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- Baelum, V, et al.
(författare)
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A global perspective on changes in the burden of caries and periodontitis : implications for dentistry.
- 2007
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 34:12, s. 872-906; discussion 940
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Tidskriftsartikel (refereegranskat)abstract
- The structure and contents of most oral health care systems and the contents of dental curricula reflect a deep-rooted tradition for attempting to cure oral diseases by refined technological means. However, better oral health conditions for the world's populations necessitate the application of up-to-date scientific knowledge to control the major oral diseases. This review points out that not only should the structure and contents of oral health care delivery systems be based on state-of-the-art knowledge about the biology of the oral diseases; they must also take into account the trends for change in caries and periodontal diseases within and between populations, and acknowledge the impact of changes in treatment philosophies for these trends. The oral disease profiles for populations in low- and high-income countries are briefly described, and it is concluded that the rapidly changing disease profiles observed in high-income countries necessitate re-thinking of the future role and organization of dentistry in such countries. The priorities for low- and middle-income countries must be to avoid repeating the mistakes made in the high-income countries. Instead, these societies might take advantage of setting priorities based on a population-based common risk factor approach. If such an approach is adopted, the training of personnel with oral health care competence must be rethought. The authors suggest three different cadres of dental care providers to be considered for an approach that allows health care planners in different populations around the world to prioritize appropriate oral health care with due respect for the socio-economic conditions prevailing.
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| 2. |
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| 3. |
- Dahlén, Gunnar, 1944, et al.
(författare)
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Subgingival bacterial clusters and serum antibody response as markers of extent and severity of periodontitis in adult Chinese
- 2016
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836. ; 124:2, s. 179-187
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated the associations between clinical, microbiological, and antibody activity manifestations of periodontitis in 123 adult rural Chinese subjects with no dental intervention. All participants were registered for full-mouth clinical attachment level (CAL) and pocket probing depth (PD) measurements, and microbial samples were taken from four sites and analyzed for 18 different bacterial species using the checkerboard'. Serum from each individual was analyzed to determine the antibody activity against the same 18 species. Exploratory factor analysis disclosed two microbial factors - Factor 1, consisting of seven species associated with periodontal health (early colonizers'); and Factor 2, consisting of eight species associated with periodontitis (putative periodontopathogens') - which explained 87% of the variation among the microbial variables. Factor 2 was consistently associated with disease-severity measures, whereas the early colonizer' factor was not. The antibody response showed weak or no correlations with bacterial load or with disease severity. We conclude that the bacteria investigated are resident in the subgingival plaque; that their load and proportions in the pocket may be ecologically driven; and that the antibody response is based on bacterial carrier state rather than on disease. The different antibody-response pattern found between the individuals may suggest that each individual could be classified as a good or a weak immune responder.
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| 5. |
- Manji, F., et al.
(författare)
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Caries and Periodontitis: Contesting the Conventional Wisdom on Their Aetiology
- 2018
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Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 52:6, s. 548-564
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Tidskriftsartikel (refereegranskat)abstract
- We review the literature on the oral microbiome and the role of the microbiota in the development of dental caries and periodontitis. While most research has been focused on identifying one or more specific determinants of these diseases, the results have provided limited predictive value and have not been able to explain the variation in the distribution of these diseases observed in epidemiological or clinical studies. Drawing on existing knowledge about the nature of the oral microbiota, we suggest that a stochastic model based on the Weiner process provides simple and parsimonious explanations for the pathogenesis of both caries and periodontitis, making few assumptions, and providing explanations for phenomena that have hitherto proved difficult, or have required complex arguments, to explain. These diseases occur as the result of the dental hard tissues and periodontal tissues integrating the random noise caused by normal metabolic activities of commensal microorganisms in the dental biofilm. The processes that result in the progression and regression of caries and periodontitis may be considered as natural, rather than pathological, even if, when left unchecked over long periods of time, they can result in the development of pathologies. The likelihood of progression or regression can be influenced by other determinants, but these processes will nevertheless occur in the absence of such influences. The distributional characteristics of the model approximate the findings of epidemiological studies indicating that, for both caries and periodontitis, there will be few sites affected in the early period after the eruption of the permanent dentition, but in those older there is an almost linear relationship with increasing age; furthermore, the longer a site survives without being affected, the less likely that it will be affected. We discuss the clinical and public health importance of these findings.
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