Assessment of efficacy of two chlorhexidine mouthrinses on oral hygiene and gingival health in adolescents wearing two types of orthodontic brackets.

OBJECTIVE: To investigate the efficacy of two formulations of chlorhexidine 0.2% (CHX) mouthrinses in terms of oral hygiene and gingival health status in adolescents with fixed orthodontic appliances wearing two different types of brackets during 18 weeks. STUDY POPULATION AND METHODOLOGY: Eighty subjects were randomly divided into two equal groups according to brackets type: (i) metal-stainless steel, (ii) ceramic. Four weeks after the placement of the fixed orthodontic appliances the subjects from each group were randomly allocated into two equal subgroups and were provided with two different mouthrinses for 14 days: (i) alcohol-free CHX, (ii) CHX with antidiscoloration system (CHX-ADS). Assessment was carried out according to gingival index (GI) and oral hygiene index-simplified (OHI-S) performed prior to the placement of the appliance (t1 ), 6 weeks (t2 ), and 18 weeks (t3 ) after the placement. To analyse the data, two-way mixed model MANOVA. Pearson correlations, one-way ANOVA and Independent Samples t test were conducted. RESULTS: Statistically significant decrease in GI and OHI-S indices after 6 weeks and then increase after 18 weeks for all groups was found. Both GI and OHI-S values were lower in subjects wearing ceramic brackets, with statistically significant difference for GI after the usage of the mouthrinse for 14 days, at t2 (P<.05). CONCLUSION: The results revealed that the ceramic brackets as well as usage of CHX-ADS resulted in improved gingival status.

Influence of Oral Hygiene Knowledge and Habits on Dental Fear in Croatian Preschool Children.

Preschool age is defined as the time from age 3 to age 6. This period in a child's life is when important attitudes and oral hygiene habits are developed and dental fear can be a severely limiting factor in dental health maintenance. The purpose of this research was to collect data on oral hygiene habits and the quality of dental fear with respect to preschool aged children, and to try to define statistically significant differences, with respect to age, sex and geographical background. The research was conducted by questionnaire method on 796 preschool aged children, ages 3-6, in two big cities located in different geographical areas (Split-coast area and Zagreb-continental area). Statistical data processing was conducted by implementing the χ²-test. Statistical analysis showed that there is a difference in oral hygiene habits between children in Zagreb and Split, and also among children of different ages and gender: the older the children are, the less the parents participate in maintaining their children's oral hygiene. By the gender girls show better oral hygiene habits. Furthermore, dental fear isn't necessarily related to past dental experiences. This study demonstrated that children mostly afraid of the dental drill.

The influence of war on the oral health of professional soldiers.

AIM: Professional soldiers, although trained to deal with specific conditions, are not immune to war stress induced behavioural changes, and since oral diseases are behaviour-related some changes in the oral cavity could be expected. PARTICIPANTS AND METHODS: The study was conducted on 640 professional soldiers in the Croatian Army, aged 19-49 years. The study group consisted of 336 soldiers in active service during the war in Croatia (1991-1997), while control group included 304 soldiers in peacetime service. Decayed, Missing and Filled Teeth Index (DMFT) and Community Periodontal Index (CPI) as well as questionnaires concerning dental behaviour and diet were employed. RESULTS: War group soldiers had significantly poorer oral health with DMFT being 14.4 in the war group and 13.1 in the controls, respectively (p < 0.001). The war group also showed a significantly higher number of periodontal pockets and excluded sextants, but lower numbers of healthy sextants (1.3 war group and 2.1 control; p < 0.001). Significant differences between the war and peacetime groups according to the number of dental visits, daily brushing frequency and diet were found. There was a tendency towards the deterioration of oral health with increase in time spent in battle fields. CONCLUSION: War conditions have a significant influence on the increased prevalence and severity of oral diseases for professional soldiers.

Degree of correlation between two periodontal indices in a rural Croatian population.

AIM: To compare the periodontal status of patients measured by two indices, the Community Periodontal Index (CPI) and the Loss of Attachment Index (LA). METHOD: The CPI and LA index scores were determined for a sample of 367 adult subjects (1,535 dentate sextants) aged 15-65 years from two rural areas in Croatia and analysed according to subject, sextant and jaw. RESULTS: Partial correlation between the CPI and LA indices was found. Cumulative for all age groups, sextants with a CPI code 0, 1 and 2 most often appeared with a LA 0-3mm. Shallow pocket sextants (4-5mm) in 64.04% also correlated with the loss of attachment values 4-5mm. In deep pocket sextants (6-8 mm), a deviation from expectations was found as they appeared more often with a LA 9-11 mm designation (46.24%), rather than with an LA 6-8mm (34.41%) score. Very similar results were found between distribution per sextant, person and jaw in CPI codes 2, 3, 4 and cumulatively. CONCLUSION: CPI itself is not sufficient for periodontal status assessment, especially for the 35-44 years of age, and even more so for the 65+ group, also for the CPI code 4 in all ages.

Suppression of salivary Streptococcus mutans and lactobacilli by topical caries preventive agents.

Reduction of cariogenic bacteria, especially salivary Streptococcus mutans and lactobacilli is a valuable clinical procedure that in many ways alleviates implementation of targeted caries preventive procedures in the entire population. The aim of this study was to investigate the caries preventive values of certain preventive procedures in in vivo conditions. Four groups of subjects, each with 18 children aged from 4-5 and 10-12 years (n = 72) were treated with different caries preventive agent (aminfluoride solution, Proxyt paste, chewing gum containing xylitol and fluoride and chlorhexidine solution). During a period of two months five control measurements for number of salivary Streptococcus mutans (SM) and lactobacilli (LB) were performed. At the end of the study the best result in the reduction of the bacteria was achieved by the application of Proxyt paste and daily use of chewing gum (p < 0.001). In patients treated with this preventive procedure the number of SM was reduced by 1 class and LB to < 10(4) CFU/ml saliva after two months of study. The results obtained indicate that professional teeth cleaning and use of chewing gum with xylitol and fluorides on daily basis can be very effective protocol for cariogenic bacteria reduction and in the individual caries prevention.

Factors predisposing to early childhood caries (ECC) in children of pre-school age in the city of Zagreb, Croatia.

The aim of this study was to investigate factors predisposing to early childhood caries (ECC) in pre-school children in the city of Zagreb, Croatia. The investigation was carried out on the sample of 145 children (77 boys and 68 girls) aged between 2 and 5 years, including clinical examination of dental status and survey on the habits among the parents. The overall prevalence of ECC was 30%: in girls it was 25%, and in boys 48%. The study on the risk factors was designed as a classic case-control study. The mean value of dmfs index among the cases amounted to 8.6, in comparison to 5.2 in the control group (p<0.05). Bottle-feeding did not represent a significant risk, but night consumption of sweet beverages after first 24 months and the lack of introduction of teeth-brushing habit after first 24 months did (p < 0.001 for both predictors). The study revealed the importance of early introduction of teeth-brushing and giving up the nightly consumption of sweet beverages in prevention of ECC.

Hypohidrotic ectodermal dysplasia: dental features and carriers detection.

Ectodermal dysplasia is a heterogeneous condition characterized by affected ectodermal structures, among which the teeth and skin with its derivatives (hair sweat glands) are the most frequent. The aim of this work is to present the analysis of dental traits in five families (affected boys and their mothers) with hypohidrotic ectodermal dysplasia (HED), and to evaluate the importance of orofacial and dental findings in the determination of female HED gene carriers. Hypodontia (oligodontia) was found in all the patients. The mothers, gene carriers, had either hypodontia or a reduced size of teeth with a particular morphological, peg shape. In patients with hypohidrotic ectodermal dysplasia the deciduous second molar teeth were mostly affected by taurodontism. The characteristic dental finding in heterozygous females of the mandibular peg shaped incisors and canines, as well as of hypodontia or peg shaped upper lateral incisors can be used as a reliable criterion for the detection of HED gene carriers.