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Notes: Abstract The main aim of this study was to compare the intervals between initial and recall bitewing radiography recommended by general dental practitioners (GDPs) with those advocated in published guidelines. A questionnaire containing eight clinical scenarios was distributed to GDPs in two areas of England, Birmingham (fluoridated) and Manchester (non-fluoridated). The response rate was 70.8% There was considerable agreement (〉66.0%) with recommended guidelines for all low caries risk scenarios, but in three out of the four high caries risk scenarios a minority of dentists were in agreement (〈49.5%). In high caries risk scenarios there was a tendency to over prescription with adult patients and under-prescription for patients in the mixed dentition. For all low risk scenarios except the youngest patient, there was a significantly greater agreement with the guidelines amongst Birmingham dentists, with the Manchester group having a greater tendency to over-prescription. This difference may be related to the effects of fluoridation of the water supply in the Birmingham area. There was generally greater agreement with the guidelines amongst younger dentists, with their older colleagues tending to tinder-prescription. The results suggest that greater emphasis on selection criteria in continuing education of dentists is required.

Notes: Abstract The aim of this study was to determine the influence of a range of patient and dentist factors on the prescription of bitewing radiography. A postal questionnaire of general dental practitioners working in the Birmingham and Manchester areas of England was used. Dentists were requested to score the influence of 15 factors upon their decision whether or not to take bitewing radiographs. Some of these factors were chosen to represent accepted “high caries risk” factors, some “low risk” factors, while others were chosen as they should be irrelevant to prescription of bitewing radiographs. There was a questionnaire response of 70.8%. Dentists recognized accepted high caries risk factors as being an indicator for bitewing radiography but the influence of low caries risk factors was less clear. Only “good oral hygiene” and the presence of “few restorations” were perceived as relevant to bitewing prescription, while fissure sealants were seen as an influence in favour of radiography by almost one third of dentists. Dentists tended to be influenced in their radio-graphic practice by the opinions of patients and fears of medico-legal consequences. Pregnancy was seen as contra-indicatory for bitewings by almost all dentists. These results suggest that greater emphasis should be placed upon radiographic selection criteria in dental education.

Notes: Abstract –  Objective: To determine the effectiveness of providing free toothpaste containing either 1450 or 440 ppm F on caries experience in 5-year-old children living in areas with different levels of material deprivation. Design:  Five-year, examiner-blind, randomized, controlled, parallel-group, clinical trial. Children were randomly assigned to three groups. Setting:  Health Districts in the north-west of England with high levels of dental caries. Clinical examinations were performed in schools during the period October 1999 to April 2000 when the children were 5–6 years old. Participants:  Children from 3-month birth cohorts resident in nine, nonfluoridated health districts. Interventions:  Toothpaste containing either 440 or 1450 ppm F and dental health literature posted at 3-month intervals and toothbrush provided annually from the age of 1–5〈inlineGraphic alt="inline image" href="urn:x-wiley:03015661:CDOE150:CDOE_150_mu1" location="equation/CDOE_150_mu1.gif"/〉 years. Comparison group received no intervention. Main outcome measures:  Mean dmft and proportion of participants with dmft 〉 0, dmft ≥ 4, upper primary incisor caries and extraction of one or more primary teeth. Outcomes tabulated for quartiles of participants based on the distribution of the Townsend index of material deprivation. Results:  A total of 3467 children were included in the final data analysis. The Townsend index was found to be useful in identifying groups of children with increased caries risk. Overall, participants in the programme using the high-fluoride toothpaste had significantly (P 〈 0.002) less caries than the comparison group with similar absolute reductions in mean dmft for the most- and least-deprived groups. Relative to the comparison group the association between deprivation and dental caries was changed so that in the most-deprived quartile those using the low-fluoride toothpaste tended to have less dental caries than the comparison group whereas in the least deprived they tended to have more. This difference in the association (slope) was statistically significant (P 〈 0.05). Provision of both low- and high-fluoride toothpaste appeared to reduce the risk of extractions for participants in the most-deprived quartile (P 〈 0.05). Conclusion:  The relative benefits of the programmes supplying the two toothpastes considered in this study are different depending on the deprivation status of the participants. For the most-deprived groups postal provision of either a low- or high-fluoride toothpaste provides similar levels of benefit. In the less deprived groups only provision of the high-fluoride toothpaste provided a benefit. The absolute caries reduction seen for provision of the high-fluoride toothpaste was not related to the deprivation status and hence the programme did not reduce deprivation-related health inequalities. Targeting the programme using the methods employed in this study is unlikely to improve the effectiveness of the programme.

Notes: Abstract. The aim of this study was to assess the effectiveness of a dentifrice containing 0.3% triclosan, 2.0% copolymer and 0.243% sodium fluoride (Colgate Total®) in the prevention of periodontal attachment loss in adolescents. A 3-year, double-blind, randomised, controlled, clinical trial was conducted on 641 adolescents, initially aged 11–13 years. The participants were enrolled from schools in economically deprived areas of Manchester, England, which had a high % of Asian pupils originating from India, Pakistan and Bangladesh. After the baseline examination, which included assessments of pocket depth, attachment loss and subgingival calculus, the adolescents were randomly allocated to use either a triclosan/copolymer or control dentifrice. The control was identical to the test dentifrice with the exception that it did not contain triclosan/copolymer. Participants were re-examined after 18 and 36 months. After 3 years, a total of 239 adolescents remained in the test and 241 in the control group. The prevalence of attachment loss increased from 2% at baseline to 24% after 3 years. The mean increment of attachment loss during the study was 0.025 mm per site in the control group and 0.018 mm per site in the test group. A linear regression model showed a statistically significant difference in attachment loss between the test and control group, in adolescents with high mean pocket depths at baseline. No adverse effects attributable to the test or control dentifrices were observed during the study. This study has demonstrated that unsupervised use of a triclosan/copolymer dentifrice can significantly reduce periodontal attachment loss, particularly in adolescents with high mean pocket depths.

Notes: Abstract A proprietary calcium hydroxide paste, Reogan Rapid, that previously has been demonstrated to induce apical closure in non-vital immature incisor teeth, was becoming unavailable. A prospective clinical trial was conducted to compare Reogan Rapid with another proprietary paste, Hypo-cal. For teeth treated with Reogan Rapid apical closure was obtained in an average of 6.8 months involving 3.1 visits and the respective figures for teeth treated with Hypo-cal were 5.1 months and 2.4 visits. These results demonstrated that Hypo-cal was as effective as Reogan Rapid when used in a standardised technique for inducing apical closure.

Notes: Abstract The aims of this study were (1) to monitor the progression and patterns of progression of loss of attachment ≥1 mm on a site basis over a 5-year period in adolescents, and (2) to relate the presence of oral deposits and inflammation to the subsequent development and progression of loss of attachment on a site basis. 167 subjects were examined at ages 14, 16 and 19 years. Loss of attachment ≥1 mm, plaque, subgingival calculus, gingival bleeding and gingival colour change were assessed on the mesiobuccal sites of the 1st molars, 1st premolars and central incisors. Each site was treated separately in the analysis to avoid the problem of within-subject site dependence. Sites were classed as progressing, non-progressing or fluctuating according to the probing attachment level measurements at each of the 3 examinations. During the 5 years of this study, a total of 542 sites in 128 subjects progressed: 1136 sites in 162 subjects did not progress; 43 sites in 30 subjects had fluctuating attachment level measurements. Sites which subsequently progressed had significantly more plaque, subgingival calculus and gingival inflammation than non-progressing sites at the baseline examination and throughout the study (p〈0.001). Between 55-57% of the maxillary 1st molars and 46-49% of the mandibular incisors progressed. In contrast, there was no progression of loss of attachment on over 80% of the maxillary central incisors and mandibular 1st premolars.

Notes: The aim of this in vitro study was to evaluate the ability of a dental subtraction radiography system to quantitatively detect differences in density between radiographic image pairs. Four periapical radiographs were taken of the upper first permanent molars on 5 human skulls using the Digora radiographic imaging system. The 4 images were a “baseline” image and 3 containing test objects consisting of either 0.5, 1 or 2 mm thick aluminium cylinders, 2.5 mm in diameter. Semi-automated image processing software was used to “warp” the 3 images with test objects into the same geometric/density registration as the corresponding baseline image using a process called patch minimization. “Difference” images were then produced and their contrast stretched. For regions of interest, with and without test objects present, the difference in density between the baseline and “test object” images was calculated using a reference aluminium step wedge. The test objects were clearly visible in all the “difference” images. The mean difference between the actual and estimated volume of the test object was 0.31 (95% CI [−0.55, 1.17]) mm3 Al. There was a strong association (r=0.83) between the actual and estimated aluminium volumes. It is concluded that this system provides adequate precision for clinical evaluation.

Notes: Abstract The aim of the study was to compare the occurrence and levels of A. actinomycetemcomitans. P. gingivalis, and P. intermedia in the subgingival plaque from sites with and without early periodontitis in adolescents using an ELISA. 47, 15- to 16-year-old adolescents (39 Indo-Pakistani. 8 white Caucasian) were examined for clinical attachment level, probing depth, supragingival plaque, subgingival calculus and bleeding on probing on the mesio-buccal and disto-buccal aspects of the 1st molars and the incisors. Based on the clinical data, 2 sites per subject were selected for subgingival plaque sampling 3 weeks later: in 32 subjects with loss of attachment 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE57:ges" location="ges.gif"/〉 mm, a diseased site (D) and a healthy comparison control site (C) were sampled: in 15 subjects in whom loss of attachment had not yet developed. 1 of the upper molar sites was selected, called the at-risk site (R), together with a C site. The presence and levels of A. actinomycetemcomitans, P. gingivalis, and P. intermedia were determined using an ELISA. The loss of attachment subgroup had significantly more pockets 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE57:ges" location="ges.gif"/〉4 mm, subgingival calculus and bleeding on probing (p〈0.05). Significantly more of the D than C sites had P. gingivalis both at detectable and at measurable levels (p〈0.05). In subjects who had no loss in clinical attachment levels, fewer sampled sites harboured any of the suspected peridontopathogens investigated, and no significant differences were found between the R or C sites (p〉0.05). Although there was a significantly higher prevalence and extent of loss of attachment 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE57:ges" location="ges.gif"/〉 1 mm in the Indo-Pakistani subjects compared with the Caucasians (p〈0.05), no differences could be identified in the distribution of the bacteria. It is concluded that monitoring of the subgingival plaque may be useful in studies of early periodontitis in adolescents, and the role of P. gingivalis needs to be elucidated in prospective longitudinal investigations.

Notes: Abstract The results of a study to investigate the effectiveness of a propolis-containing mouthrinse in the inhibition of de novo plaque formation are presented. Subjects used a propolis-containing rinse, a negative control and a positive control in a double-blind, parallel, de novo plaque formation study design. The chlorhexidine mouthrinse was significantly better than the others in plaque inhibition. The propolis-containing rinse was marginally better than the negative control, but this difference was not significant.