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CORK Bibliography: Dental Issues

38 citations. January 2009 to present

Prepared: March 2010

Agnihotri R; Pandurang P; Kamath SU; Goyal R; Ballal S; Shanbhogue AY et al. Association of cigarette smoking with superoxide dismutase enzyme levels in subjects with chronic periodontitis. Journal of Periodontology 80(4): 657-662, 2009. (29 refs.)

Background: Smoking, which is an important risk factor for periodontitis, induces oxidative stress in the body and causes an imbalance between reactive oxygen species (ROS) and antioxidants, such as superoxide dismutase (SOD). In the present study, the influence of smoking on the periodontium was determined by estimating the levels of SOD in light and heavy smokers with periodontitis. Methods: Seventy subjects in the age range of 20 to 55 years, including 60 smokers and 10 non-smokers (controls), were selected. Clinical parameters recorded were plaque index (PI), probing depth (PD), and attachment loss (AL). Smokers were divided into light smokers (<10 cigarettes/day) and heavy smokers ( >= 10 cigarettes/day) and into three subgroups: healthy, mild periodontitis, and moderate periodontitis. Gingival crevicular fluid (GCF) and saliva samples were collected. SOD levels were analyzed using spectrophotometric assay. Results: The mean levels of SOD in the GCF and saliva of smokers were decreased compared to controls. Intra- and intergroup analyses showed a significant reduction in the levels of SOD in the GCF and saliva of heavy smokers compared to light smokers and the control group. Conclusions: There was a progressive reduction in SOD levels from healthy non-smokers to light smokers to heavy smokers. These findings. high light the need to augment the efforts of smoking-cessation programs. The benefits of reduced smoking and improved antioxidant levels may motivate smoking cessation.

Agrawal SS; Rajagopal K. Nicotine contents in various toothpowders (dant manjans): Measurement and safety evaluation. Food and Chemical Toxicology 47(3): 511-524, 2009. (24 refs.)

The use of tobacco products as dentrifice is prevalent in various parts of India. Among them toothpowder (dant manjan) is very common. These nicotine containing toothpastes/tooth powders are health hazards and is also habit forming. Health experts of India rightly banned use of nicotine containing toothpowder as early as 1992 by making proper legislation. We just made an attempt to verify whether the manufacturers complying the legislation or not. Eight leading brands of toothpowders were analyzed qualitatively by gas chromatography-mass spectrum detector and also quantitatively by gas chromatography-nitrogen phosphorus detector. Our results indicated four brands were found to contain nicotine in the range of 2.53 mu g/g to 11.50 mg/g of toothpowder. This finding further confirms that addition of nicotine in dentifrice violates the regulatory norms. Regulatory authorities should give more attention to ensure that all toothpowders are free from nicotine which is also a statutory requirement.

Al-Lawati JA; Nooyi SC; Al-Lawati AM. Knowledge, attitudes and prevalence of tobacco use among physicians and dentists in Oman. Annals of Saudi Medicine 29(2): 128-133, 2009. (13 refs.)

Tobacco use among Omani physicians and dentists has not been studied, so we conducted a cross-sectional survey using a WHO questionnaire to measure prevalence and to learn about smoking practices among this population and about their knowledge and attitudes of the health effects of tobacco use and tobacco control. The 1191 subjects who participated (787 men and 404 women) ranged in age from 24 to 65 years with a Mean (SD) of 41.7 (6.8) years for men and 38.1 (6.9) years for women. The prevalence of tobacco use was 16.4% among males and less than 1% among females. Manufactured cigarettes were the most common form of tobacco used (14.7%), followed by smokeless tobacco (2.2%) and waterpipes (1.7%). Tobacco users were significantly less favorable to strict control and policy measures than never tobacco users and had less knowledge of some of the heatlh effects of tobacco use. Tobacco use among physicians and dentists in Oman is lower than in other countries in the region, but remains a cause of concern. Programs and policies should strive to maintain the low level of tobacco use or reduce it further.

Amaral CDF; Vettore MV; Leao A. The relationship of alcohol dependence and alcohol consumption with periodontitis: A systematic review. (review). Journal of Dentistry 37(9): 643-651, 2009. (39 refs.)

Objectives: The aim of this systematic review was to evaluate the studies about the relationship of alcohol dependence and alcohol consumption with periodontitis. Data and sources: A comprehensive search was per-formed in the Systematic Eletronic (PUBMED Medline, Latin American and Caribean Health Science-LILACS, Scientific electronic library online-SciELO and Cochrane Central Register of Controlled Trials-CCRT literature databases) from January 1965 to July 2008. The reference lists of the identified studies were also searched. Results: Of the 1530 papers identified, 11 cross-sectional and 5 longitudinal observational studies met the inclusion criteria. Seven of the 12 studies on alcohol consumption and 4 of the 4 studies on alcohol dependence reported positive associations between alcohol intake and periodontitis. There was heterogeneity among studies concerning the methods of assessment of alcohol dependence, alcohol consumption and periodontitis. Therefore no meta-analysis was performed. Although smoking was properly addressed in all selected studies, the confounding effect of dental plaque was taken into account in only 6 studies. Conclusion: Alcohol consumption can be considered a risk indicator for periodontitis. Longitudinal studies on the association of alcohol dependence and alcohol consumption with periodontitis are needed to confirm the association or not.

Applebaum E; Ruhlen TN; Kronenberg FR; Hayes C; Peters ES. Oral cancer knowledge, attitudes and practices: A survey of dentists and primary care physicians in Massachusetts. Journal of the American Dental Association 140(4): 461-467, 2009. (28 refs.)

Background. The authors conducted a study to assess dentists' and primary care physicians' oral cancer knowledge, attitudes and practices in the Commonwealth of Massachusetts. Methods. The authors mailed a 38-item, pretested questionnaire to a stratified sample of dentists and primary care physicians in Massachusetts. The sample population included all general medicine, internal medicine and family practice physicians listed with the Massachusetts Board of Registration in Medicine and all Massachusetts Dental Society members. The authors invited a random sample of more than 1,000 clinicians to participate in the survey. They assessed knowledge, attitudes and practices of respondents and performed a bivariate analysis of responses to questions by using statistical software. Results. Forty-nine percent of physicians reported performing an oral cancer examination in patients aged 40 to 55 years, compared with 92 percent of dentists (P < .001). For patients 56 years or older, 54 percent of physicians reported performing oral cancer examinations, compared with; 93 percent of dentists (P < .001). More than 96 percent of physicians reported that they asked patients about smoking and alcohol use. However, only 9 percent of physicians and 39 percent of dentists were able to identify the two most common sites on which oral cancer develops (P < .001). Fifty-seven percent of dentists and 24 percent of physicians correctly identified the most common symptom of early oral cancer. Conclusion. This survey identified an existing gap in knowledge and practices among physicians and dentists and underscores the need to enhance oral cancer education among both professional groups.

Bagaitkar J; Williams LR; Renaud DE; Bemakanakere MR; Martin M; Scott DA; Demuth DR. Tobacco-induced alterations to porphyromonas gingivalis-host interactions. Environmental Microbiology 11(5): 1242-1253, 2009. (67 refs.)

Smokers are more susceptible than non-smokers to persistent infection by Porphyromonas gingivalis, a causative agent of periodontitis. Patients who smoke exhibit increased susceptibility to periodontitis and are more likely to display severe disease and be refractory to treatment. Paradoxically, smokers demonstrate reduced clinical inflammation. We show that P. gingivalis cells exposed to cigarette smoke extract (CSE) induce a lower proinflammatory response (tumour necrosis factor-alpha, interleukin-6, interleukin-12 p40) from monocytes and peripheral blood mononuclear cells than do unexposed bacteria. This effect is reversed when CSE-exposed bacteria are subcultured in fresh medium without CSE. Using microarrays representative of the P. gingivalis genome, CSE-exposure resulted in differential regulation of 6.8% of P. gingivalis genes, including detoxification and oxidative stress-related genes; DNA repair genes; and multiple genes related to P. gingivalis virulence, including genes in the major fimbrial and capsular operons. Exposure to CSE also altered the expression of outer membrane proteins, most notably by inducing the virulence factors RagA and RagB, and a putative lipoprotein cotranscribed with the minor fimbrial antigen. Therefore, CSE represents an environmental stress to which P. gingivalis adapts by altering gene expression and outer membrane proteins. These changes may explain, in part, the altered virulence and host-pathogen interactions that have been documented in vivo in smokers with periodontal disease.

Calhoun JG; Kolker JL; McGowan JM; Sohn W; Ismail AI. Tobacco-free community coalitions: Opportunities for enhancing oral cancer prevention programs. Journal of Cancer Education 24(4): 275-279, 2009. (28 refs.)

Background. This study identified oral cancer (OC) education and tobacco reduction collaboration within tobacco-free community coalitions (TFCC). Methods. Data from 4 TFCC were collected via educational intervention surveys and structured focused group Interviews. Results. Of the 52 participants, 96% were aware that tobacco products are risk factors for OC, yet 33% were unaware of the high OC impact locally. About 90% agreed that primary care providers and dentists should provide OC screenings and tobacco cessation. Conclusion. There is a need for provider endorsement and public demand for OC screenings. Opportunity exists for partnering and collaborative OC prevention with TFCC.

Casto BC; Sharma S; Fisher JL; Knobloch TJ; Agrawal A; Weghorst CM. Oral cancer in Appalachia. Journal of Health Care for the Poor and Underserved 20(1): 274-285, 2009. (55 refs.)

Oral cancer accounts for 2.3% of malignancies in the US. and has one of the lowest five-year survival rates. An examination of oral cancer in Appalachia was motivated by the high incidence of lung and bronchial cancers in Appalachian states, the risk factors for which overlap with those for oral cancer. The incidence and mortality rates for oral cancer in 13 Appalachian states and the relative frequency of presumptive risk factors were examined and compared with national rates, using data from the National Program of Cancer Registries, Surveillance Epidemiology and End Results, Behavioral Risk Factor Surveillance System, the Appalachian Regional Commission, and the National Health Interview Survey. Combined incidence rates for oral cancer were higher in six of 12 Appalachian states, and mortality rates higher in 10 of 13, compared with the national average. Smoking was more prevalent than the national average in nine of 13 states, whereas alcohol consumption was the same or less in 11 Appalachian states. Only five of 13 states averaged fewer than the recommended five or more servings per day of fruits and vegetables.

Dar-Odeh NS; Abu-Hammad OA. Narghile smoking and its adverse health consequences: a literature review. (review). British Dental Journal 206(11): 571-573, 2009. (51 refs.)

Oral squamous cell carcinoma (OSCC) is a world health problem with approximately 50% of patients having a 5-year survival rate. A change in the demographics of the disease is now being recognised, particularly in Europe, where it is increasingly being seen in young males. While a variety of risk factors are important in OSCC, it is tobacco that plays a central part in the pathogenesis of the disease. Narghile is an old form of tobacco use but in the past decade, there has been a resurgence in this form of smoking. The practice is particularly common in young males and females from the Middle East but with the advent of immigration and globalisation, its use is becoming more widespread. It is now not uncommon to see narghile smoking in western countries such as the UK and USA. Studies describing the oral effects of narghile are unfortunately scarce. While adverse effects such as periodontal bone loss and dry socket have been described, its association with OSCC cannot be excluded. Variation in the type of narghile, the type of tobacco and the presence of co-factors such as cigarette smoking may all influence clinical outcome. In the present study, the practice of narghile smoking is reviewed in terms of its effect on health, particularly oral health. The association of narghile smoking and adverse effects on the orofacial region will be outlined, namely, periodontal disease, potentially malignant lesions and oral cancer.

Daud MKM; Rahman NA; Yusoff A; Mahdan MHA. Oral cancer: A retrospective study of cases registered in hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia. (review). International Medical Journal 16(1): 31-37, 2009. (24 refs.)

Objective: To determine the sociodemographic profiles (gender, age, ethnic), site of the lesion, risk factors, TNM stage and mortality of the oral cancers referred to the Maxillofacial Unit, Hospital Universiti Sains Malaysia (HUSM). Design: Retrospective record review from January 2000 to December 2005. Materials and methods: A retrospective data of histologically diagnosed oral cancer cases among patients registered in HUSM, Kelantan was collected. Data were entered and analysed using SPSS version 12.0. Chi square tests (chi(2)) was used to determine the association between the oral cancer and sociodemographic profiles, sites, risk factors, TNM staging and death. Independent t-test was used to determine the association between age and gender as well as site of cancer occurrence. Results: Eighty eight patients with oral cancer were diagnosed with age ranged from 14 to 85 years with the mean 55.1 (SD 17.98) years. 58 (63.6 per cent) patients were male. Tongue was the commonest site identified in 27 (30.7 per cent) patients followed by salivary glands in 24 (27.3 per cent) patients. The cancer of the salivary gland are significantly occurs at the younger age, 45.0 years old (SD 18.8) compared to the other sites of oral cavity, 58.8 years old (SD 16.23), P = 0.001. Smoking was the most common social habit (60.2 per cent), followed by betel nut chewing (18.2 per cent) and alcohol consumption (5.7 per cent). 15 per cent of the patients did not report any of these habits. Cancer of the palate and tonsils show the highest mortality rate (33.3 per cent) compared to the other sites. Of the 39 advanced cases (stage III, IV), 9 (23.1 per cent) were died compared to only 2 (4.7 per cent) died in the localized stage (P = 0.014). Conclusions: The present study was in agreement with the previous study in terms of predisposing factors and the sites of lesion. However, oral cancer seems to occur earlier in our population and salivary gland cancer is in rising. Therefore, a more aggressive educational campaigns need to be done to ensure the control and early detection of the disease.

Duffo GS; Farina SB. Corrosion behaviour of a dental alloy in some beverages and drinks. Materials, Chemistry and Physics 115(1): 235-238, 2009. (12 refs.)

The aim of the present work was to perform a systematic study of the effect of several beverages (alcoholic drinks, natural and artificial fruit juices, vinegar, soft drinks, milk) on the corrosion behaviour of an aluminum-bronze dental alloy. Results were compared to those obtained in artificial saliva and in a solution of sodium chloride. The material used was an aluminum-bronze alloy frequently used in Latin American countries because of its similarity in appearance to the yellow gold alloys and of economic reasons. The investigation was carried out by means of traditional electrochemical techniques: polarization tests, polarization resistance measurements and weight loss tests. The ranking of aggressiveness of the beverages and solutions studied is given by the corrosion rate computed from the weight loss measurements, and it is as follows: artificial saliva, lemon juice, vinegar, 1 M NaCl, white wine, red wine and artificial orange juice. The aggressiveness of the different liquids is independent of both the pH and electrical conductivity of the solution. The most aggressive beverage (artificial orange juice) generates a corrosion rate only 1 order of magnitude higher than that of saliva, a difference that is not relevant for the odontological use considering the short time that beverages are in contact with dental alloys in the oral environment.

El-Wajeh YAM; Thornhill MH. Qat and its health effects. British Dental Journal 206(1): 17-21, 2009. (52 refs.)

In Southern Arabia and Eastern Africa, qat chewing is a widely practised socio-cultural habit. It consists of placing the green-leaved plant into the mucobuccal fold and chewing it for several hours, with subsequent release of psychoactive agents. Qat chewing is often accompanied by smoking tobacco. The reported prevalence of qat chewing in Europe and North America is on the increase with global migration. Oral diseases reportedly associated with qat chewing include periodontitis, oral leukoplakia and oral cancer. However, precise data on the association of qat use with the development of oral cancer are sparse. The aim of this review is to 1) Educate health clinicians about qat usage and related oral/systemic health issues; and 2) Review the current literature regarding qat use and its association with oral disease but more specifically review its link with oral leukoplakia and oral squamous cell carcinoma (OSCC). To do this we searched the literature (PubMed, Science Direct and Scopus) to identify all relevant articles published over the last 20 years using a combination of terms 'qat', 'khat', 'kat', 'cathinone' and 'cathaedulis'.

Erdemir EO; Sonmez IS; Oba AA; Bergstrom J; Caglayan O. Periodontal health in children exposed to passive smoking. Journal of Clinical Periodontology 37(2): 160-164, 2010. (41 refs.)

Aim: To determine (1) the cotinine levels of saliva, urine and gingival crevicular fluid (GCF) of children in families with and without smoking members and (2) a possible association between the periodontal health of the children and exposure to passive smoking. Material and Methods: The study population comprised of 109 children in the age range 6-12 years. Children were classified as exposed to passive tobacco smoking (PTS-exposed, n=51) and as unexposed controls (PTS-unexposed, n=58). Plaque index, gingival index, bleeding on probing, probing depth and clinical attachment level (CAL) were recorded. GCF, saliva and urine samples were also collected. The levels of cotinine in these fluids were determined by enzyme-linked immunosorbent assay. Results: The mean salivary cotinine concentration was significantly increased in PTS-exposed children compared with PTS-unexposed children (p < 0.05). Further, in a dose-dependent way, the mean salivary concentration was significantly higher in children whose father or mother was a smoker (p < 0.05) as compared, respectively, with children whose fathers and mothers were non-smokers. The mean CAL was significantly less in PTS-exposed children compared with non-PTS-exposed children (0.09 mm; p < 0.05) and also in children whose father was a smoker (p < 0.05), but not in children whose mother was a smoker as compared with non-smoker fathers and mothers, respectively. The GCF cotinine levels were below the detection limits with the assay method that was used. Conclusions: We have observed that children who are exposed to passive smoking have elevated cotinine levels in their saliva concomitant with a lowered CAL.

Gansky SA; Ellison JA; Kavanagh C; Isong U; Walsh MM. Patterns and correlates of spit tobacco use among high school males in rural California. Journal of Public Health Dentistry 69(2): 116-124, 2009. (39 refs.)

Objective: To assess patterns and correlates of spit [smokeless tobacco (ST)] use among high school males in rural California. Methods: An 18-item, self-administered questionnaire was used to assess ST use among young males in 41 randomly selected high schools in 21 rural counties in California. To ensure confidentiality, students were instructed to seal their completed questionnaire in an attached envelope prior to returning it to the questionnaire administrator. Results: Overall prevalence of ST use was 9.8 percent, significantly increasing with year in school from 5 percent among freshmen to 15 percent among seniors. ST use was highest among rodeo athletes at 42 percent compared with < 6 percent among nonathletes; ST use was significantly higher among smokers (32 percent) who were 2.5-30 times more likely to use ST compared with nonsmokers, depending on race/ethnicity as a result of a significant race/ethnicity x smoking interaction of degree/magnitude. In addition, students who believed there was no, or slight risk of, harm from ST use were significantly more likely to use ST than students perceiving moderate or great risk, depending on race/ethnicity (odds ratios 3.6-13). Among all ST users, 40 percent used ST on at least 5 days in the previous week, 80 percent of those reporting a brand used the brand Copenhagen, and 41 percent (189) used ST within 30 minutes of waking. Conclusion: Dental public health practitioners, scholars, and policy-makers need to promote dental health through organized community efforts targeting high school male subgroups in rural areas that are at risk for ST-associated adverse health effects.

Gordon JS; Albert DA; Crews KM; Fried J. Tobacco education in dentistry and dental hygiene. Drug and Alcohol Review 28(5): 517-532, 2009. (67 refs.)

Introduction and Aims. Dentists and dental hygienists are in a unique position to motivate and assist their patients to quit smoking and using smokeless tobacco, and there is ample evidence that they can be effective. Tobacco plays a major role in the development and treatment of many oral diseases, and the repeated nature of dental treatment provides multiple opportunities for information, advice and brief counselling. However, dentists and dental hygienists in practice report lack of training in effective tobacco cessation skills as a significant barrier to incorporating these behaviours into routine care. Design and Methods. In this paper, we summarise the rationale for addressing tobacco use within dentistry and dental hygiene, review the extant policies regarding provision of tobacco-related education, and make recommendations for the content and format of tobacco dependence treatment training in undergraduate curricula and continuing education courses. Results. Although worldwide dental education organisations have policies encouraging their members to provide tobacco cessation services to their patients, there are no national standards for tobacco cessation curriculum in US dental schools. In addition, tobacco cessation is not considered a clinical competency. Discussion and Conclusions. For dental professionals to systematically assist their patients to quit tobacco, changes must be made to the ways treatment of tobacco dependence is viewed within dentistry and taught at the undergraduate and post-graduate levels. Until that time, the dental profession will continue to fall short of the Clinical Practice Guidelines and the policies set out by its professional organisations.

Hamamoto DT; Rhodus NL. Methamphetamine abuse and dentistry. (review). Oral Diseases 15(1): 27-37, 2009. (113 refs.)

Methamphetamine is a highly addictive powerful stimulant that increases wakefulness and physical activity and produces other effects including cardiac dysrhythmias, hypertension, hallucinations, and violent behavior. The prevalence of methamphetamine use is estimated at 35 million people worldwide and 10.4 million people in the United States. In the United States, the prevalence of methamphetamine use is beginning to decline but methamphetamine trafficking and use are still significant problems. Dental patients who abuse methamphetamine can present with poor oral hygiene, xerostomia, rampant caries ('Meth mouth'), and excessive tooth wear. Dental management of methamphetamine users requires obtaining a thorough medical history and performing a careful oral examination. The most important factor in treating the oral effects of methamphetamine is for the patient to stop using the drug. Continued abuse will make it difficult to increase salivary flow and hinder the patient's ability to improve nutrition and oral hygiene. Local anesthetics with vasoconstrictors should be used with care in patients taking methamphetamine because they may result in cardiac dysrhythmias, myocardial infarction, and cerebrovascular accidents. Thus, dental management of patients who use methamphetamine can be challenging. Dentists need to be aware of the clinical presentation and medical risks presented by these patients.

Harris JL; Patton LL; Wilder RS; Peterson CA; Curran AE. North Carolina dental hygiene students' opinions about tobacco cessation education and practices in their programs. Journal of Dental Education 73(5): 539-549, 2009. (40 refs.)

Inadequate training in tobacco cessation counseling (TCC) is a recognized, but mutable, barrier to implementation of tobacco cessation education (TCE) and intervention strategies in dental practice. The objective of this study was to identify the opinions and practices of senior dental hygiene (DH) students in North Carolina regarding their didactic training in TCE and integration of TCE into their clinical Curricula. A pilot-tested questionnaire designed by the authors was administered to a cross-sectional, non-random convenience sample of 241 graduating senior DH students enrolled in all twelve North Carolina DH educational programs. Response rate was 65 percent (n=156). Of the respondents, 99 percent agreed that hygienists should be trained to provide TCE. Nearly all respondents (99 percent) had one or more patients who smoked, and 81 percent had one or more patients who used spit tobacco. Eighty-nine percent had one or more patients who had expressed a desire to quit. Most students were comfortable providing TCC to both smokers (92 percent) and spit tobacco users (93 percent); however, 26 percent reported that they were not comfortable providing quit messages to patients unwilling to quit. Enhancements to TCE in DH curricula may increase hygienists' incorporation of TCE into their future practice.

Khocht A; Schleifer SJ; Janal MN; Keller S. Dental care and oral disease in alcohol-dependent persons. Journal of Substance Abuse Treatment 37(2): 214-218, 2009. (14 refs.)

Dental/Oral health of alcohol-dependent persons and substance abusers is often neglected. It is not clear that alcohol dependence has effects on oral health beyond those expected in nonalcoholic persons of similar socioeconomic status (SES). Study objectives were to examine the personal dental care habits, ability to access professional dental care, and the types of services received and to examine their effect on the oral health of alcohol-dependent persons and substance abusers. Forty Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised-diagnosed alcohol-dependent persons and a comparison group of 25 non-alcohol-dependent subjects matched for race, age, gender, and SES were recruited. Subjects were medically healthy. Each subject received a comprehensive oral/dental examination, and an interview was conducted to record personal dental hygiene habits, ability to access professional dental care, and types of dental services provided. No statistical differences were found between the oral care habits of the groups. Forty-four percent of all subjects had access to charity professional dental care. Tooth extraction was the main dental service they received. Seventy-five percent of subjects brushed their teeth once or more per day. In the non-alcohol-dependent group, brushing frequency was inversely associated with plaque levels (P < .05); in the alcohol-dependent group, brushing frequency showed no statistical effect on plaque levels. Access to professional dental care was inversely associated with periodontitis in the alcohol-dependent group (p < .05). Alcohol dependence may increase plaque levels above that seen in race, gender, age, and SES-matched controls, but professional dental care can limit the subsequent development of periodontal disease in these people.

Lee K. Trend of alcohol involvement in maxillofacial trauma. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology 107(4): E9-E13, 2009. (28 refs.)

Background. Ethanol is regularly consumed by individuals in social settings. However, overindulgence can lead to impaired judgment and physical harm. This study examines the trend of alcohol-related facial fractures at a tertiary trauma over 2 consecutive time periods. Study design. A retrospective database of patients presenting to the Oral and Maxillofacial Surgery service at Christchurch Hospital during an 11-year period was reviewed, and data from the 2 5.5-year periods were compared. Variables examined included demographics, type of fractures, mode of injury, and treatment delivered. Results. A total of 1,264 patients were identified to have alcohol-related facial fractures, 624 in the first half of the period and 640 in the second half. More than 90% were male, with 66% of these patients in the 15-29-year age group in each period. Assault accounted for 73% in the first period and 82% in the second period, and motor vehicle accidents accounted for 18% and 8% of fractures, respectively, in the two periods. A total of 64% and 58% of these patients required hospital admission and surgery, respectively, in the first period, and 66% were hospitalised and 60% treated surgically in the second period. Conclusion. There was no significant change between the 2 periods in terms of demographics, pattern of fractures, and treatment modality. The incidence of assault-related fractures were on the rise and motor vehicle accident-related fractures were declining. Alcohol-related fractures continued to be the main problem in young male adults involved in fights. There should be public awareness to educate these people on this harmful effect of drinking.

Lopez R; Baelum V. Cannabis use and destructive periodontal diseases among adolescents. Journal of Clinical Periodontology 36(3): 185-189, 2009. (25 refs.)

The aim of this experiment was to investigate the association between cannabis use and destructive periodontal disease among adolescents. Data from a population screening examination carried out among Chilean high school students from the Province of Santiago were used to determine whether there was an association between the use of cannabis and signs of periodontal diseases as defined by (1) the presence of necrotizing ulcerative gingival (NUG) lesions or (2) the presence of clinical attachment loss (CAL) >= 3 mm. The cannabis exposures variables considered were "Ever use of cannabis" (yes/no) and "Regular use of cannabis" (yes/no). The associations were investigated using multiple logistic regression analyses adjusted for age, gender, paternal income, paternal education, frequency of tooth-brushing and time since last dental visit. Multiple logistic regression analyses showed that "Ever use of cannabis" was significantly negatively associated with the presence of NUG lesions (OR=0.47 [0.2;0.9]) among non-smokers only. No significant associations were observed between the presence of CAL >= 3 mm and cannabis use in either of the smoking groups. There was no evidence to suggest that the use of cannabis is positively associated with periodontal diseases in this adolescent population.

Manarte P; Manso MC; Souza D; Frias-Bulhosa J; Gago S. Dental erosion in alcoholic patients under addiction rehabilitation therapy. Medicina Oral Patologia Oral Y Cirugia Bucal 14(8): E376-E383, 2009. (14 refs.)

Objective: To determine the occurrence and severity of dental erosion in alcoholic patients undergoing detoxification at the North Alcoholic Regional Centre (CRAN), Porto, Portugal, and to assess socioeconomic and behavioural covariates of dental erosion occurrence. Design: A cross-sectional descriptive study was carried out in one centre (CRAN) for addiction rehabilitation therapy in the north of Portugal. A sample of 1064 teeth was examined. The condition of the dental erosion was classified by means of severity and anatomic location, according to the Eccles and Jenkins dental erosion index, and a dichotomous outcome assessing the occurrence of dental erosion (severity dental erosion levels > 0). Dental erosion results were linked to data supplied by a questionnaire assessing socio-demographic characteristics, behaviour related to alcohol and drug use, including a history of drug and alcohol abuse, and oral health promotion using logistic multivariate regression analysis. Results: Enamel and/or dentine erosion lesions were present on 49.4% of the teeth. Among these, 36.9% of occlusal surfaces presented dental erosion with a severity level of 1, 11.4% with a severity level 2 and 1.1% with a severity level 3. The highest occurrence of severity level 3 was found to exist in palatal dental surfaces (1.9%). Dental erosion on teeth surfaces was found to be independently associated with intra oral location (by arch, tooth type), patients' socio-demographic characteristics, behaviour associated with a history of alcohol and drug abuse, and oral health promotion. Maxillary teeth, more so than mandibular teeth, presented moderate to higher severity erosion injuries (Wilcoxon test; p < 0.001); and significant differences in the severity of dental erosion were found between anterior and posterior teeth, in both the maxillary and the mandibular arches (Friedman test, p < 0.001). Conclusions: Alcohol-dependent patients undergoing a detoxification programme presented a high occurrence and a low severity of dental erosion lesions. The palatal surfaces of the anterior teeth, followed by incisive/occlusal surfaces in both anterior and posterior teeth, respectively, were most affected by erosion injuries.

Naito T; Miyaki K; Naito M; Yoneda M; Suzuki N; Hirofuji T et al. Parental smoking and smoking status of Japanese dental hygiene students: A pilot survey at a dental hygiene school in Japan. International Journal of Environmental Research and Public Health 6(1): 321-328, 2009. (27 refs.)

This study aimed to determine the frequency of smoking and to explore factors associated with the smoking habits of female students at a dental hygiene school in Japan. Questionnaires regarding cigarette smoking were given to 168 female students. The response rate was 97.6%. The prevalence of smoking, including current and occasional smokers, was 20.3%. Among family members, only the smoking status of their mother significantly influenced the smoking status of the students. The odds ratio for smoking among dental hygiene students whose mothers were smokers in comparison to students whose mothers were not smokers was 5.1 (95% confidence interval 2.1-12.2, p=0.000). Decision tree analysis showed that the smoking habit of dental hygiene students was correlated with their mothers' smoking history, as well as the smoking status of junior high school teachers, the smoking habits of close friends and a history of participating in a smoking prevention program when in elementary school. The increased smoking rate of young females, including dental hygienists, is a growing problem in Japan. The smoking statuses of dental hygiene students might be closely influenced by their mothers' smoking status.

Nishio N; Kouda K; Nishio J; Nakamura H; Sonoda Y; Takeshita T. Smoking prevalence among dentists in Hyogo, Japan 2003. Industrial Health 47(4): 431-435, 2009. (33 refs.)

We examined smoking prevalence among dentists in Hyogo, Japan, as smoking would influence their smoking cessation interventions to encourage their patients to stop smoking. In 2003, a self-administered questionnaire was mailed to all members of the Hyogo Dental Association (HDA) in Japan. Of the 1,133 members of the HDA, 327 were current smokers (28.9%). Smoking prevalence among HDA members was significantly higher than that among Japan Medical Association (JMA) members in 2004, as previously reported (16.2%) (P<0.01). Although smoking prevalence among HDA members decreased overall in 2003 in comparison with 2000, smoking prevalence among dentists aged 20-39 yr increased. These findings indicate that smoking was more prevalent among dentists in Hyogo Prefecture than among Japanese medical doctors. It is important to promote smoking cessation among Japanese dentists so that dentists will be more likely to encourage their patients to quit smoking.

Nohlert E; Tegelberg A; Tillgren P; Johansson P; Rosenblad A; Helgason AR. Comparison of a high and a low intensity smoking cessation intervention in a dentistry setting in Sweden: A randomized trial. BMC Public Health 9: article 121, 2009. (24 refs.)

Background: Tobacco is still the number one life style risk factor for ill health and premature death and also one of the major contributors to oral problems and diseases. Dentistry may be a potential setting for several aspects of clinical public health interventions and there is a growing interest in several countries to develop tobacco cessation support in dentistry setting. The aim of the present study was to assess the relative effectiveness of a high intensity intervention compared with a low intensity intervention for smoking cessation support in a dental clinic setting. Methods: 300 smokers attending dental or general health care were randomly assigned to two arms and referred to the local dental clinic for smoking cessation support. One arm received support with low intensity treatment (LIT), whereas the other group was assigned to high intensity treatment (HIT) support. The main outcome measures included self-reported point prevalence and continuous abstinence (>= 183 days) at the 12-month follow-up. Results: Follow-up questionnaires were returned from 86% of the participants. People in the HIT-arm were twice as likely to report continuous abstinence compared with the LIT-arm (18% vs. 9%, p = 0.02). There was a difference (not significant) between the arms in point prevalence abstinence in favour of the HIT-protocol (23% vs. 16%). However, point prevalence cessation rates in the LIT-arm reporting additional support were relatively high (23%) compared with available data assessing abstinence in smokers trying to quit without professional support. Conclusion: Screening for willingness to quit smoking within the health care system and offering smoking cessation support within dentistry may be an effective model for smoking cessation support in Sweden. The LIT approach is less expensive and time consuming and may be appropriate as a first treatment option, but should be integrated with other forms of available support in the community. The more extensive and expensive HIT-protocol should be offered to those who are unable to quit with the LIT approach in combination with other support.

Pan WC; Chen RM; Shen YC; Chen CC; Ueng YF. Suppressive effect of tobacco smoke extracts on oral P-glycoprotein function and its impact in smoke-induced insult to oral epidermal cells. Toxicology Letters 185(2): 116-123, 2009. (39 refs.)

P-glycoprotein (Pgp) participates in the export of numerous toxins, drugs, and physiological compounds. To examine the involvement of Pgp in smoke-induced oral cell insult, the effects of extracts of the mainstream tobacco smoke (TS) on Pgp were studied in an oral epidermal carcinoma cell line, OECM-1. TS was first extracted with cyclohexane (CTS) and the residues were further extracted with isopropanol (ITS). For comparison, cells were exposed to CTS and ITS at the concentrations according to their relative extraction yield. ITS but not CTS decreased the efflux of a Pgp substrate. rhodamine (Rh) 123, in a concentration-and time-dependent manner. The efflux was also decreased by co-exposure to CTS and ITS. However, immunoblot analysis revealed that the protein level of Pgp was not affected by ITS. Naphthalene, mainly detected in the ITS, decreased Rh 123 efflux. However, the efflux activity was not affected by benzo(a)pyrene and nicotine, which were present in the CTS and both extracts, respectively. Co-exposure to CTS in combination with ITS, naphthalene, or verapamil enhanced cell insult compared to single exposure. These results demonstrated that smoke and its constituent, naphthalene, diminished Pgp-mediated efflux. The reduction in Pgp function could be a stimulatory factor of TS-induced oral cell insult.

Petersen PE. Oral cancer prevention and control: The approach of the World Health Organization. Oral Oncology 45(4-5): 454-460, 2009. (15 refs.)

Cancer is one of the most common causes of morbidity and mortality today. It is estimated that around 43% of cancer deaths are due to tobacco use, unhealthy diets, alcohol consumption, inactive lifestyles and infection. Low-income and disadvantaged groups are generally more exposed to avoidable risk factors such as environmental carcinogens, alcohol, infectious agents, and tobacco use. These groups also have less access to the health services and health education that would empower them to make decisions to protect and improve their own health. Oro-pharyngeal cancer is significant component of the global burden of cancer. Tobacco and alcohol are regarded as the major risk factors for oral cancer. The population attributable risks of smoking and alcohol consumption have been estimated to 80% for males, 61% for females, and 74% overall. The evidence that smokeless tobacco causes oral cancer was confirmed recently by the International Agency for Research on Cancer. Studies have shown that heavy intake of alcoholic beverages is associated with nutrient deficiency, which appears to contribute independently to oral carcinogenesis. Oral cancer is preventable through risk factors intervention. Prevention of HIV infection will also reduce the incidence of HIV/AIDS-related cancers such as Kaposi sarcoma and lymphoma. The WHO Global Oral Health Programme is committed to work for country capacity building in oral cancer prevention, inter-country exchange of information and experiences from integrated approaches in prevention and health promotion, and the development of global surveillance systems for oral cancer and risk factors. The WHO Global Oral Health Programme has established a global surveillance system of oral cavity cancer in order to assess risk factors and to help the planning of effective national intervention programmes. Epidemiological data on oral cancer (ICD-10: C00-C08) incidence and mortality are stored in the Global Oral Health Data Bank. In 2007, the World Health Assembly (WHA) passed a resolution on oral health for the first time in 25 years, which also considers oral cancer prevention. The resolution WHA60 A16 URGES Member states-To take steps to ensure that prevention of oral cancer is an integral part of national cancer-control programmes, and to involve oral-health professionals or primary health care personnel with relevant training in oral health in detection, early diagnosis and treatment;The WHO Global Oral Health Programme will use this statement as the lead for its work for oral cancer control.

Ray CS; Gupta PC. Bidis and smokeless tobacco. Current Science 96(10): 1324-1334, 2009. (63 refs.)

Bidis and smokeless tobacco are the cheapest, least taxed and most commonly used tobacco products in India. They are highly addictive and high in carcinogens. They cause a broad spectrum of diseases; yet awareness about their ill-effects is low. Smokeless tobacco products containing arecanut, e. g. gutka and mawa, are especially addictive and carcinogenic. The high incidences of oral and lung cancers in India are mainly due to bidis and smokeless tobacco. Bidis bear no health warnings, and smokeless products, only warnings in English in small print. The public favours tobacco control policies and the Government tries to impose them, but the industry delays such implementation. This article highlights the widespread use of bidis and smokeless tobacco in India, reviews their harmful effects, documents public support for tobacco control policies, and provides scientific evidence for the implementation of these policies.

Renz ANPJ; Newton JT. Changing the behavior of patients with periodontitis. Periodontology 2000 51(1): 252-268, 2009. (96 refs.)

Success in periodontal treatment is highly dependent upon the ability and willingness of the patient to maintain good oral hygiene. This is achieved through a combination of personal care and seeking professional help, which includes dealing with secondary aetiological factors, such as smoking or dietary control This review considers psychological models and theories that provide an important framework for increasing understanding of the determinants of adherence to recommendations concerning health behaviors, including nicotine use. All these models share the common assumption that an individual's behavior is best understood by examining their attitudes and beliefs. The following models will be reviewed in relation to oral hygiene behaviors: health belief model; protection motivation theory; locus of control; social learning theory; theory of planned behavior; implementation intentions; stages of change model (or trans-theoretical model). For each model, an outline of the constructs involved in the model and their relationships will be given. This will be followed by a review of research exploring the relationship between the theory and health-related behaviors, including oral health-related behaviors where possible. Finally, intervention studies based on targeting the cognitions in the model will be discussed for each model.

Rosseel JP; Jacobs JE; Hilberink SR; Maassen IM; Allard RHB; Plasschaert AJM et al. What determines the provision of smoking cessation advice and counselling by dental care teams? British Dental Journal 206(7): e-article 13, 2009. (25 refs.)

Objective: To investigate determinants of the provision of smoking cessation advice and counselling by various dental professionals in the dental team (dentists, dental hygienists and prevention auxiliaries). Design: Cross-sectional design. Setting Sixty-two general dental practices in the Netherlands. Methods Multivariate logistic analyses of self-reported counselling behaviour collected from questionnaires for dentists (n = 72), dental hygienists (n = 31) and prevention auxiliaries (n = 50) in general dental practices. Main outcome measures Stimuli and barriers for smoking cessation counselling and advice behaviour to patients with or without oral health problems. Results: Dental hygienists provided more general cessation advice and counselling than dentists. However, when patients had oral complaints, dentists counselled more often compared to prevention auxiliaries. The support from experienced colleagues positively influenced the provision of advice and counselling as well as the perceived self-efficacy for all kinds of dental professionals. Conclusions: The provision of general smoking cessation advice to patients with no acute oral complaints can be improved by more involvement of the dentist and/or task delegation to prevention auxiliaries and dental hygienists. Social support is important in encouraging more smoking cessation advice and counselling. Implementation strategies for support of smoking cessation in dental care should focus on creating a positive advice culture among colleagues.

Signoretto C; Bianchi F; Burlacchini G; Sivieri F; Spratt D; Canepari P. Drinking habits are associated with changes in the dental plaque microbial community. Journal of Clinical Microbiology 48(2): 347-356, 2010. (41 refs.)

Caries and gingivitis are the most prevalent oral infectious diseases of humans and are due to the accumulation of dental plaque (a microbial biofilm) on the tooth surface and at the gingival margin, respectively. Several in vitro and in vivo studies have shown that many natural components of foods and beverages inhibit the adhesion of and/or exert activity against oral bacteria. These biological activities have mainly been attributed to the polyphenol fraction. In order to explore the possibility that diet can alter the dental plaque community, in this study we evaluated the composition of the microbiota of supra- and subgingival plaque samples collected from 75 adult subjects with different drinking habits (drinkers of coffee, red wine, or water for at least 2 years) by analyzing the microbial population through the separation of PCR-amplified fragments using the denaturing gradient gel electrophoresis (DGGE) technique. The mean numbers of bands of the DGGE profiles from all three categories were evaluated. There were no significant differences between the two kinds of plaque collected from the control group (water drinkers), and this group showed the highest number of bands (supragingival plaque, 18.98 +/- 3.16 bands; subgingival plaque, 18.7 +/- 3.23 bands). The coffee and wine drinker groups generated the lowest numbers of bands for both supragingival plaque (coffee drinkers, 8.25 +/- 3.53 bands; wine drinkers, 7.93 +/- 2.55 bands) and subgingival plaque (coffee drinkers, 8.3 +/- 3.03 bands; wine drinkers, 7.65 +/- 1.68 bands). The differences between coffee drinkers or wine drinkers and the control group (water drinkers) were statistically significant. A total of 34 microorganisms were identified, and the frequency of their distribution in the three subject categories was analyzed. A greater percentage of subjects were positive for facultative aerobes when supragingival plaque was analyzed, while anaerobes were more frequent in subgingival plaque samples. It is noteworthy that the frequency of identification of anaerobes was significantly reduced when the frequencies for coffee and wine drinkers were compared with the frequencies for subjects in the control group. The DGGE profiles of the organisms in both plaque samples from all groups were generated and were used to construct dendrograms. A number of distinct clusters of organisms from water, coffee, and wine drinkers were formed. The clustering of some of the DGGE results into cohort-specific clusters implies similarities in the microbiotas within these groups and relevant differences in the microbiotas between cohorts. This supports the notion that the drinking habits of the subjects may influence the microbiota at both the supragingival and the subgingival levels.

Studts JL; Burris JL; Kearns DK; Worth CT; Sorrell CL. "Providers Practice Prevention": Promoting dental hygienists' use of evidence-based treatment of tobacco use and dependence. Journal of Dental Education 73(9): 1069-1082, 2009. (50 refs.)

High rates of tobacco use prompted the development of a provider education program in Kentucky to promote implementation of evidence-based tobacco cessation treatment among registered dental hygienists (R.D.H.s). All R.D.H.s throughout the state were notified of the program and invited to participate. Participants were asked to complete a pre-program survey and post-program evaluation. A follow-up survey was administered one year following program participation. Two hundred and ninety-four R.D.H.s completed the pre- and post-program surveys, and the follow-up survey was completed by 53 percent (N=156) of the initial sample. Analyses exploring the immediate effect (from pre- to post-program) found the program to have had a universally positive impact (p<.05) across knowledge, attitudes, and intended clinical practices regarding tobacco use and treatment. Regarding the program's durable effects (from pre-program to follow-up), statistically significant (p<.05) and positive effects were realized for most of the outcomes, including subjective knowledge, attitudes, and practices. It was concluded that the program serves as ail effective introduction to the Treating Tobacco Use and Dependence: Clinical Practice Guideline. Additional intervention might enhance the durability of the program's efficacy and promote more complete adoption of evidence-based tobacco cessation strategies by dental hygienists, leading to an even broader impact on cancer prevention and control of tobacco-related malignancy.

Tanaka K; Miyake Y; Sasaki S. The effect of maternal smoking during pregnancy and postnatal household smoking on dental caries in young children. Journal of Pediatrics 155(3): 410-415, 2009. (25 refs.)

Objective: We investigated the effect of maternal smoking during pregnancy and postnatal household smoking on the prevalence of dental caries. Study design: Study subjects were 2015 children, age 3 years. Information on maternal smoking during pregnancy and postnatal exposure to environmental tobacco smoke (ETS) at home was obtained through questionnaires. Children were classified as having caries if 1 or more of the deciduous teeth had decayed, were missing, or had been filled. Results: Compared with nonsmoking during pregnancy, maternal smoking throughout pregnancy, but not ceasing to smoke at some time during pregnancy, was associated with an increased prevalence of caries. Regarding postnatal ETS, current but not former ETS exposure at home was independently positively associated with the prevalence of dental caries. A dose-response relationship was observed between cumulative postnatal ETS exposure at home and dental caries. Conclusions: Both in utero exposure to maternal smoking and postnatal exposure to ETS may be associated with an increased prevalence of dental caries in young children.

Tanaka K; Miyake Y; Sasaki S. The effect of maternal smoking during pregnancy and postnatal household smoking on dental caries in young children. Comment. Obstetrical & Gynecological Survey 65(1): 15-17, 2010. (0 refs.)

A number of environmental factors appear to be involved in the etiology of dental caries in Japanese children. Several reports have suggested an association between environmental tobacco smoke (ETS) and the occurrence of dental caries. However, other studies in Japan as well as Western nations have failed to show this association and it is unclear whether there is such a relationship. The role of maternal smoking during pregnancy on the etiology of dental caries in Young children is also unclear. The only 2 cross-sectional epidemiological studies addressing this issue had conflicting results. The aim of this cross-sectional study was to investigate whether maternal smoking during pregnancy and postnatal exposure to ETS were associated with an increased prevalence of dental caries among young Japanese children. Data were obtained from dental examination of 2015 children, age 3 years, and use of postal questionnaires completed by parents or guardians of those children on the extent of maternal smoking during pregnancy and postnatal ETS exposure at home. Based on their smoking history, women and their children were placed in one of 3 groups for analysis: women who smoked throughout pregnancy, those who stopped at some time during pregnancy, and those who did not smoke during pregnancy. A total of 419 (20.8%) of the 2015 children had dental caries, and the mean number of dental caries was 0.71. The prevalence of dental caries in the children of women who did not smoke at all during pregnancy was considered the background rate; compared to this group, the prevalence of dental caries was significantly higher in the children of women who smoked throughout pregnancy without stopping (adjusted prevalence ratio: 1.43; 95% CI: 1.07-1.91). The prevalence of dental caries was not significantly increased in the children of women who smoked but then stopped at some time during pregnancy. With respect to postnatal ETS, current smoking at home was independently associated with an increased prevalence of dental caries, whereas former smoking in the household had no effect on prevalence. There was a statistically significant dose-response relationship between cumulative household postnatal ETS and the prevalence of dental caries in the children (P for linear trend = 0.006). The investigators conclude from these findings that both maternal smoking during pregnancy and postnatal exposure to ETS at home may be independently associated with an increased prevalence of dental caries in young Japanese children.

Tang TH; Fitzsimmons TR; Bartold PM. Effect of smoking on concentrations of receptor activator of nuclear factor kappa B ligand and osteoprotegerin in human gingival crevicular fluid. Journal of Clinical Periodontology 36(9): 713-718, 2009. (39 refs.)

Aim: To compare the levels of the soluble receptor activator of nuclear factor kappa B ligand (sRANKL), osteoprotegerin (OPG) and their relative ratio in gingival crevicular fluid (GCF) among periodontitis patients with varying smoking histories. Material and Methods: GCF samples were collected from 149 periodontitis patients who were never smokers (n=58), former smokers (n=39) and current smokers (n=52). RANKL and OPG concentrations in GCF were measured by enzyme-linked immunosorbent assays. Results RANKL, OPG and their relative ratio were not statistically significant among the never smokers, former smokers and current smokers. However, OPG was significantly reduced and subsequently the sRANKL:OPG ratio was significantly increased in the high pack-years group as compared with never smokers. The positive correlation between pack-years and the sRANKL:OPG ratio remained statistically significant after adjusting for age and current smoking status. Conclusion: Increased lifetime exposure to cigarette smoking above a minimum threshold suppresses OPG production and leads to increased sRANKL:OPG. This may partially explain increased bone loss in smoking-related periodontitis.

Terrades M; Coulter WA; Clarke H; Mullally BH; Stevenson M. Patients' knowledge and views about the effects of smoking on their mouths and the involvement of their dentists in smoking cessation activities. British Dental Journal 207(11): e-22, 2009. (10 refs.)

Background: Smoking is correlated with a large number of oral conditions such as tooth staining and bad breath, periodontal diseases, impaired healing of wounds, precancer and oral cancer. These effects are often visible and in the early stages they are reversible after cessation of smoking. Dentists, as part of the health profession, are frequently in contact with the general population and there is evidence that they are as effective in providing smoking cessation counselling as any other healthcare group. Aims and methods: Patients' knowledge of the effects of smoking and their attitudes towards the role of dentists in smoking cessation activities were analysed via a self-completing questionnaire and compared depending on their smoking status (smokers and non-smokers). Results The results show that patients hold very positive attitudes towards dentists' role in smoking cessation. The results also show that although patients have a good knowledge of the effects of smoking on general health, smokers are significantly less aware of the relationship between smoking and gum disease and on wound healing. Conclusions: Dentists should inform their patients about the oral effects of smoking and strongly advise them not to smoke, especially in patients diagnosed with periodontal disease and requiring surgical procedures.

Westerman GH; Elsasser GN; Kavan MG. Dental student experiences with gambling: A survey of attitudes, exposure, and impact. Journal of Dental Education 73(8): 934-941, 2009. (41 refs.)

The aim of this study is to assess the extent and characteristics of glambling among dental students. Three hundred sixteen dental students enrolled at a private midwestern dental school accessed the twenty-six-item modified South Oaks Gambling Screen (SOGS) as an online Survey. Students were advised of the anonymity and confidentiality of the Survey results. Student characteristics are presented as descriptive data. One hundred eighty-six students (58.9 percent) responded. Nearly two-thirds (61.3 percent) of the respondents reported having gambled at least once during the past twelve months. Using the SOGS score, six students can be considered problem gamblers with a value of 3 but <5, and three students can be considered as pathological gamblers with it score of >= 5. Gambling is a common activity among dental students and should be considered a possible factor for students who develop academic or social difficulties. Students do not appear to have a realistic perception of what constitutes problem or pathological gambling and may benefit from programs that address this issue.

Yamazaki H; Inoue T; Yoshida K; Kotsuma T; Yoshioka Y; Koizumi M et al. Assessment of influence of smoking, drinking, leukoplakia and dental irritation on local control of early oral tongue carcinoma treated with brachytherapy: Age and dental factors are potential prognostic factors. Tumori 95(4): 461-466, 2009. (20 refs.)

Background. To examine the background characteristics of elderly patients (65 years or older) with node-negative mobile tongue cancer (T1-2N0M0) who showed worse local control than a younger group. Materials and methods. We retrospectively analyzed background data for 265 patients treated with brachytherapy with or without external radiotherapy between 1967 and 1999. We examined dental factors (such as irritation by prosthesis), leukoplakia, tobacco smoking and alcohol consumption foil comparisons between the elderly (age >= 65 years; n = 83) and a control group (64 years or younger; n = 182). Results . The elderly patients showed a worse outcome than the control group (respectively 86% and 70% at 5 years; P <0.05). Incidence of dental factors tended to be higher for elderly patients (53%) than the control group (40%, P = 0.07). Dental factors proved to have prognostic importance for local control. Five-year local control rate was 85% for patients with and 76% for patients without dental factors (P = 0.04). The elderly group positive for dental factors showed a lower 5-year local control rate (61%) than the other three groups [(elderly without the dental factor (-) group (80%), control with the dental factor (+) group (84%), and control without the dental factor (-) group (87%)] (P <0.05). Leukoplakia was found more frequently in the control (23%) than in the elderly group (5%) (P = 0.006) but had no effect on treatment outcome. Conclusions. Age and dental factors (including prosthesis irritation) are potentially important prognostic factors for local control of oral tongue cancer treated with brachytherapy. especially for elderly patients.

Yanagisawa T; Marugame T; Ohara S; Inoue M; Tsugane S; Kawaguchi Y. Relationship of smoking and smoking cessation with number of teeth present: JPHC Oral Health Study. Oral Diseases 15(1): 69-75, 2009. (39 refs.)

Smoking is associated with the number of teeth. The purpose of this study was to determine the relationship of number of teeth with smoking and smoking cessation. Subjects included 547 males aged between 55 and 75 years. Oral examinations were conducted in 2005. Smoking status information was collected from questionnaire surveys conducted in 1990, 1995, 2000, and 2005. The relationship between having more than eight missing teeth and smoking status was estimated with adjusted odds ratio. Comparing with never smokers, odds ratios of having more than eight missing teeth among current and former smokers were 1.96 and 1.86, respectively. The odds ratios in those who had stopped smoking for <= 10 years was 3.02, and for those who had ceased smoking for 11-20 years was 2.66. In those who stopped smoking for 21 years or more, there was no increase in the odds ratio. Smoking had a positive association with the number of missing teeth and smoking cessation is beneficial for maintaining teeth. The odds of having more than eight missing teeth in those who had never smoked was equal to that of individuals who reported that they had stopped smoking for 21 years or more.