Prevalence and characteristics of dental anxiety in Danish adults

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.

[Development of caries in a group of Danish school-age children after cessation of systematic fluoride rinsing]

In a municipality near Copenhagen, Denmark, where fortnightly fluoride rinses with 0.2% neutral sodium fluoride had been performed for more than a decade, 1306 children from kindergarten through sixth grade were stratified by school and grade and randomly distributed into two groups. One group continued with the fluoride rinses, the other group had the fluoride solution replaced with distilled water. Both solutions were slightly flavored. One thousand and eighty-three children completed the three-year trial. Caries was recorded clinically by the dentists in the municipal dental service using criteria common for the Child Dental Health Services, and on bitewing radiographs by one of the authors applying criteria developed by Gröndahl et al. Permanent molars and premolars were included in the study. Clinically, caries increment in the two groups was the same, with 94% of caries lesions and fillings situated in pits and fissures. According to the radiographs, caries progression in the water group was higher than in the fluoride group. This difference was statistically significant for the surfaces erupting during the study (p < 0.05).

Caries development after termination of a fluoride rinsing program

In a municipality near Copenhagen, Denmark, where fortnightly fluoride rinses with 0.2% neutral sodium fluoride had been performed for more than a decade, 1306 children from kindergarten through 6th grade were stratified by school and grade and randomly distributed into two groups. One group continued the fluoride rinses, the other group had the fluoride solution replaced with distilled water. Both solutions were slightly flavored. 1083 children completed the 3-yr trial. Caries was recorded clinically by the dentists in the municipal dental service using the diagnostic criteria for the Child Dental Health Services, and on bitewing radiographs by one of the authors applying the criteria developed by GRONDAHL et al. Permanent molars and premolars were included in the study. Clinically, caries increment in the two groups was the same with pits and fissures containing 94% of the DMFS. According to the radiographs, caries progression in the water group was higher than in the fluoride group. This difference was statistically significant for the surfaces erupting during the study (P less than 0.05).

Effect of surgical and non-surgical periodontal treatment on periodontal status and subgingival microbiota

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.

Haemophilus isolated from unusual anatomical sites

During a 15-year period Haemophilus species were isolated from unusual anatomical sites in 80 patients, mostly adults. The origin of specimens was pus and swabs from suppurative lesions, fluids from serosal cavities and gall bladder, gut content, and blood in cases with a supposed tissue focus. In 17 patients Haemophilus species were isolated in pure culture, in 63 patients in conjunction with other bacteria. 17 patients had gynaecological complaints: bartholinitis, salpingitis, and vaginal discharge. 22 patients had gastrointestinal complaints, comprising 17 with appendicitis, peritonitis following perforation of gastric ulcer, gall-duct infections, and an abscess in the stomach wall, and 5 patients with colonization of the gut. 41 patients had soft tissue and bone infections.

Dental fluorosis among participants in a non-supervised fluoride tablet program

The aim of the present study was to describe the intraoral pattern of dental fluorosis among fluoride tablet consumers. One hundred and forty-two children, of whom 56 had participated in a fluoride tablet program of 0.5/1.0 mg NaF per day were examined blindly for possible fluoride-induced enamel changes. A low prevalence of dental fluorosis was found among non-participants. The later in life the tooth was formed, the higher was the prevalence. The subjects who had participated in the fluoride tablet program showed a significantly higher prevalence of fluorosis. They could be divided into three groups: Group 1 exhibited a tooth prevalence pattern not statistically different from that of the non-participants, group 2 showed dental fluorosis in almost all teeth except in those formed before the start of the tablet program. In group 3 the early and the late formed teeth showed very little fluorosis while those formed in the few years just after the initiation of the fluoride tablet intake were affected by fluorosis.

Dental fluorosis in the primary and the permanent dentition in fluoridated areas with consumption of either powdered milk or natural cow's milk

The aim of the present study was to describe the patterns of dental fluorosis in the primary and the permanent dentition of children born and reared in two different fluoridated areas, one in which powdered milk suspended in tap water was commonly used (Narssaq, Greenland: 1.1 ppm fluoride in the water) and one in which cow's milk was provided (Vordingborg, Denmark: 1.4-1.6 ppm fluoride in the water). Dental fluorosis was recorded by Thylstrup and Fejerskov's classification. In both locations, the prevalence of dental fluorosis increased the later in life the tooth type was formed. The prevalence of dental fluorosis in the earliest formed teeth was higher in the area where powdered milk was suspended in fluoride-containing tap water than where pasteurized cow's milk was used. In the first permanent molars, the maxillary incisors, and the canines, the prevalence was rather similar in the two areas. In the latest formed teeth, the premolars, the level of fluorosis was higher in Vordingborg. The pattern of dental fluorosis suggests that when powdered milk was used frequently, the children were exposed to a higher fluoride intake earlier in life than were those consuming cow's milk during infancy and childhood.

Acute cholangitis and pancreatitis associated with sulindac (clinoril)

A 68-year-old man without previous hepatobiliary or pancreatic disease was admitted after five attacks of nausea, vomiting, abdominal pain and high fever. Laboratory investigations indicated cholestatic liver disease and pancreatitis. For 1.5 years the patient had occasionally been taking a non-steroidal anti-inflammatory drug, sulindac (clinoril, MSD, New York), for osteoarthritis. On suspicion of a drug-associated disease, a rechallenge experiment was performed with sulindac. Five hours after drug administration symptoms recurred. There was a pronounced increase in serum alkaline phosphatase and amylase. A liver biopsy 3 d later showed portal tract inflammatory infiltration and abnormal interlobular bile ducts with degeneration and necrosis of the epithelium and neutrophilic infiltration of the ducts. Sulindac-induced cholangitis has not been described previously. The pathogenetic mechanism is considered to be an immunoallergic idiosyncratic reaction to the active metabolite of sulindac absorbed by the bile duct epithelium. The lesion is apparently reversible.

Patterns of dental fluorosis in a European country in relation to the fluoride concentration of drinking water

Dental fluorosis among 456 14-16-year-old schoolchildren who had resided continuously since birth in their respective study areas was recorded using the Thylstrup and Fejerskov classification system. The children fell into four groups according to fluoride concentration of their drinking water: (1) less than or equal to 0.1 ppm; (2) 0.3-0.5 ppm; (3) 0.5-1.25 ppm; and (4) 1.26-2.0 ppm. It was found that the later in childhood the tooth was formed, the higher was the prevalence of dental fluorosis. The fluoride concentration in the drinking water affected the prevalence of dental fluorosis in all teeth except the lower incisors, which are formed very early in life. Apart from these teeth, the proportionate increase of dental fluorosis with increasing water fluoride concentration was almost the same for all tooth types. However, the actual amount of increase in the prevalence and degree of fluorosis was greatest among those teeth that formed later during childhood. The observed fluorosis is presumed to result from and reflect the drinking water habits in the population as well as the patterns of use of fluoride prophylactics.

Bacteremia in cirrhosis of the liver

In a retrospective study the average yearly incidence of bacteremia in cirrhosis patients was found to be 4.5%. This is about 5-7 times higher than in two general materials of all bacteremic patients from the same hospital. There was no difference between the distribution of bacterial strains in the 43 bacteremic cirrhosis patients and the two general materials of all bacteremic patients.

Caries clinical trial of fluoride rinses in a Danish Public Child Dental Service

365 2nd through 4th graders completed a 3-yr clinical trial on the caries-preventive effect of rinsings every second week during the school year with 10 ml of an 0.2% neutral solution of sodium fluoride. All children received regular dental examinations and treatment in clinics established by the municipality in which the study took place. The trial was performed under double-blind conditions. The caries increment on teeth erupted at baseline was 1.75 DMFS in the fluoride group and 1.83 DMFS in the placebo group (P greater than 0.05; 95% confidence limits for percentage caries reduction: -20.7% and 29.5%). The caries increment on teeth erupting during the trial was 0.73 DMFS in the fluoride group and 0.99 DMFS in the placebo group (P greater than 0.05; 95% confidence limits for percentage caries reduction: 1.0% and 51.6%).

Phenotypic differentiation of Cardiobacterium hominis, Kingella indologenes and CDC group EF-4

Eleven strains of Cardiobacterium hominis, two strains of Kingella indologenes and six strains of CDC group EF-4 were characterized. Since all three taxa are oxidase-positive, fastidious gram-negative rods with relatively few positive reactions, they may be easily confused in the microbiological laboratory. Common characteristics are acid production from glucose, aerobic growth in semi-solid agar and very slow anaerobic growth. Group EF-4 is distinguished from the other two species by its capacity to produce catalase and its lack of indole production. Cardiobacterium hominis can be distinguished from Kingella indologenes by its ability to ferment mannitol and sorbitol and by differences in enzyme production. The three taxa also differ considerably with regard to morphological and cultural characteristics.

Endocarditis caused by Cardiobacterium hominis. Two case reports

Two cases of endocarditis caused by Cardiobacterium hominis are reported. There were no unusual clinical features of endocarditis in the patients except for the extensive valvular damage present at time of hospitalization. Properties with distinguish C. hominis from other fastidious, gram negative rods are oxidase and catalase reactions, indole production and carbohydrate fermentation pattern.

Children's response to various local fluoride treatments

The aim of the study was to evaluate children's responses to four different gel tray systems and their preference to gel treatment twice a year versus fortnightly fluoride rinsing. For the study 91 children attending third grade (10-11 years) were divided into 3 groups and 119 children attending seventh grade (14-15 years) into 4 groups. The children were treated with a neutral 2% sodium fluoride tixotropic gel by means of one of the following trays: A. Air Cushion Fluoridator B. Centrays C. An individually constructed tray made of impression material (Citricon) D. An individually constructed tray made from soft acrylic. After treatment the children's response toward the treatment was evaluated by means of interviews. The majority of the children preferred gel tray treatment to fortnightly mouth rinsing (p less than 0.0003). Disposable trays were less acceptable than the individually made trays or the Air Cushion Fluoridator. However, all trays were tolerated for 15 minutes by all children. Cost analysis showed that the difference in expense using the various trays decreased as the number of treatments of the single individual increased.