Decayed, Missing, And Filled Surfaces Research Articles

Influence of oral health on mucositis in patients undergoing hematopoietic progenitor cell transplantation (HPCT)

Aims: To establish whether or not the state of patient oral health can influence the occurrence and/or severity of oral mucositis during hematopoietic progenitor cell transplantation (HPCT). Materials and Methods: The study included 72 patients awaiting HPCT. Prior to transplantation, clinical exploration and radiology were carried out and oral photographs were taken. This evaluated the extent of caries present, the number of missing teeth and the number of dental fillings in each patient; CAO (Caries and Obturations Index) DMFS (Decayed, Missing, and Filled Surfaces) and Restoration Indices were calculated. Gingival pathology was also examined by means of the Ainamo and Bay Gingival Bleeding Index. O’Leary’s Plaque Index was used to evaluate the level of patient oral hygiene. This data was analyzed to see if it exercised any influence on the mucositis grade suffered during HPCT. Results: 96,87% of patients suffered some degree of mucositis during their treatment by the Transplant Unit. The grade of mucositis was seen to be influenced by the number of missing teeth (ANOVA p<0.016) and by the DMFS Index (ANOVA p< 0.038). Although this was not one of the aims of this study, patient age and the administration of colony-stimulating factors were also seen to influence these clinical manifestations. Conclusions: The state of prior oral health can influence decisively the mucositis suffered during transplantation. Key words: Hematopoietic progenitor cell transplantation, mucositis, state of oral health.

Caries risk profile using the Cariogram in governmental and private orthodontic patients at de-bonding

To analyze various caries-related factors in orthodontic patients at de-bonding, and to test the null hypothesis that there is no difference in caries risk between governmental and private orthodontic patients immediately after orthodontic treatment. A cross-sectional examination was carried out on 89 orthodontic patients aged 13-29 years, mean age 21.5 years. They were divided into two groups based on the center of treatment, governmental group (G) (n = 45) and private group (P) (n = 44). The investigation comprised a questionnaire, plaque scoring, caries examination, bitewing radiographs, salivary secretion rate, buffering capacity, and cariogenic microorganisms. Data were entered into the Cariogram PC program to illustrate caries risk profiles. Findings revealed that "the chance of avoiding new cavities," according to the Cariogram, was high in the P-group and low in the G-group (61% and 28%, respectively) (P < .001). Decayed, missing, and filled surfaces (DMFS), plaque index, mutans streptococcus and lactobacillus counts, and salivary buffer capacity were significantly higher in the G-group compared with the P-group (P < .05). The total number of caries lesions at de-bonding in the G-group was more than two times higher than that in the P-group (150 vs 68) (P < .001). The "chance to avoid new cavities" in orthodontic patients at de-bonding was less in the governmental group compared with the private group, as illustrated by the Cariogram. The governmental group also had significantly less favorable values than the private group for most of the caries-related factors.

PCR detection of Streptococcus mutans and Aggregatibacter actinomycetemcomitans in dental plaque samples from Haitian adolescents

Streptococcus mutans and Aggregatibacter actinomycetemcomitans are oral pathogens associated with dental caries and periodontitis, respectively. The aim of this study was to determine the colonization of these two microorganisms in the dental plaque of a group of Haitian adolescents using two different polymerase chain reaction (PCR) methods, standard PCR, and quantitative real-time PCR (qPCR) assays. Fifty-four pooled supra-gingival plaque samples and 98 pooled sub-gingival plaque samples were obtained from 104 12- to19-year-old rural-dwelling Haitians. The total genomic DNA of bacteria was isolated from these samples, and all participants also received caries and periodontal examinations. Caries prevalence was 42.2%, and the mean decayed, missing, and filled surface (DMFS) was 2.67 ± 5.3. More than half of the adolescents (53.3%) experienced periodontal pockets (Community Periodontal Index score ≥3). S. mutans was detected in 67.3% by qPCR and 38.8% by PCR of the supra-gingival plaque samples (p < 0.01), and 36.6% by qPCR and 8.1% by PCR of the sub-gingival samples (p < 0.01). A. actinomycetemcomitans was detected in 85.1% by qPCR and 44.0% by PCR of the sub-gingival samples (p < 0.01), but the prevalence was similar, 67.3% by qPCR and 59.2% by PCR, in the supra-gingival plaque samples. Neither age nor gender was significantly correlated to the bacterial colonization. The results demonstrated a moderate-to-high prevalence of S. mutans and A. actinomycetemcomitans in the Haitian adolescent population, and qPCR is more sensitive than standard PCR in field conditions. These findings suggest that qPCR should be considered for field oral epidemiologic studies and may be necessary in investigations having major logistic challenges.

Association of cardiometabolic risk factors and dental caries in a population-based sample of youths

BackgroundCardiovascular disease (CVD) risk factors begin from early life and track onto adulthood. Oral and dental diseases share some risk factors with CVD, therefore by finding a clear relation between dental diseases and cardiometabolic risk factors; we can then predict the potential risk of one based on the presence of the other. This study aimed to compare the prevalence of dental caries between two groups of age-matched adolescents with and without CVD risk factors.MethodsIn this case-control study, the decayed, missing and filled surfaces (DMFS), based on the criteria of the World Health Organization, were compared in two groups of equal number (n = 61 in each group) of population-based sample of adolescents with and without CVD risk factors who were matched for sex and age group.ResultsThe study participants had a median age 13 y 5 mo, age range 11 y 7 mo to 16 y 1 mo, with male-to-female proportion of 49/51. We found significant difference between the mean values of DMFS, body mass index, waist and hip circumferences, as well as serum lipid profile in the case and control groups. Significant correlations were documented for DMFS with TC (r = 0.54, p = 0.02), LDL-C (r = 0.55, p = 0.01) and TG (r = 0.52, p = 0.04) in the case group; with LDL-C (r = 0.47, p = 0.03) in the whole study participants and with TC in control s(r = 0.45, p = 0.04).ConclusionsGiven the significant associations between dental caries and CVD risk factors among adolescents, more attention should be paid to oral health, as one of the topics to be taken into account in primordial/primary prevention of cardiometabolic disorders.

Interrelation between obesity, oral health and life-style factors among Turkish school children

Obesity, dental caries and periodontal diseases are among major public health concerns which may affect children's growth and development. This study seeks any clustering between obesity, oral health and life-style factors among school children in Istanbul, Turkey. A cross-sectional study of children, 10- to 12-year-olds, from a public and a private school was undertaken with questionnaires for children and their mothers and child oral health data, in Istanbul (n = 611). DMFS (number of decayed, missing and filled surfaces of permanent teeth), CPI (Community Periodontal Index), body mass index (BMI) and life-style factors (tooth-brushing frequency, milk consumption at breakfast and bedtimes on school nights) of children were examined. Data analysis included factor analysis, Student's t test and Chi-square tests by cross-tabulation. Public school children were more dentally diseased but less obese than were those in private school (P < 0.001). They more frequently had calculus (62%) and reported non-recommended tooth-brushing (68%) than did those in private school (37%, 56%; P < 0.05). Principal component analysis revealed that DMFS, CPI and BMI shared the same cluster among all children. A need exists for addressing obesity, oral health and nutrition jointly in health promotion strategies to improve children's well-being and empower good life-style factors.

Caries and Restoration Prevention

The authors analyzed studies of decayed, missing and filled (DMF) rates for surfaces and teeth in Norway published during the last 30 years. The result of active fluoride therapy combined with a change in criteria for when to place restorations led to a marked reduction in the need for restorations. The authors reviewed independent, cross-sectional DMF studies of representative samples of young adults performed every 10 years during the period 1973 through 2006. The clinicians involved in the studies used standardized and calibrated methods. The authors of this article also reviewed an additional series of studies collecting DMF data from representative samples of 15-year-old adolescents that also had been carried out independently from 1979 through 1996. In these studies, the investigators examined clinical records and bitewing radiographs with attention to progression of carious lesions and restorative treatments. The authors noted a marked reduction in the mean decayed, missing and filled surface (DMFS) scores from 1973 through 2006 in the two adult groups. They also found a significant decrease in treatment of caries. The reduction was most marked after the mid-1990s. They noted that the most dramatic change in the data from the 15-year-olds resulted from a change in the treatment criteria during the 1980s. Approximal lesions in enamel were monitored by the investigators of those studies in combination with the use of fluoride toothpaste. A caries treatment approach based on active caries-preventive treatment and restrictive criteria for restoration placement are good bases for reducing the need for restorations as shown in cross-sectional studies reviewed.

Trajectory Patterns of Dental Caries Experience in the Permanent Dentition to the Fourth Decade of Life

Dental caries is a chronic, cumulative disease, but no studies have investigated longitudinal patterns of caries experience. The objective of this study was to identify and describe developmental trajectories of caries experience in the permanent dentition to age 32. Longitudinal caries data for 955 participants in a longstanding birth cohort study were analyzed by trajectory analysis. Three caries experience trajectories were identified by the SAS macro PROC TRAJ; these were categorized as "high" (approximately 15%), "medium" (approximately 43%), and "low" (approximately 42%) DMFS (Decayed, Missing, and Filled Surfaces). All were relatively linear, although the higher trajectories were more "S-shaped". This effect disappeared following adjustment for the number of unaffected surfaces remaining at each age, suggesting that, among individuals following a similar caries trajectory, caries rate is relatively constant across time.

THREE-YEAR FOLLOW-UP OF AN ORAL HEALTH PROMOTION PARTNERSHIP FOR ABORIGINAL CHILDREN IN A REMOTE BRITISH COLUMBIA COMMUNITY.

Background Caries is the most common infectious disease and chronic health condition affecting children. Caries and periodontal disease are associated with increased incidence of diabetes, heart disease, stroke, and premature labor in adult life. Prevention programs have had little success in achieving a sustained improvement in the oral health of aboriginal children. Methods A remote aboriginal community and our Pediatric Residency Program formed a partnership to develop a school-based oral health intervention involving daily classroom brush-ins, regular age-appropriate topical fluoride application, oral health education, and community awareness. Follow-up data were compared for children caries free; decayed, missing, and filled surface (DMFS) scores; and brushing and nutrition. Results All 58 school-age children were recruited; 26 children had prestudy dental examinations and 42 were examined after 3 years. Conclusions A combination of great community commitment and educational/health check visits resulted in conscientious adherence to the protocol. The incidence of caries-free children rose significantly at year 1, and at year 3, this improvement has been sustained, along with increased child and parent awareness of good oral health practices and reported improvement in nutrition practices. This school-based program serves as a model that other committed aboriginal communities could readily adopt. The level of involvement by a pediatric residency program may be difficult to duplicate due to costs related to travel to remote communities.

Prevalence of malocclusions in Hungarian adolescents

The aim of this epidemiological study was to assess the prevalence of malocclusion, associated caries experience, and level of oral hygiene in the Hungarian population using the World Health Organisation (WHO) questionnaire designed to assess dentofacial anomalies. A total of 483 adolescents (289 girls, 194 boys), aged 16-18 years, were assessed. Orthodontic anomalies were detected in 70.4 per cent of the sample. Crowding and spacing were observed in 14.3 and 17 per cent, respectively, with the latter being more prevalent in the maxilla than in the mandible (10.4 and 2.9 per cent, respectively). A Class I occlusion was found in 52.8 per cent of the subjects. A half cusp anomaly in the antero-posterior molar relationship was more prevalent than a full cusp anomaly (26.9 and 20.3 per cent, respectively). The decayed, missing, and filled teeth (DMFT), the decayed, missing, and filled surfaces (DMFS), and the visible plaque indices scores (VPI) of the 340 adolescents with malocclusion were significantly higher (P < 0.05) than those of the adolescents who displayed no anomalies. The prevalence of malocclusion in the Hungarian population seems to be comparable with other European communities.

The relationship between caries in the primary dentition at 5 years of age and permanent dentition at 10 years of age – a longitudinal study

To explore a possible relationship between the caries experience and pattern in the primary dentition at 5 years of age and the permanent dentition at 10 years of age. Further, to examine the possibility of predicting children in a caries-risk group at 5 years verified at 10 years of age. A sample of 186 children (90 males) were clinically examined as 5-year-olds and re-examined as 10-year-olds by calibrated dentists. A five-graded diagnostic system including enamel caries was used. Bitewing radiographs were taken. A true risk group of children at 10 years were defined as those with at least one dentin or filled lesion on the mesial surface of 6-year molars, and/or on incisors, and/or total DMFS (decayed, missing, and filled surfaces) more than 1 SD above the mean. The prediction was measured in terms of OR (odds ratio), sensitivity/specificity, and receiver operating characteristic curves. Statistically significant correlations (r=0.5) were found between the caries experience in the two dentitions as well as between the primary second molars at baseline and the permanent teeth at 10 years. 'Primary second molars' and 'all primary molars' were the most powerful predictors for allocation into the risk group (24% of the sample). The highest achieved sum of sensitivity and specificity, 148%, was attained at a cut-off point above two carious surfaces in enamel and/or dentin in primary second molars. Statistically significant relationship in disease between the dentitions was found. More than two surfaces with caries experience in primary second molars are suggested as a clinically useful predictor at 5 years of age for being at high risk at age 10.

The Effect of Menopause, Hormone Replacement Therapy (HRT), Alendronate (ALN), and Calcium Supplements on Saliva

In menopausal women many physiological changes take place, most of which are due to decreased estrogen production. It is known estrogen influences oral health in a number of ways and saliva undergoes variations depending upon the levels of this hormone. The study was designed to evaluate the relationship of menopause, hormone replacement therapy (HRT), alendronate (ALN), and calcium supplements on salivary flow rate, saliva pH, and electrolytes. A group of a group of 14 osteoporotic women in menopause with an age average of 50.7 and 14 non-menopausal women with an age average of 42.4 and were selected as subjects. The oral status of the subjects was determined using the Community Periodontal Index of Treatment Needs (CPITN), the Decayed, Missing and Filled Teeth (DMFT) and the Decayed, Missing and Filled Surfaces (DMFS) indices. The non-stimulated whole saliva samples were subsequently collected from the women in both the control and experimental groups and then analyzed biochemically. The women comprising the experimental group received HRT supplemented with ALN and calcium; saliva collecting and analyzing procedures were repeated at the third and sixth months of the treatment. The most significant oral discomfort in women in the menopausal period was oral dryness, and this symptom was relieved after HRT with ALN and calcium supplements. The oral status of the non-menopausal women was better than the women in menopause. The salivary flow rate was decreased in the menopausal period and increased after HRT, ALN, and calcium supplementation. The saliva pH values were not affected by menopause and HRT with ALN and calcium supplementation. The level of Na+ was increased with menopause and did not change with HRT supplemented with ALN and calcium, whereas the K+ level decreased in the menopausal period and remained constant after HRT with ALN and calcium. The Cl- level was not affected by menopause and the HRT supplemented with ALN and calcium. The Ca++ level was not different in the two groups of women and did not change after HRT supplemented with ALN and calcium. HRT with ALN and calcium supplementation affected some factors in saliva positively.

Assessment of different methods for diagnosing dental caries in epidemiological surveys

The aims of the study were: (i) to assess different clinical diagnostic methods of dental caries during epidemiological surveys; (ii) to determine which combinations of methods and diagnostic adjuncts show the best performances in epidemiological surveys when compared with examinations performed in a traditional dental setting (standard); (iii) to evaluate the influence of including noncavitated (NC) lesions in dental caries estimation. Forty 12-year-old children were divided into low and moderate caries prevalence groups. The individuals were submitted to 12 epidemiological examinations (in an outdoor setting), which combined three methods (blade, mirror and mirror + CPI (Community Periodontal Index) dental probe) with or without diagnostic adjuncts (previous dental brushing and dental drying). The last examination was performed in a traditional dental setting (standard examination). The unit of measure was the DMFS (decayed, missing and filled surfaces) index according to WHO criteria. The variance analysis, Dunnet's and Tukey's tests were applied. For the DMFS analysis, the visual/tactile method, with or without diagnostic adjuncts, was the best method for both groups, presenting a performance higher than 90% when compared with the standard examination, except for the examinations without previous dental brushing for the low caries prevalence group. Previous dental brushing was more relevant than dental drying (P = 0.0054). All of the epidemiological examinations underestimated the NC diagnosis even with the association of diagnostic adjuncts when compared with the standard examination. The visual-tactile (for both groups) and the visual (mirror) methods plus dental brushing (for the moderate group) are appropriate for diagnosing cavitated lesions, but not NC lesions.

Evaluation of the association of demographics and beverage consumption with dental caries

There is much speculation about the role of carbonated soft drinks in the development of dental caries. We examine the relationships between certain demographic variables, beverage consumption, and professional dental care and their contribution to the number of decayed, missing, and filled surfaces (DMFS). The National Health and Nutrition Examination Survey III (NHANES III) conducted by the National Center for Health Statistics was used to examine DMFS among four age groups: 17–24 yr, 25–40 yr, 41–60 yr, and over 60 yr. Age has a strong, positive relationship with DMFS. About 15% of young adults aged 17–24 yr have no DMFS, and the average DMFS is only 10.4 in this age group. Less than 1% of adults over age 40 have a DMFS score of 0, and nearly one in five has the maximum of 128 DMFS. Controlling for other factors, whites have more DMFS than do blacks and Hispanics. Beverages have a weak, but statistically significant, relationship with DMFS among the older age groups only. Regular professional dental care was associated with lower DMFS among the older age groups. Age and ethnicity are the strongest predictors of DMFS. Young adults have fewer DMFS regardless of dietary factors. This study suggests that carbonated soft drinks are not associated with poor dental health. Useful strategies to reduce dental caries involve good personal dental hygiene, regular use of fluoridated toothpastes and mouthwashes, and regular care by dental professionals.

Salivary analyses and caries increment over 4 years: an approach by cluster analysis.

Caries as a multifactorial process is influenced by salivary defense. Cluster analyses should give additional information on the role of salivary variables in relation to caries increment. Samples of unstimulated and stimulated whole saliva from 28 young adults (mean age 23.5+/-2.1 years) were analyzed for flow rate, pH and buffer variables, lysozyme, lactoferrin, peroxidase, thiocyanate, secretory immunoglobulin A, and total protein. The decayed, missing, and filled surfaces (DMFS) were recorded at baseline and after 4 years. Cluster analyses were executed on the basis of salivary data. The mean caries increment (DeltaDMFS) over 4 years was 6.7+/-4.0 (range 1-16). In two-cluster processing, three out of four volunteers with low caries increments were grouped into one cluster. Only a few variables proved to be important for cluster characteristics. The results suggest that over 4 years (1) the volunteers with very low caries increment (DeltaDMFS=1) are classified always together, (2) these volunteers do not form a separate cluster by themselves, (3) low caries increment was related to higher salivary flow rate and lower levels of lysozyme and lactoferrin for unstimulated saliva and (4) the partial pressure of CO(2) was of importance in stimulated saliva.

Influence of diagnostic adjuncts to the measurement of caries prevalence at different caries thresholds

To determine the influence of diagnostic adjuncts (dental brushing and drying) in dental caries diagnosis. To analyse the underestimation levels in epidemiological examinations when compared to traditional dental setting examinations. To evaluate the influence of including noncavitated (NC) carious lesions in the estimation of the disease. 51, 12-year-old children. Four epidemiological exams performed in an outdoor setting and one performed in a traditional dental setting (visual-tactile method associated or not with diagnostic adjuncts). DMFS (Decayed, Missing and Filled Surfaces) index, according to the WHO criteria. When compared to exams carried out in a traditional dental setting, the epidemiological examinations showed no significant statistical differences for the DMFS score (p>0.05), presenting underestimation levels lower than 10% (except for the low prevalence caries group in the WHO exam). For the DMFS, previous dental brushing was more relevant than previous dental drying, although drying was the most important resource for NC diagnosis (p<0.05). The visual/tactile method, with or without diagnostic adjuncts, can diagnose cavitated lesions efficiently, but not NC lesions. However, for the low caries prevalence group, the implementation of dental brushing prior to an exam could be suggested.

A comparative study in dental caries prevalence and treatment needs of pregnant women and single females in Mosul City, Iraq

An epidemiological study was carried out to compare the prevalence of dental caries and treatment need of pregnant women and single females in Mosul City, Iraq. A total sample of 666 women (399 pregnant women and 267 single females) selected randomly. Pregnant women were selected from four health care centers, when attending to periodic maternal check up with different stages of pregnancy in Maternal and Child Health Care Center. Single females were selected randomly as control group to compare with pregnant group from health centers. Each group subdivided into 4 subgroups according to the age. Caries experience and the treatment need were diagnosed and recorded according to the criteria suggested by WHO (1997). The results showed a significant difference in the mean Decayed, Missing and Filled Surfaces (DMFS) between pregnant and single females, and the prevalence of dental caries increase with advanced age. The mean DMFS value for pregnant women is 28.78 and for single females 19.09. The study demonstrated that the decay surface component was formed more than the half of DMFS value. Educational programmes to pregnant women through medical and dental centers as well as mass media are suggested to increase the dental awareness and prev-entive behaviour.

The relationship of dental calculus to caries, gingivitis, and selected salivary factors in 11- to 13-year-old children in Chiang Mai, Thailand.

Thai children have been shown to accumulate large amounts of dental calculus. The purpose of this study was to examine the relationship of calculus to caries and gingivitis, and salivary conditions which may contribute to calculus accumulation. Four-hundred and thirty-nine (439) children from 18 schools in Chiang Mai were selected for this study. The children were given oral examinations to determine calculus index (CI); decayed, missing, and filled surfaces (DMFS); decayed, missing, and filled teeth (DMFT); gingival index (GI); and plaque index (PI). Children with mean CI scores > or =1 (206) were assigned to the calculus group; the 233 children with mean CI scores of <1 to the noncalculus group. Saliva was collected from 60 randomly-selected children in each group. Unstimulated and stimulated whole saliva and stimulated parotid saliva were assessed for flow rate, pH, and buffer capacity using 2 methods. Results showed that calculus status was not significantly associated with caries, but that there was a high association between gingivitis and plaque status with calculus accumulation (P < 0.001). There were no significant differences in saliva flow rate, pH, or buffer capacity between calculus and noncalculus groups. The lack of association between calculus status and caries indicated these 2 conditions have different etiologies and suggests the importance of plaque and calculus prevention programs, in addition to caries control efforts, to maintain oral health of Thai children.

Associations between dietary intake, dental caries experience and salivary bacterial levels in 12-year-old english schoolchildren

A population of 328 12-yr-old English schoolchildren, consuming their normal diets, was investigated in a cross-sectional study to determine the interactions between caries experience, oral hygiene status as gingival index (GI), dietary intake (as number of eating events per day and the number of eating events per day at which sugar-containing foodstuffs, confectionery or starch-containing foods were consumed) and salivary levels of caries-associated micro-organisms (mutans streptococci, lactobacilli and yeasts). The mean (±SD) decayed, missing and filled surfaces (DMFS) (excluding precavitation lesions) score was 3.05 ± 3.85 and 5.72 ± 5.00 (including precavitation lesions). The DMFS scores were significantly related to the salivary levels of caries-associated micro-organisms and to the number of eating events per day for total number of eating events and the number of eating events at which sugar-containing foods or confectionery were consumed. These associations were apparent in both bivariate and partial correlation coefficients with the caries-associated micro-organisms and GI controlled. The total daily intakes of food types, except for starch, were not associated with caries experience. No significant correlations were found between intake of food types and salivary levels of caries-associated micro-organisms except that the mean number of confectionery-eating events was correlated with lactobacillus levels ( r = 0.136, p < 0.01). The salivary levels of mutans streptococci, lactobacilli and yeasts were significantly correlated with GI scores. These data do not indicate simple associations between dietary intake, caries and levels of caries-associated micro-organisms. Poor oral hygiene, in children consuming unrestricted diets, may influence the salivary levels of mutans streptococci, lactobacilli and yeasts irrespective of the frequency or amount of sugar consumed. Multiple regression analyses revealed that three variables-GI (probably an indicator of toothbrushing behaviour with a fluoride-containing toothpaste), salivary concentration of lactobacilli and frequency of ingestion of confectionery/sugary foods-were independently and positively related to caries experience.

Prevalence of dental caries and gingivitis in a population of Mexican schoolchildren

The prevalence of dental caries and gingivitis was assessed in schoolchildren of the Tlalpan region in Mexico City. A total of 700 children (age range: 11-17 yr) of both sexes were examined. The sample population included children attending the Middle-School System, where two shifts are run (A.M. and P.M.). Decayed, missing and filled surfaces (DMFS), and Gingival Index (GI) were recorded for all existing teeth. Analysis of the data showed that mean DMFS scores increased with chronological age in both genders, were higher in the P.M. session, and more elevated in females. Similarly the mean GI scores also increased with age, and were higher in the P.M. session. In contrast to the DMFS scores, males presented higher GI scores than females at all age intervals. The results of our study indicated a distinctively high prevalence of caries and gingivitis in Mexican schoolchildren.

Caries experience, periodontal treatment needs, salivary pH, and Streptococcus mutans counts in a preadolescent Down syndrome population

The prevalence of dental caries and periodontal treatment needs in an institutionalized population with Down syndrome was examined and the relationship between caries prevalence, salivary pH, and salivary levels of Streptococcus mutans was studied. Thirty-two children with Down syndrome, aged 8 to 13, were compared with two control groups of similar age ranges: healthy children and non-Down mentally retarded (MR) children living in the same institution as the Down syndrome population. The gender ratio mixtures in each group also matched the study sample. Caries experience as indicated by decayed, missing, and filled surfaces (DMF-S) showed significantly lower mean scores for the Down syndrome group compared with both control groups. A similar pattern was found when evaluating the mean numbers of decayed surfaces. Streptococcus mutans counts, expressed as number of colony-forming units on mitis salivarius agar plates among the Down syndrome group, were the lowest, although not statistically significant compared with the counts of the healthy children. Both groups had bacterial counts which were significantly lower than those of the MR group. Significant differences between the two institutionalized groups and the healthy group were recorded for the salivary pH levels. The periodontal treatment needs as evaluated by the Community Periodontal Index of Treatment Needs showed significant difference between the MR group versus both the healthy population and the Down syndrome group. On the whole, 84% of the Down syndrome children were cariesfree.