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Influence of Betel Nut Chewing, Dental Care Habits and Attitudes on Perceived Oral Health among Adult Pakistanis

Oral Health & Preventive Dentistry — 8/14/2008

Purpose: To survey an adult population in a deprived district of Karachi, with reference to factors influencing perceived oral health.
Materials and Methods: Of 1000 questionnaires distributed to households, 994 were returned. The respondents were aged between 30 and 50 years old. Women comprised 49% of the sample.

Results: Pan and betel nut chewing had a strong influence on the perceived oral health of the respondents. Pan chewers, 32% of the respondents, had a greater risk of oral problems, odds ratio 3.63. In contrast to other oral problems, dental caries was significantly less frequent among pan chewers (odds ratio 0.63). Betel nut chewing (28%) was less deleterious to oral health: the only significant effects were a higher risk for dental caries, odds ratio 4.51, and more gingival bleeding. While most of the respondents used a toothbrush for oral hygiene, a substantial proportion (27%) used their fingers. The oral hygiene method had no influence on the perceived oral health, nor did consumption of sweets and tea with sugar. Over 80% of the participants seldom or never visited a dentist. Cleaning frequency was significantly associated with oral health: those who cleaned their teeth at least daily had fewer oral problems. Almost all participants considered that eating sweets, smoking, and chewing pan and betel nuts endangered oral health.

Conclusions: In this population, typical of deprived urban areas of Pakistan, betel nut habits and frequency of oral hygiene have a strong influence on perceived oral health, while cleaning method and sugar intake do not.

Investigating the Relationship between Self-reported Oral Health Status, Oral Health-related Behaviours and Self-Conciousness in Romania

Oral Health & Preventive Dentistry — 8/14/2008

Purpose: The aim of the present study was to investigate whether self-consciousness, self-reported oral health status and oralhealth-related behaviours were associated.

Material and Methods: The present study sample consisted of 253 first year medical students in Romania. The questionnaire included information about socio-demographic factors, behavioural variables, self-reported oral health status and three selfconsciousness subscales (Private Self-Consciousness, Public Self-Consciousness, and Social Anxiety).

Results: Significant differences were found in Public Self-Consciousness and Social Anxiety according to several variables: anxiety, stress, depression and current non-treated caries. There were significant differences in Social Anxiety for the variables of gender, smoking, perceived dental health, self-reported gum bleeding and reason for dental visit (p < 0.05). A significant difference was found in Public Self-Consciousness for the reason for dental visits (p < 0.05). Total Self-Consciousness is correlated with anxiety, stress, depression, current non-treated caries, gingival bleeding and reason for dental visit. Oral health behaviours such as tooth brushing, flossing, mouth washing and last dental visit were not influenced by each of the self-consciousness subscales.

Conclusions: The results suggest that self-consciousness might be a psychosocial risk marker that influences self-reported oral health status.

Effect of an Antifungal Denture Liner on the Saliva Yeast Count in Patients with Denture Stomatitis: A Pilot Study

Journal of Oral Rehabilitation — 8/10/2008

Summary : Although in vitro studies on the release of antifungal agents from tissue conditioners have been done, no in vivo research on the topic could be found. The purpose of this study was to determine the in vivo effect of an antifungal agent released from a tissue conditioner on the salivary yeast count. Forty edentulous patients with denture stomatitis caused by Candida albicans were divided in two groups. Group 1 (control) was treated with a tissue conditioner only. Group 2 was treated with a tissue conditioner incorporating 500 000 U nystatin. Oral rinses were performed by both groups before treatment and every second day during treatment for a period of 14 days. Total yeast counts of the oral rinses were performed and the averages and standard deviations for both groups calculated and logarithm-transformed data of the counts over time were statistically analysed using the Wilcoxon signed-rank test. The average oral rinse yeast count of the control group decreased up to day 4. Thereafter, the count increased till the end of the test period. At day 14, the oral rinse yeast level was higher than the pre-treatment level. The average yeast count of the test group decreased up to day 7. Thereafter, the count increased but remained significantly lower (P = 0�01) than the control group and did not return to its pre-treatment level. A nystatin-containing short-term denture liner significantly decreases the salivary yeast count of patients with denture stomatitis compared with a liner without nystatin.

Dental Case Management

The Journal of the American Dental Association — 8/7/2008

Background. Medicaid beneficiaries have lower rates of dentalvisits and higher rates of dental disease compared with therest of the population. Beneficiaries ascribe their low useof services to difficulties finding dentists who treat patientswith Medicaid. Dentists cite low reimbursement rates, excessivepaperwork, and patients� not keeping appointments andpoor oral health literacy as reasons for not accepting patientswith Medicaid. The authors pilot-tested the effectiveness ofa dental case management program (DCMP) in increasing dentists�participation in Medicaid and Medicaid beneficiaries�use of services.

Methods. A dental case manager recruits dentists to participatein the Medicaid program, arranges training in billing procedures,resolves billing and payment problems, educates clients aboutthe use of dental services and keeping appointments, links clientsto dental offices, identifies potential barriers to care andhelps clients obtain transportation to appointments. The authorsevaluated the levels of participation of dentists in the DCMPin Medicaid and Medicaid beneficiaries� use of services.

Results. Dentists accepting new Medicaid patients increasedfrom two to 28, with 145 dental visits a month provided to Medicaidbeneficiaries. The percentage of Medicaid beneficiaries receivingdental services increased from 9 to 41 percent after the DCMPwas implemented.

Conclusions. The authors found that the DCMP was effective inincreasing Medicaid beneficiaries� use of services, increasingdentists� participation in Medicaid, minimizing administrativeburdens related to Medicaid participation, and increasing oralhealth literacy and treatment compliance among clients withlow incomes.

Chlorine Dioxide and Chlorhexidine Mouthrinses Compared in a 3-Day Plaque Accumulation Model

Journal of Periodontology Online — 8/5/2008

Background: The aim of this study was to investigate the inhibiting effect of a chlorine dioxide mouthrinse as opposed to a mouthrinse containing chlorhexidine (0.20%) during 3 days of plaque accumulation.

Methods: At baseline, all participants (N = 77) received a professional prophylaxis and were randomly assigned to the test (chlorine dioxide) or (positive) control (chlorhexidine) group. On the following 3 days, both groups rinsed twice daily for 1 minute with 10 ml test or control solution. At the end of the experimental period, plaque was assessed, and the panelists filled out a questionnaire.

Results: Chlorhexidine inhibited plaque growth significantly more than the mouthrinse containing chlorine dioxide (plaque index = 1.39 versus 1.96, respectively; P <0.001). The results of the questionnaire showed that the panelists found chlorhexidine easier to use and more effective. However, they preferred the taste of the chlorine dioxide mouthrinse and experienced less taste alterations.

Conclusion: Chlorine dioxide mouthrinse seems to be a less potent plaque inhibitor than chlorhexidine.