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The population is ageing and people are keeping their own teeth for much longer due in part to the efforts of the dental profession in restoring teeth and reducing the number of teeth being extracted. Along with this there is now an increasing expectation by patients that they will retain their own teeth as they age and that dental practitioners will have the knowledge and skills to help them retain their own teeth. Contemporary restorative materials and techniques have increased the range of options available to assist with maintaining the dentition, and many of these procedures enable minimally invasive and cost effective management of the teeth as an alternative to complex and expensive procedures. This paper discusses the restoration of compromised and failing teeth in the ageing patient, and looks at the various issues facing the ageing dentate patient and the dilemma of when to restore or when to extract. Ultimately it is hoped that maintaining healthy teeth for life may not only improve oral function and quality of life, but may in fact reduce the impact of the physical and psychological aspects of ageing. [ABSTRACT FROM AUTHOR]

Background: Patients with cleft lip and/or palate (CL&/P) experience a higher caries prevalence. This study aimed to determine if patients with CL&/P, undergoing and not undergoing orthodontic treatment, have a different salivary biochemical profile and different salivary levels of Mutans Streptococci (MS) and Lactobacilli (LB) compared to patients undergoing and not undergoing orthodontic treatment without CL&/P. Methods: One hundred and ten subjects aged between 12 and 17 years were recruited into one of four different groups comprising two control groups and two treatment groups. The control groups comprised of subjects with and without CL&/P who were not undergoing orthodontic treatment. The treatment groups comprised of subjects with and without CL&/P undergoing orthodontic treatment. Regular reinforcement of oral hygiene instructions, dietary counselling and debridement, when necessary, were offered to subjects in the treatment groups following their orthodontic adjustment appointments. The salivary secretion time, pH of resting and stimulated saliva, salivary flow rate, buffering capacity, quantity of salivary MS and LB were measured. Results: Subjects with CL&/P undergoing orthodontic treatment at the Children's Oral Health Service tended to present with microbiological and salivary profiles that were less favourable for caries development. There was a significant difference in the percentage of subjects with ≥ 105 colony forming units (CFU)/mL of MS between the cleft treatment and non-cleft treatment groups. Subjects in the noncleft treatment group had the highest percentage of subjects (86.7 per cent) with ≥ 105 CFU/mL of MS whereas subjects in the cleft treatment group had the lowest percentage of subjects (60 per cent) with ≥ 105 CFU/mL of MS. For LB, there were significantly higher percentages of subjects with ≥ 105 CFU/mL of LB in the non-cleft treatment (76.7 per cent) and cleft treatment (73.3 per cent) groups compared to the non-cleft control (46.7 per cent) and cleft control (40.0 per cent) groups. Conclusions: Regular oral hygiene reinforcement and dental health education appears to have a positive effect in reducing the percentage of subjects with ≥ 105 CFU/mL of MS. [ABSTRACT FROM AUTHOR]

Background: Erosion is the loss of dental hard tissues from an acidic challenge, often resulting in exposure of dentinal tubules and hypersensitivity to environmental stimuli. Laser-activated fluoride (LAF) therapy with 488nm laser energy has been shown previously to increase the resistance of human enamel and dentine to acid dissolution. The aims of this study were to investigate the action spectrum of LAF in protecting tooth enamel from softening in response to an erosive challenge, and to examine for any temperature change with the treatment.Materials and Methods: Buccal and lingual surfaces of extracted sound molar and premolar teeth were used to prepare matched pairs of enamel slabs (N = 10 per group). After application of 1.23% neutral sodium fluoride gel (12 300ppm F ion), slab surfaces were lased with 488, 514.5, 532, 633, 670, 830 or 1064nm wavelength (energy density 15J/cm(-2); spot size 5mm), then exposed to an erosive challenge (1.0M HCI for five minutes). The Vicker's hardness number (VHN) was recorded before fluoride gel application and again following the acid challenge. Negative controls did not receive laser exposure.Results: All wavelengths of laser light examined provided a protective LAF effect against softening, compared with the negative control surfaces.Conclusion: From these findings, we conclude that the action spectrum of the LAF effect extends across the visible spectrum, providing protection to dental enamel from an erosive challenge. [ABSTRACT FROM AUTHOR]

Background: Laser-activated fluoride (LAF) therapy with 488 nm laser energy has been shown previously to increase the resistance of human enamel and dentine to acid dissolution in laboratory models of dental caries. The aims of this study were to examine whether LAF therapy, conducted using a range of wavelengths in the visible and near infrared regions, can protect human dental enamel from an artificial cariogenic challenge.Materials and Methods: Buccal and lingual surfaces of extracted sound, molar and premolar teeth were used to prepare matched pairs of enamel slabs (N=10 per group). After application of neutral sodium fluoride gel (12300 ppm F ion), slab surfaces were lased (energy density 15 J/cm2; spot size 5mm, wavelength 532, 633, 670, 830 or 1064nm), then exposed to an artificial cariogenic challenge for a period of seven days. The Vicker's hardness number (VHN) was recorded before and after laser treatment and again following the cariogenic challenge. Negative controls did not receive laser exposure.Results: All wavelengths of laser light examined provided an effective LAF effect, compared with the unlased negative control surfaces.Conclusion: Using this in vitro model, we conclude that the action spectrum of the LAF effect extends across the visible and near-infrared regions of the spectrum. [ABSTRACT FROM AUTHOR]

During the 2004 annual meeting of the International Association for Dental Research, the Education Research Group held a symposium on dental outreach teaching. After a brief introduction, which reviews relevant aspects of the relatively sparse literature, this paper summarises the proceedings, the themes and conclusions that emerged and the research issues that were identified. It aims to describe aspects of current practice around the world and to promote future discussion. Presenters gave details of outreach programmes for dental undergraduates in Australia, Finland, Malaysia (and Southeast Asia), the United Kingdom and the United States. From these presentations four themes emerged. They were: reasons for the introduction of outreach teaching, its perceived beneficial effects, organisational issues, educational issues. The reasons included a recognition of the need to educate dental undergraduates as members of ‘care teams’ in the environments and communities where they were ultimately like to work and the current shortage of both suitable patients and teachers (faculty) in many dental schools. A wide range of potential benefits and some disadvantages were identified. The organisational issues were, in the main, seen to relate to finance and administration. The educational issues included the need to train and monitor the performance of teachers at outreach clinics and to assess the performance of the undergraduates whilst at the outreach locations. It was concluded that new technology made it easier to teach at a distance and it was possible to create a dental ‘school without walls’. It was recognised that few evaluations of dental outreach teaching have been carried out and that there were many research questions to be answered, including: whether it should be a voluntary or compulsory part of the undergraduate curriculum, how long it should last and what type of outcomes should be assessed. [ABSTRACT FROM AUTHOR]

Fissure sealants have been used successfully as a means of preventing fissure caries. This effectiveness is directly related to sealant retention and retention is dependent upon a meticulous method of application. The aims of this study were to determine if sealant adhesion and penetration were affected by the variation in preparation of the enamel surface, or by pretreatment of the enamel surface with dentine adhesive systems, in fissures of varying morphology. Non-carious posterior teeth were visually examined and sorted according to fissure type, classified as shallow, deep or intermediate. Occlusal fissures were sealed using one of six methods, thermocycled for 200 cycles between 5 and 55°C, in artificial saliva, then placed in a 1.5% procion orange dye for 3 min. Teeth were sectioned bucco-lingually and examined with a light microscope for (1) penetration of the sealant into the fissure pattern and (ii) adhesion of the sealant. All sealant techniques employed in this study adapted well to the enamel surface as the 1.5% procion Reactive orange dye failed to penetrate any of the sealed tooth sections. Shallow fissures were well obturated in both lateral and vertical dimensions. Sealants adapted well to the vertical walls at the orifice of deep fissures but generally failed to penetrate into the deeper aspects. Reducing the etching period with 37% phosphoric acid resulted in increased voids between the sealant and enamel surface and poorer adaptation to the vertical walls. The addition of dentine adhesive systems, Scotchbond Multi-Purpose and All-Bond 2, enhanced the vertical penetration of the sealant, particularly in deep fissures. It is proposed that the dentine adhesive systems may improve the retention rate of sealants in deep fissures particularly if the fissure is not completely dry prior to resin placement. [ABSTRACT FROM AUTHOR]

The article presents a study which determines the in vitro increase in temperature of bleaching gel on the surface of the tooth, and temperature changes within the pulp during various "light-accelerated" in-office bleaching procedures. An infrared thermometer was used to record the surface temperature of the tooth and the bleaching gel and the dentine-enamel thickness was also measured. The findings reveal that the mean peak intrapulpal temperature rises recorded during bleaching ranged from 6.2±C with the Zoom light, to 2.6±C using the LED LeDemetron curing unit. In order to reduce the risk of thermal trauma due to in-office bleaching procedures, dentists should be careful about the choice of accelerating light unit and bleaching agent used.