Impact of soft drinks to health and economy: a critical review

Aims To provide information regarding the different types of soft drinks and critically reviewing their risk on the dental and general health of children and adolescents, as well as the cost associated with such drinks. Methods The literature was reviewed using electronic databases, Medline, Embase, Cochrane library, and was complemented by cross-referencing using published references list from reviewed articles. Search words; soft drinks, juices, carbonated drinks, sports and energy drinks, soft drink and dental diseases, soft drink and health, cost of soft drinks, soft drink advertising, sugar tax on soft drinks were used for this review. In total, 104 papers were reviewed by both authors; of these, 62 papers were found to have relevant information. Results The consumption of soft drinks was found to have increased dramatically over the past several decades. The greatest increase in soft drink consumption has been among children and adolescents. Some commercial soft drinks are high in sugar content and acidity. In addition, they supply energy only and are of little nutritional benefit and lack micro-nutrients, vitamins and minerals. Soft drink consumption can contribute to detrimental oral and general health. Efforts have been made by manufacturers and government agencies to reduce the potential harmful effects of sugar-containing soft drinks on teeth and general health. These include banning the sale of soft drinks in schools, restricting soft drinks advertising, modifying the composition of soft drinks and introducing tax on sugar-containing soft drinks. Conclusions The consumption of soft drinks with high sugar content and acidity can contribute to detrimental oral health and may also affect general health. Therefore, it is necessary to educate patients about the harmful effects of different types of soft drinks as it is not always easy for individuals to identify from drink labelling the ingredients which they contain

Treatment of dental plaque biofilms using photodynamic therapy: a randomised controlled study

Introduction Photodynamic therapy (PDT) is a treatment modality involving a dye that is activated by exposure to light of a specific wavelength in the presence of oxygen to form oxygen species causing localised damage to microorganisms. Aim To determine the most effective bactericidal incubation and irradiation times of erythrosine-based PDT on in vivo-formed dental plaque biofilms. Methods A randomised controlled study; 18-healthy adult participants wearing intraoral appliances with human enamel slabs to collect dental plaque samples in two separate periods of two weeks each for use in arm-1 and arm-2. These accumulated dental plaque samples were treated with PDT under different experimental conditions. Incubation times with photosensitiser (erythrosine) of 15 min and 2 min were used in arm-1 and arm-2, respectively, followed by light irradiation for either 15 min (continuous) or as a fractionated dose (5 × 30 sec). Following treatment, percentage reductions of total bacterial counts were compared between the different groups. In addition, confocal laser scanning microscopy (CLSM) and LIVE/DEAD® BacLight™ Bacterial Viability Kit were used to visualise the effect of PDT on in vivo-formed biofilms. Results Significant reductions in the percentage of total bacterial counts (~93–95%) of in vivo-formed biofilms were found when using either 2 min or 15min incubation times and applying 15 min continuous light. Although when applying fractionated light, there was more cell death when 15 min incubation time was used (~ 91%) compared with the 2 min incubation time (~ 64%). CLSM results supported these findings. Conclusion Improving the clinical usefulness of PDT by reducing its overall treatment time seems to be promising and effective in killing in vivo-formed dental plaque biofilms

Anaesthetic efficacy of articaine versus lidocaine in children's dentistry: a systematic review and meta‐analysis

Background: Over the last few years, numerous reviews and studies have awarded articaine hydrochloride local anaesthetic (LA) a superior reputation, with outcomes of different studies demonstrating a general tendency for articaine hydrochloride to outperform lidocaine hydrochloride for dental treatment. Nevertheless, there seems to be no clear agreement on which LA solution is more efficacious in dental treatment for children. There is no previous publication systematically reviewing and summarising the current best evidence with respect to the success rates of LA solutions in children. Aims: To evaluate the available evidence on the efficacy of lidocaine and articaine, used in paediatric dentistry. Design: A systematic search was conducted on Cochrane CENTRAL Register of Controlled Trials, MEDLINE (OVID; 1950 to June 2017), Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCOhost; 1982 to June 2017), EMBASE (OVID; 1980 to June 2017), SCI‐EXPANDED (ISI Web of Knowledge; 1900 to June 2017), key journals, and previous review bibliographies through June 2017. Original research studies that compared articaine with lidocaine for dental treatment in children were included. Methodological quality assessment and assessment of risk of bias were carried out for each of the included studies. Results: Electronic searching identified 525 publications. Following the primary and secondary assessment process, six randomised controlled trials (RCT) were included in the final analysis. There was no difference between patient self‐reported pain between articaine and lidocaine during treatment procedures (SMD = 0.06, P‐value = 0.614), and no difference in the occurrence of adverse events between articaine and lidocaine injections following treatment in paediatric patients (RR = 1.10, P‐value = 0.863). Yet, patients reported significantly less pain post‐procedure following articaine injections (SMD = 0.37, P‐value = 0.013). Substantial heterogeneity was noted in the reporting of outcomes among studies, with the overall quality of majority of studies being at high risk of bias. Conclusions: There is low quality evidence suggesting that both articaine as infiltration and lidocaine IAD nerve blocks presented the same efficacy when used for routine dental treatments, with no difference between patient self‐reported pain between articaine and lidocaine during treatment procedures. Yet, significantly less pain post‐procedure was reported following articaine injections. There was no difference in the occurrence of adverse events between articaine and lidocaine injections following treatment in paediatric patients

The effects of fruit smoothies on enamel erosion

Objectives: This prospective, randomised in vitro study was to investigate the pH and titratable acidity of fruit smoothie drinks and to assess the effect of these drinks on enamel erosion. Method: Fifty enamel slabs were divided into five groups which were allocated to the sample solutions groups: Innocent® smoothie strawberries and bananas (SB), Innocent® smoothie mangoes and passion fruit (MP) and Diet Coke. Distilled deionised water (DD) was used as negative control and citric acid 0.3 % as positive control. All the slabs were subjected to a 21-day pH cycling regime involving 2 min of immersions, five times a day with appropriate remineralization periods in between. Measurement of surface loss was assessed using profilometry. Independent sample t tests were used to compare mean. Results: The titratable acidity for both test smoothies were 3.5-4 times more than that needed to neutralise Diet Coke and citric acid 0.3 %. The pH of SB, MP smoothie and Diet Coke was found to be 3.73, 3.59 and 2.95, respectively. MP smoothie caused the greatest amount of surface loss followed by Diet Coke. Both smoothies were found to cause significant surface loss. MP smoothie resulted in significantly higher surface loss compared with MB smoothie and citric acid 3 %. Conclusion: The smoothies tested were acidic and had high titratable acidity. They produced a significant erosion of enamel in vitro. The results of this study suggest that there should be increased awareness of the erosive effects of smoothies especially as their consumption seems to be on the increase

Clinical practice: Swallowing problems in cerebral palsy

Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2–2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Early attention should be given to dysphagia and excessive drooling and their substantial contribution to the burden of a child with CP and his/her family. This review displays the important functional and anatomical issues related to swallowing problems in children with CP based on relevant literature and expert opinion. Furthermore, based on our experience, we describe a plan for approach of investigation and treatment of swallowing problems in cerebral palsy

Management of a child with severe hypodontia in the mixed dentition stage of development

BACKGROUND: Severe hypodontia is a condition characterized by developmental absence of six or more teeth and affects 0.14-0.3% of the overall population. Hypodontia can have a marked psychosocial effect and functional implications for a growing child. CASE REPORT: A 10-year-old girl with a medical history of hypothyroidism and repaired spinal bifida was referred to the Leeds Dental Institute as she was becoming increasingly concerned about her appearance. On clinical examination, the patient had severe wear of her over-retained maxillary primary central incisors, microdontia of mandibular anterior teeth (32, 34, 41, 42, 43), and loss of anterior vertical dimension. Radiographic examination revealed that the patient had 11 missing permanent teeth (14, 13, 12, 11, 21, 22, 23, 24, 31, 35, 44), an ectopic mandibular left canine and taurodontism of the permanent molars. TREATMENT: Management of the patient included an intensive preventive programme with placement of fissure sealants; scaling of calculus deposition on microdont teeth; composite resin reconstruction of microdont teeth; fabrication of removable partial overdentures tailored aesthetically to match the patient's age; orthodontic consultation and monitoring for the eruption of ectopic canine and permanent dentition. The patient and her parents reported marked improvement in self-esteem following dental treatment. FOLLOW-UP: After 2 years of follow-up, a new pair of dentures were made and designed to allow ease of eruption of the existing permanent dentition. All permanent teeth have erupted. The patient is ready for further assessment and planning for future orthodontic and restorative/implant treatment. CONCLUSION: This case illustrates the essential role of the paediatric dentist in the management of hypodontia in the mixed dentition stage