1/13. Failure of intense preventive efforts to arrest early childhood and rampant caries: three case reports.This report presents the first three children who developed dental caries despite being enrolled in a randomized, control trial to test methods to prevent early childhood caries. The children's caretakers received education on decreasing frequent and prolonged feeding with a nursing bottle and other sugar containing foods, as well as brushing the children's teeth daily with 0.4% SnF2 gel. One of the child's caretaker additionally received training sessions to improve confidence in eliminating the child's nursing bottle habit and in performing daily tooth brushing. The two other children received monthly topical fluoride treatments with 2% NaF. Despite these intensive preventive efforts, these three children developed dental caries. Two of the children had mutans streptococci colonization at the time of initial visit, (12 and 14 months of age, respectively). All had high mutans streptococci levels at the time that caries was detected. Incorrigible, high-frequency sugar consumption from a bottle or from solid foods was suggested in all three cases. In one case, dental caries was associated with defects of the tooth enamel. Conceivably, the cariogenic challenge and harmful behaviors in certain children may be so extreme that they can overwhelm even extraordinary preventive efforts.- - - - - - - - - - ranking = 1keywords = fluoride (Clic here for more details about this article) |
2/13. Chemical protection against postirradiation dental caries.Experience with dental caries in twenty-four patients receiving irradiation for malignant lesions of the head and neck demonstrates the critical importance of cooperation by the patient, a program of strict oral hygiene, and daily self-treatment with 0.4 per cent stannous fluoride gel. The ravaging form of dental caries associated with the postirradiation period can be essentially eliminated in cooperating patients. In nine patients who were uncooperative, fifty-seven crowns were amputated and an additional seventy-five carious surfaces were found 3.75 years after irradiation. In six patients who cooperated and used the gel on a daily basis, no crowns were amputated and only one carious area was found over the same time period.- - - - - - - - - - ranking = 1keywords = fluoride (Clic here for more details about this article) |
3/13. Congenital neutropenia. Report of a case and a biorationale for dental management.Congenital neutropenia is characterized by a marked decrease in or lack of circulating PMN's in children with no prior history of drug intake. The neutropenia is persistent and the clinical course is one of early onset of severe, recurrent, and eventually fatal infections. bone marrow studies show a maturation arrest of neutrophilic precursors. Because of their greatly increased susceptibility to infection, patients with congenital neutropenia present a difficult dental management problem. A case of congenital neutropenia has been presented, as well as a biorationale for dental treatment. On the basis of reports in the literature, the following recommendations for the management of patients with congenital neutropenia are made: 1. The prevention and control of infection and the interception of dental disease before surgical intervention becomes necessary should be the overriding considerations in the management of patients with congenital neutropenia. 2. The carious breakdown of teeth should be prevented by the daily application of a 0.4 per cent stannous fluoride gel in addition to oral hygiene and limitation of sucrose intake. 3. Periodontal therapy should be palliative only, since alveolar bone loss is progressive despite frequent oral hygiene instruction and prophylaxis. The goal of periodontal therapy for patients with congenital neutropenia should therefore be a decrease in gingival inflammation to make the patient's mouth more comfortable and to slow down alveolar bone loss. Periodontal surgery is contraindicated. 4. bacteremia and subsequent septicemia should be prevented since a minor infection can become life threatening in patients with congenital neutropenia. The patient should rinse for 30 seconds and the gingival sulci should be irrigated with a phenolated antiseptic mouthwash prior to all dental manipulations of the soft tissue. This will significantly reduce the incidence of bacteremia. 5. Surgery should be avoided if at all possible because of the high risk of post-operative infection. All surgery sholld be performed in the hospital, and the patient should be given antibiotics as determined by his physician. Primary closure should be done with fine polyglycolic acid sutures to reduce the chance of infection. If postoperative infection can be prevented, wound healing will progress normally despite the complete absence of PMN's.- - - - - - - - - - ranking = 1keywords = fluoride (Clic here for more details about this article) |
4/13. A case report: arresting dental caries.PURPOSE: To arrest dental caries in the dentin in a patient that had been refractory to other attempts at caries control. methods: Repeated applications of fluoride varnish (5%, Duraflor, Pharmascience laboratories, Montreal) in the clinic every three months along with two daily two-minute rinses with sodium fluoride at home. RESULTS: Results over five years are presented. None of the lesions identified five years earlier had been restored. The teeth were monitored with frequent bitewing radiographs and clinical exams; the interproximal decay appears inactive clinically. CONCLUSION: This present case report shows that fluoride varnish may be a good addition to preventive therapy for arresting caries in adult patients in general practice. Surgical intervention may be avoided in patients whose risk has shifted to a lower level.- - - - - - - - - - ranking = 3keywords = fluoride (Clic here for more details about this article) |
5/13. Dental laser identifies early stages of caries.In conclusion, the various methods of caries detection used, including visual inspection, radiographs, and tactile sensation, have a significant subjective component. The Diagnodent allows clinicians to add a more objective test to their armamentarium. Should the doctor choose to "watch" a suspected lesion and treat with topical fluoride, the area can be monitored for the progression or regression of decalcification. For more information, call KaVo at (888) KaVo-USA.- - - - - - - - - - ranking = 1keywords = fluoride (Clic here for more details about this article) |
6/13. Fluoride and caries prevention: 2. Clinical rationale.In order to achieve the greatest clinical benefit from the use of fluoride, we must understand its mechanism of action, so that fluoride can be given at the right time, by the best route, at the optimum dosage and in the most suitable form. The first article in this two-part series reviewed the scientific rationale behind the use of fluoride. Part 2 now illustrates fluoride therapy in practical terms, by examining nine clinical cases.- - - - - - - - - - ranking = 4keywords = fluoride (Clic here for more details about this article) |
7/13. Fermentable simple sugars in self-administered medications as aetiologic agents in rampant caries. Case report.sucrose is recognized as the most cariogenic carbohydrate. However, other simple sugars may act as substrates for cariogenic micro-organisms. The clinical features of an adult patient suffering from rampant caries are described. It was considered that the predominant aetiologic factor was prolonged intake of mineral supplements which contained the disaccharide lactose. The principal caries risk factors included drug-induced xerostomia and prolonged contact time with the substrate in a retentive form. Chemical analysis of the products revealed the presence of lactose together with starch or glucose. A strategy for preventive management prior to restorative therapy based on chlorhexidine and fluoride-containing products was followed. Possible contributions of sugar-containing medications to caries risk status are discussed.- - - - - - - - - - ranking = 1keywords = fluoride (Clic here for more details about this article) |
8/13. Management of dental caries as an infectious disease.dental caries is an infectious disease that demineralizes tooth structure as a consequence of bacterial metabolism. Chemical suppression of bacteria, especially using stannous fluoride, is gaining popularity because of its practicality and clinical efficacy.- - - - - - - - - - ranking = 1keywords = fluoride (Clic here for more details about this article) |
9/13. Fluoroderma.Papulonodular eruptions from certain bromide and iodide preparations are widely recognized entities, but skin lesions following fluoride ingestion are rare. Modern prophylaxis for postirradiation dental caries includes the use of fluoride gel preparations applied to the teeth. In two patients receiving such therapy a papulonodular eruption developed, similar to the recognized halogenodermas. These cases may help to increase awareness of this entity.- - - - - - - - - - ranking = 2keywords = fluoride (Clic here for more details about this article) |
10/13. Dietary fluoride supplementation for the prevention of caries.Fluoride supplements are effective in preventing dental caries if conscientiously taken on a daily basis from birth until at least 12 to 14 years of age. The optimal dose depends on the child's age and the existing fluoride concentration in the water supply. A dosage schedule is recommended that decreases the dose of fluoride in infancy and that is inversely related to the concentration of fluoride in the drinking water.- - - - - - - - - - ranking = 7keywords = fluoride (Clic here for more details about this article) |
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