To date, fluorides has remained to be the best means of controlling dental caries. Fluoride is given either systematically via fluoridated water or topically through other supplements including toothpastes. In recent years increasing prevalence of enamel defects or fluorosis is observed in both populations receiving or not receiving water fluoridation. It is suspected that excessive ingestion of a "standard" 1000 to 1500 ppm fluoride from toothpastes might be a contributing factor to the presence of such defects. In Malaysia, reports of enamel defects occurring amongst 12 to 16 year-old schoolchildren ranged between 67 to 88 percent. Where water fluoridation is available, the amount of fluorides received from the home is between 0.3 to 0.5 ppm F. However, almost all toothpastes sold locally contains fluoride, the content of which is unknown to the consumers. This study reports on the analysis of fluoride levels carried out on 20 toothpaste samples sold locally. Results showed that fluoride levels in all 20 samples ranged between 20 to 1970 ppm F. Only two of the 20 samples analyzed, however, indicated having a level anywhere near the "standard" level. In addition, only two type~ of children's toothpaste with a fluoride concentration of 20 and 450 ppm F were commonly available as compared to adult toothpastes in all the samples studied.
This study was undertaken to investigate the number and types (fluoride or non-fluoride) of toothpaste products available in the Malaysian market based on the label. Thirty-five brands of toothpaste were identified, of which ten (29%) were specifically recommended for children. Two of the children's toothpaste recommended that children below seven years old use a pea size amount of toothpaste. One (3%) was recommended for both children and adult. The remaining 24 (69%) did not state if they were recommended for either children or adults. To improve the flavour of the toothpastes, a variety of flavours had been added especially in children's toothpaste. Almost half of the toothpastes were for prevention of tooth decay and gum disease. Other indications were for tooth sensitivity, tooth whitening and stain removal. Twentyseven (77%) of the toothpastes were imported, while eight (23%) were made in Malaysia. Twenty-six (74%) of the toothpaste contained fluoride and the most common type of fluoride used was sodium monofluorophosphate (NaMFP). The fluoride concentration was not labeled in more than half (63%) of the fluoridated toothpaste. Of those that were fluoridated, different units of measurement were used. As there is no uniformity in the labelling of these products, it is recommended that the responsible authorities should take more action in enforcing proper labelling of the fluoride concentration in the toothpaste using standardized units.
The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of 'Gamadent' toothpaste compared to a placebo toothpaste. 'Gamadent' toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the 'Gamadent' toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, there were significant mean reductions to baseline mean values in PI (P < 0.005) and GI (P < 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P < 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P < 0.001), between the test and control sites. In conclusion, 'Gamadent' toothpaste provided noteworthy benefits, producing statistically significant improvement in all clinical parameters compared to the placebo during the healing phase after conventional initial therapy.
The aim of the study was to assess the association between past fluoride exposures from ingested toothpaste and current fluorosis manifestations in 10- 11 year old index subjects. Fluorosis was assessed with the Dean’s Index in 1343 10-11 year old index subjects. Two hundred index subjects who had younger 4-5 year old siblings were sub sampled and fluoride exposures from ingested toothpaste in their younger siblings (proxy subjects) were determined. The values for the fluoride ingested per brushing of the proxy subjects were utilised together with past frequency of toothbrushing of index subjects to extrapolate on the past exposure of index subjects. The mean extrapolated past fluoride exposure from ingestion of toothpaste was highly variable; 671.7 ug ± 739.3 ug (sem= 56.9). It was higher in the subjects with fluorosis (697.3 ug) than in those without fluorosis (646.89 ug) but differences were not of statistical significance. This approach of extrapolation has not been reported elsewhere and need to be validated. The implications of the present methodology to estimate past fluoride exposure is discussed.
The aim of this study was to assess (by direct determination) the fluoride (F) exposure from ingested toothpaste among 4-5-year-old Malaysian children.
Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral complications after radiation therapy. The management of xerostomia has been reviewed in Part I of this series. In this article, the management of dental caries, a sequalae of xerostomia following radiation therapy is reviewed.
The purpose of this study was to gather information on the oral hygiene behaviour among the visually impaired adolescents. Interview and observation methods were used to collect data. A total of 114 visually impaired adolescents were interviewed and 10 of the interviewees were selected for observation on the actual oral hygiene practices. The mean age of the sample was 16 years old. The sample comprised of 53.5% female, majority were Malays (86.8%) and most of them were from the lower income group. Fifty four percent of the sample had low vision and 45.6% were blind. All of the participants reported that they brushed their teeth daily and most of them brushed twice a day or more. Flossing (6.1%) was not common practice among this group. It was observed that they encountered some difficulties, especially when putting the toothpaste on the toothbrush and also the way that they brushed their teeth could cause detrimental effect to the oral cavity. Thus, they need to be taught on proper oral hygiene care so that they can practice safe oral hygiene care and maintain their own oral health.
Objectives: The objectives of the study were to assess: i) the staining susceptibility of composite resins, ii) the ability of whitening toothpastes in removing stains from composite resins.
Materials and Methods: Thirty specimens from each composite resins: Filtek Z350 (3M ESPE), Filtek Z250 (3M ESPE) and Beautifil (Shofu Inc.) were fabricated. After polishing, specimens were immersed in coffee for 3 days. Specimens were then brushed twice a day for 2 weeks using Colgate Total (Colgate-Palmolive, control group), Colgate Advanced Whitening (Colgate- Palmolive, test group) and Darlie All Shiny White (Hawley & Hazel Chemical Co., test group). Colour changes (?E*) were measured using Spectrophotometer at baseline, after coffee immersion and after brushing. Results were statistically analyzed using one way ANOVA and Tukey’s test.
Results: There was significant difference in terms of colour changes for Filtek Z350, Filtek Z250 and Beautifil after coffee immersion (P0.05).
Conclusions: Filtek Z350 was able to resist staining by coffee better than Filtek Z250 and Beautifil. The whitening toothpastes did not offer added advantage in terms of ability to remove stains compared to ordinary toothpaste.
Background: Mothers play an important role in preventing fluorosis due to inadvertent swallowing of fluoridated toothpaste and enhancing the effectiveness of toothbrushing amongst preschool children through proper supervision.
Aim: To investigate the knowledge of mothers with regards to the benefits and risks of fluoride toothpaste usage among preschool children and to assess the level of parental supervision during toothbrushing. In additional, we wish to investigate the toothpaste purchasing behaviour of mothers in relation to brand, price, flavour, fluoride content and the influence of advertisement.
Methodology: Cross-sectional study of a representative random sample of 373 mothers of 5-6 year old preschool children through self-administered questionnaires.
Result: The response rate was 90.3% (337). The majority (61.7%) of the mothers reported that the amount of toothpaste their children used was half-length. Most mothers (70.6%) claimed they usually apply toothpaste for their child. About one-half (50.4%) reported the children applied the toothpaste themselves. Only 41.2% of the respondents supervised their children every time during toothbrushing. The mean age at which the child started brushing and using toothpaste was about 34 months (S.D. 14.9) and 37 months (S.D.14.8) respectively. Almost all (95.8%) reported that their children rinsed their mouth after toothbrushing. The mothers’ choice of toothpaste for their child was influence by brand (91.4%), flavour (91.4%) and fluoride content (84.6%) with price being the least of the factors. The majority of the respondents (82.7%) had average to good overall knowledge scores. There was significant association (P=0.034) between the level of education of the mothers and their level of knowledge on fluoride toothpaste usage.
Conclusion: Future oral health messages for preschool children and mothers in Perlis should target areas found lacking in terms of knowledge and practices with regards to fluoride toothpaste usage. This includes regular supervision of preschool children during toothbrushing by parents and using only a small amount of toothpaste for young children.
A self-administered questionnaire survey was conducted to investigate the level of dental knowledge among senior medical, pharmacy and nursing students of Universiti Kebangsaan Malaysia, and to determine self-reported practices of oral care. Students were invited to complete a set of questionnaires on knowledge related to causes, prevention, signs and treatment of dental caries and periodontal disease; and practices related to oral hygiene and dental visits. A total of 206 questionnaire forms were distributed. 204 forms were returned complete (response rate = 99%). Dental knowledge scores ranged from 0 (no correct answer given) to 16 (gave all correct answers). The mean knowledge scores between the groups were statistically different (p < 0.05): pharmacy students scored highest (mean = 12.29, 95% CI 11.44, 13.14) followed by the medical students (mean = 12.02, 95% CI 11.33, 12.71) and nursing students (mean = 10.83, 95% CI 10.40, 11.26). Areas that had lowest knowledge scores were signs and treatment of gum disease. With regard to oral care practices, majority cited that they brushed teeth at least twice a day (94.6%) and used toothbrush and toothpaste (97.5%). Not many (21.8%) used dental floss and about half (54.2%) reported visiting the dentist more than twelve months ago. Reasons for dental visits included getting check-ups (64.6%), restorations (45.6%) and emergency care such as extractions (24.0%). In general students had at least a moderate level of dental knowledge but demonstrated poor knowledge in some areas. While most reported good oral hygiene habits, behaviour related to dental visits need to be improved. Findings suggest a need for inclusion of oral health education in the medical, pharmacy and nursing curriculum.
This study was undertaken to assess the impact of fluoride mouth rinsing on caries experience in a cohort of schoolchildren 3 years after implementation.
Matched MeSH terms: Toothpastes/administration & dosage; Toothpastes/therapeutic use
Objectives: To assess pattern of toothpaste usage among young children under 6 years old.
Materials and methods: This was a cross-sectional descriptive study carried out at the Faculty of Dentistry, Universiti Kebangsaan Malaysia. Parents of children below 6 years old were involved. 200 questionnaires were distributed and 136 (68%) were returned for analysis. The questionnaire covered the following parameters: type, frequency, and quantity of toothpaste usage among children, level of parental knowledge of fluoride concentration in toothpaste and selection criteria of suitable toothpaste for their children.
Results: Majority of the respondents (83.1%) said they used children’s toothpaste to brush their child’s teeth and 62.5 % of them knew that the toothpaste used had fluoride in it. Slightly more than half of the respondents (53.7%) said they started brushing their child’s teeth one year after eruption of the first tooth. Almost an equal proportion of the respondents reported using toothpaste twice daily (50.7%) and only 44.1% of them supervised their children’s brushing. Respondents generally used more than a pea-sized toothpaste quantity (53.6%). Taste, fluoride concentration and brand of the toothpaste appeared to be the main criteria that influenced the selection of the toothpaste (55.9%). Income and educational levels of the respondents did not influence the type of toothpaste used.
Conclusion: These findings indicated that although parents were brushing their childrens’ teeth with children toothpaste, they were still unaware of the proper usage and importance of fluoridated toothpaste.
Aim of the study: To compare the weight of retrieved food accumulated under the dentures base with and without adhesive treatment.
Materials and Method: Each subject was given 32 g of non-salted dry roasted peanuts to chew and swallow. After finishing all the peanuts, the subject was asked to brush their denture using toothbrush and toothpaste without removing the denture from the mouth and rinsed their mouth vigorously with water. The weight of the retrieved peanuts accumulated under the denture base collected, dried, and weighted. All procedures were repeated with denture adhesive.
Results: On average, the mean weight of peanuts particles recovered beneath upper dentures without application of denture adhesive was 51.21 mg which is higher than the mean weight of upper denture with adhesive treatment (35.36 mg). The similar pattern was detected for the lower dentures but at higher mean weight.
Conclusion: Application of denture adhesive significantly reduced the amount of retrieved peanut particles collected under the denture base compared to no-adhesive treatment (p< 0.005).
Dental caries is a major health problem affecting an estimated 90% of school children worldwide. This cross-sectional study aimed to evaluate oral health knowledge, attitude, and practices among secondary school students in Kuching, Sarawak. Data was collected using a pretested questionnaire on 209 randomly selected students from four schools. Results showed no significant differences between the gender and age groups in terms of knowledge level, but significant differences were observed between the schools. The students had positive attitude towards the dental services, but their dental visits were still low due to fear of dental needle and handpieces. Toothbrush and toothpaste were still the most commonly used oral hygiene aids. As compared to parents and friends, dentist was perceived to have more influence on oral hygiene practices among the students. Girls consumed more sweets, snacks and soft drinks than boys. However, girls spent longer time to brush their teeth and brush more frequently. Oral health education should be a life-long practice and incorporated into the school environment with the support of teachers and parents.
A survey was conducted to assess dental caries experience and oral health related behaviour among Malaysian Territorial Army (TA) personnel. This cross-sectional study involved 284 personnel covering their socio-demography, oral hygiene habits and related behaviour and past utilization of dental services pattern. Dental caries were assessed using DMFT index. Caries prevalence was very high (97.2%; DMFT 8.15±5.36). Untreated decay (DT) was 3.67 (±3.15) and missing teeth (MT) 2.90 (±3.73). However, few were treated teeth (FT) at only 1.58 (±2.02). Almost everyone (98.2%) claimed they brushed their teeth at least once daily and 80% used fluoridated toothpaste. However, very few participants used dental floss (11.3%) while majority (60.2%) did not know about flossing. More than 70% were current smokers. Only 13.7% were regular attendees with the majority (86.3%) visiting the dentist only when they had dental problems. The most common reason (49.7%) for their last dental visit was related to presence of symptoms and few were (27.4%) for prevention. Symptomatic attendees are significantly more likely to have more severe caries experience than preventive oriented individuals (p=0.003). These findings support the importance of promoting preventive oral health utilization behaviour among army personnel.
To assess the knowledge, attitudes and practices of Imams (Islamic clerics) concerning fluoride toothpaste and fluoridated water to improve oral health in Kelantan.
The objectives of the study were to evaluate and compare the effects of the systemic consumption of probiotic curd and the topical application of probiotic toothpaste on the Streptococcus mutans levels in the plaque of orthodontic patients.
Dentine hypersensitivity (DH) occurs on exposed dentine and is dependent on the patency of dentinal tubules. This study compared the effectiveness of red propolis extract (RPE), calcium sodium phosphosilicate (Novamin) and arginine-calcium carbonate (ACC) in occluding dentine tubules.