young children.

Traumatic dental injuries in a cohort of 16-year-olds in northern Sweden.

The prevalence and yearly incidence of traumatic tooth injury between 1 and 16 years of age were studied in a cohort of 16-year-olds, born in 1975, and residing in the County of Västerbotten, northern Sweden. The study comprised 3007 dental records from the public dental health service. The general distribution was 50.3% girls and 49.7% boys. The records showed that 35% of the children on one or more occasions had sustained injury to their primary or permanent dentition. The frequency was nearly twice as high for boys (64%) as for girls (36%). Twenty-five percent of the 16-year-olds had met with tooth injury more than once and this group consisted predominantly of boys. The incidence of injury episodes to primary and permanent teeth was 28 per 1000 per year. The boys had sustained trauma to their teeth most frequently when they were 4 years of age and between the ages of 8 and 11. This was also true for girls at 4 and at 9 years of age, although less evidently so. In the primary dentition, the majority of dental injuries had affected the supporting tissue of the maxillary incisors. In the permanent dentition, 75% of the traumatised teeth were upper incisors. Fractures of varying severity constituted 60% of all registered diagnoses in this dentition, followed by subluxation (19%) and concussion (11%).

Actinomyces of infected dental root canals.

The aim of the present study was to identity Actinomyces occurring in infected dental root canals. Out of twenty-five isolated Actinomyces strains, four were A. israelii, four were A. naeslundii, four were A. odontolyticus, and six were A. viscosus. Seven strains could be identified only as Actinomyces spp. The relative frequency of various species of Actinomyces isolated from root canals was similar to that of carious dentin. The Actinomyces strains were usually part of polymicrobial infections. These infections could usually be eliminated by one or two conventional endodontic treatments. In two cases, however, A. israelii was repeatedly isolated in pure culture from the root canals. These two infections had to be eliminated by means of periapical surgery.