Soft Toothbrush Research Articles

In vitro effects of acid challenge on incisal/occlusal cupping/cratering

Statement of problemThe cause of occlusal/incisal cupping/cratering (depressed dentin surrounded by elevated rims of enamel) has been postulated to be primarily the effect of acid on exposed dentin. It is hypothesized that abrasion, bruxism, attrition, and stress-corrosion may play a secondary role in lesion formation. The primary cause and sequence of occlusal/incisal cupping/cratering remain scientifically controversial. PurposeThe purpose of this in vitro study was to determine the effects of acid on human enamel, mantle dentin, and peritubular dentin in the creation of incisal/occlusal cupping/cratering. This study was designed to visually illustrate the role of acid in the formation of cupping/cratering. Material and methodsA soft compact toothbrush was tested using both high relative dentin abrasivity (RDA)- and low-RDA dentifrices and water only (nonabrasive) on extracted human teeth. Seventeen specimens of 4 teeth each (68 teeth) were subjected to horizontal brushing with a 1:1 dentifrice-to-water slurry or water only. Twelve of these 17 specimens, a total of 48 teeth, were subjected to acid challenge. Each of these 12 specimens were brushed for 500 strokes after each acid challenge for a total of 150000 strokes and 300 acid immersions. Half the specimens were acid challenged for 5 minutes and the other half for 10 minutes between brushings. ResultsNo visible loss of tooth structure was noted in the control specimens brushed in water only. The control specimens brushed in a 1:1 slurry of toothpaste/water demonstrated incisal/occlusal cupping/cratering. The acid-challenged specimens brushed in water only demonstrated enamel and peritubular dentin loss with elevated rims and/or plateaus of mantle dentin, the opposite of occlusal/incisal cupping/cratering. All specimens brushed with the higher abrasive dentifrice demonstrated visible wear of enamel, mantle, and peritubular dentin, culminating in occlusal/incisal cupping/cratering. Surprisingly, those acid-challenged specimens brushed with the lower abrasive toothpaste demonstrated visible wear of the enamel and peritubular dentin, resulting in elevated rims and/or plateaus of mantle dentin. ConclusionsAcid affects both the enamel and the mineralized component of dentin. This study demonstrated that incisal/occlusal cupping/cratering occurring in worn dentition can be caused by the use of dentifrice alone. Acid challenge affects the inorganic components of tooth structure but not the organic components and so does not cause the dentinal cupping/cratering of the incisal/occlusal surfaces of the human dentition.

Effects of whitening dentifrice on yttria-stabilized tetragonal zirconia polycrystal surfaces after simulating brushing

Statement of problemThe changes that occur after brushing yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) are unknown. These changes may favor the retention of microorganisms and chemisorption of water, impairing its longevity. ObjectiveThe purpose of this in vitro study was to evaluate the effects of a whitening dentifrice on Y-TZP surfaces after simulating 10 years of brushing. Material and methodsSeventy-two bar-shaped specimens (20×4×1.2 mm) were divided into 4 groups: storage in distilled water (SW, control), brushing with distilled water (BW), brushing with dentifrice (BD), and brushing with whitening dentifrice (BWD). Brushing was conducted using a linear brushing machine (878400 cycles, 0.98 N, soft toothbrush). The mean roughness (Ra) was analyzed with a profilometer and the superficial topography with scanning electron microscopy (SEM) at baseline and after treatment. Crystalline phases were characterized using x-ray diffraction. Baseline and posttreatment Ra were analyzed using the 1-way ANOVA and Tukey HSD multiple comparison test; the paired t test was used for intragroup comparison (all α=.05). ResultsThe Ra (μm) means (before/after treatment) were SW 0.28/0.28; BW 0.32/0.31; BD 0.28/0.36; BWD 0.30/0.20. No statistically significant difference was found for Ra at baseline (P=.108) than for posttreatment results (P<.001); the BD group had higher Ra values when compared with baseline (P=.019); the BWD group had the lowest values (P<.001). The BD surfaces showed pronounced scratches and detachment of the surface, while BWD showed smoother surfaces; similar crystallographic results among groups were observed. ConclusionsBrushing Y-TZP with conventional dentifrice increased roughness, while brushing with whitening dentifrice reduced roughness. Neither dentifrice changed the crystallographic phases after brushing.

Effect of different cleaning methods of polyetheretherketone on surface roughness and surface free energy properties.

To determine the effect of different individual, laboratory and professional cleaning methods on the surface-roughness (SR) and surface free energy (SFE) of polyetheretherketone (PEEK), PMMA-based (PMMA) and composite (COMP) materials. 330 specimens of PEEK, PMMA and COMP (N = 990) were prepared and divided into the following cleaning protocols (n = 30/group): (i) individual prophylaxis using (ST) soft, (MT) medium-hard and (SOT) sonic toothbrushes, (ii) in-lab cleaning protocols consisting of (SY) Sympro cleaning system, (SS) SunSparkle, (UB) ultrasonic bath and (AP) Al2O3-powder device and (iii) professional prophylaxis applying (PS) Perio Soft-Scaler, (SO) Sonicsys, (AFC) Air Flow Comfort, and (AFP) Air Flow Plus. After each protocol SR (profilometer), SFE (contact angle devise) and surface topography (SEM) were measured. Data were analyzed using multivariate analysis, Kruskal-Wallis-H- and Mann-Whitney-U-test (p&lt;0.05). No impact of material on SR was observed (p = 0.443). Cleaning using conventional air-abrasion and powders (AP), followed by AFC produced higher SR values than the remaining methods (p&lt;0.001). Within SFE, the cleaning method exerted the highest influence on SFE values (p&lt;0.001, ηP2 = 0.246), closely followed by the polymer material (p&lt;0.001, ηP2 = 0.136). PMMA and PEEK presented after cleaning lower SFE than COMP. PS, UB and SO showed lower SFE than specimens cleaned using SS, ST and SY. Cleaning using SY led to the highest SFE. With regard to SR, all methods - with exception of conventional air-abrasion - can be recommended to clean PEEK. According to the SFE, PEEK may be an acceptable material providing even lower plaque accumulation rates than COMP. The field for more research is now open for scrutiny.

Discoloration of PMMA, composite, and PEEK.

To assess the discoloration and stain removal potential of different cleaning methods relevant to individual/professional prophylaxis and laboratory cleaning on polyetheretherketone (PEEK), poly(methyl methacrylate) (PMMA)-based, and composite (COMP) materials after storage in different media for 7days. One thousand three hundred twenty specimens of PEEK, PMMA, and COMP (N=440 of each group) were prepared and stored in four different media for 7days to cause stain. Samples were divided into three cleaning groups (n=10): (i) individual prophylaxis, (ii) laboratory protocols, and (iii) professional prophylaxis. Color was determined by a portable spectrophotometer and calculated between different time points (∆E). The data was statistically evaluated using univariate analyses, Kruskal-Wallis H and Mann-Whitney U tests (p<0.05). The significantly (p<0.001) lowest discoloration was found when specimens were stored in distilled water and chlorhexidine (CHX), followed by red wine. Curry solution caused the highest discoloration. PEEK showed the significantly (p<0.001) lowest color changes, while COMP showed the highest changes. Ultrasonic bath and Air Flow Plus (AFP) were the significantly (p<0.001) most effective methods to remove staining. The least cleaning effect was found using a soft toothbrush (ST), a medium-hard toothbrush (MT), and SunSparkle (SS) cleaning system. PEEK seems more stable against discolorations than other denture resin materials. Regarding the cleaning potential, individual prophylaxis can be conducted with toothbrushes. For professional prophylaxis, air-abrasion devices using gentle powders are effective. Laboratory protocols should include gentle cleaning methods like ultrasonic bath. Clinicians and dental technicians should inform their patients about the discoloration potential of certain foods/beverages and recommend the most efficient cleaning, but preventive methods.

Oral hygiene grade and quality of life in children with chemotherapy-related oral mucositis: a randomized study on the impact of a fluoride toothpaste with salivary enzymes, essential oils, proteins and colostrum extract versus a fluoride toothpaste without menthol.

The aim of this study was to assess the impact of the use of a fluoride toothpaste (Bioxtra® , Biopharm, Milan, Italy) with salivary enzymes, essential oils, proteins and colostrum extract versus a fluoride toothpaste without menthol on the oral hygiene grade and on the quality of life (QoL) of children with oral mucositis (OM) grade 1 or 2 receiving chemotherapy for Acute Lymphoblastic Leukaemia (ALL). Patients between 6 and 14 years with OM were randomly assigned to two groups, group A (Bioxtra® toothpaste) and group B (fluoride toothpaste without menthol). The patients were instructed to brush their teeth at least twice a day using a soft toothbrush with a small head. Oral hygiene grade was assessed using the simplified oral hygiene index (OHI-s); quality of life was assessed using the short form of the Oral Health Impact Profile (OHIP-14) questionnaires. The patients were evaluated on day 1(diagnosis of OM-T0) and on day 8 (T1). Statistical analysis was performed. A total of 64 patients were enrolled. A significant difference (P < 0.001) between the mean of the OHI-s in group A (0.9 ± 1.2) and in group B (1.5 ± 1.3) was found; the overall OHIP-14 scores were not associated with the use of one or the other toothpaste (P = 0.33). Although the use of Bioxtra® toothpaste does not affect the QoL of children undergoing chemotherapy, it may be recommended as clinically effective in improving the oral hygiene grade.

Inappropriate Toothbrushes Selection Alter Composite Dental Material Restoration Surface Roughness: A Preliminary Study

Introduction. Regular dental plaque control by means of chemically and mechanically methods are among efforts to improve oral health and hygiene. Mechanical cleansing using toothbrush is still the gold standard for continually removing of dental plaque. But on the other hand, inappropriate selection of toothbrushes type selection promotes alteration on dental material restoration surface. Toothbrushes with different degree of stiffness are readily available on market and are classified as hard, medium, and soft. Mechanical friction due to regular movement of the toothbrush with various degree of stiffness was predicted as factor that related with surface roughness alteration on dental material restoration. Nowadays, resin composite material is still declared as the material of choice to repair dental hard tissue damage due to caries activity. However, it has been found that the irregularity of surface promotes bacterial adhesion and biofilm deposition, whereas the smooth surface does not favor bacterial deposition. The progress of bacterial deposition promotes secondary caries on the margin between material restoration and teeth. The aim of this in vitro study was to evaluate the influence of brushing treatment by means of three different toothbrushes on the surface of resin-based compositesExperimental. Specimens were prepared from experimental RBCs with 5 mm diameter and 2 mm thick. Specimens were divided equally into 3 different groups (group A, B, and C). Each group has 5 numbers of specimens. Group A was treated with hard toothbrush, and group B as well as C were treated with medium and soft toothbrush respectively. The toothbrush was mounted in the customized mechanically brushing machine to control the force and number of cycle during specified time. Brushing cycle and time for all groups was conducted for 1000 times of brushing in 60 minutes. Surface roughness resulted from mechanically brushing is evaluated by means of profilometer device.Results and Discussion. The results of the preliminary study shows that there is a differences of surface roughness between groups. The value of roughness varied among all group, and the highest number of roughness were found in group A (&gt; 0.2 micrometres).Conclusions. This result implies brushing with hard toothbrush preferentially has greater risk of surface damage and become pronounce factor of secondary caries.

Abstract P4-13-08: Stomatitis in patients treated with everolimus and exemestane - Results of the 3rd interim analysis of the non-interventional trial BRAWO

Abstract Background BRAWO is a German non-interventional study of 3000 patients (pts) with advanced/metastatic, hormone receptor positive and HER2 negative breast cancer treated with everolimus and exemestane (EVE+EXE). One of the objectives was the documentation of how stomatitis was managed and prevented in clinical routine. We report data of the 3rd preplanned interim analysis (IA) focusing on prophylaxis and management of stomatitis in daily clinical routine. Methods Here we report data of the first 1300 documented pts on efficacy and safety with focus on the adverse event stomatitis. Patient and treatment characteristics were associated with the occurrence of stomatitis. Furthermore chosen treatments for the management of stomatitis are described. Results At time of data cut-off 71% pts had discontinued the study, 29% were still under therapy. Patient and tumor characteristics were reported previously. The most commonly reported AEs of any grade were stomatitis (41.5%), fatigue (14.6%), nausea (12.2%), diarrhea (12.1%), dyspnea (11.3%). 75.2% of stomatitis events occurred during the first 5 weeks of treatment, regardless of the chosen starting dose 5 mg or 10 mg EVE per day. Median duration of a stomatitis episode was 28 days for 5 mg EVE start dose and 23 days for 10mg. However, there was a numerically lower stomatitis incidence and less severe intensity of stomatitis for a start dose of 5 mg vs 10 mg (Table 1). Table 1: Stomatitis incidence and severity by EVE start dose: Worst intensitiy of stomatitisTotal (n=1300)Start dose 5mg (n=316)Start dose 10mg (n=975)Other* (n=9)Number (%) of pts with at least one stomatitis event (any grade)513 (41.5)115 (36.4)421 (43.2)3 (33.3)Grade 1276 (21.2)73 (23.1)202 (20.7)1 (11.1)Grade 2198 (15.2)31 (9.8)165 (16.9)2 (22.2)Grade 330 (2.3)3 (0.9)27 (2.8)0Unknown35 (2.7)8 (2.5)27 (2.8)0*Other includes 2.5mg (n=3), 7.5mg (n=2), 15mg (n=1), 20mg(n=2), 30mg (n=1) 86.5% of pts received recommendations regarding stomatitis prophylaxis. The most frequent recommendations were: mild dental hygiene (e.g. soft toothbrush) (74.8%), avoidance of hot, sour or salty food (70.9%), rinsing with tea (61.7%), and cooling (e.g. sucking ice or frozen pineapple) (56,6%). At least one therapeutic measure was documented for 85.5% of stomatitis events. The most common therapeutic measures were non-drug mouthwash solution (58.3%), cooling (34.7%) or drug intervention (31.9%). Temporary EVE dose adjustments due to stomatitis were done in 11.6% of stomatitis events, temporary dose interruptions in 21.8%, respectively. Efficacy of EVE+EXE seemed to be independent of stomatitis occurrence within 8 weeks after therapy start: mPFS 6.9 months (95%CI, 6.4-8.0) without stomatitis, mPFS 7.4 months (95%CI, 6.3-8.6) with stomatitis. Discussion The percentage of patients with any grade stomatitis was lower in BRAWO (41.5%) than in the pivotal BOLERO-2 trial (59%), which might be explained by increased awareness and experience of treating physicians for prophylaxis and management of this type of adverse event under treatment with EVE+EXE. Most stomatitis events occurred during the first 5 weeks of treatment, which is consistent with data from BOLERO-2. Citation Format: Schütz F, Grischke E-M, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Bloch W, Tesch H, Jackisch C, Lüftner D, Fasching PA. Stomatitis in patients treated with everolimus and exemestane - Results of the 3rd interim analysis of the non-interventional trial BRAWO. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-08.

Genotoxic assessment of chlorhexidine mouthwash on exfoliated buccal epithelial cells in chronic gingivitis patients.

Background:Chlorhexidine (CHX) is the gold standard of all chemical plaque control agents and the most commonly prescribed mouthwash. However, several studies have shown cytotoxic and genotoxic effects of CHX on various eukaryotic cells. In this study, we have used micronuclei as a biomarker of DNA damage in buccal epithelial cells of chronic gingivitis patients who were given adjunct 0.2% CHX for plaque control.Materials and Methods:Chronic gingivitis patients who were exclusively on mechanical plaque control methods were taken as control (Group A) (n = 101), and chronic gingivitis patients who along with mechanical plaque control measures were taking 0.2% chlorhexidine mouthwash as adjunct were taken as cases (Group B) (n = 255). The Group B was further divided into 5 subgroups (B1, B2, B3, B4, B5) (n = 51) on increasing duration of usage of CHX from ≤1 week to 24 weeks. Buccal epithelial cells were gently scrapped from the buccal mucosa using soft toothbrush. The epithelial cells were collected in buffer solution and centrifuged at 8000 rpm for 5 min. The buccal epithelial cells were air dried, fixed, and stained with 5% Giemsa stain on preheated glass microscopic slides and observed under microscope to screen 2000 nucleated cells per individual for number of micronucleated cells and micronuclei as genotoxic measure.Results:The mean number of micronucleated cells was found to be 0.41 ± 0.71 for Group A as compared values ranging from 1.65 ± 2.09 (Group B1) to 11.7 ± 1.87 (Group B5) in different subgroups of Group B, and similarly, the mean number of micronuclei was found to be 0.48 ± 0.80 for Group A as compared to values ranging from 2.57 ± 1.64 (Group B1) to 14.5 ± 2.49 (Group B5) in different subgroups of Group B using analysis of variance (P < 0.001).Conclusion:We conclude that CHX mouthwash is genotoxic to buccal epithelial cells and there is incremental trend in genotoxicity as the duration of usage is increased.

Dietary Habits and Oral Hygiene Practice amongst Dental Students at the College of Dentistry, Princess Nourah University

The aim of the present study was to assess the dietary habits and oral hygiene practice of dental students in a new dental school. A self-administered structured closed-ended questionnaire on demographic characteristics, medical history, oral hygiene and dietary habits was distributed to dental students. Results showed that One third of students indicated that they don’t consume low pH beverages (soft drinks) at all, while 48.9% drink a soft drink or two a day. Students took varying amount of time to consume their drinks. The majority of participants consumed citric juices, fruits and/or pickles at least once a day. 91.3% of students use either soft (41.8%) or medium (49.5%) toothbrush. Only a fifth (16.9%) of the students brush their teeth after drinking soft drinks and 58.2% brush their teeth after vomiting. In conclusion, young adults need to be aware about their dietary habits & oral hygiene, and also a proper dental health program needs to be applied.

Porównanie skuteczności usuwania płytki nazębnej z użyciem miękkich szczotek manualnych

Porównanie skuteczności usuwania płytki nazębnej z użyciem miękkich szczotek manualnych

Plaque removal efficacy of Colgate 360 toothbrush: A clinical study.

Aim:The aim of this clinical study was to confirm the plaque removal efficacy of the Colgate 360 Whole Mouth Clean Toothbrush.Study Design:This was a single-center, monadic, case–controlled study with the 7 days duration.Materials and Methods:A total of eighty participants (56 male and 24 female) aged between 18 and 45 years with a minimum of 20 permanent teeth (excluding the third molars) without any prosthetic crowns and an initial plaque score of minimum 1.5 as determined by Modified Quigley-Hein Plaque Index (1970) participated in the study. There were two dropouts during the study duration, one male and one female. The participants were instructed to brush for 1 min, after which plaque index was recorded again. They were then instructed to brush their teeth twice a day for 1 min with the assigned toothbrush (Colgate 360 Whole Mouth Clean Toothbrush) and a commercially available fluoride toothpaste for the next 7 days. On the 7th day, all the participants were recalled for follow-up and plaque examination. The plaque index scores (pre- and post-brushing) were recorded, tabulated, and analyzed statistically.Results:The mean plaque indices reduced after brushing both on day 1 and day 7. There was also a reduction in mean plaque indices from day 1 to day 7. All these reductions were statistically significant (P < 0.001). The reduction in plaque scores was independent of the gender of the participants however female participants showed lower scores as compared to male participants (P < 0.001).Conclusion:The present study demonstrated a significant reduction in plaque scores with the use of Colgate 360 Whole Mouth Clean Soft Toothbrush throughout the study period. Continued use resulted in a further significant reduction in plaque scores irrespective of the gender of participants.

Effect of toothbrushing on shade and surface roughness of extrinsically stained pressable ceramics

Statement of problemThe effect of toothbrushing on extrinsically stained pressable ceramic materials is unknown. PurposeThe purpose of this in vitro study was to investigate the effects of toothbrushing on the shade and surface roughness of extrinsically stained, pressable ceramics. Material and methodsTwo materials, leucite-based (IPS Empress Esthetic [EE]; Ivoclar Vivadent AG) and lithium disilicate-based ceramic (IPS e.max Press [EP]; Ivoclar Vivadent AG), were studied. For each material, 24 disk-shaped specimens, 10 mm (diameter)×3 mm (height) were fabricated. Three different methods (n=8) of applying extrinsic stains were performed on each material: glazed only (G, control group); stained then glazed (SG); and stained and glazed together (T). The specimens were brushed with a multistation brushing machine under a load of 1.96 N at a rate of 90 strokes per minute with a soft and straight toothbrush (Oral-B #35) and a 1:1 toothpaste and distilled water slurry. Shade and roughness were measured at baseline and at 72, 144, 216, and 288 hours, which is equivalent to 3, 6, 9, and 12 years of simulated toothbrushing for 2 minutes twice a day. A repeated measures ANOVA with staining technique as a fixed factor was used to evaluate shade and roughness (α=.05). ResultsFor EE groups, no significant change was found after 12 years of simulated toothbrushing regarding shade and surface roughness, irrespective of staining techniques (P>.05). However, EP groups demonstrated a significant shade change and an increase in surface roughness after 12 years of simulated toothbrushing. Shade change was found to depend on the method of applying stain. For the EP-SG technique, a significant shade change was observed only at the 9- to 12-year interval (P=.047). However, the EP-T technique demonstrated a significant difference in shade between baseline and 3 years (P=.005) and in the 6- to 9-year interval (P=.005). Surface roughness was only significantly affected at baseline and 3 years for the EP-T group (P=.005). ConclusionsFor the shade and surface roughness of the EE groups, no statistically significant difference was found after 12 years of toothbrushing, irrespective of the staining technique. The shade and surface roughness of the EP groups were significantly statistically affected by toothbrushing time; only shade changes were found to depend on technique.

The effect of toothbrush abrasion force on dentine hypersensitivity in-vitro

ObjectivesThis study investigated the effect of tooth brushing force on changes in dentine tubule patency in an erosion-toothbrush abrasion model. Methods60 dentine samples prepared with an artificial smear layer and divided randomly into control (no toothbrush), 100g, 200g or 400g toothbrush groups. They were immersed in 3:1 artificial saliva/NaF 1450ppm and either brushed (p35 soft tooth brush; 120 strokes) or not brushed. Then samples were subjected to agitated acid challenge (0.3% citric acid pH2.6 for 2min). Finally, samples were re-brushed. Calibrated software calculated patent dentine tubules that cause DH in confocal microscopy images taken of samples at each stage. ResultsAt baseline, mean patent tubules in all samples were 188 (SD54) with no significant inter-group differences. Following first brushing, mean patent tubules decreased using 100g to 150 (SD32) (p<0.01) and increased using 400g to 215 (SD45) (p=0.02). Following acid challenge, patent tubules increased to 218 (SD40) in all samples (p<0.01) with no significant inter-group differences. Following further brushing, mean patent tubules decreased using 100g to 175 (SD72) (p<0.01), but increased with 400g to 232 (SD52). ConclusionsAt higher brushing forces (400g), more tubules were exposed. At lower brushing forces (100g), tubule patency decreased even post-acidic challenge. Clinical significanceIt is often recommended to our patients with DH to brush using lighter brushing forces but our understanding of this force on dentine tubule patency is unknown. The management of DH requires lighter brushing forces to reduce the numbers of patent dentine tubules.

Fluoride release and recharge abilities of zinc-reinforced glass ionomer cement in comparison to traditional high strength glass ionomers

Aim: The aim of this study was to compare the fluoride release and recharge characteristics of a zinc reinforced glass ionomer cement (GIC) (ChemFil Rock ™, Dentsply, York PA, USA) to that of two traditional high strength GICs (Fuji IX ™, GC Corp, Japan and Ketac-Fil™, 3M-ESPE, Germany). Materials and Methods: A total of 60 specimens (20 in each group) were used in this study. The materials were prepared according to the manufacturers' instructions and placed in plastic molds 9 mm in diameter and 2 mm high. The 20 specimens in each group were further subdivided into two subgroups of 10 each. Subgroup A (control) involved no fluoride treatment. Subgroup B involved application of a 1450 ppm dentifrice for 2 min twice daily for 30 days with a soft toothbrush. The specimens were then suspended in airtight plastic bottles containing 20 ml deionized water. A fluoride electrode was used to measure fluoride release and recharge from the discs on the 1 st , 2 nd , 7 th , 15 th , and 30 th day. Results: The results of the study showed that the zinc reinforced glass ionomer had a significantly higher fluoride release and recharge when compared to conventional high strength glass ionomers. Conclusions: The results of this study suggest that zinc reinforced glass ionomers have better fluoride recharge and release characteristics than conventional high strength glass ionomer.

Oral hygiene practices among paramedical staff of a private dental institution in India

Health promotion in dentistry is targeted at the two most common oral diseases – dental caries and periodontal disease. The maintenance of good oral hygiene is considered to be a central issue in oral health promotion. Objective: To assess the oral hygiene practices among paramedical staff of a private dental institution in India. Material and methods: A cross sectional questionnaire survey was undertaken among 100 paramedical staff of a private dental institution in Mangalore, India. Data was collected by using self designed questionnaire. Results: About 49% of the subjects brushed thrice with soft toothbrush and 55% changed their tooth brush once in 3 months. About 77% of them cleaned their tongue either by tongue cleaner, toothbrush or finger and 82% of the subjects used tooth paste. About 56% of the subjects had never used dental floss. Majority of the subjects (56%) visited the dentist only when required. Conclusion: Oral hygiene practices among the paramedical staff were poor.

Seborrheic dermatitis of the eyelid

Seborrheic (say: seb-uh-ree-uh) dermatitis is a chronic inflammatory skin condition presenting as dry whitish scales or greasy scales. Can involve the scalp, eyebrows, forehead, face, trunk, or skin folds. Dandruff and cradle cap are both forms of seborrheic dermatitis. The severity of seborrheic dermatitis can be lessened by controlling the risk factors and by paying careful attention to skin care. Seborrheic dermatitis of the eyelid margin usually responds to gentle cleaning of the lid margins nightly as needed, with undiluted Johnson and Johnson baby shampoo using a cotton swab. Remove thick scales by applying warm olive or mineral oil and then wash off several hours later with Dawn washing detergent and a soft bristle tooth-brush. For dense scalp scaling, 10% Liquor Carbonic Detergents (LCD) in nivea oil may be used at bedtime, covering the head with a shower cap. This should be done nightly for 1-3 weeks. Once controlled, washing with zinc soaps or selenium lotion with periodic use of steroid cream will help maintain remission. Recently, creams classified as topical immune modulators are being used which suppresses the immune system to treat inflammation. Further, it is thought that sunlight improves seborrheic dermatitis. In some persons, the condition gets better in the summer, especially after outdoor activities.

Assessment of the efficacy of the utilisation of conventional and electric toothbrushes by the older adults.

To evaluate the efficacy of electric and conventional toothbrushes for a group of elderly individuals. Although the electric toothbrush has been recommended for elderly individuals, there had previously never been a study regarding its efficacy. Sixty independent elders of both genders with different oral conditions from the Center Adult Day Vitória, Espírito Santo, Brazil, were randomly divided into two groups of 30 individuals. One group received the Oral B CrossAction Power electric toothbrush, whereas the other received a conventional Bitufo Class 32 soft toothbrush to perform oral hygiene. The bacterial plaque index (O'Leary Plaque Index) and DMFT index were assessed as a measure of oral hygiene and oral health. The data were analysed using the Shapiro-Wilk, Mann-Whitney and Wilcoxon tests. The results of the efficacy of the Oral B Cross Action Power electric toothbrush demonstrated that on the 7th and 15th days, the bacterial plaque indexes were 24.91 ± 12.81 and 22.11 ± 14.46, respectively, which corresponds to a 50.24% removal of bacterial plaque on the 7th and 55.83% on the 15th days. Although the electric toothbrush removed more bacterial plaque than the conventional toothbrush, the difference was not statistically significant. Both the conventional and the electric toothbrushes were effective in removing bacterial plaque within the elderly group. More studies are necessary to test the efficacy of electric toothbrushes in relation to conventional toothbrushes for elderly patients.

A new horizon in the treatment of biofilm-associated tonsillitis.

To demonstrate the efficacy of tonsil brushing in patients with chronic tonsillitis to remove the microbial biofilm on the tonsil surface using an in vitro model. Specimens from patients undergoing tonsillectomy were evaluated prior to and following surface cleaning methods, including rinsing and brushing, using scanning electron microscopy (SEM). The study population consisted of 25 randomly selected patients with chronic tonsillitis. Specimens were collected and divided into four portions. Each portion received distinct surface cleaning methods and was immediately fixed for SEM examination. The biofilm layer on the surface of the tonsils was examined using SEM. The density of the biofilm layer and the degree of persistence of the biofilm after rinsing and brushing were measured. The surface biofilm of the tonsils in the first group, which were neither brushed nor rinsed, revealed a thick layer of biofilm on the mucosal surface. The second group of tonsils, which were only rinsed, also showed a thick layer of biofilm. The third group of tonsils, which were rinsed following gentle brushing using a soft toothbrush, showed a reduction in the thickness of the biofilm layer. The fourth group of tonsils, which were brushed with a hard brush, was almost devoid of a biofilm layer. Our results demonstrate that rinsing does not effectively remove the biofilm layer on the tonsil surface. The use of a harder brush was identified as a more powerful means of removing biofilm compared with a soft brush.

Bringing up the Rearing

It is now mid-August and I have to admit, I’m feeling a bit empty. I just realized that I haven’t reared a single insect this year, and I miss it. Usually, I’ll encounter a larva or pupa that I don’t recognize, and “rear it out” in order to make identification easier. Either that, or I will purposely obtain eggs or larvae as part of some other project. But this year, at least so far, I’m more or less grubless. I realize that for some entomologists, rearing is part of the job, and if you are one of those people who rear thousands of insects, day in and day out, perhaps my perspective will seem peculiar, but for me, rearing is merely an occasional and an enjoyable part of being an entomophile. I like the nurturing aspect of rearing, and I find that it is a perfectly good replacement for gardening, in which I seem to have no interest at all. Rearing caterpillars is especially enjoyable, perhaps because caterpillars are among the best-looking of immature insects. I only realized this fact when I started writing this column, but it should have been obvious, thinking about the larvae of, for example, flies, beetles, and hymenopterans. They are all quite fascinating, but generally not crowd-pleasing, while most caterpillars are colorful, appealingly shaped, and cute. I guess it makes sense—larvae need to grow, so they need a softer exoskeleton than the adults, and unless they also possess protective coloration or setae, they wind up looking pale and grub-like. I give butterflies a great deal of my attention, but most of my caterpillar-rearing experiences have been with the larvae of moths. Either way, I enjoy it. The combination of peaceful, attractive larvae and fresh-cut plants for food (so long as you keep things clean, and avoid a disgusting layer of moldy frass on the cage bottom) makes for an aesthetically pleasing daily routine. Caterpillars do need daily care, and many of my lepidopterist friends have lamented that they couldn’t travel much during the summer because they had caterpillars to look after. It’s a lot like having a puppy, or two, or three. I think the most amusing stories involve people who decide to go into the field on collecting trips, and take all of their rearing cages with them, in the back of the vehicle. Kids like caterpillars too, and the rearing of butterflies (painted ladies and monarchs, generally) is a part of the curriculum for many students. It has resulted in a bit of a controversy over whether these reared butterflies cloud our understanding of butterfly migration, but it is certainly a big hit in the classroom. My son Jesse was extremely keen on caterpillars when he was in his pre-teens, and we always had a cage or two to look after during the summer months, as well as some trays of pupae in the fridge over the winter. Usually, we would wait for a particularly nice female moth to show up in the light trap, and then see if she would lay eggs in a paper bag. In some places (for example, Japan and eastern Europe), beetle rearing is not far behind caterpillar rearing in popularity, but not here in North America, where we don’t allow such things, at least with “exotics.” Many years ago, when I was able to get a federal permit to rear tropical scarab beetles (I focused on goliathines), I learned a great deal, had marvelous living creatures to show to my undergrad students, and was able to supplement the offerings at the local insect zoo at the Royal Alberta Museum. I miss those days. Jesse used to help me scrub the mites off the grubs’ mouthparts, holding them with one hand, under warm tap water, and scrubbing with a soft toothbrush with the other.

Instructions Given During Insertion of Complete Denture

• Limitation of the dentures: It is mechanical substitutes for oral living tissue. Individuality of a patient, not compares him to other persons, and educates the patient to the fact that every mouth is different. • Remove dentures from mouth at night: The patient should remove the denture at night because the denture will exert excessive pressure on the bone of both maxilla and mandible which lead to increase the rate of resorption of the bone that will lead to flat ridge and consequently loss of retention and stability. • Expected tissue response: Such as increase saliva at the time of insertion because the C.D. is consider a strange things, but this with time will decrease gradually [2,3]. • Appearance and C.D: Patient must understand their appearance will become more natural with time, strange bulky muscle tension will improve after the patient relax and more confident. If the patient is unhappy with their appearance occasionally the anterior teeth must be changed. • Evaluating the denture esthetic: This is done by evaluating the patient lip support, high lip line, low lip line. These factors are usually examined thoroughly during try-in stage, simple verification would be sufficient. • Speaking with Complete denture: The problem of speaking will disappear and the tongue adapt within a few weeks. Patient could be advised to read aloud and repeat words or phrases that are difficult to pronounce which contain letters such as “s”, “sh”, so the patient should read the newspaper out loud or “talk back” to the television if he is alone. In natural environment: the rugae enhance speech, but in a denture speech is affected due to the absence of rugae. Metal denture base improve speech because the metal can be fabricated thin enough to reproduce the rugae on the external surface [4]. • Care of the prostheses and tissues: The dentures must be kept very clean to prevent the fouling of food particles and the overgrowth of bacteria. It is best to brush the dentures by using any mild hand soap but do not use an abrasive soap or cleanser or tooth paste because most of them contain an abrasive material that will wear away the surface of acrylic resin. In case of handicapped patients, cleaning of the dentures by using suction hooks placed in composite. A daily gentle massage with a soft nylon toothbrush helps to increase the circulation [1,3]. • Chewing with complete denture: Learning to chew with new dentures requires 6-8 weeks. Patient begin to chew relatively soft food that cut into small pieces done on both sides at the same time and food swallow with simple push of tongue against the palate. Every day try something new. When bite such as a sandwich place the food between their teeth toward the corner of the mouth rather than between the anterior teeth then the food push inward and upward to break it apart [4].