Epidemiological studies of the relationship between dental fear, use of dental services, and oral health in different age groups in a common population are scarce. Dental fear and its relationships are usually described in individuals with high dental fear only. The purposes of this study were to describe the prevalence of dental fear in the Norwegian adult population according to age, and to explore differences in oral health, oral hygiene, and visiting habits between individuals with high and low dental fear. For the present study, data from the Trøndelag-94 study were used. The prevalence of dental fear in our study population of adults in Trøndelag, Norway was 6.6%. There was a tendency for individuals with high dental fear to engage in avoidance behavior more frequently than the low dental fear group. Individuals with high dental fear had a statistically significantly higher number of decayed surfaces (DS), decayed teeth, (DT) and missing teeth (MT) but a statistically significantly lower number of filled surfaces (FS), filled teeth (FT), functional surfaces (FSS), and functional teeth (FST). There were no differences in DMFS and DMFT between the groups of high and low dental fear. Since one of the superior aims of the dental profession is to help a patient to achieve a high number of functional teeth throughout life, consequently detecting and treating dental fear should therefore be an important aspect of dental processionals' work.

Culture-based studies have shown that Streptococcus mutans and lactobacilli are associated with root caries (RC). The purpose of the present study was to assess the bacterial diversity of RC in elderly patients by use of culture-independent molecular techniques and to determine the associations of specific bacterial species or bacterial communities with healthy and carious roots. Plaque was collected from root surfaces of 10 control subjects with no RC and from 11 subjects with RC. The bacterial 16S rRNA genes from extracted DNA were PCR amplified, cloned, and sequenced to determine species identity. From a total of 3,544 clones, 245 predominant species or phylotypes were observed, representing eight bacterial phyla. The majority (54%) of the species detected have not yet been cultivated. Species of Selenomonas and Veillonella were common in all samples. The healthy microbiota included Fusobacterium nucleatum subsp. polymorphum, Leptotrichia spp., Selenomonas noxia, Streptococcus cristatus, and Kingella oralis. Lactobacilli were absent, S. mutans was present in one, and Actinomyces spp. were present in 50% of the controls. In contrast, the microbiota of the RC subjects was dominated by Actinomyces spp., lactobacilli, S. mutans, Enterococcus faecalis, Selenomonas sp. clone CS002, Atopobium and Olsenella spp., Prevotella multisaccharivorax, Pseudoramibacter alactolyticus, and Propionibacterium sp. strain FMA5. The bacterial profiles of RC showed considerable subject-to-subject variation, indicating that the microbial communities are more complex than previously presumed. The data suggest that putative etiological agents of RC include not only S. mutans, lactobacilli, and Actinomyces but also species of Atopobium, Olsenella, Pseudoramibacter, Propionibacterium, and Selenomonas.

Stunting is associated with impaired cognitive and motor function. The effect of an education intervention including nutrition, stimulation, sanitation, and hygiene on child growth and cognitive/language/motor development, delivered to impoverished mothers in Uganda, was assessed. In a community-based, open cluster-randomized trial, 511 mother/children dyads aged 6-8 months were enrolled to an intervention (n = 263) or control (n = 248) group. The primary outcome was change in length-for-age z-score at age 20-24 months. Secondary outcomes included anthropometry and scores on the 2 developmental scales: Bayley Scales of Infant and Toddler Development-III and the Ages and Stages Questionnaire. There was no evidence of a difference in mean length-for-age z-score at 20-24 months between the 2 study groups: 0.10, 95% CI [-0.17, 0.36], p = .49. The intervention group had higher mean composite development scores than the controls on Bayley Scales of Infant and Toddler Development-III, the mean difference being 15.6, 95% CI [10.9, 20.2], p = .0001; 9.9, 95% CI [6.4, 13.2], p = .0001; and 14.6, 95% CI [10.9, 18.2], p = .0001, for cognitive, language, and motor composite scores, respectively. The mean difference in scores from the Ages and Stages Questionnaire were 7.0, 95% CI [2.9, 11.3], p = .001; 5.9, 95% CI [1.2, 10.3], p = .01; 4.2, 95% CI [1.7, 6.7], p = .001; 8.9, 95% CI [5.3, 12.3], p = .0001; and 4.4, 95% CI [0.0, 8.8], p = .05, for communication, gross motor, fine motor, problem solving, and personal-social development, respectively. The intervention education delivered to mothers promoted early development domains in cognitive, language, and motor development but not linear growth of small children in impoverished rural communities in Uganda. Our study showed that child development may be improved with a relatively low cost intervention strategy. This trial was registered at ClinicalTrials.gov as NCT02098031.

Purpose-The present study used a new 16S rRNA-based microarray with probes for over 300 bacterial species better define the bacterial profiles of healthy root surfaces and root caries (RC) in the elderly.Materials-Supragingival plaque was collected from 20 healthy subjects (Controls) and from healthy and carious roots and carious dentin from 21 RC subjects (Patients).Results-Collectively, 179 bacterial species and species groups were detected. A higher bacterial diversity was observed in the Controls as compared to Patients. Lactobacillus casei/paracasei/ rhamnosus and Pseudoramibacter alactolyticus were notably associated with most root caries samples. Streptococcus mutans was detected more frequently in the infected dentin than in the other samples, but the difference was not significant. Actinomyces were found more frequently in Controls.Conclusion-Actinomyces and S. mutans may play a limited role as pathogens of RC. The results from this study were in agreement with those of our previous study based on 16S rRNA gene sequencing with 72% of the species being detected with both methods.

The aim of the present study was to investigate dental fear in women who have been exposed to different kinds of sexual abuse. In a cross-sectional questionnaire study, 99 sexually abused women were divided into three groups: one group who reported having been exposed to sexual touching (ST); one group who reported intercourse (IC); and one group who reported sexual abuse involving oral penetration (OP). The mean score on dental fear assessments was significantly higher for all groups than for Norwegian women in general. Women in the OP group scored significantly higher than women in other groups on dental fear. The majority of the women reported that they had experienced problems in relation to dental treatment situations. About half of the women in the OP group and one-third in the other groups reported that they had never considered that there was a relationship between the abuse and their problems with dental treatment situations. Significantly more women in the OP group reported that they had not been aware of the relationship, possibly because the abuse had been repressed. The majority of the women with extreme dental fear had never informed a dentist that they had been sexually abused.

Oral health in institutionalised elderly people in Oslo, Norway and its relationship with dependence and cognitive impairment Objective: Investigating oral health's relationship with dependency and cognitive state. Background: Oral hygiene is poor in the institutionalised elderly. There are problems regarding the oral care of residents having poor mobility or cognitive impairment. Material and methods: Cross-sectional study involving 135 participants (mean age 85.7, SD 8.8 years) in two categories: nurses doing tooth cleaning and residents doing tooth cleaning. Those cleaned by nurses were categorised as co-operative or unco-operative. The oral hygiene status, presence of caries, retained roots and denture-related stomatitis were recorded. Results: Of the participants, 70% had only natural teeth. The prevalence of caries was 28%. A significant correlation showed that having more teeth gave a poorer Simplified Oral Hygiene Index (OHI-S) (p = 0.018). The number of retained roots increased with the severity of cognitive impairment (p < 0.05). Significant differences were found between nurses or residents doing the tooth cleaning on the OHI-S (p = 0.05) and percentage of dental plaque (p = 0.003). Unco-operative residents had poorer oral hygiene (p = 0.028), more caries (p = 0.008) and were more often moderate-severe cognitive impaired (p = 0.016). Conclusions: A high percentage of participants had unacceptable oral hygiene. Residents whose teeth were cleaned by the nurses had poorer oral hygiene. Unco-operative residents had the worst oral hygiene and more caries.

The purpose of the present study was to describe the bacterial diversity in the oral cavity of the elderly without root caries using bacterial microarrays, and to determine the site-and subject-specificity of bacterial colonization. Samples were collected from the tongue dorsum, mucosa of the buccal fold, hard palate, supragingival plaque from sound root surfaces, and subgingival plaque from the same roots. A new 16S rRNA gene based microarray method was used for the simultaneous detection of approximately 300 bacterial species. Overall, 175 species and clusters were detected, representing 8 phyla. Species belonging to the genera Streptococcus, Veillonella and Fusobacterium were common in all sites. The number of species per subject varied from 51 to 81. Statistical analyses revealed about 40 species or clusters with significant associations with at least one of the sites. The bacterial diversity was highest in the cheek and palate regions. Species typically associated with caries and periodontitis were detected rarely or not at all. The oral bacterial flora of the elderly appears to be diverse, and to a large extent site-rather than subject-specific.

AIMThis study evaluated a presumed gradual decline in cognitive function in nursing home residents when the anticholinergic drug scale (ADS) score increased above 3. METHODThe study population was recruited from 21 nursing homes in Norway. Criteria for inclusion were ADS score Ն 3 and no severe dementia, defined as Clinical Dementia Rating (CDR) score < 3. Primary cognitive end points were CERAD 10-word lists for recall and Mini Mental State Examination (MMSE). Secondary end points were activity of daily living (ADL), mouth dryness and serum anticholinergic activity (SAA). The patients were stratified into subgroups according to ADS score, i.e. a reference group with score 3 and test groups with scores 4, 5 or Ն6. End points were compared by analyses of covariance (ANCOVA). RESULTSOverall, 230 of the 1101 screened nursing home residents (21%) had an ADS score Ն3. After exclusion 101 residents were recruited and among these, 87 managed to participate in the study. No significant differences were detected in cognitive function or ADL when ADS increased above 3 (P > 0.10), but in vivo (mouth dryness) and in vitro (SAA) measures of peripheral anticholinergic activity were significantly higher in patients with an ADS score Ն6 (P < 0.01). CONCLUSIONThe present study does not support a progressive decline in cognitive function with ADS score above 3. This might indicate that the ADS score model has limited potential to predict the clinical risk of central anticholinergic side effects in frail elderly patients receiving multiple anticholinergic drugs.