051.Caries, oral hygiene and gingival status of insulin dependent

diabetic Saudi children

DR. ARHAM CHOHAN, DR. AMJAD H. WYNE, DR. R. AL-SHARARI
College of Dentistry, King Saud University, Riyadh, Saudi Arabia

The objective of the present study was to determine caries, oral hygiene and gingival health status of insulin dependent diabetes mellitus (IDDM) Saudi children and to compare the findings with a similar age control group. A total of 134 diabetic children (mean age 9.1 years) and 177 healthy children (mean age 7.9 years) were examined for dental caries, oral hygiene and gingival health status. The mean dmft score for diabetic and control groups was 4.87 (SD 3.97) and 7.17 (SD 4.74), respectively. The mean DMFT score for diabetic and control groups was 3.19 (SD 2.92) and 2.32 (SD 2.62). There was a significant difference (P<.05) between mean dmft and DMFT scores of diabetic and control groups. A great majority (83.6%) of the diabetic children had fair or poor oral hygiene and a similar trend was found in the control group. Almost three-fourth (72.4%) of the diabetic children had mild to moderate gingivitis as compared with 60.4% in the control group. A strong positive correlation (P<0.0001) was found between oral hygiene and gingival status in both diabetic and control groups. In conclusion, the caries prevalence and severity was low in the diabetic children as compared with healthy children. Very few children had good oral hygiene. More diabetic children had mild to moderate gingivitis than healthy children.
Saudi Dental Journal 2006;18(SI)-Abstr.051

DR. MESHARI F. AL-OTAIBI
Security Forces Medical Center, Makkah, Saudi Arabia

The miswak, a traditional chewing stick for cleaning teeth, is made from the plant Salvadora persica. For religious and cultural reasons, miswak use is firmly established and widespread in Saudi Arabia and most other Muslim countries. Only recently has scientific evaluation of the miswak been undertaken. The aims of the this resreach were: 1) to compare mechanical plaque removal and gingival health after miswak use and toothbrushing, and ; 2) to compare the effect of miswak use and toothbrushing on subgingival plaque microflora. A single-blind, randomized crossover design was used in a study with the subjects comprised 15 healthy Saudi Arabian male volunteers aged 21 to 36 years, attending the Dental Center at Al-Noor Specialist Hospital in Makkah City. The Turesky modified Quigley-Hein plaque and Le-Silness gingival indices and digital photographs of plaque distribution were recorded and plaque was sampled for DNA-testing. Inhibition zones around miswak material were examined on agar plates with Actinobacillus actinomycetemcomitans and the leukotoxicity of this bacterium was analyzed in a bioassay with macrophages +/- miswak extracts. Compared to tooth brushing, use of the miswak resulted in significant reductions in plaque (P<0.001) and gingival (P <0.01) indices. A., actinomycetemcomitans was significantly reduced by miswak use (P <0.05) but not by tooth brushing. These results were supported by the in vitro observations that extracts from S. persica interfered with growth and leukotoxicity of A. actinomycetemcomitans. It was concluded that miswak use was at least as effective as toothbrushing for reducing plaque and gingivitis, and that the antimicrobial effect of Salvadora persica is beneficial for prevention/treatment of periodontal disease.
Saudi Dental Journal 2006;18(SI)-Abstr.052

DR. EARL ERNEST GUILE
Preventive Dental Services, Aramco Dental Services Department

Fifty years ago, Switzerland inaugurated the first use of salt as a vehicle to get optimal fluorides to their population and minimize the debilitating scourge of dental caries. Since that time, many countries have established this modality of prevention, benefiting over 160 million people. It is proposed that this modality is ideal for Saudi Arabia because:

1. Salt fluoridation offers a safe, scientifically accepted method for preventing the high
   rate of dental caries. It is combined with iodized salt for multiple health benefits and
   is comparable in metabolism and benefits to water fluoridation.
2. In a country with many rural areas dependent on well water, salt is a less costly alternative to water fluoridation.
3. Salt fluoridation should be the single systemic source of fluoride in a country. Salt fluoridation does not increase the risk of fluorosis.
4. Salt fluoridation is the cheapest public health preventive method for preventing
   dental caries. For every $1 spent for salt fluoridation between $100 and $140 is
   saved from restorations.
5. Fluoridated salt reduced caries in Jamaica by 84% between 1986 and 1995.
6. Fluoride maps have been developed for Saudi Arabia. Fluoridated salt will not be available on the market in areas of excess natural fluoride in the water.
7. Consumers have a freedom of choice with fluoridated salt.

In conclusion, the dental profession in Saudi Arabia can be a leader in the region to stem the epidemic of caries with the time tested method of salt fluoridation.
Saudi Dental Journal 2006;18(SI)-Abstr.053

DR. MONTASER N. AL-QUTUB*
DR. R.P. DARVEAU**

*College of Dentistry, King Saud University, Riyadh,Saudi Arabia  **University of Washington, Seattle, U.S.A.

Background: Porphyromonas gingivalis (Pg), a gram negative bacterium, is recognized as an important etiologlc agent of human adult periodontitis. Heme is utilized by Pg as a source for iron, and has been shown to regulate virulence factors including lipopolysaccharide (LPS). Pg-LPS contains multiple, structurally different lipid-A species. Lipid-A is a key bacterial component recognized by the innate host defense system and may contribute to inflammatory responses elicited by the host in response to Pg.

Objectives: To examine the effect of hemin concentration in the culture media on Pg lipid-A structural-heterogenity and alterations in the innate immune host response to Pg-LPS.

Methods: Pg strain 33277 was grown in Triptocase Soy Broth (TSB) with different hemin concentrations (0pg/ml,5ug/ml,20pg/ml, 125pg/ml). LPS was extracted using phenol-water. Lipid-A was hydrolyzed from LPS and analyzed by MALDI-TOF mass spectrometry. Pg-LPS with different patterns of lipid-A structural distribution were examined on MonoMac6 for IL-8 and on Human Umbilical Vein Endothelial Cells (HUVEC) for E-selectin stimulation, using ELISA.

Results: Increased hemin concentration in (TSB) changes lipid-A distribution w ithin the LPS from predominantly a (penta-acylated (5 fatty acids) monophosphorylated) form with a mass ion at m/z 1690 (Pgl690) to a (tetra-acylated monophosphorylated) form with two major mass ions at m/z 1435 and 1450 (Pg 1435/1450). LPS of Pg grown in (TSB) with high hemin concentration (Pgl435/1450-LPS) elicited less IL-8 secretion from MonoMac6 cells and less E-selectin from HUVEC when compared to LPS of Pg grown in lower hemin concentrations (Pgl690-LPS).

Conclusion: Increased hemin concentrations in TSB significantly shifted the lipid-A composition of Pg-LPS from penta-acylated (Pgl690) to tetra-acylated (Pgl435/ 1450) monophosphorylated forms. A corresponding decrease in the ability of Pg-LPS to stimulate the secretion of IL-8 from MonoMac6 and E-selectin from HUVEC was observed. Hemin in the periodontal pocket may signal Pg to alter innate host responses by altering its lipid-A compostion.
Saudi Dental Journal 2006;18(SI)-Abstr.054

DR. ABDULLAH M. ALDOSARI* DR. NAZEER KHAN*
PROF. ENOSAKHARE S. AKPATA** DR. THAKIB AL-SHALAN*
*King Saud University,Riyadh, Saudi Arabia
**Kuwait University, Kuwait

This presentation will cover the results of the Southern province of the Kingdom wide study currently going on, which is financed by KACST. The Southern province constitutes Al Baha, Aseer, Jazan and Najren administrative regions. The children of age groups of 6-7 years, 12-13 years and 15-19 years were included in this study. 5699 children were screened from these four regions. One thousand eight hundred sixty-seven children were screened from 1st age group, 1719 were from 2nd age group and 2113 were from 3rd age group. The mean dmft/DMFT values of Aseer region's children were significantly higher than Al Baha and Jazan's children in all the three age groups. Female children showed significantly higher dmft/DMFT than male children in all age groups and regions, except Al Baha region for 6-7 years old children. There were no significant mean dmft/DMFT differences between urban and rural children, except in Najran children of age group of 6-7 years. The children with 'poor' hygiene showed significantly higher dmft/DMFT than with 'good' hygiene in all age groups and regions. The treatment needs of Aseer and Najran regions' children showed the higher percentage (prevalence), especially for one or two surface fillings, while Al Baha's children showed the higher percentage (prevalance), especially for one or two surface fillings, while Al- Baha's children showed the least.
Saudi Dental Journal 2006;18(SI)-Abstr.055