Prevalence, characteristics and consequences of dental anxiety in a randomly selected sample of 645 Danish adults were explored in telephone interviews. Participation rate was 88%. Demographics, fear of specific procedures, negative dentist contacts, general fear tendency, treatment utilization and perceived oral conditions were explored by level of dental anxiety using a modified Dental Anxiety Scale (DAS). A Seattle fear survey item and a summary item from the Dental Fear Survey (DFS) were also included for fear description comparisons. Correlation between these indices (DAS-DFS: rs = 0.72; DAS-Seattle item: rs = 0.68) aided semantic validation of DAS anxiety intensity levels. Extreme dental anxiety (DAS > or = 15) was found in 4.2% of the sample and 6% reported moderate anxiety (DAS scores 14-12). Bivariate (B) and logistic regression (L) odds ratios (OR) showed that high dental anxiety was associated with gender, education and income, but not with age. Extreme dental anxiety for dentate subjects was characterized by fear of drilling (ORL = 38.7), negative dentist contacts (ORL = 9.3), general fear tendency (ORL = 3.4), avoidance of treatment (ORL = 16.8) and increased oral symptoms (ORB = 4.4). Moderate dental anxiety was also related to drilling (ORL = 22.3), but with less avoidance due to anxiety (ORL = 6.8) compared with low fear subjects.
The purpose of this study was to evaluate, on a short-term basis, the clinical and microbiological effects of a single course of scaling and root planing as compared with those obtained by flap surgery in patients with moderate to advanced periodontitis. 11 patients participated in the study. Using a split-mouth design, one quadrant of the mouth was treated with reverse bevel flap surgery, whereas the contralateral one was subjected to a single course of scaling and root planing. 2 approximal sites on single-rooted teeth with a pocket depth greater than or equal to 5 mm were monitored clinically and microbiologically for 16 weeks after active treatment. Both techniques resulted in a gain of probable attachment levels, a reduction in bleeding on probing and a reduced mean pocket depth, although 31.2% of the sites in the scaling and root planing group still had 6-7 mm deep pockets at 8 and 16 weeks after treatment. Both techniques reduced median relative proportions and frequencies of detection of black-pigmented Bacteroides species. A highly statistically significant increase (p less than 0.01) in median proportions of oral streptococci was recorded only for surgery within the 1st month post-operatively. No correlation was found between residual pocket depth and any of the microbiological parameters considered in the study, suggesting that residual pocket depth does not exert a significant influence on bacterial subgingival recolonization after therapy. The results from this study suggest that surgery can be as effective as scaling and root planing in favoring the establishment of micro-organisms compatible with periodontal health, although this effect is limited to the 1st month after therapy.
The caries-preventive effect of Duraphat® lacquer versus fluoride mouthrinses was evaluated in a 5-year clinical trial. The lacquer group received Duraphat application every 6th month and a placebo rinse every 2nd week during the school year. The fluoride rinse group received a 0.2% sodium fluoride rinse every 2nd week during the school year and a placebo lacquer every 6th month. All children received regular dental examination and treatment in clinics established by the municipality in which the study took place. Fluoride content of the drinking water varied between 0.1 and 0.2 ppm F––. Caries was recorded clinically and radiographically and increments calculated after 3 and 5 years. On teeth erupted at baseline the clinical caries increment after 5 years was 2.96 DMF-S in the lacquer group and 2.77 DMF-S in the fluoride rinse group, evaluated for the 248 3rd grades completing the study. Caries increment in teeth erupting during the trial was 2.20 DMF-S in the lacquer group and 2.30 DMF-S in the fluoride rinse group. The corresponding figures for radiographic caries increment were 1,01 and 0.82 DMF-S for teeth erupted at baseline, and 0.59 and 0.45 DMF-S for teeth erupting during the trial. None of the differences were statistically significant. Mean time needed to apply the lacquer was approximately 4 min, when working with a chairside assistant and 6 min, when working without a chairside assistant.
The fluoride uptake from six different fluoride solutions applied to the buccal surfaces of extracted, newly erupted premolars was measured. The fluoride concentration of two symmetrically situated areas were compared at various distances from the enamel surface after treatment of one of the areas with a fluoride solution. Exposure of enamel to sodium fluoride, acidic phosphate fluoride, monofluorophosphate, stannous fluoride, sodium hexafluorostannate and cetylaminhydrofluoride was found to produce significant but widely variable increases in the fluoride content of the superficial layers. The uptake of fluoride from all test solutions, except cetylaminhydrofluoride appeared to be confined mainly to the outermost 10–15 μm of enamel.
In order to study the mechanisms by which fluoride exerts its effects on dental enamel, enamel fluoride concentration, dental fluorosis and dental caries were compared among 14- to 16-year-old permanent residents and new arrivals in areas with 1.0–2.1 parts/106 fluoride in Denmark. Examinations were done blindly. No significant differences in concentration of fluoride in the enamel surface and in prevalence of dental caries could be found between the two groups. The distribution of fluoride-induced enamel changes, i.e. dental fluorosis, within the dentition was similar in both groups. However, the new arrivals exhibited a lower prevalence than permanent residents. These findings are discussed in relation to the widespread use of topical fluorides in the Danish Child Dental Care Service. It is concluded that maximum caries reduction through local use of fluoride may now be obtained without the risk of significant increase in prevalence of dental fluorosis.
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