Poliklinik für Präventive Zahnheilkunde und Kinderzahnheilkunde

Aim of this 2-year follow-up study was to assess the dental health status and the caries pattern of first permanent molars in German and immigrant children. 300 German and 69 immigrant children living in the Westphalian Ennepe-Ruhr district were involved in this study. The mean age of the population was 8.0 years at the baseline (1997) and 9.8 years at the second examination. The surface-related caries status according the WHO criteria (1997) was completed by recording non-cavitated lesions and the number of sealants in permanent molars. 13 % (1997) and 26 % (1999) of the 8-year old immigrant children had a caries-free mixed dentition; in Germans were recorded 40 % (1997) and 42 % (1999). The caries prevalence in immigrant children (1997: 0.9 DMFS/1999: 1.5 DMFS) was significantly higher compared to the German children (1997: 0.5 DMFS/1999: 0.8 DMFS). Moreover, a significantly lower utilisation of fissure sealants was registered in immigrant children (1997: 0.4/1999: 0.7) compared to their German classmates (1997: 0.5/1999: 1.4). Immigrant children have to be characterized as high caries-risk population. Risk-orientated public dental health programmes involving sealant application seems to be necessary for socio-economically underprivileged children.

AIM: The aim of the study was to assess the caries inhibition effect of fluoride varnishes among preschool children with high caries risk. At the same time, the suitability of this measure should be examined in the frame of group prevention programmes in kindergartens. METHOD: This was an examiner-blind, clinically controlled 2-year study with 200 randomly selected 2- to 4-year-old preschool children with high caries risk. At the baseline, caries-free surfaces, initial caries lesions as well as the caries status (dmfs) were recorded. After the baseline, all subjects were divided into 3 groups. Subjects of group A received every 6 months (altogether four times) applications with the fluoride varnish Fluoridin N5 (VOCO GmbH, Cuxhaven, Germany), children of the group B received every 6 months (altogether four times) applications with Duraphat (Colgate Palmolive GmbH, Hamburg, Germany), while the subjects of group C did not receive any fluoride varnish applications and constituted the control group. A final examination was performed after two years similar to the baseline. Statistical analysis was based on the SPSS programme at a significance level of 95%. RESULTS AND CONCLUSIONS: The results confirmed the caries inhibition efficacy of both fluoride varnishes. This is shown as well in the almost constant number of caries-free surfaces and initial caries lesions in the two F-groups during the observation period. The caries-free surfaces in group C were significantly reduced along with an increase of initial caries lesions. The caries reduction, based on the control group, amounted in group A to 56% and in group B to 57%. The results documented the caries inhibition effect of both fluoride varnishes which are suitable for intensive group prevention programmes for pre-school children.

AIM: This study aimed to compare the oral health status of 6-16 year old pupils with mental disability (MD) and psycho-emotional disorders (PED) from Lower Saxony (LS) and Thuringia (TH). METHODS: Oral examination was provided for 571 pupils with MD from TH, 118 students with MD and 80 students with PED from LS. Caries experience, odontogenic infections, fissure sealants and periodontal health were recorded. Data were statistically analysed by linear and binary logistic regression after adjusting for age. RESULTS: Students with PED revealed highest caries prevalence and experience in both dentitions with highest prevalence of odontogenic infections in the primary dentition. In 6-11 year old pupils with MD, there were only minor differences in odontogenic infections between TH and LS. Pupils with PED aged 6-11 years had a more that two-fold higher risk to develop dental caries and odontogenic infections than peers with MD. Care index was higher in pupils with PED compared to those with MD in both dentitions. Pupils with MD from TH were less affected with dental caries and received better care than those from LS. Compared to peers without mental disabilities or disorders, pupils with MD or PED were more affected with dental caries in both dentitions. They revealed a lower care index and less fissure sealants. CONCLUSION: Pupils with MD or PED reveal unsatisfactory oral health status constituting a group with particular high caries risk, while those with PED are most affected by caries and odontogenic infections. The care index is insufficient especially in pupils with MD compared to those with PED or peers without disabilities and indicates disparity in oral health for this vulnerable group.

AIM: The aim of this study was to make a comparison of the oral health status of students with and without disabilities (Sw/D, Sw/oD) aged 6-18 years from the city of Erfurt. METHODS: 328 students with mental retardation (MR), physical disability (PD) and hearing impairment (HI) were examined according to WHO standard (1997). The control group consisted of 400 age-matched Sw/oD. Data analysis was performed in age groups 6-12 and 13-18 years. RESULTS: Caries prevalence of 6- to 12-year-old Sw/D (68.7%) was significantly higher than in Sw/oD (57%) (p=0.019).The caries experience of Sw/D was 2.3 dmft/0.5 DMFT and 1.6 dmft/0.4 DMFT of Sw/oD. PD had a lower restorative index than other Sw/D (p ≥ 0.023). There was no difference in caries prevalence and caries experience among 13- to 18-year-old Sw/D (51%; 1.9 DMFT) and Sw/oD (59%; 2.1 DMFT). MR had a lower prevalence of fissure sealants and less sealed teeth (p ≤ 0.042) and their periodontal health was inferior compared to other Sw/D. CONCLUSION: Intensive preventive measures should be intensified to compensate for oral health inequalities, particularly in MR.

The result of a scanning electron microscopic study of fourteen interdental brushes, available on the German and Swiss market, was that all products have an insufficient finish of bristle ends. Only one brush showed 17.3% of acceptably rounded bristle ends. In addition, the unacceptable rounded bristle ends were classified, corresponding to their variation of form. The results allowed to estimate the degree of damaging potential of the periodontal tissues, using interdental brushes.

Klinische Untersuchungen an Halitosispatienten zeigen eindeutig, dass in der deutlichen Mehrzahl der Fälle die Quelle des unangenehmen Geruchs in der Mundhöhle zu finden ist (90%). Entspre­ chend dieser Studien waren die Hauptquellen für intraorale Halitosis Zungenbeläge, Gingivitis/ Parodontitis und die Kombination aus beidem. Daher ist es absolut naheliegend, dass der Zahn­ arzt in der Lage sein sollte, intraorale Halitosis unter üblicherweise vorliegenden Praxisbedin­ gungen erfolgreich zu behandeln. Zahnärzte, die sich für die Diagnose und Behandlung interes­sieren, stehen jedoch vor der Herausforderung, wissenschaftlich fundierte Erkenntnisse und Strategien in die Praxis übertragen zu müssen. Daher werden in der vorliegenden Arbeit die Ergebnisse eines internationalen Konsensus­ Workshops zusammengefasst. Zu diesem Work­ shop trafen sich internationale Halitosisexperten mit dem Ziel, Einigkeit über generelle Richtlinien zu erzielen, wie Patienten mit Mundgeruchs­ beschwerden unter Praxisbedingungen diagnos­tiziert und behandelt werden können.

Seit Mitte der 80er Jahre des letzten Jahrhunderts wird in den Industriestaaten ein Kariesrückgang im bleibenden Gebiss registriert [8]. Im Milchgebiss ist diese Entwicklung u.a. wegen der weltweit angestiegenen frühkindlichen

AIM OF THE STUDY: Pain in children and adolescents in Germany is a common health problem which has a high socioeconomic impact. There have been no studies allowing a reliable estimation of the prevalence of pain in children in the 5 (th) grade (age range 9-13 years) in schools in the region of the city of Greifswald and the administrative district East Pomerania. This population-based cross-sectional study examined the prevalence of pain in children, the treatment of pain and compared these data with the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). METHODS: Data were collected within the extended dental school examination in autumn 2007 including a self-completion questionnaire for the students. Also the parents answered a self-completion questionnaire containing questions on their children's socio-economic status. The pain and sociodemographic questions are compatible with those used in the "German Health Survey for Children and Adolescents" (KiGGS). RESULTS: Students from 19 schools completed a questionnaire on general pain (n=852, proportion of response: 93.2%, mean age: 10 years). Comparing to the KiGGS the overall 3-month prevalence is much higher (95.5%). For boys and girls headache is the pain associated with the most burden ("Hauptschmerz"). 1/4 of the girls (27.9%) and 1/5 (22.4%) of the boys reported their pain with the most burden during the last 3 months with a frequency of at least one time per week. Students with low socio-economic status took medication against pain ("Hauptschmerz") less frequently than students with high socio-economic status. Because of their pain ("Hauptschmerz") students with low socio-economic status visited a doctor less often than students with a mean or high socio-economic status. CONCLUSION: Compared to other epidemiological studies, pain is also a common health problem for children in the city of Greifswald and the administrative district East Pomerania. The data base enables comprehensive conclusions on the health-related state of students in Greifswald/East Pomerania. Further studies should examine additional factors on medication and the degree of doctor?s visits, e. g., parental attitudes towards medication and parental motivation towards the degree of visiting a doctor.

Between 1974 and 1976, fluoridated salt (250 ppm F) was introduced in the Swiss Canton of Glarus and has been used since by the bakeries and most households (domestic salt) in the Canton. Caries prevalence in schoolchildren of this Canton declined from 1974 to 1992 by 80 to 85%. As an example, 12-year-old children had 6.5 DMFT in 1974, but only 1.1 in 1992. In 1992, most DF sites were fissures and pits and most of them filled. Caries prevalence in primary teeth (dmft) decreased by 49 to 66% in the age groups 7, 8 and 9, and most of the reduction had occurred before 1983. In 1974, the average fluoride concentration in urine amounted to 0.36 ppm; between 1979 and 1992 it increased from 0.74 to 0.86 ppm. 46 to 60% of the bread samples contained between 3 to 9 ppm F; this bread had obviously been produced with fluoridated salt. Salt fluoridation contributed to caries decline until up to 1987, while subsequent caries reductions in permanent teeth must have been caused by other factors. In comparison to other Swiss data the caries prevalence of pupils in the Canton of Glarus was low in 1992.

The purpose of this cross-sectional study was to assess the changes in dental health in 12- and 15-year-old Turkish immigrants and German students who were included in a school-based caries-preventive programme for ten years (1993-2003). In 1993 352 and 402 12- and 15-year-olds and in 2003 352 and 402 12- and 15-year-olds were investigated, respectively. 23.6% of the 12-year-olds and 21.5% of the 15-year-olds were of Turkish origin. The clinical examination was performed with support of artificial light at school. Caries was diagnosed according to the WHO standard using the DMFT Index for permanent dentition. Within the ten-year period the highest increment of caries-free dentitions was found in 12- and 15-year old Germans attending grammar schools with 41,5% and 27% and secondary modern schools with 22,3% and 17%, respectively. The proportion of caries-free Turkish students attending secondary modern schools, only increased imperceptible in both age groups (1.2%). A significant caries decline of 1.5 DMFT was observed in 12-year old Germans at grammar schools, only. In 15-year olds caries declined in German students at secondary modern schools (2.5 DMFT), and at Grammar schools (2.2 DMFT), significantly, however caries experience in Turkish students remained nearly unchanged (0.3 DMFT). A strong polarisation of dental caries was found in 2003. Among the 12-year-olds 23% of those at secondary modern school accumulated 70% of the total caries experience (>3 DMFT) and at grammar school 9% of students accumulated 76% of the whole amount of caries (>1 DMFT). Among the 15-year-olds 73% of the total caries experience (>3 DMFT) was concentrated in 32% of the students at secondary modern schools, while 25% of the students at grammar schools exhibited 84% of the whole amount of caries (>1 DMFT). Intended concepts in caries prevention in the future should aim to improve dental health especially in Turkish students at secondary modern schools while taking social inequality of this risk group into account.

The reunification of the two German states has resulted in social transformations in Eastern Germany after 1990, in the wake of which disadvantageous effects on oral health were to be expected. Contrary to the predicted caries increase, a caries decline in the juvenile population could be proven by epidemiological comparative studies (n = 50612) (decrease between 1983-1989 and 1993-1995 by 34.2%). The caries decline is probably caused by a broader availability of fluorides, a high level of individual dental curative and preventive care (fissure sealings) and by changed oral health behaviour and nutritional habits. Reference is made to a possible tangent between a high level of antibiotics consumption and the virulence of oral pathogenic streptococci.

BACKGROUND AND OBJECTIVE: The periodontal region is a source of gram-negative bacterial infection. The pathogens involved have recently also been demonstrated in atheromatous plaques. They may increase the risk of myocardial infarction. In this study a strategy for eradicating periodontal bacteria and thus healing in patients with periodontal pockets and advanced destruction of alveolar bone was examined. PATIENTS AND METHODS: Initial periodontal status was documented in 36 patients with periodontitis (24 women, 12 men) who were then randomly assigned to one of three groups. Those in two of the groups were given either metronidazole or doxycycline orally as adjuvant treatment, while the third group received no antibiotics. Patients in all groups were treated according to a two-step procedure. In step 1, extensive supra- and subgingival plaques and concrements were removed. In step 2, root debridement and/or closed curettage of all pockets was undertaken in one visit, and the antibiotic given to the patients in groups 1 and 2. Results were assessed 3 weeks after the first step and 6 months, 2 and 4 years after step 2. RESULTS: The initial examination at 3 weeks revealed significant changes in all three groups with regard to the incidence of plaque and sulcus bleeding, but not regarding probing depth and attachment level. However, there were significant changes in probing depth and attachment level in all groups after step 2. Periodontal attachment was significantly improved at 2 and 4 years in the patients on metronidazole, but not those on doxycycline or no antibiotics. The greatest decrease in bleeding tendency was recorded in the metronidazole group. This group also had the greatest gain of new alveolar bone compared with the other two groups. Complete eradication of Porphyromonas gingivalis and Actinobacillus (Hemophilus) actinomycetemcomitans, important pathogenic bacteria that may have an atherogenic action, was obtained only in patients on metronidazole. CONCLUSION: The tissue-sparing two-step procedure brought about good clinical and radiological results, which can be significantly bettered by the addition of metronidazole, achieving eradication of pathogens involved in periodontal disease.

AIM: Pregnancy is related with changes in oral health. While the medical care of pregnant women in Germany is well-regulated, there are no structured recommendations for dental examinations. During an "Oral Health Awareness Week" the periodontal conditions of pregnant women in the Federal State of Thuringia (Germany) were examined. METHODS: 85 pregnant women participated in this study. Oral health indices (PSI, BoP and DMFT) were recorded. 61 of the 85 women followed the invitation to repeat the investigations after parturition. Additionally, birth weight and height of the newborn were recorded. RESULTS: There were no correlations between periodontal condition and birth weight. However, pregnant women demonstrated in high levels periodontal inflammation (only 1.2% showed periodontal health). Pregnant woman with periodontitis (PSI 3 and 4) demonstrated clear deficiencies in health education regarding oral health and adverse pregnancy outcomes. CONCLUSIONS: These findings implicate the importance of periodontal care in pregnant women. An association between periodontitis and reduced birth weight was not observed in the studied Thuringian cohort.

Scanning electron microscopic study of bristle heads of 8 toothbrush brands commercially available in the Federal Republic of Germany and Switzerland has shown qualitative variations in the rounding of bristle ends. The percentage of acceptable end rounding of the bristles was for 4 brands above 75% and for 2 brands 55-56%. For 2 products, the percentage was below 40%. The new method of welding bristle bundles at their base into the head of the toothbrush was used only by one producer.

The main goal of this study was the evaluation of an intervention programme for the promotion of health literacy in school-aged children (grade 5-6). The project and the programme were highly accepted, the extension of the annual dental health examination was suitable to collect data within evaluation projects in schools. In spite of positive outcomes, a longer supervision phase would be necessary in order to optimise and to implement other programme components fully.

Das Ziel der vorliegenden Studie war es, die Wirkung verschiedener Pflanzenextrakte auf das Wachstum parodontalpathogener Bakterien zu untersuchen. Zur Bestimmung des antibakteriellen Effekts von Ingwer (Zingiber officinalis), Salbei (Salvia officinalis), Kamille (Chamomilla recutita), Rosmarin (Rosmarinus officinalis), Nelke (Syzygium aromaticum), Myrrhe (Commiphora abyssinica) und Rathania (Krameria lappacea) gegenüber Fusobacterium nucleatum ATCC 10 953, Porphyromonas gingivalis ATCC 33 277, Actinobacter actinomycetemcomitans ATCC 33 384 und Enterococcus faecalis ATCC 29 212 wurde der Agar-Diffusionstest verwendet. Das Bakterienwachstum konnte durch die meisten Pflanzenextrakte in unterschiedlichem Maße gehemmt werden. Der Nelkenextrakt wies die höchste antibakterielle Wirksamkeit auf, welche teilweise die von Chlorhexidin (Positivkontrolle) übertraf. Die vorliegenden Ergebnisse zeigen, dass Pflanzenstoffe die antibakterielle Parodontitis-Therapie sinnvoll unterstützen könnten.

Ziel: Bestimmung der Eliminationszeit von Fluorid aus der interdentalen Plaque nach einmaliger Applikation von hochkonzentrierten Fluoridgelen und eines Fluoridlackes bei Verwendung einer fluoridfreien Zahnpaste im Vergleich zur täglichen Verwendung einer Fluoridzahnpaste zur Mundhygiene.

The free ionic concentration of fluoride of 16 toothpastes for adults, of 5 pastes for children, and of one fluoride gel were analysed straight after production and after 4 months of storage. The fresh products containing fluoride as inorganic salt of hydrofluoric acid or as organic fluoride salt contained more than 65% of the manufacturers declaration of ionic fluoride. In the pastes containing sodiummonofluorphosphate the assessed concentration of free fluoride ions was less than 20% of the declaration. After 4 months of storage more than 75% of the ionic fluoride found in the new products could still be detected. The pastes containing sodiummonofluorphosphate, however, showed an increase of the ionic concentration of fluoride.

Mütter über ihre Rolle bei der Keimübertragung aufklären können und über die Gefahr des Saugens süßer Getränke aus der Babyflasche - insbesondere nachts

Gingival recession and wedge-shaped defects are caused mainly by incorrect tooth brushing procedures. The aim of this epidemiologic study was to determine if in addition there is a relationship to the regular use of an amine fluoride gel (pH 5.2) applied by a toothbrush. In a regression analysis, the effect of age, sex, education, toothbrushing frequency, gingival bleeding (PBI) and use of the gel on the occurrence of wedge-shaped defects was investigated. Similarly, the influence of these variables on the occurrence of gingival retraction without any hard tissue defect was investigated. Both types of lesions showed a statistically significant relationship to age and PBI. Moreover, use of the amine fluoride gel was significantly and negatively correlated with the occurrence of wedge-shaped defects.