Oral-prophylaxe最新文献

Fluoride containing varnishes represent clinically proved means for individual caries prevention by topical application due to their prolonged contact time between fluoride and enamel. The fluoride accumulation in vitro and in vivo, the inhibition of demineralization, the experimentally and clinically proved reduction of caries and the toxicological safety during varnish application are reviewed. A reduction of caries between 20-50 per cent may be registered after semiannual application of such varnishes due to their high caries protective properties.

Ten years after a previous questionnaire campaign, a new survey of teachers and child specialists once again covers the areas of oral hygiene, nutritional control and fluoride prophylaxis. The evaluation shows that several information gaps have now been filled in.

For this study an extensive oral examination was performed in 111 women between 21 and 48 years of age recreating themselves in special rest homes. A mean DMF-T of 19.1 and a mean DMF-S of 62.5 was found; women with a low education (Sonderschule) showed an especially high DMF-S of 85.0, participants with a secondary education (Abitur) had a DMF-S-Index less by half. The oral hygiene of the women was insufficient (mean QHI 2.6), papilla bleeding was easy to provoke in most of them. 98% of the women needed periodontal treatment, 10.8% showed a probing depth of 6-8 mm. 60.8% of 942 examined restorations needed to be renewed, the reason was mostly marginal leakage.

The cytotoxicity of 15 commercial toothpastes was examined in human epithelial cell cultures. The following parameters were evaluated: protein concentration, DNA-synthesis, cell morphology and autoradiography. In comparison to the control cell culture, one toothpaste had no influence on the cell growth at all. The other pastes caused a more or less strong growth inhibition, which also depended on the concentration of the toothpaste suspension. The presented investigations showed that the cytotoxicity tests applied to toothpastes yielded a good validity.

Various hypotheses have been introduced and discussed in the past decade to explain the aetiology of caries and paradontopathies: Non-specific/group-specific/specific plaque hypothesis, exogenic plaque hypothesis, ecological change theory. Principles and strategies of chemotherapy for dental plaque-related ailments are treated on the basis of these theories.

Within the framework of an averaging study (clinical examination combined with written questionnaire) an attempt was made to determine the extent to which theoretical and practical knowledge of caries prophylaxis influences the behaviour and dental health of school children. Mean DF and DMF levels, it was demonstrated, are significantly reduced in children who know more; also, a higher percentage of children reported brushing their teeth more than once a day. In spite of this, a considerable discrepancy is noticed between knowledge and behaviour. Improved integration of dental hygiene instruction in the school day could improve school children's motivation to change their behaviour on a lasting basis.

In Italy (58 million inhabitants) over the last 15 years a decrease in caries incidence could be observed: Children (6-10 years old) 1970: 84.5%, DMF-T 4.77; 1980-85: 72%, DMF-T 3.64). Per capita sugar consumption went down from 32.0 kg in 1974 to 28.2 kg in 1983. 30.770 dentists are in practice--incl. medical doctors, who are allowed to practise dentistry--, 8600 of them are members of the Italian Dental Association AMDI. AMDI together with Mentadent Gibbs organised the "Month of Mouth Prevention" in 1988, 4,400 dentists with 305,552 patients joined the programme. Thanks to this programme many data about oral hygiene in Italy have emerged: frequency of brushing, kind and choice of toothbrush, use of toothbrushes (38.5 mio sold in 1988) etc. In Italy water fluoridation ist not practised, in some areas NaF pills have been used.

This paper reports on the clinical efficacy of a toothbrush (Denta-Solar) with an integrated TiO2 semiconductor element as compared to a conventional toothbrush. A significant reduction in the papilla bleeding index and the plaque indices was recorded in subjects using the Denta-Solar brush; the tartar situation near the gingivae was seen to deteriorate in those using conventional toothbrushes. This supports the assumption that the plaque reduction is due to the special construction features of the Denta-Solar.

As a result of 25--30 years of caries research practiced in Switzerland, a level for an effective caries prevention has been reached. The results are conclusive and show that at present the caries rate has been considerably reduced. An adequate and regular application of fluoride is the basis for an effective caries prevention. Other important measures are an optimal oral hygiene and a proper nutritional diet. In Switzerland, we are coming very near to the two aims set by WHO for the year 2000 in respect of healthy teeth, namely: a) half of the 5 years olds should be caries-free, b) 12 year olds should have no more than 3 carious teeth. In many Swiss communities, these two aims have already been achieved. Group prevention begins in kindergarten (ca. 4 year olds) and continues up to the fourth year of ground school education. On entering the middle school level (ca. 11 years olds), the patients leaves the group-prevention and receives individual prevention instruction. Also the substance matter changes from caries-prevention to gingivitis-prevention. It seems that with group-prevention, no noticeable improvement has been made against gingivitis. Carrying out the program are private local dentists with contract arrangements, or the canton's school dental clinic. The dentist delegates the prevention program to specially trained personnel. Public funds finance the prevention measures in its entirety. In the last few years we have discovered a small group of patients showing a higher caries-susceptibility despite the general improvement of oral hygiene.(ABSTRACT TRUNCATED AT 250 WORDS)