Soft drinks and dental health: a review of the current literature.

The systematic review was commissioned by the Australian National Health and Medical Research Council (NHMRC) to evaluate the scientific literature relating to the health effects of fluoride and fluoridation. The systematic review's research questions relate to the caries-reducing benefits and associated potential health risks of providing fluoride systemically (via addition to water, milk and salt) and the use of topical fluoride agents, such as toothpaste, gel, varnish and mouthrinse. Although the review summarises the recent evidence, it does not constitute health policy or clinical practice recommendations. A literature search was undertaken using the Medline and Embase databases (via www.embase.com
 ). In addition, the Cochrane Systematic Review and Clinical Trial databases were searched to help identify additional systematic reviews and original studies. Because of the availability of recent systematic reviews, searches were limited to publications from 1996 onwards . The search was conducted in December 2006 and limited to English-language publications. Based on types of intervention (individual or population) and the outcomes assessed (efficacy or safety), the hierarchy of study types considered most relevant for answering each of the clinical questions defined in this review was chosen (Table 1). The levels of evidence used by NHMRC for intervention and aetiological studies are summarised in Table 2.
 Screening of eligible studies was conducted by three reviewers. Data were extracted for all of the included systematic reviews and individual studies using standardised data-extraction forms. This included information about the study design, NHMRC level of evidence, population, intervention, comparator, outcome definitions and results. Information relating to potential biases and study quality were also extracted. Where appropriate, study results were pooled using standard meta-analysis techniques. In total, 5418 nonduplicate citations were identified. After applying the inclusion and exclusion criteria, 408 citations were considered potentially eligible for inclusion in the review. After the review of the full papers of potentially eligible articles, 77 citations were included in the review. The summary of findings was presented in the context of the research questions (Table 3).
 Fluoridation of drinking water remains the most effective and socially equitable means of achieving community-wide exposure to the caries prevention effects of fluoride. It is recommended (see also www.nhmrc.gov.au/news/media/rel07/_files/fluoride_flyer.pdf
 ) that water be fluoridated in the target range of 0.6–1.1 mg/l, depending on the climate, to balance reduction of dental caries and occurrence of dental fluorosis.n particular with reference to care in hospital for those following stroke.

/pdf/a-systematic-review-of-the-efficacy-and-safety-of-l84tk2wkvy.pdf

A systematic review of the efficacy and safety of fluoridation

Objectives:
Early childhood caries (ECC) is a devastating form of dental decay with multi-factorial origin. The aim of this cross-sectional study is to investigate the prevalence and related risk factors of ECC in preschool children of urban Bangalore (India).

https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0039-1698943.pdf

Prevalence of early childhood caries and associated risk factors in preschool children of urban Bangalore, India: A cross-sectional study.

Dental caries is prevalent, and secondary caries causes restoration failures. This article reviews recent studies on developing a new generation of bioactive resins with anticaries properties. Extensive effects were made to develop new antimicrobial composites, bonding agents, and other resins containing quaternary ammonium methacrylates to suppress plaque buildup and bacterial acid production. The effects of alkyl chain length and charge density and the antimicrobial mechanisms for chlorhexidine, nano-silver, quaternary ammonium methacrylates, and protein-repellent agents were discussed. Synergistic effects of contact-killing and protein-repellent properties were shown to yield the greatest biofilm-inhibition effects. The combination of antimicrobial, protein-repellent, and calcium phosphate nanoparticle remineralization was suggested to provide maximal anticaries effects. In addition, for use orally, cytotoxicity and biocompatibility were important considerations for the new bioactive materials. Furthermore, rather than kill all bacteria, it would be more desirable to modulate the oral biofilm compositions via bioactive resins to suppress cariogenic/pathogenic species and promote benign species. For widespread clinical use of the new antimicrobial and therapeutic materials, whether they would induce bacterial drug resistance needs to be determined, which requires further study. Nonetheless, the new generation of bioactive anticaries resins with therapeutic and biofilm acid-inhibiting properties has the potential to substantially benefit oral health.

/pdf/developing-a-new-generation-of-antimicrobial-and-bioactive-swyxj4xwa9.pdf

Developing a New Generation of Antimicrobial and Bioactive Dental Resins.

islittle information intheliterature onthe relationship amongthefrequency ofcarbohydrate consumption, theuseoffluoride toothpaste, and enameldemineralization. Theaimofthis investigation wastocomparetheextentof demineralization ofenamelslabs insitu, witha sugar-based solution, consumedinconstant amounts butwithvarious frequencies insubjects bothwithandwithout theuseoffluoride (F) toothpaste. Eightsubjects woreremovable mandibular appliances carrying anenamel slab cut fromwhite-spot lesions. Thesubjects were required todrink 500mL ofa 120-gm/L sugar solution either once, 3,5,7,or10times/day for30 seconeachoccasion, foraperiod of5dayswhile brushing their teeth twicedaily witheither aF (1450 ppmNaF)oraF-free toothpaste. Mineral analysis revealed that whenthesubjects usedaF toothpaste, netdemineralization wasevident only withtheseven-and10-times/day regime(ns). WhenF-free toothpaste wasused, statistically significant demineralization wasobserved when thefrequency exceeded 3times/day. Thisstudy demonstrates theimportance ofF-containing toothpaste inenamelre-/demineralization by varying thefrequency ofcarbohydrate challenge insitu.

Enamel Demineralization in situ with Various Frequencies of Carbohydrate Consumption with and without Fluoride Toothpaste

Despite the well-known decline in the overall prevalence and incidence of dental caries in the Western societies, there remain persistent pockets of high caries. These are located generally within inner-city, low-socio-economic and immigrant populations throughout Europe and elsewhere. However, two other groups continue to record high caries: the very young and the elderly. Both show remarkable similarities in their characteristics and in many ways caries has the same aetiology, prevalence, treatment and preventive strategies. Both groups of people are mainly dependent on others for their care. Pre-school children are looked after by their parents who dictate their lives including choice of food, diet and oral care. The elderly are a mixed group. Firstly, there are the young elderly who are free living and totally look after themselves. Secondly, there are the elderly who are partially dependent and require support but mainly choose their own life-styles, including diet, and are responsible for their own oral care. Finally, there are the sick elderly who are dependent on carers who, just like the parents of the very young, dictate diet, food choice and provide oral care. It is mainly the third group of elderly, and to a lesser extent the second group, that present a problem of dental caries. These two groups of people pose a serious and difficult problem for dentistry in that they may present with high levels of dental caries and a significant percentage of the population are affected. In both instances the aetiology is multi-factorial and diet plays a major role. But the choice of diet may not be their own and they may often be victims of ignorance and poor practice by others. In addition, the prevention of dental caries is also dependent on the actions of their carers. Both the elderly and very young can be difficult to treat because of poor co-operation or behavioural problems. Thus, the dental profession is challenged by children and the elderly to devise not only workable prevention strategies but also methods of treatment and oral care.

Risk groups: nursing bottle caries/caries in the elderly.

Assessment of the acido/cariogenicity of 11 fruits and cereals was carried out using methods recommended at the San Antonio Conference: plaque pH by sampling (PS), indwelling electrode (IDE) and intra-oral cariogenicity test (ICT), together with additional tests of the total carbohydrate content of salivary expectorants, acid anion profiles of plaque, liberated maltose in plaque, total food carbohydrate and fluoride concentration All foods within each test were compared with sucrose and sorbitol as positive and negative controls Results for foods were ranked against sucrose for cH area under the curve for PS, for mean ratio [H+] of food versus sucrose (IDE) and mean change in indenter penetration length in enamel after exposure (ICT) Results showed that different rankings of foods were obtained with each method, with a greater degree of commonality for PS and ICT versus IDE Factor analysis identified liberated maltose in plaque, area below the curve (PS), total food carbohydrate and plaque pH drop (PS) as being important in determining the potential cariogenicity of foods It was concluded that each of the methods was of value and could be used to assess potential acido/cariogenicity of foods The recommendation that it was desirable that at least two methods should be used was confirmed

Integration of Methods for Determining the Acido/Cariogenic Potential of Foods: A Comparison of Several Different Methods

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Risk groups: nursing bottle caries/caries in the elderly.

Integration of Methods for Determining the Acido/Cariogenic Potential of Foods: A Comparison of Several Different Methods