Tooth Decay - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

OOTH ECAY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. ...

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OOTH ECAY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Tooth Decay: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84660-X 1. Tooth Decay-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on tooth decay. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON TOOTH DECAY .......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Tooth Decay .................................................................................. 8 E-Journals: PubMed Central ....................................................................................................... 13 The National Library of Medicine: PubMed ................................................................................ 16 CHAPTER 2. NUTRITION AND TOOTH DECAY ................................................................................ 31 Overview...................................................................................................................................... 31 Finding Nutrition Studies on Tooth Decay ................................................................................. 31 Federal Resources on Nutrition ................................................................................................... 33 Additional Web Resources ........................................................................................................... 33 CHAPTER 3. ALTERNATIVE MEDICINE AND TOOTH DECAY .......................................................... 35 Overview...................................................................................................................................... 35 National Center for Complementary and Alternative Medicine.................................................. 35 Additional Web Resources ........................................................................................................... 41 General References ....................................................................................................................... 43 CHAPTER 4. DISSERTATIONS ON TOOTH DECAY ............................................................................ 45 Overview...................................................................................................................................... 45 Dissertations on Tooth Decay ...................................................................................................... 45 Keeping Current .......................................................................................................................... 46 CHAPTER 5. PATENTS ON TOOTH DECAY ...................................................................................... 47 Overview...................................................................................................................................... 47 Patents on Tooth Decay ............................................................................................................... 47 Patent Applications on Tooth Decay ........................................................................................... 75 Keeping Current .......................................................................................................................... 88 CHAPTER 6. BOOKS ON TOOTH DECAY .......................................................................................... 89 Overview...................................................................................................................................... 89 Book Summaries: Federal Agencies.............................................................................................. 89 Book Summaries: Online Booksellers........................................................................................... 93 Chapters on Tooth Decay ............................................................................................................. 94 Directories.................................................................................................................................... 96 CHAPTER 7. MULTIMEDIA ON TOOTH DECAY ............................................................................... 97 Overview...................................................................................................................................... 97 Video Recordings ......................................................................................................................... 97 Audio Recordings......................................................................................................................... 98 CHAPTER 8. PERIODICALS AND NEWS ON TOOTH DECAY .......................................................... 101 Overview.................................................................................................................................... 101 News Services and Press Releases.............................................................................................. 101 Newsletter Articles .................................................................................................................... 104 Academic Periodicals covering Tooth Decay ............................................................................. 104 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................. 105 Overview.................................................................................................................................... 105 U.S. Pharmacopeia..................................................................................................................... 105 Commercial Databases ............................................................................................................... 106 Researching Orphan Drugs ....................................................................................................... 107 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 111 Overview.................................................................................................................................... 111 NIH Guidelines.......................................................................................................................... 111 NIH Databases........................................................................................................................... 113 Other Commercial Databases..................................................................................................... 115

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APPENDIX B. PATIENT RESOURCES ............................................................................................... 117 Overview.................................................................................................................................... 117 Patient Guideline Sources.......................................................................................................... 117 Finding Associations.................................................................................................................. 132 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 135 Overview.................................................................................................................................... 135 Preparation................................................................................................................................. 135 Finding a Local Medical Library................................................................................................ 135 Medical Libraries in the U.S. and Canada ................................................................................. 135 ONLINE GLOSSARIES................................................................................................................ 141 Online Dictionary Directories ................................................................................................... 142 TOOTH DECAY DICTIONARY................................................................................................. 143 INDEX .............................................................................................................................................. 181

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with tooth decay is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about tooth decay, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to tooth decay, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on tooth decay. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to tooth decay, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on tooth decay. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON TOOTH DECAY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on tooth decay.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and tooth decay, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “tooth decay” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Baby Bottle Tooth Decay-Early Childhood Caries Source: Pediatric Dentistry. 21(5): 18. Reference Manual 1999-2000. Contact: Available from American Academy of Pediatric Dentistry. Publications Department, 211 East Chicago Avenue, Suite 700, Chicago, IL 60611-2616. Summary: A child's bedtime or nap time use of a bottle containing juice, milk, formula, or any other liquid sweetened with fermentable carbohydrates increases the risk of severe dental caries due to prolonged contact between cariogenic bacteria on the susceptible tooth surface and the sugars in the consumed liquid. This chapter from the American Academy of Pediatric Dentistry's Reference Manual outlines the oral health policies that pertain to baby bottle tooth decay (BBTD) and early childhood caries. Inappropriate bottle feeding of children can lead to BBTD and early childhood caries

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depending on the contents as well as the frequency and duration of bottle use. The policy lists 5 recommendations for pediatric dentists to suggest to their patients: Infants should not be put to sleep with a bottle. Parents should be encouraged to have infants drink from a cup as they approach their first birthday. Consumption of juices from a bottle should be avoided (use a cup instead). Oral hygiene measures should be used by the time the first primary tooth emerges. An oral health consultation visit within 6 months of the first tooth erupting is recommended to educate parents and provide anticipatory guidance for prevention of dental disease. •

Mouthful of Advice: Managing Tooth Decay During and After Treatment Source: MAMM. 3(8): 60-61. June 2001. Contact: Available from MAMM. 54 West 22nd Street, 4th Floor, New York, NY 10010. (212) 243-2916. Fax (646) 365-1369. Website: www.mamm.com. Summary: Many women are warned that they might have mouth sores during chemotherapy. What they may not know is that chemotherapy increases the risk of tooth decay both during treatment and long afterwards. This article reviews these risks and offers strategies for coping with oral health concerns during and after cancer treatment. The author stresses that the key to reducing short term oral side effects and long term tooth decay is to work closely with a dentist at all times: before, during, and after treatment. A thorough dental evaluation prior to starting chemotherapy is essential. During and after treatment, scrupulous attention to oral hygiene is necessary. Regular trips to the dentist, including tooth cleanings every three months, can help rid the mouth of decay causing bacteria. The author reviews products and techniques that can stimulate the flow of saliva. Some dentists recommend patients not undergo dental care during chemotherapy because of their low white blood cell and platelet counts. However, when dental crises arise during treatment, oncologists (cancer specialists) and dentists can usually work together to solve them. The article includes a brief list of online resources for readers who want more information.

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Baby Bottle Tooth Decay: What Causes It and How Dental Hygienists Can Help Treat It Source: Access. 11(6): 35-38. July 1997. Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Chicago, IL 60611. (800) 243-2342 or (312) 440-8900; Fax (312) 4408929; E-mail: [email protected]; http://www.adha.org. Summary: This article describes baby bottle tooth decay (BBTD), a serious dental disease that afflicts infants and toddlers under the age of three. The rampant, carious condition results in the destruction of primary teeth. The author emphasizes the need for all health care professionals, especially dental care professionals, to understand BBTD and work for its prevention. Topics include the etiology and clinical manifestations of BBTD; treatment options and costs; long-term ramifications of BBTD; social, socioeconomic, and cultural considerations; inappropriate feeding patterns; and preventing BBTD. To prevent BBTD, weaning by the age of 12 months is important. In addition, alternatives to a sleeptime bottle are noted. One sidebar lists current brochures on BBTD and their sources. 11 references.

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Preventing Baby Bottle Tooth Decay and Early Childhood Caries Among AI/AN Infants and Children Source: Primary Care Provider. 22(3): 37-39. March 1997. Summary: This article describes community-based and clinic-based interventions designed to prevent baby bottle tooth decay (BBTD) and early childhood dental caries (ECC) among American Indian (AI) and Alaska Native (AN) infants and children. The authors discuss a community-based BBTD prevention program implemented in 12 communities; the program was multidisciplinary and incorporated a variety of strategies. The two major components are one-to-one counseling of the caretakers of infants and a community-wide intervention. Community-based prevention activities included computerized mailings to caretakers of infants, smile contests, health fair booths, public service announcements, posters, news articles, and parenting workshops. The authors also discuss clinic-based interventions to prevent BBTD and ECC, including the monthly application of iodine on the teeth of infants and young children, topical fluoride varnishes, early parent education, early dental care (first oral examination by the age of 12 to 18 months), and the use of atraumatic restorative treatment in young children. The authors also briefly discuss the Indian Health Service ABCD program (Access for Baby and Children's Dentistry), which includes risk assessment, early intervention and referral, pharmacologic and restorative protocols, education of parents, and preventive recall. 13 references. (AA-M).

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Sickle Cell Anemia and Dental Caries: A Literature Review and Pilot Study Source: SCD. Special Care in Dentistry. 22(2): 70-74. March-April 2002. Contact: Available from Special Care Dentistry. 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2660. Summary: This article reports on a cohort study undertaken to determine whether individuals with sickle cell anemia (SCA) were more susceptible to dental caries (cavities) than non SCA control subjects. Thirty-five cases of SCA (aged 6 years and older) were identified from a screening of 15,900 current patient files at the Howard University College of Dentistry Dental Clinic. A total of 140 non SCA control subjects was selected. While there was virtually no difference in DMFS (decayed, missing, filled surfaces) between SCA cases and controls for 6 to 19 years olds, for subjects aged 20 and older, the DMFS was 30.4 percent higher in the SCD cases. For all ages, the M component for SCA cases was 40.7 percent higher, and the D component was 20.0 percent higher, while the F component was only 3.5 percent higher than for controls. Untreated decay was 24.4 percent higher in the SCA cases. The findings from this pilot study suggest that SCA cases have a higher susceptibility to dental caries or that SCA patients may have different treatment pathways once caries is detected. The authors conclude that while none of the observed differences were statistically significant, these findings were of clinical interest and should be pursued in future large scale studies. 3 figures. 2 tables. 24 references.

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Diagnosis and Treatment of Dental Caries-Related Emergencies in a Children's Hospital Source: Pediatric Dentistry. 19(8): 470-475. November-December 1997. Summary: This article reports on a comprehensive review of 362 caries related (dental cavities) emergency visits presenting to a children's hospital. The review was undertaken to investigate aspects of care which have not been previously reported.

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Areas of interest included patient characteristics such as age and whether the emergency visit was the first contact with a dentist, association of the emergency visit with a nursing bottle habit, diagnoses, treatment provided, and behavior management techniques used at the emergency visit. The emergency appointment was the first contact with a dentist for 27 percent of all patients and for 52 percent of children 3.5 years and younger. Patient visits related to nursing caries totaled 19 percent, and these patients had a disproportionately high share of all primary tooth diagnoses. Nursing caries (baby bottle tooth decay) patients accounted for 48 percent of patients requiring papoose restraint and were the majority of patients receiving multiple extractions. Papoose restraint was used most often for young patients needing extraction who presented during clinic hours and were treated by an attending dentist. Maxillary first and second primary molars were implicated in a high number of cellulitis patients (57 percent) yet represented only 23 percent of primary tooth diagnoses. For the vast majority of patients, the emergency diagnosis was not complex and the treatment provided was straightforward. 3 figures. 3 tables. 8 references. (AA-M). •

Dental Caries in Children Under Age Three Attending a University Clinic Source: Pediatric Dentistry. 21(4): 261-264. July-August 1999. Contact: Available from American Academy of Pediatric Dentistry. Publications Department, 211 East Chicago Avenue, Suite 700, Chicago, IL 60611-2616. Summary: This article reports on a study undertaken to determine the rates of dental caries and to assess the restorative needs of children under 3 years of age attending an urban university clinic from 1993 to 1997. In the retrospective study, data were abstracted from patient records and included demographic information, caries experience, and restorative needs. The sample group comprised 55 percent males and 45 percent females; the study population was predominantly African American (51 percent) and Hispanic (34 percent), with a mean age of 20 months. A majority of the population (92 percent) had dental benefits through Medicaid. Nearly one third of the study population and as much as 56 percent of the children between 24 and 36 months had dental caries. Among those children off the bottle (50 percent), children with severe dental caries had been weaned off the bottle at a significantly older age compared with those without any caries (16.9 months versus 10 months). The authors conclude that this study provides further validity to the early oral health exam and early dental treatment, not only for preventive measures but also for restorative needs. The relatively high prevalence of early childhood caries could have been prevented by appropriate primary preventive strategies. 3 figures. 19 references.

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Dental Experiences and Parenting Practices of Native American Mothers and Caretakers: What We Can Learn for the Prevention of Baby Bottle Tooth Decay Source: Journal of Dentistry for Children. 66(2): 120-126. March-April 1999. Contact: Available from American Society of Dentistry for Children. John Hancock Center, 875 North Michigan Avenue, Suite 4040, Chicago, IL 60611-1901. (312) 943-1244. Summary: This article reports on the dental experiences and parenting practices of Native American mothers and caretakers, with an emphasis on the prevention of baby bottle tooth decay (BBTD). The authors discuss the prevalence of BBTD, interventions for BBTD, the use of a focus group study to elucidate the American Indian experience in this area, the dental treatment experiences of the adult and the child, concerns and caring for the parent's and the child's teeth, and feeding practices. The authors note that an ethnographic approach (training local women to gather perceptions) has provided

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sensitive and useful information. In addition to promoting early screening and preventive services for young children, enhancing efforts to provide positive dental experiences for mothers and women of childbearing age is recommended. While some parents and caretakers may lack knowledge concerning BBTD, effort should be made to correct misinformation, such as that a young child can clean his or her own teeth, and providing brief counseling regarding culturally appropriate options. 16 references. •

National Institutes of Health Consensus Development Conference Statement: Diagnosis and Management of Dental Caries Throughout Life, March 26-28, 2001 Source: JADA. Journal of the American Dental Association. 132(8): 1153-1161. August 2001. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867. Website: www.ada.org. Summary: This article reports on the National Institutes of Health Consensus Development Conference on the Diagnosis and Management of Dental Caries Throughout Life, convened in March 2001. The conference was undertaken to provide health care providers, patients, and the general public with a responsible assessment of the currently available data regarding the diagnosis and management of dental caries (cavities) throughout life. A nonfederal, nonadvocate 13 member panel representing the fields of dentistry, epidemiology, genetics, medicine, oral biology, oral radiology, pathology, periodontics, public health, statistics, and surgery, as well as a public representative, was convened. In addition, 31 experts in these same fields presented data to the panel and to a conference audience of approximately 700. The evidence included presentations by experts; a systematic review of the dental research literature; and an extensive bibliography of dental caries research articles. Scientific evidence was given precedence over clinical anecdotal experience. The article reports the findings in six areas: the best methods for detecting early and advanced dental caries (the validity and feasibility of traditional and emerging methods); the best indicators for an increased risk of dental caries; the best methods available for the primary prevention of dental caries initiation throughout life; the best treatments available for reversing or arresting the progression of early dental caries; clinical decisionmaking regarding prevention or treatment, based on detection methods and risk assessment; and new research directions for the prevention, diagnosis, and treatment of dental caries. The full Consensus Development Conference statement is available on the Web (www.consensus.nih.gov). The article concludes with a list of the panel members and conference presenters and their affiliations.

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Dental Caries: Diagnosis and Treatment Source: New York State Dental Journal. 68(2): 38-40. February 2002. Contact: Available from Dental Society of the State of New York. 7 Elk Street, Albany, NY 12207. (518) 465-0044. Summary: This article reviews the current thinking about the diagnosis and treatment of dental caries (cavities). Topics include a definition of tooth decay, etiology, epidemiology, risk assessment, examination and diagnosis of the initial lesion, and specific considerations including white spot lesions, active lesions, hidden lesions, variations among dentists, and instruments. The authors stress that the diagnosis of tooth decay must go beyond the clinical detection of a carious lesion. The practitioner should assess the individual's risk factors as well as the activity of the lesion. The traditional instrumentation has limitations. Therefore, researchers are urged to find new

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diagnostic tools to allow earlier detection, to predict disease activity, and to assess the susceptibility of an individual. In addition, patients' cooperation is the main factor for the success of a preventive dentistry program; the authors consider how the dentist's role can have a positive impact on patient compliance. 21 references. •

Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States Source: Atlanta, GA: Centers for Disease Control and Prevention (CDC), Fluoride Recommendations Work Group. 2001. 42 p. Contact: Available from Superintendent of Documents, U.S. Government Printing Office (GPO). Washington, DC 20402-9371. (202) 512-1800. Website: www.gpo.gov. PRICE: Contact GPO for current price; full-text also available online free of charge. Summary: Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (tooth decay, cavities) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries. During the late 1990s, CDC convened a work group to develop recommendations for using fluoride to prevent and control dental caries in the United States. This report includes these recommendations, as well as a critical analysis of the scientific evidence regarding the efficacy and effectiveness of fluoride modalities in preventing and controlling dental caries; ordinal grading of the quality of the evidence; and assessment of the strength of each recommendation. Because frequent exposure to small amounts of fluoride each day will best reduce the risk for dental caries in all age groups, the work group recommends that all persons drink water with an optimal fluoride concentration and brush their teeth twice daily with fluoride toothpaste. The recommendations in this report guide dental and other health care providers, public health officials, policy makers, and the public in the use of fluoride to achieve maximum protection against dental caries while using resources efficiently and reducing the likelihood of enamel fluorosis. The recommendations address public health and professional practice, self-care, consumer product industries and health agencies, and further research. 4 figures. 4 tables. 270 references.

Federally Funded Research on Tooth Decay The U.S. Government supports a variety of research studies relating to tooth decay. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to tooth decay.

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore tooth decay. The following is typical of the type of information found when searching the CRISP database for tooth decay: •

Project Title: CHEMICAL RELEASE & IMMUNE SENSITIZATION BY DENTAL RESINS Principal Investigator & Institution: Jewett, Anahid; Assistant Professor; Dental Research Institute; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-SEP-1993; Project End 30-APR-2004 Summary: (Adapted from investigator's Abstract): This is a competing continuation application whose overall goal is to ensure that resin-based materials which are placed onto teeth as part of dental care can continue to be used safely. Resin based materials which polymerize in the mouth are now used by dentists in many ways to help prevent tooth decay and for tooth repair and replacement. Bonding technologies, which are all based on this class of materials, are used for fissure sealing to help prevent decay, for bonding orthodontic brackets to teeth, and as part of many different types of tooth repair to improve appearance and function. It is very likely that new and modified materials of the same general type will continue to be developed and that the use of this type of material in dentistry will continue to increase in the coming years. The materials are very helpful to patients and have remarkably few negative side effects. However, severe allergic dermatitis in some dentists and other dental workers is linked to the use of the materials, and the incidence of such allergy appears to be increasing. Fortunately, allergic responses are less common in patients, but we do not know why this is so or whether it will continue to be so. Some patients experience pain in the dental pulp after resins are used in deep fillings, for reasons that may be related to direct chemical damage caused by released chemicals, by allergy to them, or to both. It has previously been shown in laboratory studies that two chemicals are released from these materials during the first days after they are placed on teeth. The first aim will be to confirm this release in experimental animals (guinea pigs), and study what happens to the chemicals in the body (their uptake, distribution, time of storage, breakdown and excretion). The second aim will be to study mechanisms of allergic responses to these chemicals at the cellular and molecular level using guinea pigs and mice. The third aim will be to determine whether there are differences between the risk of allergy with skin contact (as can occur in dental workers) relative to contact with the inside of the mouth and through tooth structure to the tooth pulp (as can occur in patients) in the same animals. The fourth aim will be to study allergic responses at the cellular and molecular level using blood and other tissues donated by volunteer dentists and other dental workers, to ensure that the experimental studies of the phenomenon using animal models and animal tissues in culture are valid. The studies described will help to prevent and treat adverse effects of this class of dental materials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EARLY CHILDHOOD CARIES--PREVENTION AND TREATMENT OUTCOMES Principal Investigator & Institution: Weintraub, Jane A.; Lee Hysan Professor & Chair; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2003

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Summary: Early Childhood Caries (ECC), previously called Baby Bottle Tooth Decay and Nursing Caries, is a form of dental caries that affects infants and young children. The often severe disease is difficult and expensive to treatment. Strategies to identify very young children at risk for ECC and rigorous testing of interventions are not well developed. This project has two major components with different research designs; both will determine in certain factors are associated with increased ECC incidence, but will involve very different study populations: A) a population-based retrospective cohort study among 6,058 children born between 1986-1993 to members of the Kaiser Permanente Health Plan in the Pacific Northwest (KPNW) and B) a prospective, randomized clinical trial (RCT) among initially caries-free children under age three at two public health facilities in San Francisco, one serving a primarily Latino and one a primarily Asian population. A) Factors to be assessed from KPNW patient records include information about the child, the parents, the mother (i.e., medications prescribed during pregnancy), the siblings, and the dental providers. Behavioral information (i.e., bottle use, oral hygiene) will be ascertained from questionnaires. Among children born between 1986-90, we will determine if ECC in the primary dentition increases the risk of caries treatment on first permanent molars. B) The RCT will 1) Compare the efficacy of once or twice/year fluoride varnish (FV) application plus counseling to counseling alone in preventing ECC; 2) Assess pre-intervention salivary markers (biologic an chemical), behavioral and demographic factors as predictors of ECC; 3) Compare the efficacy of these interventions between sites serving different ethnic populations with a high prevalence of ECC; and 4) Determine the salivary fluoride release profile from fluoride varnish applied to a sub-set of subjects. If successful, this study will provide methods for targeting children at risk for ECC and evidence that an intervention is efficacious in preventing ECC in this young age group. Collaboration among UCSF, KPNW, the San Francisco public health community and industry will facilitate translation of findings into the dental public health and private sectors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFICACY OF TAILORED ORAL HEALTH EDUCATION Principal Investigator & Institution: Pallonen, Unto E.; Associate Research Scientist; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002 Summary: (Provided by the applicant): The long-term objective of this project is to develop an effective tailored behavior change expert system (ES) education program to promote and maintain good oral health and prevent oral diseases among low-income children and their caregivers. To achieve this, the proposed multimedia-based, self-help intervention is designed to be easy to use and easy to diffuse for large-scale use through personal computers. Due to the current lack of tailored self-help behavior change dental interventions, substantial time and resources are needed to develop the content and to test the instruments and feasibility of the proposed interventions. This project has five specific aims: 1) To design and produced two interventions to promote oral health and prevent oral disease among caregivers and their children: (i) an interactive, tailored, theory-driven, behavior change ES education program, and (ii) an untailored health information HI comparison program. 2) To assess the feasibility and usability of these unique interventions with a small-scale feasibility study prior to their final implementation. 3) To revise the interventions based on the findings of the feasibility study and implement the efficacy trial. 4) To evaluate the efficacy of the interventions with two clinical outcomes: gingivitis among caregivers and untreated tooth decay

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among caregivers and their children. 5) To examine the extent to which the clinical outcomes are mediated by the affective, evaluative, and situational individual factors influenced by the tailored intervention, or by broader psychosocial factors addressed in other center projects. The efficacy of the tailored ES intervention, whether it results in better oral health than the untailored HI intervention, will be tested by the randomized controlled trial. In year 4 of the course of the longitudinal center research, the participating caregivers, low income African Americans recruited from the poorest 39 census tracks in the city of Detroit, will be randomly assigned to one of the two education programs at the beginning of the multimedia intervention session. The oral follow-up examination at year four will be the baseline measurement of this trial, and changes in the outcomes will be assessed in the follow-up examination in year 6. Both the participants and examiners will be blinded from the intervention regimens. Production and evaluation of a state of the science, interactive, tailored multimedia selfhelp ES program for oral health will provide an opportunity to obtain currently nonexistent information about the ability to influence behaviors that determine oral health status among low SES African Americans caregivers and their children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENE REGULATION AND PHYSIOLOGY OF STREPTOCOCCUS MUTANS Principal Investigator & Institution: Burne, Robert A.; Professor & Chair; Oral Biology; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2002; Project Start 01-APR-1997; Project End 30-APR-2007 Summary: (provided by applicant): Dental caries remains among the most prevalent infectious diseases worldwide. Over 84 percent of U.S. children, 96 percent of U.S. adults, and 99.5 percent of Americans 65 years of age and older have experienced tooth decay. To conceptualize and develop novel anticaries strategies that can be effectively distributed to the population, a molecular dissection of the genetics, physiology and biochemistry of cariogenic microorganisms is needed. Our work during the previous funding period has led to the discovery of novel and unique mechanisms for the control of the degradation of dental plaque polysaccharides and revealed important connections between the amount of carbohydrates available to cells and the capacity of these cells to express essential virulence determinants, including the capacity to produce exopolysaccharides and to tolerate acidic conditions. Further, our work has led to the discovery that global regulators of carbohydrate metabolism play essential roles in regulation of virulence and expression of acid tolerance. The major goals of this application are to continue with our fundamental studies on gene regulation and physiology of S. mutans, with a particular focus on the control of virulence gene expression by carbohydrate availability, pH and the global control protein CcpA. To accomplish these goals, we have established the following four Specific Aims. 1. A detailed analysis of a transcriptional activator required for fructanase (fruA) expression and analysis of the molecular basis for PTS-mediated control of expression of fructan degradation. 2. Identification of the protein(s) that interacts with the fruA catabolite response elements. 3. Molecular dissection of the basis for the control of exopolysaccharide production by carbohydrate availability and CcpA. 4. Physiologic and genetic analysis of the linkage between limitation for carbohydrate, the CcpA regulon and control of virulence gene expression. These studies combine sophisticated molecular genetic tools with powerful physiologic techniques to dissect the pathways used by S. mutans to alter its pathogenic potential in response to carbohydrate availability. Understanding these pathway will allow for the design of technologies that

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Tooth Decay

subvert the capacity of S. mutans to become a numerically significant constituent of a cariogenic microflora. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STREPTOCOCCUS MUTANS SUGAR TRANSPORT & BIOFILM FORMATION Principal Investigator & Institution: Ajdic, Dragana; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: Sugar transport and metabolism by Streptococcus mutans is directly related to the onset and formation of human dental caries (tooth decay). In S. mutans, sugar substrates are taken up by ABC transporters (e.g., the maltose transport and multiple sugar metabolism transport (MSM) systems), by specific permeases, and most commonly by phosphoenolpyruvate (PEP)-sugar phosphotransferase systems (PTS). To better understand this important dental pathogen, we have sequenced the entire DNA sequence of the genome of strain UA159 at the University of Oklahoma. Detailed computational analyses of the S. mutans genome showed the presence of five ABC transporters and fourteen PTS systems for the probable transport of sugars or sugar alcohols including glucose, sucrose, maltose, lactose and fructose. Since the uptake and metabolism of carbohydrates is the key step in the formation and release of cariogenic acid, and since completion of the genomic DNA sequence of S. mutans strain UA159 now permits us to locate all of the predicted coding regions, this proposed work will examine the global gene response in S. mutans. Additionally, because S. mutans grows in a plaque that is a natural biofilm, it is crucial to determine the alterations in gene expression in biofilm cultures. Therefore, the specific aims of this proposal are to 1) analyze the differences in global gene expression observed when S. mutans UA159 is grown in the presence of the most common dietary sugars (sucrose, maltose, lactose, glucose, and fructose) in planktonic culture and in biofilm, and 2) identify multiple transporters for the same sugar (as well as genes influenced by transport systems) in S. mutans planktonic and biofilm cultures by individually inactivating those systems. We hypothesize that many genes will have differential patterns of expression in response to the availability of carbohydrate source and culture state. The information obtained from the proposed study should dramatically advance our understanding of this important human pathogen and facilitate new approaches for treatment and intervention aimed at reducing the incidence of dental caries. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: USE DISOREDERS

OF

ADIPOSE-DERIVED

PREADIPOCYTES

IN

BONE

Principal Investigator & Institution: Gimble, Jeffrey M.; Chief Scientific Officer; Artecel Sciences, Inc. 801 Capitola Dr, Ste 8 Durham, Nc 27713 Timing: Fiscal Year 2002; Project Start 28-SEP-1999; Project End 31-JAN-2003 Summary: Non-healing bone fractures and periodontal bone loss constitute significant clinical problems with few approved medical options. Bone repair is enhanced by the presence of osteoblasts or osteoblastic precursor cells. Subcutaneous adipose tissue is a plentiful, accessible, and replenishable source of human stromal cells for transplantation. In Phase I of this SBIR, we tested the hypothesis that human adipose tissue-derived stromal cells are capable of osteoblast function. Substantial in vitro data indicates that these stromal cells differentiate into cells biochemically and

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morphologically similar to osteoblasts. The ability of these cells to form bone in vivo was examined as well. Phase II of this SBIR will extend these in vivo experiments. Specific Aim 1 examines the ability of human adipose tissue-derived stromal cells to form ectopic bone in hydroxyapatite ceramic cubes implanted subcutaneously in immunodeficient mice. Specific Aim 2 explores whether the introduction of a modified bone morphogenetic protein receptor will enhance mineralization by these cells in vitro. Specific Aim 3 will determine if these modified bone morphogenetic protein receptor expressing stromal cells form bone more rapidly and efficiently than control cells using the in vivo murine model described in Aim 1. Together, these studies will provide a strong foundation for pre-clinical experiments in a large animal (canine) fracture repair model. PROPOSED COMMERCIAL APPLICATION: This technology will provide a cost-effective alternative source of stromal cells capable of osteoblast differentiation for autologous and allogeneic transplantation into sites of bone defects and fractures. This has commercial application to orthopedic and periodontal surgical treatments of joint replacement, fracture repair, and bone resorption secondary to tooth decay. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “tooth decay” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for tooth decay in the PubMed Central database: •

Amount and avidity of salivary and serum antibodies against Streptococcus mutans in two groups of human subjects with different dental caries susceptibility. by Lehtonen OP, Grahn EM, Stahlberg TH, Laitinen LA.; 1984 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=263427

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An In Vitro Microbial-Caries Model Used to Study the Efficacy of Antibodies to Streptococcus mutans Surface Proteins in Preventing Dental Caries. by Fontana M, Buller TL, Dunipace AJ, Stookey GK, Gregory RL.; 2000 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=95821

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Coimmunization with Complementary Glucosyltransferase Peptides Results in Enhanced Immunogenicity and Protection against Dental Caries. by Taubman MA, Smith DJ, Holmberg CJ, Eastcott JW.; 2000 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=97477

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Comparison of an Adherence Domain and a Structural Region of Streptococcus mutans Antigen I/II in Protective Immunity against Dental Caries in Rats after Intranasal Immunization. by Hajishengallis G, Russell MW, Michalek SM.; 1998 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=108112

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Competitive displacement of mutans streptococci and inhibition of tooth decay by Streptococcus salivarius TOVE-R. by Tanzer JM, Kurasz AB, Clive J.; 1985 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=261912

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Construction and Characterization of an Effector Strain of Streptococcus mutans for Replacement Therapy of Dental Caries. by Hillman JD, Brooks TA, Michalek SM, Harmon CC, Snoep JL, van der Weijden CC.; 2000 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=97174

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Correlation of level and duration of Streptococcus mutans infection with incidence of dental caries. by Zickert I, Emilson CG, Krasse B.; 1983 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=348045

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Dental caries: a nation divided. by Weir E.; 2002 Oct 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=134183

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Diepitopic Construct of Functionally and Epitopically Complementary Peptides Enhances Immunogenicity, Reactivity with Glucosyltransferase, and Protection from Dental Caries. by Taubman MA, Holmberg CJ, Smith DJ.; 2001 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=98453

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Effect of neonatal thymectomy on dental caries in rats. by Ebersole JL, Taubman MA, Smith DJ.; 1982 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=347867

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Effective immunity to dental caries: enhancement of salivary anti-Streptococcus mutans antibody responses with oral adjuvants. by Morisaki I, Michalek SM, Harmon CC, Torii M, Hamada S, McGhee JR.; 1983 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=264894

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Effective immunity to dental caries: gastric intubation of Streptococcus mutans whole cells or cell walls induces protective immunity in gnotobiotic rats. by Michalek SM, Morisaki I, Harmon CC, Hamada S, McGhee JR.; 1983 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=348000

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Experimental immunization of rats with a Streptococcus mutans 59-kilodalton glucan-binding protein protects against dental caries. by Smith DJ, Taubman MA.; 1996 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=174189

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Immunization of rats with synthetic peptide constructs from the glucan-binding or catalytic region of mutans streptococcal glucosyltransferase protects against dental caries. by Taubman MA, Holmberg CJ, Smith DJ.; 1995 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173421

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Immunization with purified protein antigens from Streptococcus mutans against dental caries in rhesus monkeys. by Lehner T, Russell MW, Caldwell J, Smith R.; 1981 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=350881

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Intranasal Immunization against Dental Caries with a Streptococcus mutans-Enriched Fimbrial Preparation. by Fontana M, Dunipace AJ, Stookey GK, Gregory RL.; 1999 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=103731

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Local active gingival immunization by a 3,800-molecular-weight streptococcal antigen in protection against dental caries. by Lehner T, Mehlert A, Caldwell J.; 1986 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=260911

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Local passive immunization by monoclonal antibodies against streptococcal antigen I/II in the prevention of dental caries. by Lehner T, Caldwell J, Smith R.; 1985 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=261150

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Non-cariogenicity of the disaccharide palatinose in experimental dental caries of rats. by Ooshima T, Izumitani A, Sobue S, Okahashi N, Hamada S.; 1983 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=347905

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Oral passive immunization against dental caries in rats by use of hen egg yolk antibodies specific for cell-associated glucosyltransferase of Streptococcus mutans. by Hamada S, Horikoshi T, Minami T, Kawabata S, Hiraoka J, Fujiwara T, Ooshima T.; 1991 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=259011

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Passive Immunization with Bovine Milk Containing Antibodies to a Cell Surface Protein Antigen-Glucosyltransferase Fusion Protein Protects Rats against Dental Caries. by Mitoma M, Oho T, Michibata N, Okano K, Nakano Y, Fukuyama M, Koga T.; 2002 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127952

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Passive Transfer of Immunoglobulin Y Antibody to Streptococcus mutans Glucan Binding Protein B Can Confer Protection against Experimental Dental Caries. by Smith DJ, King WF, Godiska R.; 2001 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=98269

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Prevalence of dental caries in 4- to 5-year-old children partly explained by presence of salivary mutans streptococci. by Granath L, Cleaton-Jones P, Fatti LP, Grossman ES.; 1993 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=262623

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Protection of gnotobiotic rats against dental caries by passive immunization with bovine milk antibodies to Streptococcus mutans. by Michalek SM, Gregory RL, Harmon CC, Katz J, Richardson GJ, Hilton T, Filler SJ, McGhee JR.; 1987 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=260710

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Role of a cell surface-associated protein in adherence and dental caries. by Bowen WH, Schilling K, Giertsen E, Pearson S, Lee SF, Bleiweis A, Beeman D.; 1991 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=259084

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Salivary immunoglobulin A and serum antibodies to Streptococcus mutans ribosomal preparations in dental caries-free and caries-susceptible human subjects. by Gregory RL, Filler SJ, Michalek SM, McGhee JR.; 1986 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=261109

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STUDIES ON DENTAL CARIES, WITH SPECIAL REFERENCE TO ACIDURIC ORGANISMS ASSOCIATED WITH THIS PROCESS I. ISOLATION AND DESCRIPTION OF ORGANISMS. by Morishita T.; 1929 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=375078

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Tonsillar Application of Formalin-Killed Cells of Streptococcus sobrinus Reduces Experimental Dental Caries in Rabbits. by Fukuizumi T, Inoue H, Tsujisawa T, Uchiyama C.; 1999 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=96329

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with tooth decay, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “tooth decay” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for tooth decay (hyperlinks lead to article summaries): •

30th year reunion of four scientists marks less tooth decay around the world--the monofluorophosphate story. Author(s): Heydt H. Source: J Dent Assoc S Afr. 1980 December; 35(12): 837-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7028817

6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A fluoride analysis program to reduce tooth decay in rural children. Author(s): Nichols WA. Source: J Ark Med Soc. 1989 December; 86(7): 273-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2532205

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A fluoride analysis program to reduce tooth decay in rural children. Author(s): Nichols WA. Source: Ark Dent J. 1989 September; 60(3): 16-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2517190

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A new approach for calibrating dental caries frequency of skeletal remains. Author(s): Duyar I, Erdal YS. Source: Homo : Internationale Zeitschrift Fur Die Vergleichende Forschung Am Menschen. 2003; 54(1): 57-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12968423

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A study of baby bottle tooth decay and risk factors for 18-month old infants in rural Japan. Author(s): Tsubouchi J, Higashi T, Shimono T, Domoto PK, Weinstein P. Source: Asdc J Dent Child. 1994 July-August; 61(4): 293-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7989636

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An epidemiologic study of tooth decay in Newark school Children. Author(s): Houpt M, Koenigsberg S, Shey Z. Source: J N J Dent Assoc. 1983 Spring; 54(2): 64-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6575139

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An experimentally supported “law of tooth decay” and its application. Author(s): Lu KH. Source: Archives of Oral Biology. 1966 August; 11(8): 757-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5226771

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Aspects of tooth decay in recently arrived refugees. Author(s): Kingsford Smith D, Szuster F. Source: Aust N Z J Public Health. 2000 December; 24(6): 623-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11215013

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Baby bottle tooth decay (BBTD): issues, assessment, and an opportunity for the nutritionist. Author(s): Johnsen D, Nowjack-Raymer R. Source: Journal of the American Dietetic Association. 1989 August; 89(8): 1112-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2668384

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Baby bottle tooth decay and complications during pregnancy and delivery. Author(s): Peretz B, Kafka I. Source: Pediatr Dent. 1997 January-February; 19(1): 34-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9048411

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Baby bottle tooth decay in Native American children in Head Start centers. Author(s): Broderick E, Mabry J, Robertson D, Thompson J. Source: Public Health Reports (Washington, D.C. : 1974). 1989 January-February; 104(1): 50-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2493662

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Baby bottle tooth decay prevention--a new program for the Texas Department of Health. Author(s): Crow DR. Source: Tex Dent J. 1992 August; 109(8): 141. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1455391

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Baby bottle tooth decay. Author(s): Henderson HZ. Source: Indiana Med. 1992 May-June; 85(3): 197. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1602119

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Baby bottle tooth decay: a concern for all mothers. Author(s): Von Burg MM, Sanders BJ, Weddell JA. Source: Pediatric Nursing. 1995 November-December; 21(6): 515-9, Quiz 520-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8700605

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Baby bottle tooth decay: a preventable health problem in infants. Author(s): Johnsen DC. Source: Update Pediatr Dent. 1988 November; 2(1): 1-4, 6-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3076058

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Baby bottle tooth decay: a problem affecting young children in North Dakota. Author(s): Mangskau K. Source: Northwest Dent. 1991 November-December; 70(6): 25. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1815193

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Baby-bottle tooth decay: are we on the right track? Author(s): Smith PJ, Moffatt ME. Source: Int J Circumpolar Health. 1998; 57 Suppl 1: 155-62. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10093266

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Beriberi secondary to tooth decay. Author(s): Probert CS. Source: Lancet. 1989 July 1; 2(8653): 51-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2567829

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Biological factors in dental caries enamel structure and the caries process in the dynamic process of demineralization and remineralization (part 2). Author(s): Hicks J, Garcia-Godoy F, Flaitz C. Source: J Clin Pediatr Dent. 2004 Winter; 28(2): 119-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14969369

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Biological factors in dental caries: role of saliva and dental plaque in the dynamic process of demineralization and remineralization (part 1). Author(s): Hicks J, Garcia-Godoy F, Flaitz C. Source: J Clin Pediatr Dent. 2003 Fall; 28(1): 47-52. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14604142

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Changes in maternal attitudes toward baby bottle tooth decay. Author(s): Kanellis MJ, Logan HL, Jakobsen J. Source: Pediatr Dent. 1997 January-February; 19(1): 56-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9048415

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Childhood tooth decay: is it linked to lead? Author(s): Barrett JR. Source: Environmental Health Perspectives. 2000 November; 108(11): A521. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11221675

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Children with baby bottle tooth decay treated under general anesthesia or sedation: behavior in a follow-up visit. Author(s): Peretz B, Faibis S, Ever-Hadani P, Eidelman E. Source: J Clin Pediatr Dent. 2000 Winter; 24(2): 97-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11314329

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Comparison of diagnostic methods for dental caries. Author(s): Meneghim Mde C, Assaf AV, Zanin L, Kozlowski FC, Pereira AC, Ambrosano GM. Source: J Dent Child (Chic). 2003 May-August; 70(2): 115-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14528770

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Comparison of temperaments of children with and without baby bottle tooth decay. Author(s): Kendrick F, Wilson S, Coury DL, Preisch JW. Source: Asdc J Dent Child. 1998 May-June; 65(3): 198-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9668950

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Decline in primary tooth decay in New Zealand. Author(s): Spencer AJ. Source: Community Health Stud. 1989; 13(1): 100-3. No Abstract Available. Erratum In: Community Health Stud 1990; 14(1): 95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2736900

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Decline in primary tooth decay in New Zealand. Author(s): Colquhoun J. Source: Community Health Stud. 1988; 12(2): 187-91. No Abstract Available. Erratum In: Community Health Stud 1990; 14(1): 95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3416587

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Dental caries experience and availability of sugars in Iraqi children before and after the United Nations sanctions. Author(s): Jamel H, Plasschaert A, Sheiham A. Source: Int Dent J. 2004 February; 54(1): 21-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15005469

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Dental caries experience in a young adult military population. Author(s): Hopcraft M, Morgan M. Source: Aust Dent J. 2003 June; 48(2): 125-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649403

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Dental caries experience in children with congenital heart disease: a case-control study. Author(s): Stecksen-Blicks C, Rydberg A, Nyman L, Asplund S, Svanberg C. Source: International Journal of Paediatric Dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children. 2004 March; 14(2): 94-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15005697

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Dental caries experience in northern Manhattan adolescents. Author(s): Mitchell DA, Ahluwalia KP, Albert DA, Zabos GP, Findley SE, Trinh-Shevrin CB, Marshall SE, Lamster IB, Formicola AJ. Source: J Public Health Dent. 2003 Summer; 63(3): 189-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12962473

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Dental caries experience in older people over time: what can the large cohort studies tell us? Author(s): Thomson WM. Source: British Dental Journal. 2004 January 24; 196(2): 89-92; Discussion 87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14739966

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Dental caries experience of female inmates. Author(s): Heng CK, Morse DE. Source: J Public Health Dent. 2002 Winter; 62(1): 57-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14700091

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Dental caries in school-age children residing in five Guatemalan communities. Author(s): Archila L, Bartizek RD, Gerlach RW, Jacobs SA, Biesbrock AR. Source: J Clin Dent. 2003; 14(3): 53-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14520774

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Dental experiences and parenting practices of Native American mothers and caretakers: what we can learn for the prevention of baby bottle tooth decay. Author(s): Weinstein P, Troyer R, Jacobi D, Moccasin M. Source: Asdc J Dent Child. 1999 March-April; 66(2): 120-6, 85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10431622

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Dietary factors in the prevention of dental caries: a systematic review. Author(s): Lingstrom P, Holm AK, Mejare I, Twetman S, Soder B, Norlund A, Axelsson S, Lagerlof F, Nordenram G, Petersson LG, Dahlgren H, Kallestal C. Source: Acta Odontologica Scandinavica. 2003 December; 61(6): 331-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14960004

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Early childhood caries (ECC)/baby-bottle tooth decay--a reminder. Author(s): Peretz B. Source: Refuat Hapeh Vehashinayim. 2002 October; 19(4): 92. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12510256

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Early childhood tooth decay. Pediatric interventions. Author(s): Schulte JR, Druyan ME, Hagen JC. Source: Clinical Pediatrics. 1992 December; 31(12): 727-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1451381

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Economic evaluation of dental caries prevention: a systematic review. Author(s): Kallestal C, Norlund A, Soder B, Nordenram G, Dahlgren H, Petersson LG, Lagerlof F, Axelsson S, Lingstrom P, Mejare I, Holm AK, Twetman S. Source: Acta Odontologica Scandinavica. 2003 December; 61(6): 341-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14960005

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Ethnicity, location, age, and fluoridation factors in baby bottle tooth decay and caries prevalence of Head Start children. Author(s): Barnes GP, Parker WA, Lyon TC Jr, Drum MA, Coleman GC. Source: Public Health Reports (Washington, D.C. : 1974). 1992 March-April; 107(2): 16773. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1561298

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Factors related to severe untreated tooth decay in rural adolescents: a case-control study for public health planning. Author(s): Skaret E, Weinstein P, Milgrom P, Kaakko T, Getz T. Source: International Journal of Paediatric Dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children. 2004 January; 14(1): 17-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14706024

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Fighting tooth decay: the fluoride plan. Author(s): Cormier JF, Trammel H. Source: Pediatric Nursing. 1979 May-June; 5(3): 18-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=255220

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Fluoride supplements and changes in tooth decay on the Island of Tristan da Cunha: 1966-1996. Author(s): Mossey PA, Southwick CA, Wrieden WL, Longbottom P, Topping G, Stirrups DR. Source: British Dental Journal. 2003 August 9; 195(3): 159-62; Discussion 149. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12907985

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Head start combats baby bottle tooth decay. Author(s): Phillips MG, Stubbs PE. Source: Children Today. 1987 September-October; 16(5): 25-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3677853

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Hidden sugar. OTCs add to tooth decay. Author(s): Fujii D. Source: Am Pharm. 1979 October; 19(11): 39-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=517395

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Is attention-deficit hyperactivity disorder a risk factor for dental caries? A casecontrol study. Author(s): Broadbent JM, Ayers KM, Thomson WM. Source: Caries Research. 2004 January-February; 38(1): 29-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14684974

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Jarman underprivileged area scores, tooth decay and the effect of water fluoridation. Author(s): Jones C, Taylor G, Woods K, Whittle G, Evans D, Young P. Source: Community Dent Health. 1997 September; 14(3): 156-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9332040

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Knowledge of male and female midwestern college students about baby bottle tooth decay. Author(s): Logan HL, Baron RS, Kanellis M, Brennan M, Brunsman BA. Source: Pediatr Dent. 1996 May-June; 18(3): 219-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8784913

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Lanarkshire children's tooth decay halved. Author(s): Wills S. Source: Dent Update. 2001 June; 28(5): 263. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11490641

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Lanarkshire children's tooth decay halved? Author(s): Morris J. Source: Dent Update. 2001 November; 28(9): 474. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11806192

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Letter: Vaccination against tooth decay. Author(s): Lehner T. Source: Lancet. 1975 September 20; 2(7934): 557. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=51383

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Measuring inequalities in the distribution of dental caries. Author(s): Antunes JL, Narvai PC, Nugent ZJ. Source: Community Dentistry and Oral Epidemiology. 2004 February; 32(1): 41-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14961839

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Mexican-American parents with children at risk for baby bottle tooth decay: pilot study at a migrant farmworkers clinic. Author(s): Weinstein P, Domoto P, Wohlers K, Koday M. Source: Asdc J Dent Child. 1992 September-October; 59(5): 376-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1401413

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Parental awareness, habits, and social factors and their relationship to baby bottle tooth decay. Author(s): Febres C, Echeverri EA, Keene HJ. Source: Pediatr Dent. 1997 January-February; 19(1): 22-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9048409

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Pit and fissure sealants in the prevention of tooth decay. Author(s): Starr RM, Gravitz RF. Source: Pediatric Nursing. 1985 July-August; 11(4): 289-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3848800

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Possible explanations for decline in tooth decay in New Zealand. Author(s): Colquhoun J. Source: Community Dentistry and Oral Epidemiology. 1992 June; 20(3): 161-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1623712

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Prevalence and distribution of enamel defects and dental caries in a region with different concentrations of fluoride in drinking water in Sri Lanka. Author(s): Ekanayake L, van der Hoek W. Source: Int Dent J. 2003 August; 53(4): 243-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12953893

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Preventing baby bottle tooth decay in American Indian and Alaska native communities: a model for planning. Author(s): Bruerd B, Kinney MB, Bothwell E. Source: Public Health Reports (Washington, D.C. : 1974). 1989 November-December; 104(6): 631-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2511598

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Preventing baby bottle tooth decay: eight-year results. Author(s): Bruerd B, Jones C. Source: Public Health Reports (Washington, D.C. : 1974). 1996 January-February; 111(1): 63-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8610193

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Prevention of dental caries in partially erupted permanent teeth with a CO2 laser. Author(s): Kato J, Moriya K, Jayawardena JA, Wijeyeweera RL, Awazu K. Source: Journal of Clinical Laser Medicine & Surgery. 2003 December; 21(6): 369-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14709222

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Relation of salivary inorganic phosphorus and alkaline phosphatase to the dental caries status in children. Author(s): Gandhy M, Damle SG. Source: J Indian Soc Pedod Prev Dent. 2003 December; 21(4): 135-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14765611

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Reliability of digital radiography of interproximal dental caries. Author(s): Sanden E, Koob A, Hassfeld S, Staehle HJ, Eickholz P. Source: Am J Dent. 2003 June; 16(3): 170-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12967070

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Results of a promising open trial to prevent baby bottle tooth decay: a fluoride varnish study. Author(s): Weinstein P, Domoto P, Koday M, Leroux B. Source: Asdc J Dent Child. 1994 September-December; 61(5-6): 338-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7897002

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Social deprivation and tooth decay in Scottish schoolchildren. Author(s): Jones CM, Woods K, Taylor GO. Source: Health Bull (Edinb). 1997 January; 55(1): 11-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9090173

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Sports drinks and tooth decay. Author(s): Murray B, Moss SJ. Source: The Journal of the American Dental Association. 1997 September; 128(9): 1200, 1202, 1204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9297941

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Stress and tooth decay. Author(s): Smith GE. Source: Probe (Lond). 1989 September; 31(9): 12-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2631105

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Sugar, sugar substitutes, and tooth decay. Author(s): Brook M. Source: Community Health (Bristol). 1972 May-June; 3(6): 257-62. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5073827

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Sugars and dental caries. Author(s): Touger-Decker R, van Loveren C. Source: The American Journal of Clinical Nutrition. 2003 October; 78(4): 881S-892S. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14522753

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Ten-year incidence of tooth loss and dental caries in elderly Swedish individuals. Author(s): Fure S. Source: Caries Research. 2003 November-December; 37(6): 462-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14571127

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The association between socioeconomic development at the town level and the distribution of dental caries in Brazilian children. Author(s): Peres MA, Peres KG, Antunes JL, Junqueira SR, Frazao P, Narvai PC. Source: Revista Panamericana De Salud Publica = Pan American Journal of Public Health. 2003 September; 14(3): 149-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14653902

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The bilateral occurrence of dental caries among 12-13 and 15-19 year old school children. Author(s): Wyne AH. Source: The Journal of Contemporary Dental Practice [electronic Resource]. 2004 February 15; 5(1): 42-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14973559

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The mystery of declining tooth decay. Author(s): Diesendorf M. Source: Nature. 1986 July 10-16; 322(6075): 125-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3523258

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The pathogenesis of streptococcal infections: from tooth decay to meningitis. Author(s): Mitchell TJ. Source: Nat Rev Microbiol. 2003 December; 1(3): 219-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15035026

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The prevalence of baby bottle tooth decay among two native American populations. Author(s): Kelly M, Bruerd B. Source: J Public Health Dent. 1987 Spring; 47(2): 94-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3471967

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The relationship between healthful eating practices and dental caries in children aged 2-5 years in the United States, 1988-1994. Author(s): Dye BA, Shenkin JD, Ogden CL, Marshall TA, Levy SM, Kanellis MJ. Source: The Journal of the American Dental Association. 2004 January; 135(1): 55-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14959875

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The relationship between periodontitis and tooth decay in juvenile diabetes mellitus cases and in healthy children. Author(s): Akyuz S, Oktay C. Source: J Marmara Univ Dent Fac. 1990 September; 1(1): 58-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2129918

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The relationship between water fluoridation and socioeconomic deprivation on tooth decay in 5-year-old children. Author(s): Jones CM, Worthington H. Source: British Dental Journal. 1999 April 24; 186(8): 397-400. Erratum In: Br Dent J 2000 October 14; 189(7): 390. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10365462

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The Star Wars of dentistry. Using the erbium laser to treat tooth decay. Author(s): Margolis F. Source: Cds Rev. 2002 March-April; : 26-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11957829

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The use of topical fluoride to prevent or reverse dental caries. Author(s): Jacobsen P, Young D. Source: Spec Care Dentist. 2003 September-October; 23(5): 177-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14965183

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Tooth decay in our poorest children: what can we do? Author(s): Milgrom P. Source: J Indiana Dent Assoc. 2000-01; 79(4): 24-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11314077

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Tooth decay in the developing world. Author(s): Smith GE. Source: N Z Med J. 1987 October 28; 100(834): 669-70. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3452146

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Tooth decay in the developing world: could a vaccine help prevent cavities? Author(s): Smith GE. Source: Perspectives in Biology and Medicine. 1988 Spring; 31(3): 440-53. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3293018

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Tooth decay rising? Author(s): Readhead P. Source: The Journal of the American Dental Association. 1997 December; 128(12): 1626, 1628. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9415755

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Tooth decay, dietary changes and disease. Author(s): Dickens C. Source: Aust Dent J. 1998 April; 43(2): 133. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9612989

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Tooth decay. Author(s): Sanders HJ. Source: Dental Assistant (Chicago, Ill. : 1994). 1981 March-April; 50(2): 17-9, 32 Contd. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6945215

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Tooth decay. Author(s): Sanders HJ. Source: J Calif Dent Assoc. 1981 January; : 37-49. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6937466

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Tooth decay. Author(s): Walker AR. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1973 September 22; 47(37): 1695-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4148541

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Tooth decay. Part II. Author(s): Sanders HJ. Source: Dental Assistant (Chicago, Ill. : 1994). 1981 May-June; 50(3): 25-7, 32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6945220

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Tooth decay. Part III. Author(s): Sanders HJ. Source: Dental Assistant (Chicago, Ill. : 1994). 1981 July-August; 50(4): 28-31, 48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6945225

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Treating and preventing tooth decay. Author(s): Keniry AJ. Source: Midwife Health Visit Community Nurse. 1986 October; 22(10): 354-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3641001

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Validation methodology in publications describing epidemiological registration methods of dental caries: a systematic review. Author(s): Sjogren P, Ordell S, Halling A. Source: Community Dent Health. 2003 December; 20(4): 251-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14696746

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Vegetarian vs. normal as casual agents in tooth decay. Author(s): Herre CW, Herwig RV. Source: J Kans State Dent Assoc. 1977 October; 61(4): 12-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=96194

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Water fluoridation and tooth decay in 5 year olds. Authors did not compare like with like. Author(s): Gibson SL, Gibson RG. Source: Bmj (Clinical Research Ed.). 1998 January 17; 316(7126): 231. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9468712

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Water fluoridation and tooth decay in 5 year olds. Samples were unequal and too small. Author(s): Vemmer T. Source: Bmj (Clinical Research Ed.). 1998 January 17; 316(7126): 230-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9468711

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Water fluoridation in Philadelphia reduced tooth decay among school-children by 49.6% in 31 years. Author(s): Costa AB. Source: Pa Dent J (Harrisb). 1988 May-June; 55(3): 16. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2480563

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Water fluoridation, poverty and tooth decay in 12-year-old children. Author(s): Jones CM, Worthington H. Source: Journal of Dentistry. 2000 August; 28(6): 389-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10856802

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Water fluoridation, tooth decay in 5 year olds, and social deprivation measured by the Jarman score: analysis of data from British dental surveys. Author(s): Jones CM, Taylor GO, Whittle JG, Evans D, Trotter DP. Source: Bmj (Clinical Research Ed.). 1997 August 30; 315(7107): 514-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9329305

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Xylitol: a sugar that fights tooth decay. Author(s): Passson C. Source: J Colo Dent Assoc. 1993 April; 71(3): 19-23. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8408742

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Xylitol: the sugar that does not cause tooth decay. Author(s): Makinen KK. Source: Refuat Hapeh Vehashinayim. 1978 April; 27(2): 36-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=283060

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Xylitol: the sugar that prevents tooth decay. Author(s): Svenson D, Bridges D. Source: Dent Hyg (Chic). 1977 September; 51(9): 401. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=348510

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CHAPTER 2. NUTRITION AND TOOTH DECAY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and tooth decay.

Finding Nutrition Studies on Tooth Decay The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “tooth decay” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “tooth decay” (or a synonym): •

A fluoride analysis program to reduce tooth decay in rural children. Source: Nichols, W A J-Ark-Med-Soc. 1989 December; 86(7): 273-4 0004-1858

•

A study of baby bottle tooth decay and risk factors for 18-month old infants in rural Japan. Author(s): Department of Pediatric Dentistry, University of Washington. Source: Tsubouchi, J Higashi, T Shimono, T Domoto, P K Weinstein, P ASDC-J-DentChild. 1994 Jul-August; 61(4): 293-8 0022-0353

•

Baby-bottle tooth decay: are we on the right track? Author(s): Department of Community Health Sciences, Winnipeg, Manitoba, Canada. Source: Smith, P J Moffatt, M E Int-J-Circumpolar-Health. 1998; 57 Suppl 1155-62 12399736

•

Dental caries in developing countries. Preventive and restorative approaches to treatment. Author(s): Columbia University School of Dental and Oral Surgery, USA. Source: Cirino, S M Scantlebury, S N-Y-State-Dent-J. 1998 February; 64(2): 32-9 0028-7571

•

Diet and dental caries in preschool children. Author(s): ICRC, Geneva, Switzerland. Source: McMahon, J Parnell, W R Spears, G F Eur-J-Clin-Nutr. 1993 November; 47(11): 794-802 0954-3007

•

Early childhood tooth decay. Pediatric interventions. Author(s): Department of Restorative and Preventive Dentistry, Loyola University Chicago School of Dentistry, Maywood, IL 60153. Source: Schulte, J R Druyan, M E Hagen, J C Clin-Pediatr-(Phila). 1992 December; 31(12): 727-30 0009-9228

•

Epidemiology of dental caries. Author(s): Department of Children's Dentistry, Eastman Dental Hospital, London, England. Source: Winter, G B Arch-Oral-Biol. 1990; 35 Suppl1S-7S 0003-9969

•

Ethnicity, location, age, and fluoridation factors in baby bottle tooth decay and caries prevalence of Head Start children. Source: Barnes, G.P. Parker, W.A. Lyon, T.C. Jr. Drum, M.A. Coleman, G.C. PublicHealth-Rep. Rockville, Md. : U.S. Department of Health & Human Services, Public Health Service. Mar/April 1992. volume 107 (2) page 167-173. 0033-3549

•

For the dental patient: Diet and tooth decay. Source: Anonymous J-Am-Dent-Assoc. 2002 April; 133(4): 527 0002-8177

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Head start combats baby bottle tooth decay. Source: Phillips, M G Stubbs, P E Child-Today. 1987 Sep-October; 16(5): 25-8 0361-4336

•

Periodic health examination, 1995 update: 2. Prevention of dental caries. The Canadian Task Force on the Periodic Health Examination. Source: Lewis, D W Ismail, A I CMAJ. 1995 March 15; 152(6): 836-46 0820-3946

•

Prevention and reversal of dental caries: role of low level fluoride. Author(s): Department of Restorative Dentistry, University of California at San Francisco, 94143, USA. [email protected] Source: Featherstone, J D Community-Dent-Oral-Epidemiol. 1999 February; 27(1): 31-40 0301-5661

Nutrition

33

•

Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention. Source: Anonymous MMWR-Morb-Mortal-Wkly-Repage 2001 August 17; 50(RR-14): 142 0149-2195

•

Results of a promising open trial to prevent baby bottle tooth decay: a fluoride varnish study. Author(s): Dental Public Health Sciences, University of Washington, Seattle. Source: Weinstein, P Domoto, P Koday, M Leroux, B ASDC-J-Dent-Child. 1994 SepDecember; 61(5-6): 338-41 0022-0353

•

The role of xylitol in the prevention of dental caries. Source: Macdonald, H.B. J-Can-Diet-Assoc. Toronto, Ont. : The Association. Winter 1988. volume 49 (1) page 49-51. charts. 0008-3399

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

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•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMDHealth: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to tooth decay; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Minerals Sodium Fluoride Source: Healthnotes, Inc.; www.healthnotes.com

•

Food and Diet Cherries Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,49,00.html Cinnamon Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,271,00.html Sugar Alcohols Source: Healthnotes, Inc.; www.healthnotes.com Water Source: Healthnotes, Inc.; www.healthnotes.com

35

CHAPTER 3. ALTERNATIVE MEDICINE AND TOOTH DECAY Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to tooth decay. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to tooth decay and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “tooth decay” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to tooth decay: •

An In vitro microbial-caries model used to study the efficacy of antibodies to Streptococcus mutans surface proteins in preventing dental caries. Author(s): Fontana M, Buller TL, Dunipace AJ, Stookey GK, Gregory RL. Source: Clinical and Diagnostic Laboratory Immunology. 2000 January; 7(1): 49-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10618276

•

Another update for Canadian dentists regarding chlorhexidine varnish therapy for the prevention of dental caries. Author(s): Lewis DW. Source: Journal (Canadian Dental Association). 1994 August; 60(8): 717-20; Discussion 721-2, 725. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8087680

•

Antibacterial activity of Camellia sinensis extracts against dental caries. Author(s): Rasheed A, Haider M.

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Source: Arch Pharm Res. 1998 June; 21(3): 348-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9875456 •

Assessing risk indicators for dental caries in the primary dentition. Author(s): Vanobbergen J, Martens L, Lesaffre E, Bogaerts K, Declerck D. Source: Community Dentistry and Oral Epidemiology. 2001 December; 29(6): 424-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11784285

•

Black tea extract and dental caries formation in hamsters. Author(s): Linke HA, LeGeros RZ. Source: International Journal of Food Sciences and Nutrition. 2003 January; 54(1): 89-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12701240

•

Canadian Consensus Conference on the appropriate use of fluoride supplements for the prevention of dental caries in children. Author(s): Limeback H, Ismail A, Banting D, DenBesten P, Featherstone J, Riordan PJ. Source: Journal (Canadian Dental Association). 1998 October; 64(9): 636-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9812431

•

Changing patterns of dental caries in Ethiopian adolescents who immigrated to Israel. Author(s): Sarnat H, Cohen S, Gat H. Source: Community Dentistry and Oral Epidemiology. 1987 October; 15(5): 286-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3477362

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Control of dental caries. Author(s): Newbrun E. Source: Southern Medical Journal. 1977 October; 70(10): 1161-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=910166

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Dental caries and dental fluorosis among schoolchildren who were lifelong residents of communities having either low or optimal levels of fluoride in drinking water. Author(s): Selwitz RH, Nowjack-Raymer RE, Kingman A, Driscoll WS. Source: J Public Health Dent. 1998 Winter; 58(1): 28-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9608443

•

Dental caries experience in Indians of the Upper Xingu, Brazil. Author(s): Rigonatto DD, Antunes JL, Frazao P. Source: Revista Do Instituto De Medicina Tropical De Sao Paulo. 2001 March-April; 43(2): 93-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11340483

Alternative Medicine 37

•

Dental caries in nineteenth century upper Canada. Author(s): Saunders SR, De Vito C, Katzenberg MA. Source: American Journal of Physical Anthropology. 1997 September; 104(1): 71-87. Erratum In: Am J Phys Anthropol 1998 March; 105(3): 405. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9331454

•

Dental caries in South African rural black women who had large families and long lactations. Author(s): Walker AR, Dison E, Walker BF. Source: J Trop Med Hyg. 1983 December; 86(6): 201-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6672228

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Dental caries prevalence and the use of fluorides in different European countries. Author(s): Kalsbeek H, Verrips GH. Source: Journal of Dental Research. 1990 February; 69 Spec No: 728-32; Discussion 820-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2312894

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Dental caries prevention by traditional Chinese medicines. Part II. Potent antibacterial action of Magnoliae cortex extracts against Streptococcus mutans. Author(s): Namba T, Tsunezuka M, Hattori M. Source: Planta Medica. 1982 February; 44(2): 100-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7071194

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Dental caries, fluoride levels and oral hygiene practices of school children in Matebeleland South, Zimbabwe. Author(s): Sathananthan K, Vos T, Bango G. Source: Community Dentistry and Oral Epidemiology. 1996 February; 24(1): 21-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8833509

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Dental caries, fluorosis, and fluoride exposure in Michigan schoolchildren. Author(s): Szpunar SM, Burt BA. Source: Journal of Dental Research. 1988 May; 67(5): 802-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3284939

•

Does raw sugar cane juice protect against dental caries. Author(s): Fox FW, Noriskin JN. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1976 December 25; 50(55): 2146. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1013866

•

Effect of dietary supplements of fluoride on development of dental caries in the rat. Author(s): Joost Larsen M, Poulsen S, Thylstrup A.

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Source: Caries Research. 1978; 12(3): 180-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=272955 •

Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Author(s): Nase L, Hatakka K, Savilahti E, Saxelin M, Ponka A, Poussa T, Korpela R, Meurman JH. Source: Caries Research. 2001 November-December; 35(6): 412-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11799281

•

Effects of propolis on dental caries in rats. Author(s): Ikeno K, Ikeno T, Miyazawa C. Source: Caries Research. 1991; 25(5): 347-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1836157

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Effects on dental caries incidence of frequent ingestion of small amounts of sugars and stannous EDTA in chewing gum. Author(s): Glass RL. Source: Caries Research. 1981; 15(3): 256-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6783308

•

Fluoride supplements and changes in tooth decay on the Island of Tristan da Cunha: 1966-1996. Author(s): Mossey PA, Southwick CA, Wrieden WL, Longbottom P, Topping G, Stirrups DR. Source: British Dental Journal. 2003 August 9; 195(3): 159-62; Discussion 149. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12907985

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Incidence of dental caries in Lucknow school-going children. Author(s): Chandra S, Chawla TN. Source: J Indian Dent Assoc. 1979 April; 51(4): 109-10. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=296202

•

Letter: Does raw sugar cane juice protect against dental caries? Author(s): Fox FW, Noriskin JN. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1976 May 8; 50(20): 760. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=935949

•

Oolong tea polyphenols inhibit experimental dental caries in SPF rats infected with mutans streptococci. Author(s): Ooshima T, Minami T, Aono W, Izumitani A, Sobue S, Fujiwara T, Kawabata S, Hamada S.


Source: Caries Research. 1993; 27(2): 124-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8319255 •

Oral lesions and dental caries status in perinatally HIV-infected children in Northern Thailand. Author(s): Pongsiriwet S, Iamaroon A, Kanjanavanit S, Pattanaporn K, Krisanaprakornkit S. Source: International Journal of Paediatric Dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children. 2003 May; 13(3): 180-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12752917

•

Patterns of breast and bottle feeding and their association with dental caries in 1- to 4year-old South African children. 1. Dental caries prevalence and experience. Author(s): Roberts GJ, Cleaton-Jones PE, Fatti LP, Richardson BD, Sinwel RE, Hargreaves JA, Williams S. Source: Community Dent Health. 1993 December; 10(4): 405-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8124629

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Prevention of dental caries by acupuncture. Author(s): Shimura N, Nakamura C, Hirayama Y, Turumoto A, Okada S. Source: Bull Tokyo Med Dent Univ. 1980 September; 27(3): 137-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6936090

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Prevention of dental caries by Oriental folk medicines--active principles of Zizyphi Fructus for inhibition of insoluble glucan formation by cariogenic bacterium Streptococcus mutans. Author(s): Kohda H, Kozai K, Nagasaka N, Miyake Y, Suginaka H, Hidaka K, Yamasaki K. Source: Planta Medica. 1986 April; (2): 119-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3725931

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Proposed approach to dental caries and oral hygiene via a mouthwash. Author(s): Oliver VM. Source: Meharri Dent. 1968 June; 27(3): 16. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4970874

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Question from the clinician: fluoride supplementation and dental caries. Author(s): Gleiner S. Source: Pediatrics in Review / American Academy of Pediatrics. 2002 May; 23(5): 186-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11986495

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Relationship between dental caries and vegetarian and non-vegetarian diets. Author(s): Rahmatulla M, Guile EE.

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Source: Community Dentistry and Oral Epidemiology. 1990 October; 18(5): 277-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2249415 •

Relationship of betel chewing and dental caries. Author(s): Chandra S, Desai VM. Source: J Indian Dent Assoc. 1970 November; 42(11): 269-76. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4395934

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Risk factors in dental caries. Author(s): Hunter PB. Source: Int Dent J. 1988 December; 38(4): 211-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3063664

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Short-term consumption of probiotic-containing cheese and its effect on dental caries risk factors. Author(s): Ahola AJ, Yli-Knuuttila H, Suomalainen T, Poussa T, Ahlstrom A, Meurman JH, Korpela R. Source: Archives of Oral Biology. 2002 November; 47(11): 799-804. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12446187

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Stress, relaxation and saliva: relationship to dental caries and its prevention, with a literature review. Author(s): Morse DR, Schacterle GR, Furst ML, Esposito JV, Zaydenburg M. Source: Ann Dent. 1983 Winter; 42(2): 47-54. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6399971

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Studies on dental caries prevention by traditional medicines. VIII. Inhibitory effect of various tannins on glucan synthesis by glucosyltransferase from Streptococcus mutans. Author(s): Kakiuchi N, Hattori M, Nishizawa M, Yamagishi T, Okuda T, Namba T. Source: Chemical & Pharmaceutical Bulletin. 1986 February; 34(2): 720-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2939967

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Studies on dental caries prevention by traditional medicines. X. Antibacterial action of phenolic components from mace against Streptococcus mutans. Author(s): Hattori M, Hada S, Watahiki A, Ihara H, Shu YZ, Kakiuchi N, Mizuno T, Namba T. Source: Chemical & Pharmaceutical Bulletin. 1986 September; 34(9): 3885-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3815609

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Sugar consumption and dental caries. Author(s): Nadanovsky P.


Source: British Dental Journal. 1994 October 22; 177(8): 280-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7946663 •

The relation between betel chewing and dental caries. Author(s): Moller IJ, Pindborg JJ, Effendi I. Source: Scand J Dent Res. 1977 January; 85(1): 64-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=265084

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The relative effects of three dietary supplements on dental caries. Author(s): Finn SB, Jamison HC. Source: Asdc J Dent Child. 1980 March-April; 47(2): 109-13. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6928859

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The role of early dietary habits in dental caries development. Author(s): Ismail AI. Source: Spec Care Dentist. 1998 January-February; 18(1): 40-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9791306

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Vegetarian vs. normal as casual agents in tooth decay. Author(s): Herre CW, Herwig RV. Source: J Kans State Dent Assoc. 1977 October; 61(4): 12-4.

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•


•

Chinese Medicine: http://www.newcenturynutrition.com/

•

drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

•

Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMDHealth: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to tooth decay; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Ear Infection Source: Integrative Medicine Communications; www.drkoop.com Gingivitis Source: Healthnotes, Inc.; www.healthnotes.com Immune Function Source: Healthnotes, Inc.; www.healthnotes.com Multiple Sclerosis Source: Healthnotes, Inc.; www.healthnotes.com Otitis Media Source: Integrative Medicine Communications; www.drkoop.com

•

Chinese Medicine Bibo Alternative names: Long Pepper; Fructus Piperis Longi Source: Chinese Materia Medica

•

Herbs and Supplements Alfalfa Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Camellia Sinensis Source: Integrative Medicine Communications; www.drkoop.com Chaparral Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Green Tea Alternative names: Camellia sinensis Source: Healthnotes, Inc.; www.healthnotes.com Green Tea Alternative names: Camellia sinensis Source: Integrative Medicine Communications; www.drkoop.com


Green Tea Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10032,00.html Gymnema Alternative names: Gurmar; Gymnema sylvestre Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Strontium Source: Healthnotes, Inc.; www.healthnotes.com Zizyphus Alternative names: Jujube; Ziziphus sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON TOOTH DECAY Overview In this chapter, we will give you a bibliography on recent dissertations relating to tooth decay. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “tooth decay” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on tooth decay, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Tooth Decay ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to tooth decay. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Changes in disparities in dental caries experiences in United States adults by Lubwama, Robert N.; PhD from University of Michigan, 2003, 140 pages http://wwwlib.umi.com/dissertations/fullcit/3079494

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THE EFFECTS OF VISUAL AND AUDITORY ACUITY LOSSES AND DENTAL CARIES ON ACADEMIC ACHIEVEMENT AMONG DISADVANTAGED THIRDGRADE CHILDREN. by GASTON, ALONZO DUBOIS, EDD from University of Cincinnati, 1974, 149 pages http://wwwlib.umi.com/dissertations/fullcit/7502329

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WATER-BORNE MOLYBDENUM: A STUDY OF ITS RELATIONSHIP TO DENTAL CARIES IN COLORADO. by LUDINGTON, THEODORA TSONGAS, PHD from University of Colorado at Boulder, 1976, 167 pages http://wwwlib.umi.com/dissertations/fullcit/7623648

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Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. PATENTS ON TOOTH DECAY Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “tooth decay” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on tooth decay, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Tooth Decay By performing a patent search focusing on tooth decay, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on tooth decay: •

Alkaline oral hygiene composition Inventor(s): Libin; Barry M. (15 Thornhedge Rd., Bellport, NY 11713) Assignee(s): None Reported Patent Number: 5,645,821 Date filed: October 6, 1995 Abstract: An alkaline oral hygiene composition which when brushed or otherwise applied to surfaces of the teeth and adjacent gingival tissue functions not only to clean and whiten the teeth but also to prevent the formation of plaque, to neutralize acids causing tooth decay and to remove from the surfaces extraneous material which discolor the teeth. Included in the composition is at least one alkaline metal compound powder having minimal abrasivity which imparts to the composition an overall pH in excess of 9 whereby when used in the acidic environment of the oral cavity, retains its alkalinity to counteract the activity of pathogenic bacteria causing plaque and to neutralize the production in the oral cavity of acids causing tooth decay. The alkaline composition also saponifies foreign material attached to the teeth surfaces so that these materials which discolor the teeth can be washed away. Excerpt(s): This invention relates generally to oral hygiene compositions which are brushed or otherwise applied to surfaces of the teeth and adjacent gum tissues, and in particular to a composition which includes an alkaline metal compound powder, the composition not only acting to clean and whiten the teeth but also to counteract the formation of plaque, to neutralize acids responsible for tooth decay, and to remove extraneous material from the surfaces of the teeth which otherwise discolor the teeth. As noted in the Leopold U.S. Pat. No. 4,485,089, the typical toothpaste for cleaning and whitening teeth makes use for this purpose of a dental abrasive, such as silica. Such abrasives score and damage the enamel surface of the teeth. Also included in a typical toothpaste is a cleaning agent such as dicalcium phosphate, water and a humectant, such as glycerin or sorbitol. A humectant serves to retain moisture in the toothpaste, particularly, at the nozzle of the tube where the paste can be in prolonged contact with the air. A conventional toothpaste mainly carries out a cosmetic function. While it serves in conjunction with a toothbrush to clean the teeth and improve their appearance, the toothpaste does little to prevent tooth decay, to inhibit the growth of plaque or to in other respects maintain the teeth and gums in a healthy condition. Web site: http://www.delphion.com/details?pn=US05645821__

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Apparatus for the treatment of dental caries Inventor(s): Baysan; Aylin (London, GB), Holland; Gregory R. (Irvine, CA), Lynch; Edward (Belfast, GB), Mc Pherson; Roger (Cerritos, CA), Schemmer; Jurgen H. (King City, CA), Weisel; Tom (Mesa, CA) Assignee(s): Curozone Ireland Limited (ie) Patent Number: 6,454,566 Date filed: November 13, 2000

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Abstract: Apparatus for the treatment of dental caries includes a source of oxidizing gas and a handpiece for delivering the gas to a tooth. A cup attached to the handpiece is provided for receiving the gas and exposing a selected area of the tooth to the gas. The cup includes a resilient edge for sealably the edge for engaging the tooth around the selected area to prevent escape of a gas therepast. Excerpt(s): The present invention generally relates to the treatment of dental caries, and more particularly is directed to apparatus for the treatment of dental caries utilizing an oxidizing gas. The role of specific micro-organism such as, for example, streptococcus mutants in dental caries is well documented. Enzymes produced by such microorganisms synthesize dextran from the sucrose passing through the month with food or drink resulting in the formation of dental plaque and dental caries. Dental caries is the decay of teeth caused by demineralization of the enamel surface with organic acids produced by bacteria which adhere to teeth surfaces. Web site: http://www.delphion.com/details?pn=US06454566__ •

Bacteriophage-encoded enzymes for the treatment and prevention of dental caries and periodontal diseases Inventor(s): Delisle; Allan L. (Sykesville, MD) Assignee(s): University of MD (college Park, Md) Patent Number: 6,635,238 Date filed: September 14, 2001 Abstract: A method for the treatment and prevention of dental caries and periodontal diseases using bacteriophages and phage-encoded anti-bacterial enzymes to inhibit establishment of bacteria in the oral cavity is provided. Also provided are methods for studying the cell wall of an oral bacterium, a method for preventing spoilage of perishable items and a method for removing dextrans from surfaces utilized in sugar manufacture. Purified enzymes and the isolated DNA fragments encoding them are also provided. Excerpt(s): This invention relates to bacteriophage-encoded enzymes useful in preventing dental caries and periodontal diseases. More specifically, this invention relates to lysozyme-like enzymes isolated from bacteriophages which are capable of killing cariogenic bacteria and other periodontal disease-causing organisms. The invention also relates to dextranase-like enzymes suitable for dental treatments (i.e., loosening plaque) and other applications where it is desired to remove dextran and other bacterial polysaccharides (i.e., mutan) synthesized from sucrose. With regard to their function in dental plaque, phages are likely to influence the plaque flora in several potentially significant ways. Prophages, for example, provide immunity to superinfection by homoimmune phages and would presumably assist lysogens which carry them in competing with other bacteria in plaque by killing phage-sensitive competitors in a manner analogous to bacteriocinogenic cells. The semi-solid nature of dental plaque provides an especially favorable environment for this type of competition. Alternatively, lytic phage would be expected to select for phage-resistant mutants of sensitive strains and for mucoid mutants (phenotypically phage-resistant), which could well have altered colonizing and pathogenic properties. Actinophage-resistant mutants have in fact already been used to study cell surface structures that appear to be involved in specific, intergeneric oral bacterial coagreggation reactions (Delisle, A. L. et al (1988) Infect. Immun. 56:54-59; Tylenda, C. A. et al (1985) Infect. Immun. 48:228-233), which are

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believed to play an important role in colonization of dental plaque (Kolenbrander, P. E. et al (1985) In, S. E. Murgenhagen and B. Rosan (eds) pp. 164-171, American Society for Microbiology, Washington, D.C.). The literature on S. mutans phages dates back to 1970, when Greer first claimed to be able to induce phages, by treatment with mitomycin C, from oral streptococcal strains AHT, BHT and HHT (Greer, S. W., et al (1970) IADR Abstr. 160; J. Dent. Res, 48A:88) and subsequently claimed that the same virus was present in all of eight cariogenic streptococci he examined, but not in non-cariogenic strains (Greer, S. W., et al (1971) J. Dent. Res. 50:1594-1604). He then reported that lysogens could be cured of their prophages by treatment with acridine orange (Greer, S. W., et al (1971) IADR Abstr. 57: J. Dent. Res. 49:67) and nitrosoguanidine (Greer, S. W., et al (1972) IADR Abstr. 68: J. Dent. Res. 50:65). The latter was used to isolate temperaturesensitive mutants, one of which was heat-inducible and could be used to obtain cured cells by brief heating. Greer also proposed a curing procedure based on radiosensitization of DNA by incorporating 5-bromodeoxyuridine lysogens (Ramberg, E. et al (1973) IADR Abstr. 113: J. Dent. Res. 52a), but its application to S. mutans was never subsequently reported. Greer never reported the successful isolation of an infectious phage which could be grown in S. mutans. Difficulties in repeating Greer's induction experiments led many microbiologists to assume that he was really working with enterococci, which were common contaminants in the oral streptococcal cultures being exchanged among various laboratories during this time. Web site: http://www.delphion.com/details?pn=US06635238__ •

Breath mint with tooth decay and halitosis prevention characteristics Inventor(s): Thistle; Robert (P.O. Box 19296, Johnston, RI 02919) Assignee(s): None Reported Patent Number: 6,083,527 Date filed: November 5, 1998 Abstract: A candy-like confection which contains a natural sweetener is provided. The confection preferably includes XYLITOL as the natural sweetener and calcium hydroxide which increases the pH level of the saliva in the mouth to reduced the presence of bacteria in the mouth. As a result, resultant tooth decay and associated bad breath are prevented. Vitamins may be added to the confection to enable the simultaneous delivery of vitamins, prevention of tooth decay prevention and bad breath while enjoying a candy-like confection. Excerpt(s): The present invention relates generally to the field of oral hygiene. More specifically, this invention relates to the field of tooth decay and halitosis prevention. It is known that plaque is a microbial coating on tooth surfaces, bound together by natural polymers (mucopolysaccharides), formed by microbial action on the cell debris, food remnants, sugars and starches in the mouth. Embedded in this polymer matrix are the bacteria normal to the oral cavity but, when trapped against tooth surfaces and protected by the matrix from easy removal, problems result. Most dental texts implicate plaque in the formation of tooth decay. In addition, these embedded bacteria release toxins that cause gingivitis, bleeding and swelling of the gums. Gingivitis can lead to periodontis in which gums recede, pockets of infection form and teeth loosen. Plaque formation is an ongoing process. Various gel and paste dentrifice preparations, mouth rinse and mouth prerinse preparations made plaque and/or tartar control claims. One disadvantage of these preparations is that only a relatively short time during which the teeth are being cleaned or the mouth is being rinsed is available for the preparations to

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take effect. These preparations generally have little residual effect on plaque formation. Additionally, some of these preparations such as mouth rinses and prerinses contain various antimicrobial substances which may alter the critically balanced microflora of the mouth. Another disadvantage of these preparations is the general infrequency of use. That is, most are used once or perhaps twice daily and seldom when they are most needed, e.g., after meals, snacks, smoking, drinking, coffeebreaks, etc. Web site: http://www.delphion.com/details?pn=US06083527__ •

Cariostatic materials and foods, and method for preventing dental caries Inventor(s): Hiji; Yasutake (c/o Tottori University School of Medicine, 86, Nishi-machi, Yonago-shi, Tottori-ken, JP) Assignee(s): None Reported Patent Number: 4,912,089 Date filed: November 6, 1987 Abstract: The decomposition of sugar and production of glucan by Streptococcus mutans which causes dental caries are prevented by a purified Gymnemic acid as a cariostatic material derived from Gymnema sylvestre. The Gymnema sylvestre itself is used as a cariostatic food. Excerpt(s): The present invention relates to cariostatic materials and foods and further to a method for preventing dental caries. Dental caries afflict humankind from ancient times, and particular attention has been given to a relationship between sugar and dental caries from the time when it was prevailingly said that "Degree of Consumption of Sugar is Barometer of Culture". Many results of researchers for prevention of dental caries have been accumulated. Basic points of view of methods for preventing dental caries have conventionally been in that Streptococcus mutans which are one kind of Streptcoccus are excluded from the mouth or oral cavity by administration of germicide or antibiotic; in that cariostatic artificial sweet materials are employed and sugar is not ingested; and in that dentine is strengthened using fluoridating to resist the attack by the Streptoccocus mutans. Web site: http://www.delphion.com/details?pn=US04912089__

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Cell-associated glucosyltransferase, an antibody thereto, and a dental caries prophylactic composition containing said antibody as an effective component Inventor(s): Fujita; Isamu (Ikeda, JP), Hiraoka; Junichiro (Yokohama, JP), Horikoshi; Toshio (Odawara, JP), Kodama; Yoshikatsu (Gifu, JP), Tokoro; Tohru (Gifu, JP), Yokoyama; Hideaki (Kakamigahara, JP) Assignee(s): Ghen Corporation (gifu, Jp), Kanebo Ltd. (tokyo, Jp) Patent Number: 5,439,680 Date filed: December 2, 1994 Abstract: Cell-associated glucosyltransferase of S. mutans serotypes c, e or f producing dental caries was isolated and purified and its characteristics as an enzyme were revealed. Furthermore, an antibody against said enzyme was prepared from eggs of the hens immunized with said enzyme. Since this antibody effectively prevents adherence

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of the aforementioned S. mutans to tooth surfaces, it is useful as an effective component for a dental caries prophylactic composition. Excerpt(s): The present invention relates to cell-associated glucosyltransferase which reacts with sucrose and catalyzes a reaction of synthesizing water-insoluble glucans, to a method of purifying this enzyme and to a method of producing this enzyme. The present invention also relates to an antibody having immunological activity against Streptococcus mutans which is known as pathogenic bacteria inducing dental-caries and to a dental caries prophylactic composition which contains said antibody as an effective component. In view of dental caries prophylaxis, a number of investigations have been undertaken to elucidate the properties of S. mutans known as causative bacteria for dental caries and the mechanism of involvement of said bacteria in the development of dental caries. Web site: http://www.delphion.com/details?pn=US05439680__ •

Chewing gum designed to prevent tooth decay by blending a soluble extract of cacao bean husk Inventor(s): An; Bong J. (Kyungpuk, KR), Kwon; Ik B. (Seoul, KR), Park; Hyung H. (Seoul, KR) Assignee(s): Lotte Confectionery Co., Ltd. (seoul, Kr) Patent Number: 4,908,212 Date filed: January 13, 1989 Abstract: Chewing gum designed to prevent tooth decay, for which a cacao bean husk is extracted by adding water or ethyl alcohol and an extract which is freeze dried after solvent is collected and concentrated by vacuum evaporation is added to the known raw materials of chewing gum in the ratio of 0.1-1.0%. Excerpt(s): The present invention relates to chewing gum blended of an extract of cacao bean husk. More particularly, it relates to chewing gum blended of a soluble extract of cacao bean husk gifted with a biologically active function for the prevention of tooth decay by blocking the synthesis of insoluble glucan (plaque). Recently, decayed teeth are increasing in number due to excessive ingestion of sugar in particular. The major cause of decayed teeth is that glucan is created from sugar by the bacteria existent in the oral cavity and it forms plaque by being attached to the surface of tooth. Thus, teeth are decayed by those bacteria based on such plaque. Web site: http://www.delphion.com/details?pn=US04908212__

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Composite dental cement composition containing titanium Inventor(s): Cohen; Brett I. (Nanuet, NY), Leutsch; Allan S. (New York, NY), Sharma; Brahma D. (Louisville, CO) Assignee(s): Essential Dental Systems, Inc. (south Hackensack, Nj) Patent Number: 5,034,433 Date filed: April 10, 1990 Abstract: A composite dental cement composition that is suitable for application with dental posts for either post insertion in a tooth or during core formation is provided. The

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cement composition includes a polymer matrix in an amount between about 15 and 50 weight percent, a filler in an amount between about 35 and 80 weight percent, and titanium in an amount between about 1 and 15 weight percent. The titanium ingredient chemically interacts with the polymer matrix in order to increase compressive strength of the cement composition. A fluoride compound may be added in order to substantially eliminate caries and further tooth decay. Excerpt(s): This invention relates to a restorative composite dental cement composition, and more particularly, to a dental cement composition having a substantially high compressive strength that is suitable for application with a dental post or as a core build-up material. Dental restorative cement compositions have achieved wide commercial success and are extensively used in clinical dental practice. The leading U.S. patent on dental restorative cement compositions is U.S. Pat. No. 3,066,112 to Bowen, which describes a dental cement composition that consists of a liquid polymerizable organic resin matrix and finely divided inorganic filler materials. As described in the Bowen patent, the liquid polymerizable organic resin matrix is typically prepared by combining bisphenol A-glycidyl methacrylate with one or more active monomers, preferably other methacrylates. As part of the system, a catalyst or initiator is used, such as benzoyl peroxide, along with a base or polymerization accelerator such as a toluidine compound. Other ingredients such as stabilizers, absorbents and pigments may be added to the composition. Web site: http://www.delphion.com/details?pn=US05034433__ •

Composition of anti-cavity chewing gum and method of fighting tooth decay by using erythrose as anticaries agent Inventor(s): Greenberg; Michael J. (Northbrook, IL) Assignee(s): Wm. Wrigley Jr. Company (chicago, Il) Patent Number: 5,294,449 Date filed: April 9, 1992 Abstract: A chewing gum formulation to fight cavities comprises sufficient erythrose to give the chewing gum anti-caries properties. Also disclosed is a method of reducing or preventing dental caries by inhibiting the growth of Streptococcus mutans in the presence of fermentable carbohydrates in the mouth. This method comprises contacting the teeth with chewing gum containing erythrose, wherein the erythrose is present in sufficient quantity to give the chewing gum anti-caries properties. Excerpt(s): This invention relates to a method for preventing or reducing dental caries wherein the carbohydrate erythrose is employed in chewing gum to inhibit growth of Streptococcus mutans ("S. mutans") in the mouth. The present invention also relates to chewing gum formulations containing erythrose. Foods containing natural sugars such as sucrose and dextrose have long been recognized as a major contributing cause of dental caries. The sugars are easily utilizable sources of nutrition for bacteria, specifically S. mutans found in the mouth. This bacteria is also responsible for the formation of plaque. S. mutans ferments residual sugar, thereby producing acids that dissolve the minerals of the teeth. In recent years, certain anti-cariogenic substances have been incorporated into chewing gum and other orally-usable products. For example, U.S. Pat. No. 4,390,523, issued Jun. 28, 1983, to Huchette et al., teaches the substitution of sorbose for sucrose as a sweetener in chewing gum in order to reduce the production of fermentation acids in the mouth.

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Web site: http://www.delphion.com/details?pn=US05294449__ •

Compositions for inhibiting dental caries and/or middle ear infections and uses thereof Inventor(s): Aaltonen; Antti Sakari (Marttilantie 2as.6, FIN-03850 Pusula, FI), Suhonen; Jouko (663 Garth Ct., Yorktown Heights, NY 10598) Assignee(s): None Reported Patent Number: 6,143,330 Date filed: August 24, 1998 Abstract: Compositions for treating or preventing dental caries and/or middle ear infections. These compositions comprise antibodies to dental caries and/or antibodies to bacteria causing middles ear infections and/or an agent preventing the adhesion, accumulation or reporduction of the pathogens of tooth or middle ear. The preferred agent is xylitol. Methods for using these compositions are also included. Excerpt(s): This invention relates to an immune milk preparation for the prevention of middle ear infections (otitis media) in children. The preparation contains antibodies produced against bacteria which cause middle ear infections and, if desired, also dental caries inhibiting agents. So called immune milk can be produced by vaccinating a pregnant cow against certain pathogens whereby the cow organism forms antibodies to these diseases, which antibodies are transferred to the colostrum. The remedying effects of immune milk have been known for a long time. Already since the beginning of the century immunized goat or cow milk has been tested in the treatment of various bacterial and viral diseases. The most important of the more recent studies are concentrated on the diseases dependent on the microbes of the gastrointestinal tract, i.a. rheumatoid arthritis, dental caries, gingivitis, diarrheas, dysentery, gastritis and cryptosporidiosis. A dental caries inhibiting product of immunized cow's milk, which contains specific antibodies to killed Streptococcus mutans cells, is known (U.S. Pat. No. 4,324,782). In the United States usual immune milk is produced by maintaining the antibody level with boosters. The amount of antibodies is rather small, and the effect is based on daily administration. In Taiwan immune milk is sold as a health drink. In Australia powder containing antibodies to rotavirus has been mixed into i.a. infant formulas (Murtomaa-Niskala, 1994). Whole milk products also contain non-specific antibacterial factors which may have effect of microbial flora (Takahashi et al., 1992). In Finland immune milk has been prepared against i.a. Helicobacter pylori infection (Oona et al., 1994), and antibodies to Streptococcus mutans and Streptococcus sobrinus, obtained from the colostrum of an immunized bovine (Loimaranta et al., 1996), have been studied at the Dental Department of the University of Turku (Prof. Jorma Tenovuo, personal communication). This immune milk has been produced at the Centre of Agricultural Research in Jokioinen. Web site: http://www.delphion.com/details?pn=US06143330__

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Compositions for preventing tooth decay Inventor(s): Atsumi; Kiminori (Chuo, JP), Sakuma; Shuji (Chuo, JP) Assignee(s): Kabushiki Kaisha Sangi (tokyo, Jp) Patent Number: 4,923,683 Date filed: September 25, 1989 Abstract: A tooth-decay preventing composition containing hydroxy-apatite and a fluoride, wherein at least one of the hydroxy-apatite and/or fluoride is microencapsulated or coated. Excerpt(s): The present invention relates generally to a composition for preventing tooth decay, and more particularly to a tooth-decay preventing composition containing hydroxy-apatite and a fluoride, wherein at least either one or the hydroxy-apatite or fluoride is microencapsulated or coated, and moreover a tooth-decay preventing composition, wherein compositions containing hydroxy-apatite and a fluoride coexist in an unmixed state. Fluorides are known to be effective in preventing tooth decay by virtue of such effects as strengthening of the enamel, suppression of the enzymatic action of bacteria which convert saccharides into acids, and suppression of the propagation of microorganisms relating to the corrosion destruction of enamel and dentine. Sodium fluoride, sodium monofluorophosphate, stannous fluoride and the like (hereinafter referred to simply as fluorides) are used for dentifrice compositions. However, to use a fluoride for dentifrice compositions in an amount sufficient to be really effective in preventing tooth decay is deemed by same as being impossible, since the amount of fluorine that can be incorporated in dentifrice compositions as fluoride is limited to 1,000 ppm or less, because of the toxicity of fluorine itself. Thus, the development of compositions sufficient to produce a decay preventive effect using an amount of fluorine within the set limits is still being awaited. On the other hand, hydroxy-apatite serves to absorb dental plaque responsible for tooth decay, while simultaneously it adheres to the surfaces of teeth, and thereby promoting the recalcification and strengthening of teeth. For this reason, hydroxy-apatite is added to dentifrice compositions as a satisfactory decay preventive. Accordingly, if a composition could be prepared containing hydroxy-apatite and a fluoride in such a way that they might exhibit a synergistic effect, then it would be expected that an ideal tooth-decay preventing composition could be obtained. However, it has been found that mixing of hydroxy-apatite with the fluoride causes easy conversion of hydroxy-apatite into apatite fluoride and calcium fluoride. Apatite fluoride and calcium fluoride fail to exhibit the decay-preventing action that the fluoride has, since they serve neither to absorb dental plaque nor recalcify and strengthen teeth. Besides, they are not absorbed onto the surfaces of teeth. Thus, although hydroxy-apatite and the fluoride are independently effective for the prevention of tooth decay, no tooth-decay preventing effect whatsoever is obtained with a composition wherein they exist together freely. For these reasons, a tooth-decaying preventing composition containing both the fluoride and hydroxyapatite is not available in the prior art. An object of the present invention is to provide a tooth-decay preventing composition which permits hydroxy-apatite and a fluoride to produce a synergistic effect upon the prevention of tooth decay, and which exhibits an improved fluorine effect as compared with the fluoride-containing compositions used theretofore in the prior art. Web site: http://www.delphion.com/details?pn=US04923683__

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Compounds with chelation affinity and selectivity for first transition elements and their use in cosmetics and personal care products, inhibition of metalloenzymes, and inhibition of reperfusion injury Inventor(s): Cyjon; Rosa L. (Haifa, IL), Klein; Joseph Y. (Haifa, IL), Klein; Ofer (Haifa, IL), Simhon; Elliot D. (Haifa, IL), Winchell; Harry S. (Lafayette, CA), Zaklad; Haim (Haifa, IL) Assignee(s): Concat, Ltd. (concord, Ca) Patent Number: 6,264,966 Date filed: February 22, 2000 Abstract: This invention involves the use of a class of compounds with chelation affinity and selectivity for first transition series elements. Application or administration of the free or conjugated compound, or physiological salts of the free or conjugated compound, results in decrease of the bioavailability and/or chemical action of first transition series elements. These characteristics make such compounds useful in cosmetics and personal care products to decrease odor arising from microbial growth on body surfaces and in body cavities, decrease microbial growth on teeth, plaque, and gums that cause tooth decay and gum disease, inhibition of oxidative damage to the skin, inhibition of enzymatic action of metalloenzymes dependent on first transition series elements, and inhibition of reperfusion injury. Excerpt(s): All literature and patent citations appearing in this specification are hereby incorporated herein by reference. First transition series elements are essential to the replication and growth of all cells and viruses. They are essential co-enzymes required in a variety of metabolic processes. Iron and copper can catalyze free radical formation leading to oxidative damage to tissues. Consequently, alterations of the bioavailability and function of first transition series elements can affect cell systems, metabolic processes, and complex phenomena that are affected by such processes. It is generally appreciated that most body odors arise from chemical byproducts of microbial growth. Thus, antimicrobial agents such as triclosan are commonly added to personal care products and cosmetics to inhibit development of body odors (such as underarm odor) through inhibition of microbial growth. See, Antiperspirants and Deodorants, 2d Ed., K. Laden, Ed., 1999, Marcel Dekker, Inc., New York, N.Y. Web site: http://www.delphion.com/details?pn=US06264966__

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Dental cleaning liquid and gel Inventor(s): Cloonan; Richard A. (17550 Plaza Marlena, San Diego, CA 92128), Towle; Lawrence E. (14721 Caminito Orense Este, San Diego, CA 92129) Assignee(s): None Reported Patent Number: 6,224,376 Date filed: July 13, 1998 Abstract: An dental hygiene solution is provided comprising water; sodium tripolyphosphates in an amount from 100 to 1000 mg per gallon of water; disodium edetate in an amount from 0.01 to 1.0 ml of saturated solution per gallon of water (0.1 mg to 10 mg per gallon of water); and a detergent in an amount from 1 to 10 ml per gallon of water, which detergent is effective to remove plaque from the tooth surface and thereby reduce the risk of oral diseases associated with plaque such as tooth decay

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or mouth ulcers. Further provided herein is a dental hygiene paste or gel comprising the same ingredients as the solution and further including a binding agent, such as carboxymethyl-celloulose sodium in an amount from 80 g to 150 g per gallon of water. Excerpt(s): The present invention relates to dental hygiene, and more particularly to the cleaning of teeth in humans and other animals. Even more particularly, the present invention relates to a cleaning liquid and a cleaning gel or paste for cleaning human or other animal teeth. The practice of oral hygiene in hospitals, skilled nursing facilities, home health care and the like has always been a rather vague and ill defined procedure. Some people in such institutions are, of course, able to care for themselves by using conventional tooth brushes and commercially available oral hygiene products such as toothpaste, mouth washes, and the like. However, others both in and out of such institutions are largely or totally dependent on others. For example, people suffering from arthritis, stroke victims, and other medically compromised people, may find it difficult to hold and manipulate a tooth brush while other more severely ill people, such as senile or comatose patients, simply cannot maintain their own oral hygiene programs. Those people who find it difficult to hold and manipulate a conventional tooth brush are very often ineffective when it comes to accomplishing adequate oral hygiene. Similarly, those attempting to help the people who are unable to help themselves, such as the staff personnel of a hospital or nursing home, or the family of such a person, may not be trained in the techniques needed for administering proper oral hygiene to others. Additionally, it is very awkward, messy and difficult for untrained medical or lay people to help others with performing oral hygiene routines. As a result, very often, even in medical institutions, the practice of oral hygiene is inadequate and in some cases, non-existent. Web site: http://www.delphion.com/details?pn=US06224376__ •

Dental laser apparatus and method for treating tooth decay Inventor(s): Kowalyk; Kenneth (Hilton Head Island, SC) Assignee(s): Medical Laser Technology, Inc. (hilton Head Island, Sc) Patent Number: 5,281,141 Date filed: March 16, 1992 Abstract: A dental laser apparatus and method is disclosed for removing tooth decay. A substance which selectively attaches to tooth decay is applied to the tooth. This substance has a predetermined absorption band. A laser having an output wavelength which corresponds to the absorption band is supplied and is absorbed primarily by the decayed portions of the tooth. The use of Acid Red 52 dye as the substance and a frequency doubled Nd:YAG laser as the source is disclosed as one embodiment. Excerpt(s): The invention relates generally to a dental laser assembly and method for treating tooth decay. More specifically, it relates to an apparatus and method for selectively removing carious lesions and/or dental decay from human teeth without affecting the adjacent healthy dentin and enamel. An all too familiar problem with human teeth is tooth decay. It is well known that a common method of treating tooth decay involves anesthetizing the local area, using a mechanical drill (or similar equipment) to remove the decayed portion of the tooth, placing a restorative material in the cavity area and curing the restorative material. This traditional treatment method has many well known disadvantages. In order to overcome some of these drawbacks, it has been proposed to use a laser to assist in some of the steps of the traditional

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treatment method. Over the last 25 years there have been numerous papers, patents, and studies relating to the use of various types of lasers as a medical tool. In particular, CO.sub.2, Argon and Nd:YAG lasers have been proposed for a variety of applications and have been used for a number of "soft tissue" dental procedures, for example, cutting tissue. However, "hard tissue" dental applications for the laser have been slower in coming due to a number of complex issues. "Hard tissue" dental applications include, for example, using a laser to remove enamel and/or tooth decay. Web site: http://www.delphion.com/details?pn=US05281141__ •

Device for detecting dental caries Inventor(s): Hibst; Raimund (Erbach, DE), Konig; Karsten (Blaustein, DE) Assignee(s): Kaltenbach & Voigt Gmbh & Co. (de) Patent Number: 5,306,144 Date filed: January 12, 1993 Abstract: A device for detecting dental caries has an illumination device which emits radiation of a pre-determined wavelength towards a tooth. A filter accepts radiation returned by the tooth in a pre-determined spectral range. The accepted radiation is evaluated for caries detection. The illumination device has at least one light guide, by means of which the radiation can be supplied to the tooth. The illumination device emits radiation in the spectral range from 360 to 580 nm. The filter accepts the returned radiation in the spectral range above 620 nm. The device can be used in a flexible manner and enables a low level of caries to be identified. Excerpt(s): The invention concerns a device for detecting dental caries, having an illumination device which emits radiation of a pre-determined wavelength towards at least one tooth, and having at least one filter which accepts radiation returned by the tooth in a pre-determined spectral range, with the accepted radiation being evaluated for the detection of caries. A device of this type is described in the journal SPIE, Vol. 907, Laser Surgery: Characterization and Therapeutics, 1988, S. Albin et al., "Laser Induced Fluorescence of Dental Caries", pages 96 to 98. In the known device, a laser emits monochromatic radiation towards the tooth, and this induces fluorescent radiation. From carious places of the tooth there is issued fluorescent radiation which is characteristic of caries and differs from the returned radiation of a healthy tooth in its intensity and spectral distribution. The returned radiation is observed using a filter. The places of the tooth affected by caries appear as dark spots during observation. The known device is provided for laboratory operation, in which optimum test conditions are present and usable test results, even in the case of low sensitivity of the device, can be achieved. For practical use in dental diagnosis, however, it is necessary to increase the sensitivity of the device considerably in order to detect caries. Furthermore, the known device is difficult to handle, so that it is not suitable as a means of diagnosis for use with humans or animals. Web site: http://www.delphion.com/details?pn=US05306144__

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Device for the oral administration of an active substance for prevention of tooth decay in infants Inventor(s): Suhonen; Jouko (Huswisenstrasse 7, CH-8426 Lufingen, CH) Assignee(s): None Reported Patent Number: 5,395,392 Date filed: February 22, 1994 Abstract: For the administration of an active substance of tooth decay in infants, a device (10) constructed in the form of a pacifier is provided, whose mouth disk (11) is detachably connected to the mouthpiece (10) whose interior (18) serves as accommodation chamber for the active substance (20), which comprises xylite and/or combinations of xylite and fluorides, such as sodium fluoride, or of xylite with sorbitol and fluorides and which is disposed in the interior (18) in the form of powder or tablets, in which, within the wall section (13a) located within the lower area of the mouthpiece (12), a plurality of perforations (15) are constructed, and in which, in the wall section (13b) located within the upper area of the mouthpiece (12), a plurality of preperforated, circular sections (115) are constructed having the smallest dimensions and which can be pressed through so as to form perforations (15) (FIG. 1). Excerpt(s): The present invention can be employed in the field of infant care and, more particularly, within the area of preventive measures and relates to a device for the oral administration of an active substance for the prevention of tooth decay in infants. The device include comprising a teat or nipple with a mouth disk or plate and a pacifier-like mouthpiece of rubber or the like provided with perforations, through which, in combination with the saliva of the infant, the active substance is dissolved and dispenses. The mouth disk is detachably connected to the mouthpiece. In this case, the invention is to a device for the oral administration of an active substance or ingredient over a fairly long period of time as well as to a pacifier for the oral adminstration of an active substance over a prolonged period of time. Dental medicine (prophylactodontia) has for some time been increasingly studying the so-called prevention of dental illnesses such as tooth decay by employing appropriate measures or therapies in juveniles or children. Web site: http://www.delphion.com/details?pn=US05395392__

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Dog chew toy for canine dental care and methods for making chew toy Inventor(s): O'Rourke; Anthony (Malibu, CA) Assignee(s): Booda Products, Inc. (gardena, Ca) Patent Number: 5,329,881 Date filed: August 31, 1992 Abstract: A chew toy for dogs comprising a length of cotton rope formed of a plurality of cotton threads impregnated with fluoride particles so as to dispose the fluoride particles throughout the toy such that the cotton rope provides a gentle cleaning and flossing of the dog's teeth and massaging of the dog's gums when chewed and contains the fluoride for gradual release as the fluoride combines with the saliva on the teeth of the dog as the dog chews and/or tugs on the toy to prevent tooth decay. The fluoride particles are applied to the individual cotton fibers prior to forming the fibers into the length of rope to provide the desired fluoride distribution throughout the toy.

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Excerpt(s): The present invention relates to a novel chew toy for dogs for improving canine teeth care. In recent years, veterinarians have become increasingly aware of the need for improved canine dental care. Many veterinarians are recommending the regular brushing of a dog's teeth to prevent decay and gum disease. Such a practice, however, is distasteful to many pet owners and not generally enjoyed by dogs. As a result, such recommendations have been largely ignored and a dog's teeth are generally ignored by its owner until a problem arises. A popular chew toy for dogs previously developed by applicant comprises a short length of cotton rope having large knots formed near the ends thereof so as to resemble a classic dog bone configuration. The soft cotton rope provides a cleaning and flossing of the dog's teeth and a gentle massaging of the dog's gums when chewed and thus provides therapeutic dental benefits as well as playful enjoyment for the dog. While providing an excellent means for cleaning the dog's teeth and promoting healthful gums, such devices do not provide a complete solution to the problem of canine tooth care. Just as fluoride is now universally recognized as a necessary element of human dental care, it would also be highly beneficial for canine dental care. Unfortunately, there does not currently exist an acceptable means for applying fluoride to a dog's teeth. Based on past experiences, brushing a dog's teeth with a cleaning agent containing fluoride would not present an acceptable method to pet owners. Regular fluoride applications by a veterinarian would be too expensive for most pet owners. The present invention overcomes these problems by providing a vehicle for the fluoride which requires no effort on the part of the dog owner, is inexpensive and highly attractive to dogs. In addition to fluoride, a complete dental care program includes tartar and plaque control. A build-up of tartar or plaque between the teeth and gums can cause the gums to separate from the teeth and lead to tooth decay and gum disease. The chew toy of the present invention also provides a vehicle for agents known to inhibit the build-up of tartar and plaque on teeth and thereby provides dog owners with an inexpensive and very convenient means for maintaining their pets' teeth and gums in a healthy condition. Web site: http://www.delphion.com/details?pn=US05329881__ •

Glucosyltransferase inhibitors, as well as dental caries prevention methods and anticarious foods using the same Inventor(s): Nakahara; Koichi (Ibaraki, JP), Ogura; Kyoichi (Kyoto, JP), Ono; Hiroyuki (Kobe, JP) Assignee(s): Suntory Limited (osaka, Jp) Patent Number: 5,409,692 Date filed: January 24, 1994 Abstract: Glucosyltransferase inhibitors containing as an active ingredient an extract of fermented tea leaves are described. Illustrative examples of the fermented tea leaves include Oolong tea, black tea and Pu-erh tea. Also described are foods or beverages for the prevention of dental caries, which contain an effective amount of one of such inhibitors. Dental caries can be prevented by taking such foods or beverages. Excerpt(s): The present invention relates to glucosyltransferase inhibitors and methods for preventing dental caries by using the same, and more specifically to glucosyltransferase inhibitors comprising as an active ingredient an extract from fermented tea leaves having glucosyltransferase inhibitory action, methods for preventing dental caries by using the same and anticarious beverages and foods containing the same. Although a variety of theories were proposed in the past as to a

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possible cause for dental caries, it is now recognized that dental caries is a type of bacterial infectious disease based on the chemicoparasitic theory proposed by Miller. The mechanism of occurrence of dental caries on the basis of the above theory is as follows. Namely, an enzyme called "glucosyltransferase" which is produced by oral streptococci, notably by Streptococcus mutans produces a sticky, insoluble polysaccharide (glucan) by using as a substrate sugar in the mouth. Cells of Streptococcus mutans (hereinafter abbreviated as "S. mutans") adhere to the surfaces of teeth by the glucan so produced, so that they form granules (dental plaques). Various microorganisms led by S. mutans are symbiotically growing in the dental plaques. Organic acids are produced by the metabolic activities of these microorganisms. The pH on the surfaces of the teeth drops as a result of the action of these organic acids, resulting in decalcification of the enamel surfaces. Consequently, dental caries takes place and proceeds. Web site: http://www.delphion.com/details?pn=US05409692__ •

Kit for use in the conditioning of dental cavities Inventor(s): Blomlof; Leif (Lidingo, SE), Lindskog; Sven (Stockholm, SE) Assignee(s): Peridoc AB (stockholm, Se) Patent Number: 6,197,212 Date filed: January 26, 1999 Abstract: A process for the conditioning of dental cavities by etching in preparation for bonding restoration to enamel and dentin, comprising the steps: a) etching the dentin part of a dental cavity using an aqueous composition containing, as an active constituent, EDTA, in an effective amount, and b) etching the enamel part of said cavity using a conventional etching acid; and a kit for use in such process for conditioning. Excerpt(s): The present invention relates to a process for the conditioning of dental cavities by etching in preparation for bonding restorations to enamel and dentin, and the invention also covers a kit for use in such conditioning process. Mechanical interlocking of the resin-based restoration to irregularities in the mineralized surface. Chemical bonding of the resin-based restoration to exposed collagen. Web site: http://www.delphion.com/details?pn=US06197212__

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Manufacturing process of glucosyltransferase inhibitors from cacao bean husk Inventor(s): Kim; Dong Young (Kyungki-do, KR), Kim; Han Soo (Kyungki-do, KR), Kwon; Ik Boo (Seoul, KR), Park; Hyen Joo (Seoul, KR), Park; Hyung Hwan (Kyungki-do, KR) Assignee(s): Lotte Confectionery Co., Ltd. (kr) Patent Number: 6,159,451 Date filed: July 13, 1999 Abstract: This invention relates to a process for manufacturing a fraction of cacao bean husk having an inhibitory activity against glucosyltransferase in the prevention of tooth decay and more particularly, to the process for manufacturing a fraction of cacao bean husk having more potent activity against glucosyltransferase in the prevention of tooth decay, while providing an economically feasible recovery process designed to treat

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enormous wastes of cacao bean husk, wherein it comprises the steps in which:an extract of cacao bean husk, which has already proven to exhibit an excellent inhibitory activity against glucosyltransferase, is formed from cacao bean husk; and,the extract is again added to an adsorption resin and fractioned by 50% thanol aqueous solution. Excerpt(s): the extract is again added to an adsorption resin and fractioned by 50% ethanol aqueous solution. Cacao (Theobroma cacao L.), an active ingredient of chocolate and cocoa, denotes a mysterious meaning of God's food. The country of origin for cacao is said to be some areas ranging from Central America to the northern parts of South America. Several countries in Central America have regarded cacao as one of the valuable foods including corn, which had been long cultivated from the prehistoric times. It was said that Aztec leaders, who inhabited in the Central America during 13.about.16 centuries, would take a roasted cacao bean, mixed with some spices, as a tonic. Thereafter, cocoa was widely distributed through the whole regions of Europe and a solid chocolate was invented by a young person in Switzerland for the first time in the world. Such first introduction of chocolate has contributed much to drastic production increase of cacao bean. Currently, chocolate is the most popular favorite food, which is beloved by all people around the world. Cacao bean, an active ingredient of chocolate, commonly contains a large amount of edible fibers and polyphenols, even though its composition is somewhat different depending on the country of origin. These polyphenols having a larger portion in green tea has been reported to have various biological activities in the body; for example, a tooth decay prevention action [Sakanaka, S., et al., Biosci & Biochem., 56, 592,1992], antihypertensive actions [Iwata, K., et al., Jpn. Soc. Nutr. Food Sci., 40, 469, 1987], cardiovascular action [Hertog, M.G.L., et al., Lancet, 342, 1007, 1993] and antioxidative action [Ramaretnam, N., et al., Trends in Food Sci. Technol., 6, 75, 1945]. Recently, through intensive studies to extract these polyphenols from some plants containing a large amount of these polyphenols such as green tea, oolong tea, apple and grape, they are being widely used as raw materials of functional foods, cosmetics and pharmaceuticals. Web site: http://www.delphion.com/details?pn=US06159451__ •

Material and apparatus for removing dental caries Inventor(s): Horiguchi; Shoji (Hachioji, JP), Ochiai; Tetsuo (Nukata-gun, JP), Watanabe; Masatomo (Hashima, JP) Assignee(s): Sintobrator, Ltd. (tokyo-to, Jp) Patent Number: 6,132,212 Date filed: October 27, 1998 Abstract: There is disclosed a dental caries-removing material consisting of grinding granules ejected against dental caries, or pathological issues, to remove them. The granules are obtained by pulverizing untoxic stones of seeds and have Vickers hardness values (JIS Z 1051)(Hv) of 10 to 60 and granular diameters of 40 to 160.mu.m. This material is prepared by pulverizing and grading stones of seeds (such as peach, plum, apricot, or Japanese apricot). Excerpt(s): The present invention relates to a material and apparatus for selectively removing dental caries without damaging sound dentine. Dental caries occur and progress by the following mechanism. Dentine consisting of inorganic and organic components is bated by acids produced by bacteria and thus softens. Subsequently, the remaining organic components are decomposed by bacteria, creating voids. Dental

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caries would recur unless portions softened and invaded with bacteria are removed. Thus, caries must be fully removed. Web site: http://www.delphion.com/details?pn=US06132212__ •

Method for preparing vaccine for dental caries and vaccinal compositions for dental caries used as nasal drop Inventor(s): Koga; Toshihiko (Tokyo, JP), Ohta; Hirotaka (Kanagawa, JP), Okahashi; Nobuo (Komae, JP), Shibuya; Koji (Kanagawa, JP), Takahashi; Ichiro (Yokohama, JP) Assignee(s): Lion Corporation (tokyo, Jp), National Institute of Health (tokyo, Jp) Patent Number: 5,352,450 Date filed: May 29, 1990 Abstract: A method for preparing a vaccine for dental caries comprises the step of culturing a variant which is obtained by integrating a protein antigen (PAc)-expressing gene into the chromosomal gene of a Streptococcus mutans GS-5 strain to obtain the protein antigen, the protein antigen being produced on the surface of cells of oral Streptococcus mutans or it being extracellularly produced by the microorganism and having a molecular weight ranging from about 170,000 to 220,000. Streptococcus mutans GS-5 (K-3), in which a protein antigen-expressing gene is integrated into the chromosomal gene thereof, has an ability of producing the protein antigen on the surface of the cells or extracellularly. A preventive vaccine composition for dental caries for nasal drops comprises the protein antigen thus produced by the strain: Streptcoccus mutans, the vaccine being intranasally administered. The method makes it possible to enhance the yield of PAc and to simplify processes for purifying PAc. The vaccine composition makes-it possible to internally easily absorb the protein antigen, PAc, in high efficiency and it also makes it possible to effectively increase the antibody titer observed after the administration thereof. Excerpt(s): The present invention relates to a method for preparing a vaccine for dental caries, a novel variant of Streptococcus mutans GS-5 as well as a vaccinal composition for dental caries which is used as nasal drops. Streptococcus mutans group is the most crucial pathogenic factor in dental caries in human beings and animals. The S. mutans group is divided into 7 species depending on the characteristics of their DNA's and S. mutans of serotype c, which is most closely related to human dental caries, posesses, on its surface, substances having various antigenicities such as serotype-specific polysaccharide antigens, lipoteichoic acid and protein antigens. One of these substances present on the bacterial cell surface, a protein antigen having a molecular weight of about 190,000 determined by SDS polyacrylamide gel electrophoresis, is a fine fibrous structure called fimbriae. This protein antigen is known variously as I/II, B, P1 and IF and it does not yet have a uniform name. Thus, this protein antigen is herein called PAc (protein antigen serotype c). Web site: http://www.delphion.com/details?pn=US05352450__

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Method of preventing tooth decay by laser beam irradiation and chemical treatment Inventor(s): Fox; Jeffrey I. (Salt Lake City, UT), Higuchi; William I. (Salt Lake City, UT), Powell; G. Lynn (Salt Lake City, UT) Assignee(s): University of Utah (salt Lake City, Ut) Patent Number: 4,877,401 Date filed: March 9, 1988 Abstract: A method for preventing tooth decay comprising: (1) laser irradiation of the tooth's surface with a carbon dioxide laser (wavelength=10.6 microns) at 20 to 50 watts for 1 to 400 seconds, and (2) subsequent chemical treatment of the tooth with a chemical agent such as ethane-1-hydroxy-1, 1-diphosphonic acid at concentrations greater than about 0.00001 molar. The resulting tooth has a reduced dissolution rate in acid and increased resistivity to cavities. Excerpt(s): This invention relates to a method for preventing tooth decay. Several methods, compositions, and devices have been described for preventing dental caries or cavities. U.S. Pat. No. 4,273,535 to Yamamoto et al. describes a device and method for preventing tooth decay by the use of high speed, repetitious pulses of laser beams projected from a Q-switched continuous excitation Nd:YAG laser through a glass beam guide. Yamamoto et al. also discloses coating the tooth immediately before the laser treatment with a fluorine compound. Web site: http://www.delphion.com/details?pn=US04877401__

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Method of treating dental caries with monoclonal antibodies against the antigen I and antigen I/II of streptococcus mutans Inventor(s): Lehner; Thomas (Barnet, GB2) Assignee(s): Council of Governors of the United Medical and Dental Schools of Guy's (london, Gb2) Patent Number: 5,352,446 Date filed: November 30, 1992 Abstract: A method of combatting dental caries in a mammal comprises topical application to a surface of a tooth in the mammals mouth of a monoclonal antibody raised against antigen I or antigen I/II of Streptococcus mutans serotype c. Excerpt(s): This invention relates to vaccines against dental caries. Streptococcus mutans has been recognised for many years as the major organism responsible for the development of dental caries in mammals. Various vaccines have been proposed in the past based on various antigenic fragments of S. mutans. One such vaccine is described in British Patent No. 2,060,647 based upon the antigen known as I or I/II. Antigen I has a molecular weight, as determined by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) of 146-155 Kd. Antigen I/II is believed to be a conjugate of antigen I and antigen II, this I, II antigen having a molecular weight determined by SDSPAGE of 175-195 Kd. U.S. patent application Ser. No. 579,117 now U.S. Pat. No. 4,594,244 describes antigen X which is a much smaller molecule having a molecular weight, determined by SDS-PAGE of about 3.5-4.5 Kd but which appears to include the same antigenic determinants included within antigens I and I/II. Antibodies against antigens I, I/II and X are known. The above-mentioned British Patent describes the raising of antibodies against antigens I and I/II by conventional procedures in

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experimental animals, for example rhesus monkeys, rabbits and mice. These antibodies are proposed primarily for the purification of the antigen by affinity chromatography but the Patent Specification mentions the possibility of using such antibodies for passive immunisation by conventional means. Conventional passive immunisation involves parenteral administration of the antibodies but while such techniques are theoretically available, as a practical matter, passive immunisation has never been regarded as clinically attractive and indeed, the British Patent refers to the preferred use of the antigenic materials for direct immunisation. Web site: http://www.delphion.com/details?pn=US05352446__ •

Methods and apparatus for the detection of dental caries Inventor(s): Longbottom; Christopher (Fife, GB), Los; Przemyslaw (Wroclaw, PL), Pitts; Nigel Berry (Perth, GB) Assignee(s): The University Court of the University of Dundee (dundee, Gb) Patent Number: 6,230,050 Date filed: August 5, 1999 Abstract: The present invention is directed to a method and apparatus for the detection of dental caries. The method comprises the steps of placing at least one probe electrode in electrical contact with a surface of a patient's tooth, placing a second electrode in electrical contact with another part of the body of the patient, passing an alternating electrical current between said probe and second electrodes, and measuring the electrical impedance between the electrodes. Excerpt(s): This invention relates to methods and apparatus for use in detecting dental carious (i.e. dental decay, or "caries" or "carious lesions") by electrical and/or electronic means. Caries is defined as the progressive decay of tooth or bone, and dental caries is the most common ailment known world wide. Dental caries can be treated by either removing the decayed material in the tooth and filling the resultant space with a dental amalgam, or in severe cases, by removal of the entire tooth. The early diagnosis of dental caries is of utmost importance to any subsequent treatment since by the time pain is felt due to decay of the tooth, the treatment required to restore the tooth may be extensive and in some cases, the tooth may be lost. Web site: http://www.delphion.com/details?pn=US06230050__

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Non-rotary caries removal and restoration system Inventor(s): Rainey; J. Tim (P.O. Box 1044, Refugio, TX 78377) Assignee(s): None Reported Patent Number: 5,975,896 Date filed: November 6, 1998 Abstract: A non-rotary caries removal and restoration system for use in the treatment of tooth structures. The system includes at least two solution constituent reservoirs adapted to separately store the constituents of a solution capable of abating organic tooth decay. Each of the solution constituent reservoirs are fluidly connected to an activation reservoir by means of pump and solution constituent conduits. The activation reservoir is adapted to receive, mix, and activate the solution constituents to form and

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hold said solution. A solution channel is fluidly connected to the activation reservoir by a solution conduit and adapted to dispense the solution upon or into a carious lesion having an organic component or matrix of decay. A handpiece shaped for hand use houses driver adapted to communicate sonic energy to an energy transfer tip. The energy transfer tip is releaseably coupled to the driver and configured to agitate the solution dispensed upon or into the carious lesion or matrix of tooth decay. A selectively engageable driver activation device is connected to the driver allowing an operator to selectively engage the driver to agitate the solution dispensed upon or into the carious lesion or matrix of tooth decay. Excerpt(s): The present invention relates generally to the dental field, and more specifically to the removal of the organic decay component of a carious lesion and restoration of the healthy tooth structure. Various methods are employed in modern dentistry to remediate and restore a decaying tooth structure. The most common present-day method of restoration includes the mechanical drilling and removal of the decaying area and a portion of the healthy tooth structure thereabout. This procedure is invasive in that it cuts into the healthy tooth structure and therefore has the potential for causing the patient pain and resultingly requires anesthesia. Previously, it has also been discovered that a solution of N-monochloro-DL-2-aminobutyrate, commonly referred to as NAMB, is useful in the abatement of the organic component of tooth decay. In previous procedures, the NAMB solution is applied to the decaying area, but must be massaged or agitated manually against the carious lesion. As a result, such a procedure was only usable upon flat and easily accessible tooth structures. In practice, this accounted for about 5% of all carious lesions. In view of the fact that very few situations of decay could be treated using NAMB, and the fact that such treatment was labor intensive and time consuming, such procedures have never enjoyed popularity and have for all practical purposes disappeared from practice. Web site: http://www.delphion.com/details?pn=US05975896__ •

Nursing bottle Inventor(s): Meyer; Charles (410 Phillip Ave., Glen Ellyn, IL 60137), Schein; Douglas (653 W. Oakdale, Apartment 2N, Chicago, IL 60657), Silas; Paul (4813 Kristie Dr., Apartment 26, Del City, OK 73115) Assignee(s): None Reported Patent Number: 5,897,007 Date filed: May 9, 1997 Abstract: A nursing bottle helps reduce tooth decay. The nursing bottle contains a first reservoir for water, a second reservoir for a cariogenic liquid, and a nipple with two fluid flow paths. The first fluid flow path runs from the cariogenic liquid reservoir to an outlet opening in the tip of the nipple. The second fluid flow path runs from the water reservoir to lateral outlet openings near the tip of the nipple. When the reservoirs are filled and the bottle is used, the water enters the baby's mouth nearer the teeth than does the cariogenic liquid, thereby rinsing the teeth and reducing tooth decay. Excerpt(s): This invention relates to nursing bottles. More particularly, this invention relates to nursing bottles that reduce the risk of tooth decay. Babies are born with the instinct to suckle milk from their mothers' breasts, but it is often necessary for them to drink liquids from other sources. Babies are unable to drink liquids from glasses or cups without spilling so it is common throughout the world to feed liquids to babies in

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nursing bottles, also known as baby bottles. A nursing bottle features a rubber nipple with a small hole in its tip secured across an opening in the top of a liquid container. A nursing bottle is used by filling the container with liquid, securing the nipple, inverting the bottle, and placing the nipple into the baby's mouth. The baby then sucks on the nipple to withdraw the liquid. Unfortunately, the use of a nursing bottle can cause tooth decay, also known as dental caries. Tooth decay is the erosion of the protective enamel surface of the tooth which occurs when the tooth is exposed to an acidic environment. The human mouth contains various types of bacteria, including Streptococcus mutans. S. mutans digest simple carbohydrates such as sucrose (table sugar) and produce acidic wastes. When a simple carbohydrate is introduced into the mouth, S. mutans multiply and their acidic wastes can drastically affect the acidity of the mouth. While the normal pH in the mouth is about 7 (neutral), the pH can drop to about 4 when a concentrated sucrose solution is consumed. Tooth enamel softens and erodes when exposed to a pH less than about 6.5. It can thus be seen that foods and liquids containing simple carbohydrates do not directly cause tooth decay. Instead, they cause a multiplication of S. mutans, whose acidic wastes are responsible for the erosion of the tooth enamel. Foods and liquids that contain simple carbohydrates and lead to tooth decay are referred to as cariogenic. Common cariogenic liquids include milk, fruit juices, and sugar-sweetened carbonated sodas. Web site: http://www.delphion.com/details?pn=US05897007__ •

Oral cleaning apparatus Inventor(s): Rimkus; Ronald J. (Flossmoor, IL) Assignee(s): Amtec Products, Inc. (flossmoor, Il) Patent Number: 6,015,293 Date filed: December 31, 1997 Abstract: A disposable oral cleaning apparatus for cleaning and removing particles and bacteria from the upper surface of the tongue and between the teeth, including an elongated handle, a head component and a flexible connector connecting the elongated handle and the head component. The head component has a pre-cleaning portion, a cleaning portion and an absorbent portion to provide an initial cleaning of the coating of the tongue, a secondary deep cleansing of the pores of the tongue, and a final absorption and removal of all debris. The oral cleaning apparatus is adapted to promote proper cleansing of the tongue and teeth so as to eliminate oral bacteria and bad breath, to reduce tooth decay, gum disease and plaque buildup, and promote proper oral hygiene with no deleterious changes to the tongue. Excerpt(s): The present invention relates generally to an oral cleaning apparatus for cleaning and medicating the surface of the tongue. Generally, brushing, flossing and rinsing with mouthwash have been standard methods utilized to eliminate oral bacteria and bad breath. According to studies, however, bacteria on the surface of the tongue can cause up to 75% of bad breath odor. As such, numerous devices have been conceived to try to remove bacterial growth on the surface of the tongue. Prior attempts to provide a means for cleaning the tongue generally fall into two categories: scraper-style cleaners and brush-style cleaners. Scraper-style tongue cleaners are disclosed in U.S. Utility Pat. Nos. 5,438,726, 5,282,814, 5,005,246 and 2,218,072. Scraper-style tongue cleaners are also disclosed in U.S. Design Pat. Nos. Des. 367,707 and Des. 285,342. Web site: http://www.delphion.com/details?pn=US06015293__

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Periodontal probe tip for diagnosing periodontitis and dental decay Inventor(s): Yeh; Richard T. (13572 Montague St., Arleta, CA 91331) Assignee(s): None Reported Patent Number: 5,725,373 Date filed: July 17, 1996 Abstract: A periodontal probe tip 14 is made of strong flexible plastic with thermochromatic plastic ingredient and litmus test paper band, Probe tip 14 is an indicator for measuring the depth of periodontal pocket and for sensing gum temperature increasing and sensing acidity around tooth, Probe tip 14 will show color change to indicate gum disease and tooth decay initiating the disease process, People will have time to interrupt the disease process and on to better oral health. Excerpt(s): The present invention relates to a periodontal probe and is particularly directed to a periodontal probe tip which is diagnosing periodontitis and tooth decay in the very early stages by color change. Gum disease and tooth decay are caused by bacterial invasion which result in decompostion of bone around tooth and tooth infection, if left untreated. Gum disease and tooth decay can be prevented by good oral hygiene and be treated. The treatment will mainly be directed to interrupt the progress of the disease. Web site: http://www.delphion.com/details?pn=US05725373__

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Pharmaceutical composition, containing medium-chain fatty acids as active ingredients, for dental caries and periodontal disease Inventor(s): Min; Byung-Moo (#13-501 Rex Apt., 300-3 Ichon-dong, Yongsan-ku, Seoul 140-030, KR) Assignee(s): None Reported Patent Number: 6,180,599 Date filed: September 27, 1999 Abstract: The present invention relates to a new use of medium-chain fatty acids in prevention and treatment of dental caries and a pharmaceutical composition containing medium-chain fatty acids as active ingredients.Particularly, the present invention relates to the use of the salt form of medium-chain fatty acids; nonanoic acid, capric acid, undecanoic acid, lauric acid, tridecanoic acid or myristic acid, for prevention and treatment of dental caries and periodontal disease. The pharmaceutical composition containing medium-chain fatty acids as active ingredients may include lectins and/or fluoride in addition to medium-chain fatty acids. Excerpt(s): The present invention relates to a new use of medium-chain fatty acids as a prophylactic against dental caries and as a therapeutic treatment of the disease, and a pharmaceutical composition containing these medium-chain fatty acids as active ingredients. Particularly, the present invention relates to the use of the salt form of specific medium-chain (C.sub.9 -C.sub.14) fatty acids; nonanoic acid (C.sub.9) capric acid (C.sub.10), undecanoic acid (C.sub.11), lauric acid (C.sub.12), tridecanoic acid (C.sub.13) or myristic acids (C.sub.14), as a prophylactic against dental caries and therapeutic treatment of the same disease and periodontal disease. The pharmaceutical composition of these medium-chain fatty acids may include lectins and/or fluoride as well. Dental caries, one of the most prevalent and significant forms of oral disease, can

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lead to loss of teeth in spite of development of therapeutics. Caused by dental plaque formed on the surface of teeth, dental caries results in tooth loss as a result of organic acids, the natural metabolite of plaque bacteria contained in dental plaque, which decalcify dental hard tissue locally and gradually. Web site: http://www.delphion.com/details?pn=US06180599__ •

Prevention of dental caries Inventor(s): Berrocal; Rafael (St-Legier, CH), Guggenheim; Bernhard (Zurich, CH), Nesser; Jean-Richard (Savigny, CH) Assignee(s): Nestec S.a. (vevey, Ch) Patent Number: 5,427,769 Date filed: December 6, 1993 Abstract: Dental caries are prevented by contacting teeth with an edible composition containing micellar casein which has been isolated from an animal milk and which is incorporated in the composition in an amount sufficient to inhibit oral colonization by Streptococcus sobrinus. Excerpt(s): This invention relates to an anti-cariogenic. Certain casein derivatives are known for their anti-cariogenic properties. Thus, U.S. Pat. No. 5,015,628 (University of Melbourne) describes an anti-cariogenic composition containing in particular phosphopeptides obtained, for example, by trypsic hydrolysis of alpha or beta casein as the active agent. Web site: http://www.delphion.com/details?pn=US05427769__

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Process for the removal of soft tooth decay using a unique abrasive fluid stream Inventor(s): Everett; Michael (Glendale, CA), Kutsch; V. Kim (Albany, OR) Assignee(s): Kreativ, Inc. (albany, Or) Patent Number: 5,601,430 Date filed: September 15, 1995 Abstract: A dental repair process removes an area of tooth decay from a tooth structure, and prepares the tooth structure, including dentin and enamel surfaces of the tooth structure, for bonding with a filler material. It is characterized by the use of a soft abrasive particulate material such as a urea resin with a Mohs hardness in the range of from 3.0 to 4.0 and a particle size of 10 to 200 microns. Such material is capable of effectively removing soft tooth decay when carried in a fluid stream that is directed towards the decayed area under pressure. Excerpt(s): This invention relates to employing a soft particulate abrasive in a fluid stream for removing soft tooth decay from a tooth. Using abrasives carried in a fluid stream to remove material in a precise manner is not new. Kirschner U.S. Pat. No. 5,160,547 discloses an air abrasion process for removing material from sensitive substrates in general, using sodium bicarbonate as the abrasive media. Carr U.S. Pat. No. 4,731,125 discloses an air abrasion method for cleaning paint from composite airplane panels using a plastic abrasive media. Drury U.S. Pat. No. 5,145,717 discloses an air abrasion method of resist removal in the manufacture of printed circuit boards using

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a plastic abrasive media. Air abrasion in dentistry also is not new. Rzewinski U.S. Pat. No. 4,494,932 discloses an air abrasion apparatus and method for cleaning teeth, i.e., removing difficult stains and heavy plaque using an unspecified soluble powder. Karst U.S. Pat. No. 4,950,160 discloses an air abrasion instrument for polishing teeth using an unspecified abrasive powder. Finally, Goldsmith U.S. Pat. No. 5,275,561 discloses a fluid abrasion method of preparing a tooth structure, including dentin and enamel surfaces, for bonding a composite to the prepared surfaces using aluminum oxide as the abrasive material. While aluminum oxide works well as an abrasive for removal of hard caries material and on healthy tooth structure to roughen it as a pretreatment for bonding, it is inefficient in removing soft caries material from decayed tooth structure. The process of this invention provides a way to remove the soft caries material using an abrasive that is softer than aluminum oxide. Web site: http://www.delphion.com/details?pn=US05601430__ •

Proton motive force toothbrush Inventor(s): Moran; Francis Xavier (71 College Ave., West Somerville, MA 02144) Assignee(s): Moran; Francis Xavier (somerville, Ma) Patent Number: 6,496,998 Date filed: March 26, 2001 Abstract: The present invention is used to obtund tooth decay and periodontal lesions by obstructing the proton motive force that exists in bacteria. The result is that glycolysis, DNA synthesis and chelation is upset and this will cause bacteria to dissolute logrithmically. The invention is also used to harden and remineralize enamel and dentin by using fluoride compounds available in over-the-counter dental cleansers. The invention takes into consideration the vector magnitude of the hydration layer between the enamel and the pellicle plaque layer of teeth which insulates the teeth from the electrical potentials of electrophoresis. The claim that electrical potentials can be placed on teeth does not take this physico-chemical phenomenon into consideration. This invention uses the proper voltage to produce ionization of molecules in a salivary slurry of gels, dentrifice's and rinses. Excerpt(s): 1. This invention relates to a toothbrush having sufficient means for providing sufficient voltage for electrolysis of dentifrice, gels, and rinses to produce hydronium ions and an aqueous acid media. There is a hydration layer between the enamel of teeth and a natural covering of a glyco-protein adhesive film called a pellicle that is present on all teeth in the oral cavity. This layer of water molecules is vectorial with a positive charge directed toward the oxyanion of the phosphate ion of the apatite crystals of enamel. This vector magnitude insulates the tooth against electrical potentials produced by electrophoresis. Any claim that a potential on teeth by electrophoresis does not take this physico-chemical phenomena into account. The present invention uses the phenomena of electrolysis to obtund decay of teeth and periodontal disease. Without limiting the invention to any mechanism, it is believed the production of a weak acid media, using an electromotive force for electrolysis, will react with the fluoride and bicarbonate compounds, if present, of the dentrifice, gels, and rinses in the oral cavity. This is a more organized and active use of these products compared with the random and passive diffusion that occurs when brushing in the absence of this energy. The present invention provides an efficient means to obtund decay and periodontal disease by lowering the count of acid-producing bacteria in plaque. At the same time, the

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present invention will strengthen the apatite crystal bundles of the hard tissues of teeth and bleach the teeth. Web site: http://www.delphion.com/details?pn=US06496998__ •

Removal of dental caries with high speed water jet Inventor(s): Gordon; Eugene Irving (Mountainside, NJ), Hasen; Joel (New Providence, NJ), Odrich; Ronald B. (Bronx, NY), Turdiu; Parid (West New York, NJ), Winter; Alan A. (Morristown, NJ) Assignee(s): Medjet, Inc. (edison, Nj) Patent Number: 6,164,966 Date filed: March 17, 1999 Abstract: A method and device for the high speed fluid (preferably water) jet removal of dental caries. The water jet is of a controlled upper and lower speed and pressure with a low speed and pressure being of at least 5 to 10 kpsi, sufficient to pierce and flush decayed tissue of a caries with a small beam fluid jet diameter. A pulsed or continuous fluid jet is used to remove and completely flush caries material from a tooth in a time period of under a second with a maximum stagnation pressure of about 30 kpsi, at which point healthy dentin is affected. A coherent or pseudo-coherent water jet operating at high stagnation pressure (range 10,000 to 20,000-psi and no more than 30kpsi), in a brief burst (.apprxeq.1 second) and small beam diameter (30 to 100-.mu.m) will cleanly remove caries without damage to the tooth structure in particular the sound dentin at the boundary of the caries. No anaesthetic is accordingly required in the absence of a possible exposed nerve. Excerpt(s): This invention relates to methods and devices for the removal of the dental caries and in particular those methods and devices with lessened damage to healthy dentin and reduced pain for the patient. At present the method of choice for removing decayed dentin and other structure in a dental caries associated with a cavity, preparatory to filling the tooth, is a mechanical dental drill. The dental drill is guided by a dentist to drill into a tooth until all remnants of the caries are separated from the healthy dentin. Thereafter a low pressure water jet or air spray is used to wash or remove the caries material from the tooth. The process involved entails a certain degree of inevitable pain as a result of small portions of healthy dentin being removed as well. In addition, the high pitched whine of a dental drill is often accompanied by psychological trauma of the patient. In fact, fear of the dental drill is a major reason that people in need of dental care postpone visits to a dentist. Recently research has involved the use of lasers to selectively burn out the caries prior to filling of the tooth. Though the lasers are silent they nevertheless also inevitably remove a small portion of healthy dentin. Web site: http://www.delphion.com/details?pn=US06164966__

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Replacement therapy for dental caries Inventor(s): Hillman; Jeffrey D. (Gainesville, FL) Assignee(s): University of Florida Research Foundation, Inc. (gainesville, Fl) Patent Number: 5,607,672 Date filed: June 7, 1995 Abstract: Recombinant Streptococcus mutans strains characterized by a deficiency in lactic acid production and production of a recombinant alcohol dehydrogenase (ADH) are described, These recombinant S. mutans strains are suitable for use in a method for preventing treating dental caries. Excerpt(s): This invention relates to methods and compositions for the prevention of dental caries. The ability of a given bacterium to colonize a host is determined by a number of factors such as the bacterium's metabolic needs, and the interactions of the bacterium with the pre-existing bacterial flora. Bacterial interactions can be generally classified as either "positive" or "negative." In positive interactions, an "effector" bacterial strain alters the microenvironment to promote colonization of a second, "target" organism. In "negative" interactions, the effector strain alters the microenvironment in a manner that decreases or completely prevents target bacterium colonization. Negative interactions between competing bacteria during host colonization are commonly termed bacterial interference. Therapeutic regimens which take advantage of bacterial interference to replace a pathogenic bacterial strain with a non-pathogenic, effector strain are termed replacement therapies. Successful replacement therapy requires an effector strain that: 1) is non-pathogenic, 2) alters the microenvironment so as to prevent colonization or outgrowth of pathogenic organisms, 3) persistently colonizes the host at risk to prevent reinfection by the target pathogenic organism, and aggressively displace the pathogenic organism from the tissues at risk where the pathogen is part of the host's indigenous flora. Web site: http://www.delphion.com/details?pn=US05607672__

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Saliva substitute Inventor(s): Turgeon; Jean A. (308 E. Main St., Grass Valley, CA 95945) Assignee(s): None Reported Patent Number: 5,541,165 Date filed: September 27, 1994 Abstract: A saliva substitute composition includes glycerin, gum, water, and a pH buffering system. Sweeteners, colorants, and preservatives may be optionally combined. The glycerin component serves both as a lubricant and as a delivery vehicle for water from the composition to moisten the mouth. The gum component provides further lubrication and serves a water retention function. Gum arabic, xanthum, or sorghum are examples. The pH buffering system includes acidic and basic components. Citric acid or citrate salts and carbonate was found to be an effective buffering system. The composition is used to maintain moisture in the mouth when little or no natural saliva is produced, providing relief from dry mouth, as a symptom of xerostomia, mucositis, and stomatitis, as well as general inflammation and/or ulceration of mucous membranes, while avoiding pH imbalances which may lead to tooth decay and/or injury to the upper digestive tract including the oral cavity, oropharynx, or esophagus. These

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compositions may be further incorporated in mouthwashes and soft drinks, as well as oral medicaments. Excerpt(s): The present invention relates to oral compositions. More particularly, the present invention relates to oral compositions which provide substitutes for, or augmentation of natural saliva. For millions of Americans dry mouth is a chronic disorder which may lead to numerous health, nutritional, and social hazards. Sores often develop in dry areas inside the mouth of those afflicted. Speech may become strained and painful, which may lead sufferers to withdrawal from social contact. Even eating, drinking, and breathing become difficult tasks. The inability to enjoy a standard of living taken for granted by most may further cause disillusionment and depression. In the article "When the mouth runs dry" Tufts University Diet & Nutrition Letter, April 1991, Vol. 9, No. 2, pp. 7-8, it was disclosed that, over the course of several days, a group of senior citizens with dry mouth were eating foods lower in 12 nutrients ranging from vitamin A to thiamin than a group without the problem. Particularly lacking in their diets were potassium, vitamin B6, iron, calcium, and zinc as well as fiber. A reason suggested by this reference for less healthful eating is that the parched, crusty, and sensitive conditions dry mouth creates can hamper the ability to tolerate spicy or acidic foods. Web site: http://www.delphion.com/details?pn=US05541165__ •

Tasteful toothpaste and other dental products Inventor(s): Cutler; Edward T. (Merion, PA) Assignee(s): Pilot Research & Development Co. (merion, Pa) Patent Number: 5,496,541 Date filed: January 27, 1995 Abstract: Dental products employing a ternary surfactant system of poloxamers, anionic polysaccharides, and nonionic cellulose ethers. This ternary surfactant system has greatly enhanced foaming power relative to poloxamers alone or to poloxamers plus anionic polysaccharides or to poloxamers plus nonionic cellulose ethers. The poloxameranionic polysaccharide-nonionic cellulose ether surfactant system has little or no taste, is nonirritating, and has excellent adhesion to tooth surfaces and oral mucosa. Inclusion of a mild abrasive plus one or more of xylitol, raw licorice, licorice extract, and glycyrrhizin and its derivatives enhances the clinical efficacy of the formulations by further reducing plaque buildup thus brightening teeth and reducing tooth decay and periodontal disease.The surfactant system can be used in a dentifrice paste or gel, powder, granules, disintegrable tablet, and a mouthwash, lozenge, and chewing gum. Excerpt(s): This invention relates to good tasting dental products having improved foaming properties. In particular this invention relates to dental products containing a poloxamer/anionic polysaccharide/non-ionic cellulose ether surfactant system, wherein the poloxamer, anionic polysaccharide and non-ionic cellulose ether are present in specific ratios. Surfactants play a key role in dentifrices. They emulsify fats and oils coating the oral cavity, they prevent dentifrice loss by drooling during brushing, and they provide a means for contacting active ingredients with teeth and gums during brushing. Unfortunately, most toothpaste surfactants have undesirable properties. They taste bad, both during and after brushing, and they irritate oral and gastric mucosa. Common dentifrice surfactants (for example, sodium lauryl sulfate, sodium N-lauroyl sarcosinate, etc) may even contribute to periodontal disease, which affects 75% of the

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U.S. population. These common surfactants cause chronic inflammation and sloughing of oral mucosa, thus facilitating infection by pathogenic microorganisms. See also: H. Bleeg, Scand. J. Dent. Res., 98, 235 (1990). Current harsh surfactants may also aggravate tooth sensitivity and tooth staining in susceptible individuals. Although hundreds of brands of toothpaste are sold in the United States today, nearly all of them use sodium lauryl sulfate as a surfactant because it is one of the cheapest, most efficient foaming agents known; however, it has the physiological incompatibilities previously mentioned. The fact that toothpaste does not taste good has been acknowledged in the patent literature (and, of course, consumers have known it all along). Web site: http://www.delphion.com/details?pn=US05496541__ •

Test kit for analyzing body fluids and analysis method Inventor(s): Althoff; Jorg (Greven, DE), Moll; Claus-Jurgen (Moers, DE), Paessens; Theodor (Kalkar, DE) Assignee(s): M & M Dental-medizin Gmbh (moers, De) Patent Number: 5,981,300 Date filed: May 29, 1997 Abstract: A test kit is disclosed for analyzing a patient's saliva to determine the patient's risk of tooth decay, which contains: (a) a support; (b) an absorbent material in contact with said support and capable of removing saliva from the mouth and of absorbing the saliva; (c) a composition coated on said absorbent material, said composition soluble in saliva and capable of reaction inside the mouth of the patient with the saliva to reduce the pH of the saliva; and (d) a color scale for determining outside of the mouth of the patient the pH of the saliva absorbed by the absorbent material in which the composition is dissolved to measure the reaction of the composition with the saliva in the patient's mouth to determine the patient's risk of tooth decay. Excerpt(s): This invention relates to a test kit for analyzing body fluids, more particularly saliva. The prevention of tooth decay involves regular examinations at the dentist, a six-month check-up generally being recommended. However, this advice is often not heeded because the layman is not aware of his own personal risk of tooth decay and often mistakenly believes that, in his case this risk is minimal. Accordingly, it would be useful to have a test which could be carried out by the layman himself and which would provide information as to his own personal risk of tooth decay in a simple, quick and inexpensive manner. Web site: http://www.delphion.com/details?pn=US05981300__

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Use of bacteriophages to inhibit dental caries Inventor(s): Norris; Alan H. (120 Saddle Mountain Rd., Rome, GA 30161) Assignee(s): None Reported Patent Number: 4,957,686 Date filed: February 6, 1990 Abstract: Because S. Sanguis is the first colonizer of newly cleaned teeth and because other bacteria then attach to it, the formation of dental plaque is reduced on newly cleaned teeth by introducing into the mouth bacteriophages which are parasitic to S.

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Sanguis. Because S. Sanguis is the means of attachment of plaque forming bacterial colonies to tooth surfaces and forms 10-15% of the organisms in plaque, destruction of S. Sanguis by introduction of its parasitic bacteriophages will remove plaque from teeth surfaces. And removal of plaque containing acid forming bacteria and other harmful bacteria reduces the incidence of dental caries and other disease. Excerpt(s): 1. U.S. Pat. No. 4,659,561, Apr. 21, 1987 Entitled "Process for treating the oral cavity". Inventors Paula Fives-Taylor, Charles P. Novotny. 2. U.S. Pat. No. 4,891,210, Jan. 2, 1990 entitled "Use of Bacteriophages in Dental Hygiene". Inventor Alan H. Norris. of which this application is a continuation in part. The most recent conclusions on the causation of dental caries are expressed in U.S. Pat. No. 4,659,561. These envisage that the initial breach in the tooth enamel, which is the tooths protective surface, is made by acid forming bacteria. Once the enamel is damaged, many other bacteria can further attack and erode the dentine. But while the enamel is intact, bacteria other than acid forming bacteria do not cause cavities. There are many types of bacteria which form acid including Streptococcus mutans, strains of Lactobacillus and others. Web site: http://www.delphion.com/details?pn=US04957686__

Patent Applications on Tooth Decay As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to tooth decay: •

Compounds with chelation affinity and selectivity for first transition series elements and their use in cosmetics and personal care products, inhibition of metalloenzymes, and inhibition of reperfusion injury Inventor(s): Cyjon, Rosa L.; (Haifa, IL), Klein, Joseph Y.; (Haifa, IL), Klein, Ofer; (Haifa, IL), Simhon, Elliot D.; (Haifa, IL), Winchell, Harry S.; (Lafayette, CA), Zaklad, Haim; (Haifa, IL) Correspondence: Townsend And Townsend And Crew; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20010041170 Date filed: April 20, 2001 Abstract: This invention involves the use of a class of compounds with chelation affinity and selectivity for first transition series elements. Application or administration of the free or conjugated compound, or physiological salts of the free or conjugated compound, results in decrease of the bioavailability and/or chemical action of first transition series elements. These characteristics make such compounds useful in cosmetics and personal care products to decrease odor arising from microbial growth on body surfaces and in body cavities, decrease microbial growth on teeth, plaque, and gums that cause tooth decay and gum disease, inhibition of oxidative damage to the skin, inhibition of enzymatic action of metalloenzymes dependent on first transition series elements, and inhibition of reperfusion injury.

9

This has been a common practice outside the United States prior to December 2000.

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Excerpt(s): All literature and patent citations appearing in this specification are hereby incorporated herein by reference. First transition series elements are essential to the replication and growth of all cells and viruses. They are essential co-enzymes required in a variety of metabolic processes. Iron and copper can catalyze free radical formation leading to oxidative damage to tissues. Consequently, alterations of the bioavailability and function of first transition series elements can affect cell systems, metabolic processes, and complex phenomena that are affected by such processes. It is generally appreciated that most body odors arise from chemical byproducts of microbial growth. Thus, antimicrobial agents such as triclosan are commonly added to personal care products and cosmetics to inhibit development of body odors (such as underarm odor) through inhibition of microbial growth. See, Antiperspirants and Deodorants, 2d Ed., K. Laden, Ed., 1999, Marcel Dekker, Inc., New York, N.Y. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Detection material for initial dental caries Inventor(s): Ishihara, Yoko; (Tokyo, JP), Okada, Akane; (Tokyo, JP), Yoshii, Eiichi; (Tokyo, JP) Correspondence: Oblon Spivak Mcclelland Maier & Neustadt PC; Fourth Floor; 1755 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20020119100 Date filed: December 18, 2001 Abstract: To simply and accurately detect initial dental caries without impairing the aesthetics, the detection material for initial dental caries contains 0.001 to 5% by weight of at least one dye selected from fluorescein sodium, fluorescein potassium, dibromofluorescein sodium, and dibromofluorescein potassium compounded in a solvent. It is preferred that the solvent is one member selected from water, ethanol, glycerin, isobutyl alcohol, ethyleneglycol, diethyleneglycol, triethyleneglycol, acetone, and propylene glycol, or a mixed solution of two or more of these members. Excerpt(s): About a half of the causes of losing teeth is considered to be dental caries, and hence, it is important to prevent the dental caries. However, with respect to the dental caries, demineralization gradually proceeds in an unseen portion under a surface layer of a tooth, and as a result, when a subjective symptom such as one that can be observed with naked eye has appeared, the dental caries often proceeds to such an extent that the conservation remedy is needed. In other words, what is important in preventing the dental caries is to find out the demineralization proceeding under the surface layer of the tooth at an initial stage as far as possible, thereby giving a person a guidance for brushing the subject portion or subjecting to a treatment for stopping the progress of the demineralization by applying a fluoride. At the initial stage of the dental caries, even if the conservation remedy were needed, the remedy could be simple, so that a risk of the secondary dental caries can be minimized. The demineralization under the surface layer as initial dental caries of a tooth is non-cavitation-forming dental caries that is free from substantial defects, formed due to the matter that during longterm repetition of demineralization wherein calcium ions and phosphate ions elute out from teeth due to plaque bacteria-producing acids and remineralization as a phenomenon wherein the calcium ions and phosphate ions are again taken into the teeth, a balance of the both is broken, and the environment is inclined towards the demineralization side over a long period of time. Thereafter, when the symptoms proceeds to some extent, it is confirmed as a white spot on an enamel from the clinical

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standpoint. It is considered that so far as the plaque is eliminated, and the surface of the teeth is brought into contact with saliva over a long period of time as far as possible, the initial dental caries up to the presence of a white spot does not proceed to the dental caries accompanied by substantial defects. In addition, it is already confirmed that when a fluoride is applied to an diseased part, the remineralization is promoted, whereby the initial dental caries can be restored to an original sound teeth to some extent. Accordingly, the detection for the initial dental caries has become important more and more in preventing the dental caries. As a method for detecting the initial dental caries, a method in which a site from which the plaque has been eliminated is dried and inspected using a dental explorer and a dental mirror is the main current. However, it is very difficult to confirm the initial dental caries before the presence of a white spot. Further, there may be present a white spot portion generated by other causes than the demineralization such as one seen in the case of enamel hypoplasia. Accordingly, its diagnosis relied on the experiences and lacked in accuracy. Besides, as the detection and diagnosis techniques for the initial dental caries, there is hitherto known a method for measuring an electric resistance value of a tooth. However, this method involved a problem from the standpoint of the practical use because the measured values are scattered according to the measurement conditions and differences among individuals. Further, there are disclosed methods using devices, for example, a method in which a laser light having a specific wavelength is irradiated, and a reflected light from the irradiated site is quantitated, whereby the degree of progress of the dental caries is evaluated (see Japanese Patent Laid-Open No. 337142/1993); a method using an infrared camera (see Japanese Patent Laid-Open No. 233758/1996; and a method in which the water content in an initial dental caries site is quantitated by an infrared light (see Japanese Patent Laid-Open No. 71092/1996). The devices to be used in these methods are each required to use a large-sized and expensive detector, and therefore, have not been generally spreaded. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Electrolytic method and device Inventor(s): Moran, Francis Xavier; (Somerville, MA) Correspondence: Medlen & Carroll, Llp; Suite 350; 101 Howard Street; San Francisco; CA; 94105; US Patent Application Number: 20030054321 Date filed: September 27, 2002 Abstract: The present invention is used to obtund tooth decay and periodontal lesions by obstructing the proton motive force that exists in bacteria. The result is that glycolysis, DNA synthesis and chelation is upset and this will cause bacteria to dissolute logrithmically. The invention is also used to harden and remineralize enamel and dentin by using fluoride compounds available in over-the-counter dental cleansers. The invention takes into consideration the vector magnitude of the hydration layer between the enamel and the pellicle plaque layer of teeth which insulates the teeth from the electrical potentials of electrophoresis. The claim that electrical potentials can be placed on teeth does not take this physico-chemical phenomenon into consideration. This invention uses the proper voltage to produce ionization of molecules in a salivary slurry of gels, dentrifice's and rinses. Excerpt(s): This is a non-provisional application having priority to provisional application No. 60/227,267 filed on Nov. 15, 2000. This invention relates to a toothbrush

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having sufficient means for providing sufficient voltage for electrolysis of dentifrice, gels, and rinses to produce hydronium ions and an aqueous acid media. There is a hydration layer between the enamel of teeth and a natural covering of a glyco-protein adhesive film called a pellicle that is present on all teeth in the oral cavity. This layer of water molecules is vectorial with a positive charge directed toward the oxyanion of the phosphate ion of the apatite crystals of enamel. This vector magnitude insulates the tooth against electrical potentials produced by electrophoresis. Any claim that a potential on teeth by electrophoresis does not take this physico-chemical phenomena into account. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Material for evaluating dental caries activity Inventor(s): Matsumoto, Yuko; (Tokyo, JP) Correspondence: Oblon, Spivak, Mcclelland, Maier & Neustadt, P.C.; 1940 Duke Street; Alexandria; VA; 22314; US Patent Application Number: 20030113266 Date filed: November 20, 2002 Abstract: A material for evaluating dental caries activity that is capable of evaluating dental caries activity, i.e., the released amount of an acid from dental plaque, which is important in dental health, by a simple manner in a short period of time, contains an absorptive material having carried thereon a pH indicator having an indicator range of pH 3.5 to 8.0 and a sugar, and has been adjusted to have a pH value higher than the indicator range of the pH indicator, in which dental plaque taken from a subject is directly applied on the material to evaluate dental caries activity by change in color. Excerpt(s): The present invention relates to a material for evaluating dental caries activity, which is capable of evaluating activity of dental caries in an oral cavity of a subject by a simple manner in a short period of time. Evaluation of dental caries activity in dental surgery is to estimate and determine activity of dental caries, i.e., as to whether or not dental caries of teeth currently developed further proceeds, and as to whether or not there is a possibility of future development of dental caries due to activity of dental caries although no dental caries is currently developed. Therefore, it has great significance in dental health. It is considered that development and progress of dental caries of teeth are caused in such mechanisms referred to as a decalcifying phenomenon that cariogenic bacteria present in dental plaque attached to the teeth metabolize carbohydrate to produce an acid, and calcium ions and phosphoric ions in the teeth are eluted by the acid. Therefore, a method of measuring a released amount of an acid from dental plaque is studied as a method for evaluating dental caries activity. Because it is considered that the released amount of an acid from dental plaque depends on the number of cariogenic bacteria present in the dental plaque, such a method is carried out by a measuring test for the number of mutans streptococcus in the dental plaque and a measuring test for the number of lactobacilli in the dental plaque. However, these methods have such disadvantages that expensive culturing equipments, sophisticated operation techniques and prolonged culturing periods are required. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method and laser apparatus for preventing tooth decay Inventor(s): Cozean, Colette; (Lake Forest, CA), Nammour, Samir; (Brussels, BE), Powell, Lynn; (Salt Lake City, UT) Correspondence: Knobbe Martens Olson & Bear Llp; 2040 Main Street; Fourteenth Floor; Irvine; CA; 92614; US Patent Application Number: 20030170586 Date filed: March 6, 2002 Abstract: A method and apparatus for preventing tooth decay by treating the tooth surface, including the occlusal surface and unexposed surfaces such as subgingival, interproximal, and contact areas, with a laser with a coherent or noncoherent light source are described. This process makes the tooth more resistant to acid and better able to bond fluoride, thus requiring a lower concentration of fluoride. The method allows the treatment to penetrate deeper into the tooth then previously accomplished with other methods and can be used in a dental office or at home. Excerpt(s): This invention relates to an apparatus and a method for preventing tooth decay using electromagnetic radiation. Tooth decay is caused by demineralization of the tooth structure at either the enamel or root surface. The enamel is a thin layer (1-2 mm) composed of a crystal-type structure of hydroxyapatite or calcium phosphate hydroxide, containing large amounts of calcium and phosphorus. Dental enamel is a porous material and although it contains about 96% by weight of mineral, this is equivalent to approximately 85 percent by volume. The remaining 15 percent by volume is made up of water, protein and lipid, which form the diffusion channels through which acids and minerals can travel into or out of the tooth. The dentin, the major part of the core of the tooth, is composed of CaCO.sub.3, a chalk-like material. Although it is 70% by weight of mineral, it also contains 20% by weight organic and 10% by weight water. This corresponds to 47% by volume mineral. Tooth decay, or dental caries results from the growth of bacteria on the tooth. The bacteria metabolize sugars to acid which can dissolve the tooth. The bacteria grow as a plaque on the tooth and conventional treatment involves periodic removal of the plaque and strengthening of the tooth to make it more resistant to the acid produced by the bacteria. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method and system for recording carious lesions Inventor(s): Benn, Douglas K.; (Gainesville, FL), Dankel, Douglas D. II; (Gainesville, FL), Kostewicz, Stephen H.; (Gainesville, FL) Correspondence: Saliwanchik Lloyd & Saliwanchik; A Professional Association; 2421 N.W. 41st Street; Suite A-1; Gainesville; FL; 326066669 Patent Application Number: 20020178032 Date filed: May 2, 2002 Abstract: A method and system is provided for charting tooth decay to assist in caries management. Specifically, the invention provides a computer system, a Graphical User Interface(GUI), a method, and associated computer code for presenting an interactive tooth chart comprising selectable, anatomically correct tooth icons corresponding to a dental patient's teeth. The invention allows a user to select regions of each individual tooth icon to record the condition of the selected region. According to the invention, a

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dental patient is selected from a patient data base, the patent's teeth are examined, and the condition of each tooth region is recorded using selectable icons. The invention further provides automatic characterization of dental conditions based on standard values and previously recorded conditions to indicate progression of disease. In an alternative embodiment, the invention provides a recommended course of clinical management based on the information recorded. In another embodiment the invention automatically classifies patients into risk categories and provides suggested x-ray exam intervals. Thus, particular advantages of the current invention include ease of recording dental conditions, more accurate dental charting, and automatic analysis of recorded dental data, advantageously resulting in better patient care and more efficient use of a dental care provider's time. Excerpt(s): This application claims the benefit of U.S. Provisional Application Ser. No. 60/288,524, filed May 3, 2001, incorporated herein by reference. A portion of the disclosure of this patent document, including drawings and screen shots, contains material that is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or the patent disclosure as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyright rights whatsoever. The present invention relates to caries management. More specifically, the invention relates to a method and system for charting tooth decay to assist in caries management. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for the treatment and prevention of dental caries Inventor(s): Anderson, Maxwell H.; (Seattle, WA), Chen, Li; (Los Angeles, CA), Morrison, Sherie L.; (Los Angeles, CA), Shi, Wenyuan; (Los Angeles, CA), Trinh, Kham; (Alhambra, CA), Wims, Letitia; (Culver City, CA) Correspondence: David J. Meyer; 11355 W. Olympic BLVD.; Los Angeles; CA; 90064; US Patent Application Number: 20020068066 Date filed: June 15, 2001 Abstract: Dental caries in man may be prevented or treated by oral ingestion of human or humanized murine monoclonal IgG and IgM antibodies that bind to surface antigens of cariogenic organisms, such as S. mutans. The genetically engineered monoclonal antibodies engage the effector apparatus of the human immune system when they bind to cariogenic organisms, resulting in their destruction. In a preferred embodiment, monoclonal antibodies to cariogenic organisms are produced by edible plants, including fruits and vegetables, transformed by DNA sequences that code on expression for the desired antibodies. The antibodies are applied by eating the plants. Excerpt(s): Removal of the damaged portion of a tooth and restoration by filling can, at least temporarily, halt the damage caused by oral infection with cariogenic organisms. However, the "drill and fill" approach does not eliminate the causative bacterial agent. Proper oral hygiene can control the accumulation of dental plaque, where cariogenic organisms grow and attack the tooth surfaces. However, dental self-care has its limits, particularly in populations that are unable to care for themselves, or where there is a lack of knowledge of proper methods of self care. Administration of fluoride ion has been shown to decrease, but not eliminate the incidence of dental caries. In view of the overwhelming evidence of the involvement of cariogenic organisms in the pathogenesis of dental caries, it is not surprising that there have been a number of different attempts

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to ameliorate the condition using traditional methods of anti-microbial therapy. The disadvantage of antimicrobial agents is that they are not selective for cariogenic organisms. Administration of non-specific bacteriocidal agents disturbs the balance of organisms that normally inhabit the oral cavity, with consequences that cannot be predicted, but may include creation of an environment that provides opportunities for pathogenic organisms. In addition, long term use of antimicrobial agents is known to select for organisms that are resistant to them. Hence long term and population-wide use of antimicrobial agents to prevent tooth decay is not practical. Vaccination of humans to elicit an active immune response to S. mutans, or other cariogenic organisms, is also not a practical solution at this time. One drawback of this approach is that vaccination elicits production of predominantly IgG and IgM antibodies, but they are not secreted into saliva. The majority of antibodies present in saliva are of the IgA isotype, which can bind to, but cannot activate lymphocytes or complement components to kill bacteria. Accordingly, vaccination is not believed likely to be capable of producing antibodies that can trigger the immune system to kill cariogenic organisms in the mouth. There is no known method for selectively increasing the titer of vaccination induced antibodies of the IgG or IgM isotypes in the oral cavity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

METHOD FOR THE TREATMENT AND THE PREVENTION OF DENTAL CARIES AND PERIDONTAL DISEASES USING BACTERIO PHAGE-ENCODED ENZYMES Inventor(s): DELISLE, ALLAN L.; (SYKESVILLE, MD) Correspondence: Steven B. Kelber; Long Aldridge & Norman, Llp; 701 Pennsylvania Avenue, N.W.; Suite 600; Washington; DC; 20004; US Patent Application Number: 20010014463 Date filed: June 30, 1997 Abstract: A method for the treatment and prevention of dental caries and periodontal diseases using bacteriophages and phage-encoded anti-bacterial enzymes to inhibit establishment of bacteria in the oral cavity is provided. Also provided are methods for studying the cell wall of an oral bacterium, a method for preventing spoilage of perishable items and a method for removing dextrans from surfaces utilized in sugar manufacture. Purified enzymes and the isolated DNA fragments encoding them are also provided. Excerpt(s): This invention relates to bacteriophage-encoded enzymes useful in preventing dental caries and periodontal diseases. More specifically, this invention relates to lysozyme-like enzymes isolated from bacteriophages which are capable of killing cariogenic bacteria and other periodontal disease-causing organisms. The invention also relates to dextranase-like enzymes suitable for dental treatments (i.e., loosening plaque) and other applications where it is desired to remove dextran and other bacterial polysaccharides (i.e., mutan) synthesized from sucrose. With regard to their function in dental plaque, phages are likely to influence the plaque flora in several potentially significant ways. Prophages, for example, provide immunity to superinfection by homoimmune phages and would presumably assist lysogens which carry them in competing with other bacteria in plaque by killing phage-sensitive competitors in a manner analogous to bacteriocinogenic cells. The semi-solid nature of dental plaque provides an especially favorable environment for this type of competition. Alternatively, lytic phage would be expected to select for phage-resistant mutants of sensitive strains and for mucoid mutants (phenotypically phage-resistant), which could well have altered

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colonizing and pathogenic properties. Actinophage-resistant mutants have in fact already been used to study cell surface structures that appear to be involved in specific, intergeneric oral bacterial coagreggation reactions (Delisle, A. L. et al (1988) Infect. Immun. 56:54-59; Tylenda, C. A. et al (1985) Infect. Immun. 48:228-233), which are believed to play an important role in colonization of dental plaque (Kolenbrander, P. E. et al (1985) In, S. E. Murgenhagen and B. Rosan (eds) pp. 164-171, American Society for Microbiology, Washington, D.C.). The literature on S. mutans phages dates back to 1970, when Greer first claimed to be able to induce phages, by treatment with mitomycin C, from oral streptococcal strains AHT, BHT and HHT (Greer, S. W., et al (1970) IADR Abstr. 160; J. Dent. Res, 48A:88) and subsequently claimed that the same virus was present in all of eight cariogenic streptococci he examined, but not in non-cariogenic strains (Greer, S. W., et al (1971) J. Dent. Res. 50:1594-1604). He then reported that lysogens could be cured of their prophages by treatment with acridine orange (Greer, S. W., et al (1971) IADR Abstr. 57: J. Dent. Res. 49:67) and nitrosoguanidine (Greer, S. W., et al (1972) IADR Abstr. 68: J. Dent. Res. 50:65). The latter was used to isolate temperaturesensitive mutants, one of which was heat-inducible and could be used to obtain cured cells by brief heating. Greer also proposed a curing procedure based on radiosensitization of DNA by incorporating 5-bromodeoxyuridine lysogens (Ramberg, E. et al (1973) IADR Abstr. 113: J. Dent. Res. 52a), but its application to S. mutans was never subsequently reported. Greer never reported the successful isolation of an infectious phage which could be grown in S. mutans. Difficulties in repeating Greer's induction experiments led many microbiologists to assume that he was really working with enterococci, which were common contaminants in the oral streptococcal cultures being exchanged among various laboratories during this time. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Model of dental caries Inventor(s): Marshall, Thomas D.; (San Antonio, TX) Correspondence: Meyertons, Hood, Kivlin, Kowert & Goetzel, P.C.; P.O. Box 398; Austin; TX; 78767-0398; US Patent Application Number: 20040067477 Date filed: July 11, 2003 Abstract: A model of dental caries may include simulated decay material in a cavity in an artificial tooth. The artificial tooth may be made of resin. The cavity may include an opening that extends from a simulated enamel surface to, e.g., at least the dentinoenamel junction of the tooth. The model may include at least one groove that extends from the opening (e.g., along the dentinoenamel junction). The cavity may contain simulated decay material in a groove and/or the opening. The simulated decay material is a homogenous substance that may include a curable resin, a porous substance, and/or coloring. The simulated decay material may be detectable with caries detecting stain. An etching solution and/or a curable bonding substance may be applied to the cavity before the simulated decay material is applied. The simulated decay material may simulate dental caries in color, texture, and/or tenacity. Excerpt(s): This application claims priority to U.S. Provisional Application No. 60/395,432 entitled "MODEL OF DENTAL CARIES" filed Jul. 11, 2002. The abovereferenced provisional application is hereby incorporated by reference as if fully set forth herein. The present invention generally relates to a model of dental caries. Embodiments of the invention relate to a model of dental caries that simulates dental

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decay in color, texture, and/or tenacity. Traditionally, pre-clinical dental students learn to treat various classifications of decayed teeth by working on pristine resin teeth (teeth without defects) arranged in simulated upper and lower resin jaws. In some cases, students may work with resin teeth with defects. These defects may include various defects caused by human dental decay (caries). Some resin teeth have defects but contain no simulated decay material. Other resin teeth for pre-clinical use contain simulated decay material. Currently, simulated carious resin teeth are produced by cutting away the outer layer of a resin crown, cutting defects into the prepared tooth, inserting simulated carious material into the defects, and then covering the prepared tooth with a resin crown. No opening is provided into the dental cavity. Furthermore, the simulated carious material may be a heterogeneous substance with unrealistic color, texture, and/or tenacity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Multi-functional dental composition Inventor(s): Melman, Steven A.; (Potomac, MD) Correspondence: Patent Adminstrator; Katten Muchin Zavis Rosenman; 525 West Monroe Street; Suite 1600; Chicago; IL; 60661-3693; US Patent Application Number: 20020156130 Date filed: January 12, 2001 Abstract: This invention relates to novel dental compositions and methods for preventing dental plaque and carie formation and generally for inhibiting tooth decay and brightening/whitening teeth. The compositions of this invention comprise organic acids such as acetic acid and salts thereof which can be combined with pharmaceutically acceptable carriers or diluents to be administered in the form of conventional dental compositions. The compositions of the present invention also preferably contain sodium hexametaphosphate. Excerpt(s): The present invention relates generally to an oral hygiene product. More particularly, the present invention relates to a dental composition such as a tooth paste, cream, gel or dentifrice, a mouth wash or rinse, a dental pack, or dental floss. Specifically, the invention relates to multi-functional dental products containing acetic acid. Bacterial aggregation on the teeth is known as plaque and causes dental caries, gingivitis, periodontitis and other gum diseases. A variety of microorganisms are present in the oral cavity. These range from the natural flora of the host to pathogenic species. Among these microorganisms are the gram-positive rods associated with the formation of plaque (a dense, enamel-adherent, microorganism-containing polysaccharide matrix). Specific areas, including periodontal and subgingival spaces, and interpapillary spaces of the tongue present environments that harbor bacteria. These spaces are difficult to reach by tooth brushing, and are only moderately affected by standard mouthwashes. Mechanical methods have been used for some time for the prevention of dental plaque but have not generally achieved sufficient results. Studies have shown that mechanical methods such as the use of dental floss and inter-space brushes do not efficiently eliminate plaque. The persistence of these microorganisms in such environments greatly increases the risk of calculus and plaque build up and carie formation, which in turn presents the danger of gingival inflammation and periodontal disease. Thus chemical plaque control as a substitute or supplement to mechanical methods is sought. U.S. Pat. No. 4,636,382 describes morpholino compounds which are useful for the inhibition or removal of dental plaque. The '382 patent also discloses that a

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wide variety of chemical and biological agents have been suggested for the inhibition of plaque, such as penicillin, chlorohexidine, 8-hydroxyquinoline and ethylenediamine tetraacetate. However, many of these chemical and biological agents are described as exhibiting insignificant effects and often causing serious side effects. U.S. Pat. No. 4,610,871 describes the use of monoalkyl or dialkyl ethers of dianhydrohexitols to inhibit the formation of plaque and calculus on teeth. U.S. Pat. No. 4,178,363 describes the use of n-undecylenic fatty acid or a calcium or zinc salt thereof for reducing dental plaque and infections of the teeth and gums. U.S. Pat. No. 4,119,711 describes spiro 1(hydroxyalkyl)-piperidino derivatives which have efficacy in reducing the formation of plaque. U.S. Pat. No. 3,976,765 describes bis-biguanido hexanes in combination with nonionic surfactants and certain foam stabilizers for use in a variety of oral preparations. Additionally, U.S. Pat. No. 3,887,712 discloses that alexidine dihydrofluoride is useful in the treatment of dental plaque, calculus, gingivitis and related periodontal diseases. U.S. Pat. No. 4,160,821 discloses that a glycerine solution of zinc chloride or other acceptable zinc salts provides effective therapy for gingivitis when applied to the gingivae and teeth. U.S. Pat. Nos. 6,149,895; 5,240,415; 5,648,064; and 5,645,428 disclose teethbleaching compositions having as active ingredient hydrogen peroxide. U.S. Pat. No. 4,012,839 teaches a technique of disinfecting caries-infected or potentially caries-infected dental tissue with silver nitrate, silver thiocyanate or its complexes. U.S. Pat. No. 4,060,600 teaches a method of treating teeth in dentistry, for the prevention of calculus, removal of caries, and dissolution of plaque, comprising applying an aqueous solution containing a hypochlorite of an alkali and/or alkaline earth metal, and an amino compound capable of forming water-soluble non-mucous irritating N-chloro and/or Ndichloro derivatives thereof to the teeth. U.S. Pat. No. 4,327,079 provides a dentifrice composition containing synthetic hydroxyapatite powder which is neutral or weakly alkaline or contains 0.1 to 20% by weight of NaCl and/or KCl and 0.003 to 3% by weight of MgCl.sub.2 as useful for fortifying a surface of a tooth, promoting remineralization of the surface of the tooth and eliminating plaque from the tooth. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Reductant rinse for use with ozone treatment of dental caries Inventor(s): Lynch, Edward; (Northern Ireland, GB), Schemmer, Jurgen; (King City, CA) Correspondence: Walter A. Hackler; 2372 S.E. Bristol, Suite B; Newport Beach; CA; 92660-0755; US Patent Application Number: 20030143164 Date filed: March 12, 2002 Abstract: A reductant rinse including xylitol prevents buildup in ozone carrying lines in apparatus for the treatment of dental caries. Excerpt(s): This invention relates to the use of reductants in the ozone in the treatment of dental caries. The great destructive disease of teeth is dental caries which may be defined as the acid dissolution of enamel, dentine or cementum as a consequence of the metabolism of micro-organisms living within deposits on the teeth known a plaque. Dental caries is believed to be associated with specific micro-organisms, the principal ones being Streptococcus Mutans, Lactobacilli, Actinomyces Visosus Serovar 2, Actinomyces Naeslundii and "Intermediate" Actinomyces, other Streptococci and yeasts. These are acid producing micro-organisms which produce acids such as acetic and lactic acids from the dietary carbohydrates. The micro-organisms associated with dental caries are unique and are ecologically very different from those associated with, for

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example, infected root canals. (iii) the protection of any newly exposed non-carious dentine with restorative material. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Risk check sheet for dental caries Inventor(s): Kumaoka, Masayuki; (Tokyo, JP), Nishikata, Hiromi; (Tokyo, JP), Tosaki, Satoshi; (Tokyo, JP), Watanabe, Yoshiko; (Tokyo, JP) Correspondence: Oblon Spivak Mcclelland Maier & Neustadt PC; Fourth Floor; 1755 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20030011191 Date filed: June 14, 2002 Abstract: To enables a technician for dental care to grasp the risk of dental caries of a patient and show its state to the patient in an easily understandable way, a risk check sheet for dental caries is constituted of a list sheet provided with three kinds of risk items consisting of a risk of dental caries caused by a resistance, a risk of dental caries caused by intra-oral bacteria, and a risk of dental caries caused by eating habit, each having a plurality of check items, as to each of which one from a plurality of selection items having different ranks is to be alternatively selected, and numericalizing data of the risks of dental caries from by summing up evaluation scores given in the selection items for each risk item; and a chart sheet provided with a standard circle centering around an origin and having indicator circles provided radially with a distance of 120 degree centering around the origin from each other and allocated for data of the three kinds of risks of dental caries based on the numerical data by the list sheet. Excerpt(s): The present invention relates to a risk check sheet for dental caries, which enables a technician for dental care to grasp the risk of dental caries of a patient and to show its state to the patient in an easily understandable way. In order to consider a measure for inhibiting the progress of "dental caries" as a condition-pluricausal disease caused by the intra-oral state or life habit and to plan for treating it, a movement in which a technician for dental care confirms the intra-oral state and life habit of a patient through inquiries or inspections and grasps "whether easily or hardly to be attacked by the dental caries", that is, "a risk of dental caries", of the patient per se starts to occur. To make the patient per se understand the risk of dental caries is necessary in giving a motivation against the maintenance and continuation of oral care. For example, the caries risk radar chart as disclosed in Clinical Cariology (published by Ishiyaku Publishers, Inc.) is concerned with a method in which among the results obtained by checking the amount of dental plaque, the level of Mutans streptococci, the level of Lactobacilli, the number of eating and drinking per day, the amount and quality of saliva, the buffer capacity of saliva, DMFT (an index showing the caries experience of permanent teeth, which is expressed by a value obtained by dividing the sum of cariesexperienced teeth of permanent teeth of a subject by the number of subjects), the shape of fissure in enamel, the fluoride mouth wash, the fluoride application, the family makeup, the level of bacteria of the family, and the like by using a "Caries Risk Questionnaire", the eight major factors, i.e., the buffer capacity of saliva, the level of Mutans stroptococci, the level of Lactobacilli, the number of eating and drinking, the accumulated amount of dental plaque, the use status of fluoride, the DMFT, and the amount and quality of saliva, are selected as parameters related to the risk of dental caries and plotted in the radar chart, and the risk of dental caries is confirmed from the size and shape of a graph thus drawn. Accordingly, the risk of dental caries can be

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simply shown in a visual form. However, not only the number of the parameters related to the risk of dental caries is high and the procedures are complicated, but also each of the parameters uses technical terminologies, which is difficult for a general patient to understand. Therefore, it has been difficult to make the patient per se understand the risk of dental caries and give a motivation for the maintenance and continuation of oral care. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

SYNTHETIC PEPTIDE VACCINES FOR DENTAL CARIES Inventor(s): SMITH, DANIEL J.; (NATICK, MA), TAUBMAN, MARTIN A.; (NEWTONVILLE, MA) Correspondence: Patricia Granahan; Hamilton Brook Smith And Reynolds; Two Militia Drive; Lexington; MA; 02173 Patent Application Number: 20010048926 Date filed: November 10, 1997 Abstract: Vaccine compositions and immunogenic compositions are described which are glucosyltransferase subunit vaccines for dental caries and which contain at least one peptide which corresponds to a sequence of glucosyltransferase containing aspartate 413, aspartate 415 or both aspartate 413 and aspartate 415. These subunit vaccines elicit antibodies which protect an immunized mammal from dental caries. Methods of provoking an immune response to intact glucosyltransferase are also described. Excerpt(s): This application is a continuation-in-part of U.S. application Ser. No. 08/057,162, filed Apr. 30, 1993, which is a continuation-in-part of U.S. application Ser. No. 07/877,295, filed May 1, 1992. The entire teachings of these priority applications are incorporated herein by reference. Mutans streptococci have been convincingly implicated in the initiation of dental caries in humans. The ability of these organisms to accumulate and colonize on the tooth surface has been associated with the synthesis of glucans from sucrose. Glucans are synthesized by constitutively secreted glucosyltransferase (GTF) enzymes. These enzymes have been considered as potential components of a dental caries vaccine because of their role in the pathogenicity of Mutans streptococci. However, vaccines based on intact GTF have a variety of disadvantages such as the presence of inappropriate epitopes and excess molecular material that does not possess appropriate immunogenic features. Although the exact basis for experimental protection with GTF-type vaccines is unclear, it is quite likely that protection involves functional inhibition of the catalytic and/or the glucan-binding activities of GTF. Epitopes associated with these functions would theoretically be primary targets for immunological attack, provided that the relevant sequences are located in molecular areas that are accessible to antibody. Subunit vaccines provide a method to block functional domains without inducing immunity to irrelevant or unwanted epitopes. It has been reported that synthetic peptide vaccines associated with catalytic or glucan-binding domains of GTF could protect rats from experimental dental caries (Taubman et al., Infect. Immun. 63:3088-3093 (1995)). One of the peptides that was successfully used as a vaccine (Smith et al., Infect. Immun. 62:5470-5476 (1994)) demonstrated a sequence containing an aspartic acid (aspartate 451 in S. mutans GTF-B) to which the glucosyl moiety of sucrose was covalently bound (Mooser et al., J. Biol. Chem. 266:8916-8922 (1991)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Toothpaste Inventor(s): Baumgartner, Irene; (Schwabach, DE) Correspondence: Patent Attorney's Gotz & Kuchler; Farberstrabe 20; Nurnberg; 90402; DE Patent Application Number: 20020048553 Date filed: July 30, 2001 Abstract: The herein-described invention promotes oral and dental health by encouraging children to brush longer, therewith promoting healthier gums and preventing tooth decay. Therefor, the invention provides a toothpaste containing capsules or particles filled with child-friendly flavorings and dyes which will burst open or liquefy through the motion and pressure of brushing to release their tasty contents as a reward for an intense brushing. Excerpt(s): The invention refers to a toothpaste, especially for children, that contains active ingredients as well as flavors and eventually dyes. Regular brushing is the key to a good dental hygiene. That is not only true for the teeth of adults, but also for the primary dentition of children. Without regular brushing, cavities are predictable. Motivating children to brush can be a difficult task; yet it is an important one. To encourage children in their brushing, flavors have been added to a toothpaste. However, this is not enough, because children have the tendency to swallow the flavored toothpaste instead of brushing, sometimes they even choose to swallow consciously. Parents can attest to this. If swallowing the toothpaste, children are not receiving the necessary fluorine to prevent tooth decay. To harden enamel, fluorine is added to children's toothpaste. The amount of fluorine added is within prescribed limits to prevent an unhealthy overdose of fluorine ingestion. This is important as the majority of children under the age of two receive additional doses of fluorine through a tablet form, fluorine enhanced table salt or fluoridated water. Through these means, the amount of fluorine a child receives is within the acceptable limits. Too much fluorine can be as dangerous as not enough. Ingesting an unnecessary amount of fluorine that their developing bodies not need or benefit from can lead to other possible medical concerns. Consequently, it becomes necessary to police the amount of fluorine ingested, to make sure the child does not "snack" on the sweet fruity and enticing taste. To date, only two unacceptable facts exist, the first, that the colorful, sweet toothpaste is eaten and swallowed more than used for thorough brushing, and second, that an overingestion of fluorine can result in a variety of harmful effects. Drawn from the disadvantages of current practice, the problem arises to improve a known toothpaste so that by the tasty ingredients children will be motivated to a thorough brushing for removing plaque, instead of swallowing the toothpaste. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Use of bacterial phage associated lysing proteins for treating bacterial dental caries Inventor(s): Fischetti, Vincent; (West Hempstead, NY), Loomis, Lawrence; (Columbia, MD) Correspondence: Jonathan E. Grant; 2120 L Street, N.W.; Suite 210; Washington; DC; 20037; US Patent Application Number: 20030082110 Date filed: June 21, 2002

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Abstract: A composition and method for treating bacterial dental caries by the use of an effective amount of at least one lytic specific for the bacteria causing dental caries. The lytic enzyme is genetically coded for by a bacteriophage which may be specific for said bacteria. The enzyme may be at least one lytic protein or peptides in a natural or modified form Excerpt(s): This is a continuation-in-part of U.S. patent application Ser. No. 09/671,881, filed Sep. 28, 2000, which is a continuation in part of application Ser. No. 09/497,495, filed Apr. 14, 2000, which is a continuation of U.S. patent application Ser. No. 09/395,636, filed Sep. 14, 1999, now U.S. Pat. No. 6,056,954 which is a continuation of U.S. patent application Ser. No. 08/962,523, filed Oct. 3, 1997, now U.S. Pat. No. 5,997,862. The present invention relates to methods and compositions for the treatment of bacterial infections by the use of bacteria-associated phage proteins, or peptides and peptide fragments thereof. More specifically, the invention pertains to phage lytic and/or holin proteins, or peptides and peptide fragments thereof, blended with a carrier for the treatment and prophylaxis of bacterial infection. In the past, antibiotics have been used to treat various infections. The work of Selman Waksman in the introduction and production of Streptomycetes, and Dr. Fleming's discovery of penicillin, as well as the work of numerous others in the field of antibiotics, are well known. Over the years, there have been additions and chemical modifications to the "basic" antibiotics in attempts to make them more powerful, or to treat people allergic to these antibiotics. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with tooth decay, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “tooth decay” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on tooth decay. You can also use this procedure to view pending patent applications concerning tooth decay. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON TOOTH DECAY Overview This chapter provides bibliographic book references relating to tooth decay. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on tooth decay include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “tooth decay” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on tooth decay: •

Sjogren's Syndrome Source: Torrance, CA: Homestead Schools, Inc. 2001. 101 p. Contact: Available from Homestead Schools, Inc. 23844 Hawthorne Boulevard, Suite 200, Torrance, CA 90505. (310) 791-9975. Fax (310) 791-0135. E-mail: [email protected]. Website: www.homesteadschools.com. PRICE: $48.00 plus shipping and handling. Course No. 6590. Summary: Sjogren's syndrome is a chronic disorder of unknown cause characterized by a particular form of dry mouth (xerostomia) and dry eyes. This continuing education program for dentists focuses on Sjogren's syndrome (SS). Topics include the symptoms of SS and how to distinguish between primary and secondary SS; autoimmune response systems and the role of hereditary and environmental factors in causing SS; other causes of dry eyes and xerostomia; the salivary and nonsalivary causes of xerostomia; treatment approaches for patients with SS; the advantages and side effects of certain

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medications used by SS patients; treatment alternatives to oral Candida mucositis, oral dryness, and tooth decay for patients with SS; other symptoms of SS and their treatments, including vaginal dryness, fatigue, depression, and heartburn; and the use of pilocarpine tables for the treatment of xerostomia and dry eye symptoms in patients with SS. The document concludes with a posttest with which readers can qualify for continuing education credit, a glossary of terms, and an appendix of product and manufacturer information. The document is illustrated with numerous black and white photographs. 4 figures. 14 tables. 62 figures. •

Healthy mouth, healthy body: The natural dental program for total wellness Source: New York, NY: Kensington Publishing. 2000. 278 pp. Contact: Available from Kensington Publishing Corporation, 850 Third Avenue, New York, NY 10022 / Web site: http://www.kensingtonbooks.com. $13.00. Summary: This book focuses on alternative prevention and treatment methods for dental care with attention to the impact on the entire body. Topics include the overall health and diet of the patient, reducing bacteria and stress, vitamin, mineral, and herbal supplements, reducing sugar in the diet, and the use of acupressure and acupuncture techniques. Conditions such as temporomandibular joint problems, periodontal disease, tooth decay, tooth pain, and halitosis are discussed. Selected references, a resource section, and an index are provided.

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The ASDC kid's mouth book Source: Chicago, IL: American Society of Dentistry for Children. 1999. 144 pp. Contact: Available from American Society of Dentistry for Children, 210 E. Chicago Avenue, Suite 710, Chicago, IL 60611. Telephone: (312) 943-1244 / fax: (312) 943-5341 / e-mail: [email protected] / Web site: http://www.asdckids.org. $44.00, plus $5.00 shipping and handling. Summary: This book is designed for parents and children as an easy-to- understand guide to children's oral health. Included are explanations of dental terms, procedures, and treatments with accompanying color photographs to aid in understanding. Chapter topics include: tooth development; tooth decay and nursing; dental plaque; preventing mouth diseases; periodontal diseases, oral surgery; trauma to the mouth and teeth and preventing it; sealants; a safe and comfortable patient; emergency treatment, and orthodontics. A glossary and index are provided.

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Complete Guide to Children's Dental Care: From Prenatal Through Teens Source: Southampton, NY: Health Monitor Press. 1993. 139 p. Contact: Available from Health Monitor Press. P.O. Box 2700, Southampton, NY 11969. (516) 287-3140; Fax (516) 287-3136. PRICE: $14.95 plus shipping and handling. ISBN: 0963599801. Summary: This book is designed to provide parents with a comprehensive overview of how to care for their children's teeth, from infancy through adolescence. Twelve chapters cover topics including tooth development, tooth anatomy, pregnancy, teething, primary and permanent teeth, dental plaque, tooth decay and its prevention, the importance of oral hygiene, baby bottle tooth decay, dental care, the use of fluoride and sealants, dental radiography (X-rays), food and nutritional concerns, dental emergencies, and orthodontics. Each chapter features answers to common questions and

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concerns that parents may have. The book concludes with a glossary of terms and a subject index. Numerous black-and-white photographs illustrate the text. •

Eating Hints for Cancer Patients: Before, During and After Treatment Source: Bethesda, MD: National Cancer Institute (NCI), National Institutes of Health (NIH). 1999. 60 p. Contact: Available from National Cancer Institute (NCI). Publications Ordering Service, P.O. Box 24128, Baltimore, MD 21227. Voice (800) 422-6237. TTY (800) 332-8615. Fax (301) 330-7968. PRICE: Single copy free; bulk rates available. NIH Publication Number 99-2079. Summary: This booklet contains a variety of ideas about food needs and eating problems that patients undergoing cancer therapy may encounter. The authors emphasize the need for eating well during cancer treatment and outline the nutrition problems that may arise with different cancer treatments. Strategies for coping with side effects are provided for loss of appetite, sore mouth or throat, changed sense of taste or smell, dry mouth, nausea, vomiting, diarrhea, constipation, weight gain, tooth decay, and lactose intolerance. The next section provides suggestions for increasing protein and calorie intake, including the use of healthy snacks. Another section discusses diets for patients with special needs, including the clear liquid diet, full liquid diet, soft diet, fiber restricted diet, low lactose diet, and commercial products to improve nutrition. The booklet includes a glossary of related terms and the contact information for two resource organizations: the Cancer Information Service (800-422-6237) and the American Cancer Society (800-227-2345). The booklet then provides 40 pages of recipes designed to help patients achieve better nutrition during cancer treatment. A recipe index is provided. Colorful drawings illustrate the booklet. 8 tables.

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Dental Health for Adults: A Guide to Protecting Your Teeth and Gums Source: Boston, MA: Harvard Health Publications. 2003. 52 p. Contact: Available from Harvard Health Publications. P.O. Box 421073, Palm Coast, FL 32142-1073. (800) 829-9045. Website: www.health.harvard.edu/SHR. PRICE: $16.00 for subscribers; $24.00 all others. Summary: This document is a new special health report from Harvard Medical School. The report outlines a prevention program that can address tooth decay and gum infection. The report describes oral health problems, medications and treatments, and restoration options for damaged teeth. Topics include the basics of mouth anatomy and physiology; home care of the teeth, including brushing, flossing, mouth rinses, fluoride, and treating bad breath (halitosis); working with the dentist, including the dental check up, X rays, types of dentists, and the role of dental insurance; dealing with dental anxiety; general health and its impact on oral health, and vice-versa; plaque diseases, including tooth decay and cavities, choosing a material to fill the cavity, gum disease, gingivitis, periodontitis; pulp diseases, including root canal therapy and tooth extraction; dealing with dental emergencies; tooth replacements, notably bridges, dentures, and dental implants; orthodontics; and cosmetic dentistry. The booklet concludes with a glossary of terms and a resource section that lists organizations and publications. A final section includes a listing of and order for form other Special Health Reports on a wide range of topics.

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Prevention and Treatment Considerations for the Dental Patient With Special Needs Source: Academy of Dentistry for Persons with Disabilities, American Academy of Pediatric Dentistry. 199x. 89 p. Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Chicago, IL 60611. (800) 243-2342 or (312) 440-8900; Fax (312) 4408929; E-mail: [email protected]; http://www.adha.org. PRICE: $2.00 for booklet, $15.00 for slides (30-day rental only, plus $50.00 refundable deposit); nonmembers add 25 percent (Illinois residents add 8 percent sales tax). Order number 2933. Summary: This manual includes a basic discussion of prevention and treatment considerations for dental patients with special needs. Topics covered include quality of life; dietary considerations; plaque; periodontal disease; nursing-related caries (baby bottle tooth decay); the sugar content of medications; phenytoin (Dilantin); overretained teeth; bruxism; drooling; mastication, rumination, and pouching; mental retardation; the Down Syndrome pattern of tooth eruption; dental implications of cerebral palsy; orthodontic therapy; trauma; self-injurious behavior; physical and sexual abuse; restraint and management; supporting devices; toothbrushing, including positioning techniques; preventive agents; adaptive equipment; and psychosocial factors. The manual concludes with a glossary of terms for the use of non-dental professionals, a list of resources, and a bibliography. Black and white photographs illustrate many of the conditions discussed. 45 references.

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Aunt Rita's Patient: A Story About AIDS Contact: American Red Cross, St Paul Area Chapter, 176 S Roberts St S, Saint Paul, MN, 55107-1404, (651) 291-6789, http://www.arcstp.org. Summary: This student workbook presents information about Acquired immunodeficiency syndrome (AIDS), its transmission, and its prevention, in story form. It tells a story about Paul's and Melanie's Aunt Rita, who is a doctor and has a patient with AIDS. The children learn about the immune system and how Human immunodeficiency virus (HIV) weakens it, stages of HIV infection, and its transmission through blood, semen, and vaginal fluids. It also talks about ways HIV cannot be transmitted in casual contacts in everyday life, and ways to stay healthy and prevent falling ill with flu, measles, tooth decay, or AIDS.

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Meet Your Teeth: A Fun, Creative Dental Care Unit Source: Santa Barbara, CA: Learning Works, Inc. 1996. 56 p. Contact: Available from Health EDCO. P.O. Box 21207, Waco, TX 76702-1207. (800) 2993366 or (817) 776-6461; Fax (888) 977-7653. PRICE: $7.95 plus shipping and handling. Item Number HE50655. Summary: This workbook presents a thematic unit on teeth and dental health for children in grades one through four. The book contains more than 50 pages of activities and information on topics including brushing and flossing, identifying the parts of a tooth, eating healthy, and learning about routine dental procedures. The book includes puzzles, word games, codes, word searches, and other student activities, as well as dental clip art, awards, bookmarks, and certificates for the teacher to incorporate into the lesson. Specific topics covered include tooth anatomy, baby and permanent teeth, the different kinds of teeth, the causes of tooth decay and gum disease, toothbrushing guidelines, the role of proper nutrition, X rays, how a cavity is filled, how teeth are straightened, what happens in a dental emergency, healthy snacks, and careers in

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dentistry. An answer key is provided for the word searches and other puzzles. The work book is illustrated with line drawings.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “tooth decay” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “tooth decay” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “tooth decay” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Biological Basis of Dental Caries: An Oral Biology Textbook by Lewis Menaker; ISBN: 0061417262; http://www.amazon.com/exec/obidos/ASIN/0061417262/icongroupinterna

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Concepts Concerning Dental Caries Prevention by John Gabrovsek; ISBN: 0875272096; http://www.amazon.com/exec/obidos/ASIN/0875272096/icongroupinterna

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Cost and Benefit of Fluoride in the Prevention of Dental Caries by G.N. Davies; ISBN: 9241700092; http://www.amazon.com/exec/obidos/ASIN/9241700092/icongroupinterna

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Dental Caries As a Cause of Nerval Disorders by Patrick Stortebecker, Tore Patrick Sthortebecker; ISBN: 0941011003; http://www.amazon.com/exec/obidos/ASIN/0941011003/icongroupinterna

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Dental Caries: A Treatable Infection by Walter J. Loesche; ISBN: 0398047677; http://www.amazon.com/exec/obidos/ASIN/0398047677/icongroupinterna

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Dental caries; a multifactorial disease by George Edward White; ISBN: 0398032173; http://www.amazon.com/exec/obidos/ASIN/0398032173/icongroupinterna

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Diagnosis and management of dental caries January 1980 through December 2000 : 1,592 citations (SuDoc HE 20.3516/2:2001-1) by Martha Glock; ISBN: B000114IRO; http://www.amazon.com/exec/obidos/ASIN/B000114IRO/icongroupinterna

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Diet, Nutrition and Dental Caries (Journal: Caries Research, Supplement 1, 1990: Vol 1) by M. E. Curzon (Editor), J. M. Ten Cate (Editor); ISBN: 3805553056; http://www.amazon.com/exec/obidos/ASIN/3805553056/icongroupinterna

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Early detection of dental caries II : proceedings of the 4th Annual Indiana Conference, Indianapolis, Indiana; ISBN: 0965514927; http://www.amazon.com/exec/obidos/ASIN/0965514927/icongroupinterna

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Fluorides and Dental Caries; ISBN: 0398034486; http://www.amazon.com/exec/obidos/ASIN/0398034486/icongroupinterna

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Fluorides and dental caries; contemporary concepts for practitioners and students by Ernest Newbrun; ISBN: 0398025630; http://www.amazon.com/exec/obidos/ASIN/0398025630/icongroupinterna

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Freedom from Tooth Decay and Gum Disease by Leonard Horowitz; ISBN: 0960938664; http://www.amazon.com/exec/obidos/ASIN/0960938664/icongroupinterna

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Glucosyltransferases, Glucans, Sucrose and Dental Caries by R. J. Doyle, J. E. Ciardi; ISBN: 0917000102; http://www.amazon.com/exec/obidos/ASIN/0917000102/icongroupinterna

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Hello Reader: Make Your Way For Tooth Decay (Level 3) by Bobbi Katz, Steve Bjorkman (Illustrator); ISBN: 0590522906; http://www.amazon.com/exec/obidos/ASIN/0590522906/icongroupinterna

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How You Can Prevent Tooth Decay by Mike Tecton; ISBN: 0922070423; http://www.amazon.com/exec/obidos/ASIN/0922070423/icongroupinterna

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Immunologic Aspects of Dental Caries by William Bowen (Author); ISBN: 0917000005; http://www.amazon.com/exec/obidos/ASIN/0917000005/icongroupinterna

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Nutrition Counseling for Dental Caries Prevention by Ae Nizel; ISBN: 0721698417; http://www.amazon.com/exec/obidos/ASIN/0721698417/icongroupinterna

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Preventing Dental Caries by G. Neil Jenkins; ISBN: 0875272177; http://www.amazon.com/exec/obidos/ASIN/0875272177/icongroupinterna

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Risk Markers for Oral Diseases: Volume 1, Dental Caries Markers of High and Low Risk Groups and Individuals by N. W. Johnson (Editor); ISBN: 0521375630; http://www.amazon.com/exec/obidos/ASIN/0521375630/icongroupinterna

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Strategy for Dental Caries Prevention in European Countries According to Their Laws and Regulations: Proceedings by S. O'Hickey (Editor), R. M. Frank (Editor); ISBN: 1852210087; http://www.amazon.com/exec/obidos/ASIN/1852210087/icongroupinterna

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The analysis, physiology and effects of fluoride : analytical techniques for fluoride analysis in biological materials, the metabolism and mechanism of action in reducing dental caries, and the effects of fluoride : a select bibliography by Naomi Wallis; ISBN: 0854942092; http://www.amazon.com/exec/obidos/ASIN/0854942092/icongroupinterna

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The Official Patient's Sourcebook on Tooth Decay by Icon Health Publications, et al; ISBN: 0597831491; http://www.amazon.com/exec/obidos/ASIN/0597831491/icongroupinterna

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Tooth Decay (Itªs Not Catching) by Angela Royston; ISBN: 1403448272; http://www.amazon.com/exec/obidos/ASIN/1403448272/icongroupinterna

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Tooth Decay and Cavities (My Health) by Alvin Silverstein, et al; ISBN: 0531164128; http://www.amazon.com/exec/obidos/ASIN/0531164128/icongroupinterna

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WHO Study of Dental Caries Etiology in Papua New Guinea (WHO Offset Publications) by R.G. Schamschula; ISBN: 9241700408; http://www.amazon.com/exec/obidos/ASIN/9241700408/icongroupinterna

Chapters on Tooth Decay In order to find chapters that specifically relate to tooth decay, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and tooth decay using the “Detailed Search” option. Go to the following

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hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “tooth decay” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on tooth decay: •

Dental Caries in the Child and Adolescent Source: in McDonald, R.E. and Avery, D.A., eds. Dentistry for the Child and Adolescent. 7th ed. St. Louis, MO: Mosby, Inc. 2000. p. 209-246. Contact: Available from Harcourt Health Sciences. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177. Fax (800) 874-6418. Website: www.harcourthealth.com. PRICE: $72.00 plus shipping and handling. ISBN: 0815190174. Summary: This chapter on dental caries is from a textbook on dentistry for the child and adolescent that is designed to help undergraduate dental students and postdoctoral pediatric dentistry students provide comprehensive oral health care for infants, children, teenagers, and individuals with various disabilities. The authors of this chapter stress that dental caries continue to be a major problem in dentistry and should receive significant attention in everyday practice, not only from the standpoint of restorative procedures, but also in terms of preventive practices. Topics include caries prevalence in preschool children, caries prevalence in school children; theories of the cause of dental caries; caries in the primary, mixed, and young permanent dentitions; secondary factors in dental caries (anatomic characteristics of the teeth, arrangement of teeth in the arch, presence of dental appliances and restorations, hereditary factors); rampant caries; early childhood caries (ECC, also called baby bottle tooth decay or nursing caries); control of dental caries; encouragement of good oral hygiene; the use of fluorides; pit and fissure sealants; a caries vaccine; the natural protective mechanisms of the mouth; dental caries activity tests; and the dentist's role in the caries control program. In the clinical management of rampant caries, the dentist's role consists in seeking the cause, correcting bad habits or deficiency states, restoring the teeth, and finally, making use of all available preventive and control measures. The authors conclude that successful management of the dental caries problem demands a carefully completed dental and medical history, the use of currently accepted diagnostic aids, the application of sound principles of restorative dentistry, a comprehensive preventive program, and regular recall appointments for maintenance work and reemphasis of the preventive procedures. 9 figures. 2 tables. 132 references.

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Oral Treatment and Prevention of Tooth Decay Source: in Carsons, S. and Harris, E.K., eds. New Sjogren's Syndrome Handbook. New York, NY: Oxford University Press. 1998. p. 156-162. Contact: Available from Sjogren's Syndrome Foundation, Inc. 8120 Woodmont Avenue, Suite 530, Bethesda MD 20814-1437. (301) 718-0300 or (800) 475-6473. Fax (301) 718-0322. Website: www.sjogrens.org. PRICE: $20.00 for members; $25.00 for nonmembers; plus shipping and handling. ISBN: 0195117247. Summary: This chapter on oral treatment and prevention of tooth decay is from a comprehensive guide to Sjogren's syndrome (SS). The authors offer clinical guidelines, primarily for health care professionals providing oral treatment and prevention of tooth decay for their patients with SS. The first section on the prevention and treatment of tooth decay (dental caries) covers diet, oral hygiene, the risk of tooth decay, the use of topical fluoride, dental restoration, and recall examinations. The second section

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addresses the diagnosis and treatment of oral candidiasis, discussing the diagnosis and treatment of the disease. Other sections discuss salivary flow stimulation (including the use of drug therapy with pilocarpine tablets), the use of saliva substitutes, the need to review the patient's current prescription drug use, and problems associated with excessive water consumption. 1 table.

Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to tooth decay have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:10 •

Early childhood caries resource guide Source: Arlington, VA: National Center for Education in Maternal and Child Health. 1998. 26 pp. Contact: Available from National Maternal and Child Health Clearinghouse, 2070 Chain Bridge Road, Suite 450, Vienna, VA 22182-2536. Telephone: (703) 356-1964 or (888) 4344MCH / fax: (703) 821-2098 / e-mail: [email protected] / Web site: http://www.nmchc.org. Available at no charge. Summary: This resource guide is designed to assist health professionals, caregivers, and others in the prevention of early childhood caries (ECC), also known as baby bottle tooth decay. The guide is divided into three sections. The first section lists journal articles appearing in the literature between 1997 and 1998. The second section contains the following types of materials: books; curricula, manuals, and modules; guidelines; pamphlets and brochures; and videotapes. The third section lists federal agencies and professional organizations that may serve as resources. [Funded by the Maternal and Child Health Bureau].

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You will need to limit your search to “Directory” and “tooth decay” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “tooth decay” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.

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CHAPTER 7. MULTIMEDIA ON TOOTH DECAY Overview In this chapter, we show you how to keep current on multimedia sources of information on tooth decay. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on tooth decay is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “tooth decay” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “tooth decay” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on tooth decay: •

Preventing baby bottle tooth decay (BBTD): A comprehensive training program for community workers and health professionals Source: Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. ca. 1995. 14 items, 49 slides, 2 videotapes (14 minutes, and 13.5 minutes, VHF 1/2 inch). Contact: Available from Kit Shaddix, Division of Oral Health, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Atlanta, GA 30333. Telephone: (404) 639-3535 / e-mail: [email protected] / Web site: http://www.cdc.gov. Single copies available at no charge (slides and videotapes no longer available as of 9/98). Summary: This teaching guide contains materials used in two train-the-trainer sessions that focused on baby bottle tooth decay. The training sessions were held during April and May 1995 in Estes, Colorado. The guide includes fact sheets, evaluation materials, background materials for three different modules, a packet of sample promotional materials, and slides and videotapes for use with the training modules. The first module

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describes the history of the program that developed these materials and includes background information on organizing a community-based prevention program. The second and third modules contain training guides and training manuals for giving presentations to community workers and health professionals. •

Baby Bottle Tooth Decay: A Professional's Guide Source: San Rafael, CA: Dental Health Foundation. 1992. Contact: Available from Dental Health Foundation. 4340 Redwood Highway, Suite 319, San Rafael, CA 94903. (415) 499-4648. PRICE: $29.50 plus $3.00 shipping and handling. Summary: This videotape about baby bottle tooth decay was developed for health professionals and childcare providers. The program offers information to assist in educating parents and caregivers about prevention, early intervention, causes and effects of baby bottle tooth decay. It is suggested for use in grand round presentations, in-service programs, and other training opportunities. (AA-M).

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Preventing baby-bottle tooth decay in Hmong children Source: Minneapolis, MN: University of Minnesota. 1997. 1 videotape (8- 1/2 minutes). Contact: Available from Amos Deinard, (612)638-0700, ext. 212, [email protected], University of Minnesota, 420 Delaware Street, S.E., Mail Code 85, Minneapolis, MN 55455. Telephone: (612) 638-0700 / e- mail: [email protected]. $75.00 for first videotape; $40 for each additional videotape. Summary: This videotape in the Hmong language describes healthy oral health habits for infants of adults who have recently emigrated to the United States. The videotape addresses the following topics: not putting infants to bed with a bottle, not allowing siblings to share infants' bottles, how tooth decay occurs, the consequences and treatment of severe tooth decay, and the importance of taking infants to the dentist for an examination. Tips are also provided on weaning infants from a bottle and on infant tooth care. The videotape is accompanied by an English interpretation of the Hmong script.

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “tooth decay” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on tooth decay: •

Teeth Multimedia Kit Source: Fort Atkinson, WI: NASCO. 1993. (anatomical multimedia kit). Contact: Available from NASCO. 901 Janesville Avenue, Fort Atkinson, WI 53538-0901. (414) 563-2446; FAX, (414) 563-8296. PRICE: $298.00. Order Number SB17098UC. Teeth Model Only $263.00 (Order Number SB16061UC). Multimedia Materials only $70.00 (Order number SB17099UC).

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Summary: This multimedia kit features the Denoyer-Geppert Teeth Model with seven dissectible parts. The model depicts the positions of teeth in the lower right jaw. The healthy incisor divides into two parts; one premolar has an amalgam filling, while another has caries and abscess. A removable bridge is also part of this set. Media materials include a cassette, captioned filmstrip, and printed materials covering topics including the anatomy of a tooth, tooth decay and repair, and oral hygiene. Materials are packed in a convenient portable carrying case with an instructional guide. (AA-M).

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CHAPTER 8. PERIODICALS AND NEWS ON TOOTH DECAY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover tooth decay.

News Services and Press Releases One of the simplest ways of tracking press releases on tooth decay is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “tooth decay” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to tooth decay. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “tooth decay” (or synonyms). The following was recently listed in this archive for tooth decay: •

Novel tooth decay vaccine uses genetically modified tobacco Source: Reuters Medical News Date: May 16, 2002

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CDC finds tooth decay common in third graders Source: Reuters Health eLine Date: March 28, 2002

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New compound appears to have the capacity to heal dental caries Source: Reuters Industry Breifing Date: August 27, 2001

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Fluoride in table salt cuts tooth decay in Jamaica Source: Reuters Health eLine Date: August 21, 2001

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Too much juice can cause tooth decay, diarrhea Source: Reuters Health eLine Date: May 07, 2001

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Consensus panel calls for innovative research into dental caries management Source: Reuters Medical News Date: March 28, 2001

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Tooth decay linked to cardiac arrhythmias in elderly Source: Reuters Medical News Date: November 26, 2002

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Tooth decay linked to heart arrhythmia in very old Source: Reuters Health eLine Date: November 25, 2002

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Fiery sushi condiment may fight tooth decay Source: Reuters Health eLine Date: December 15, 2000

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Youngsters with cavities at risk for future tooth decay Source: Reuters Health eLine Date: September 06, 2000

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Modified S. mutans effective in preventing tooth decay in rats Source: Reuters Medical News Date: February 02, 2000

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Breastfeeding may protect against tooth decay Source: Reuters Health eLine Date: January 27, 2000

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Study links lead to tooth decay Source: Reuters Health eLine Date: June 22, 1999

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Tooth decay may slow child's growth Source: Reuters Health eLine Date: April 08, 1999

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A New Look at "Baby Bottle" Tooth Decay Source: Reuters Health eLine Date: October 21, 1997

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Lead Linked to Tooth Decay Source: Reuters Health eLine Date: September 02, 1997

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Tooth Decay Associated With Social Deprivation In Britain Source: Reuters Medical News Date: August 29, 1997

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Bottled Water Lacks Fluoride, May Promote Tooth Decay Source: Reuters Medical News Date: August 12, 1997

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FDA Approves First Laser Designed To Treat Tooth Decay Source: Reuters Medical News Date: May 08, 1997

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FDA Clears Laser for Tooth Decay Source: Reuters Health eLine Date: May 07, 1997

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “tooth decay” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “tooth decay” (or synonyms). If you know the name of a company that is relevant to tooth decay, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “tooth decay” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “tooth decay” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on tooth decay: •

Tooth Decay and Sjogren's Syndrome: Recognizing the Risk, Preventing and Managing Dental Caries Source: Moisture Seekers Newsletter. 13(2): 1, 3-4. February 1995. Contact: Available from Sjogren's Syndrome Foundation, Inc. 8120 Woodmont Avenue, Suite 530, Bethesda MD 20814-1437. (301) 718-0300 or (800) 475-6473. Fax (301) 718-0322. Website: www.sjogrens.org. Summary: This newsletter article presents information about tooth decay and Sjogren's syndrome (SS). The author emphasizes the need for readers to understand the nature of tooth decay and its relation to the flow of saliva, to the diet, and to the bacteria that live on the surfaces of the teeth. Specific topics covered include why SS patients are at particular risk for dental caries (cavities); tooth decay as an infectious disease; the role of mutans streptococci (MS) and how MS is transmitted by mothers to their children; the life cycle of the bacteria in the mouth; and the role of saliva in protecting the mucous membranes and the teeth. The article is part of a series of articles on this topic.

Academic Periodicals covering Tooth Decay Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to tooth decay. In addition to these sources, you can search for articles covering tooth decay that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for tooth decay. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with tooth decay. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to tooth decay: Sodium Fluoride •

Systemic - U.S. Brands: Fluoritab; Fluorodex; Flura; Flura-Drops; Flura-Loz; Karidium; Luride; Luride Lozi-Tabs; Luride-SF Lozi-Tabs; Pediaflor; Pharmaflur; Pharmaflur 1.1; Pharmaflur df; Phos-Flur http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202527.html

Vitamins and Fluoride •

Systemic - U.S. Brands: Adeflor; Cari-Tab; Mulvidren-F; Poly-Vi-Flor; Tri-ViFlor; Vi-Daylin/F http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202600.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

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Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to tooth decay by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “tooth decay” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for tooth decay: •

intraoral fluoride releasing system (trade name: IFRS) http://www.rarediseases.org/nord/search/nodd_full?code=1175

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “tooth decay” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 25441 541 258 14 29 26283

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “tooth decay” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

15

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

19 Adapted 20

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on tooth decay can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to tooth decay. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to tooth decay. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “tooth decay”:

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Child Dental Health http://www.nlm.nih.gov/medlineplus/childdentalhealth.html Cosmetic Dentistry http://www.nlm.nih.gov/medlineplus/cosmeticdentistry.html Dental Health http://www.nlm.nih.gov/medlineplus/dentalhealth.html Gum Disease http://www.nlm.nih.gov/medlineplus/gumdisease.html Oral Cancer http://www.nlm.nih.gov/medlineplus/oralcancer.html Tooth Disorders http://www.nlm.nih.gov/medlineplus/toothdisorders.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on tooth decay. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Air Abrasion: An Option for Removing Tooth Decay Source: Chicago, IL: American Dental Association (ADA). 1998. [2 p.]. Contact: Available from American Dental Association (ADA). Catalog Sales, P.O. Box 776, St. Charles, IL 60174. (800) 947-4746. Fax (888) 476-1880 or (630) 443-9970. Website: www.ada.org. PRICE: $19.00 for 100; nonmembers add 50 percent; bulk rates available. Item number W603. Summary: A dental drill may not be the only option for removing tooth decay. In some cases, a new method, called air abrasion, provides an alternative to the traditional dental drill. This brochure describes air abrasion, a process that 'sandblasts' the tooth to rapidly remove tooth decay and enamel. It uses a pressurized stream of microscopic, non-toxic abrasive powder to remove the decay. The brochure lists the advantages of air abrasion and the limitations of its use. Air abrasion may be particularly useful for children, small cavities, people who dislike the dental drill or the noise it produces, and people who cannot have local anesthesia. Because of the way the tooth is prepared by air abrasion, only the tooth-colored, composite resin can be used. The brochure encourages patients to ask their dentists about air abrasion. 1 figure.

Patient Resources

•

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Information Sheet: Baby Bottle Tooth Decay Source: Louisville, KY: School of Dentistry, University of Louisville. 1993. 1 p. Contact: Available from University of Louisville. School of Dentistry, Health Sciences Center, 501 South Preston, Louisville, KY 40292. (502) 588-5096. PRICE: Single copy free; bulk discounts available. Summary: Baby bottle tooth decay is a condition that can destroy the primary teeth of an infant or young child. Baby bottle tooth decay can develop when a baby frequently receives a bottle of milk, formula, fruit juice or sweetened liquid as a pacifier or comforter. This fact sheet presents a basic introduction to the problem of baby bottle tooth decay and how it can be prevented. Topics covered include using plain water in the nighttime bottle, brushing and flossing the child's gums and teeth, and the role of fluoride.

•

Adult Tooth Decay (Cavities) Source: Oakville, Ontario: Halton Region Health Department. 2001. 2 p. Contact: Available from Halton Region Health Department. The Regional Municipality of Halton, 1151 Bronte Road, Oakville, Ontario, Canada, L6M 3L1. (905) 825-6000. Fax (905) 825-8839. Website: www.region.halton.on.ca/health. Email: [email protected]. PRICE: Contact organization for print copies. Summary: Natural teeth are always at risk of tooth decay. Healthy teeth can be damaged if food or plaque are not removed daily. This bookmark-type brochure reminds readers of the problems of adult tooth decay (dental caries). The document lists the typical causes of tooth decay, relates the complications that can occur with tooth decay, then offers recommendations to prevent tooth decay. Readers are encouraged to contact the Halton Region (Ontario, Canada) Health Department for more information (www.region.halton.on.ca/health).

•

Sealants Help Prevent Tooth Decay Source: Chicago, IL: American Dental Association (ADA). 1998. [2 p.]. Contact: Available from American Dental Association (ADA). Catalog Sales, P.O. Box 776, St. Charles, IL 60174. (800) 947-4746. Fax (888) 476-1880 or (630) 443-9970. Website: www.ada.org. PRICE: $19.00 for 50; nonmembers add 50 percent; bulk rates available. Item number W647. Summary: This brochure answers common questions about dental sealants and their role in preventing tooth decay. Dental sealants are made from a plastic material that is applied to the chewing surfaces of the back teeth (premolars and molars). This plastic resin bonds into the depressions and grooves (pits and fissures). The resulting sealant acts as a barrier, protecting the tooth enamel from plaque and acids. Topics include the causes of tooth decay, why sealants are only used on certain teeth, the use of sealants in adults, the application procedure for sealants, how long sealants last, factors that make an adult a candidate for sealants, and cost considerations. When one considers that properly applied and maintained sealants are extremely effective in preventing pit and fissure decay, sealants are a very cost-effective measure. Savings in both dollars and discomfort can be gained by application of sealants. 2 figures.

•

Helping Children Wrestle Away Tooth Decay Source: Chicago, IL: Oral Health America. 199x. [4 p.].

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Contact: Available from Oral Health America. 410 North Michigan Avenue, Suite 352, Chicago, IL 60611-4211. (312) 836-9900. PRICE: Single copy free. Summary: This brochure describes the National Sealant Alliance, a program of Oral Health America. The Sealant Alliance is striving to increase the demand for dental sealants, thereby dramatically reducing the number of individuals, particularly children, who suffer needlessly from dental caries and its effects. The Sealant Alliance and other programs focus on activities that help expand the use and acceptance of dental sealants, with an eye to the goals of Healthy People 2000. The brochure includes an introductory section that explains how the grooves and pits in teeth (particularly back teeth) make them susceptible to dental caries (decay) and explains how sealants can be used to treat to prevent decay. The brochure also describes how local groups can participate in the Alliance project. The brochure lists the organizations to whom grants and donations of sealant materials have been made. The brochure concludes with a brief description of the Oral Health American project. Oral Health America's programs are providing sealants for low-income children, educating people about spit tobacco, increasing access to oral health care for the elderly and children who have limited access to dental services, and developing various other programs geared towards improving oral health among the U.S. population. One color photograph depicts four teeth: an untreated tooth with deep pits and fissures, an acid etching process, a dried tooth, and a tooth with sealant applied and dried. •

Baby bottle tooth decay Source: Chicago, IL: American Dental Association. 1997. 2 pp. Contact: Available from Catalog Sales, American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611-2678. Telephone: (312) 440-2500 / fax: (312) 440-2800 / Web site: http://www.ada.org. $17.00 for 50 copies. Summary: This brochure encourages early, well-child dental visits and provides advice for parents about the prevention of dental problems. The brochure, with supporting color photographs, discusses the hazards of frequent, prolonged exposure to liquids sweetened with sugar and also emphasizes five things that parents can do to prevent baby bottle tooth decay.

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Prevent Baby Bottle Tooth Decay Source: Boise, ID: Idaho Department of Health and Welfare. 199x. 2 p. Contact: Available from Idaho Department of Health and Welfare. WIC and Dental Health Programs, Statehouse, Boise, Idaho, 83720. (208) 334-5964. PRICE: $0.20 per copy; $125.00 for negatives for reproduction. Summary: This brochure enumerates the steps to preventing baby bottle tooth decay. After a list of questions for the reader, the brochure summarizes how baby bottle tooth decay happens and what parents and caretakers can do to prevent it. The brochure concludes with a list of suggestions to comfort the baby at bedtime without using a nighttime bottle. Full color pictures of mild, moderate, and severe tooth decay are included.

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Dental sealants help prevent tooth decay Source: Augusta, ME: Maine Department of Human Services. 1992. 2 pp.

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Contact: Available from Karen Vogt, Maine Department of Human Services, Oral Health Program, State House, 151 Capitol Street, Station Number One, Augusta, ME 043330011. Telephone: (207) 287-2361 / fax: (207) 287-4631 / e-mail: [email protected]. Samples free; $1.00 each for photocopy masters. Summary: This brochure explains what dental sealants are and when they are indicated for children, stressing their value as a preventive measure. Designed for parents with a fifth grade reading level, the brochure uses multicultural illustrations and simple text to describe how sealants work and how the procedure is done. It was developed with input from focus groups and health professionals and was field tested among adult basic education students. •

What Sugar Can Do to Your Baby's Teeth is Really Rotten: The Harmful Effects of Baby Bottle Tooth Decay Source: Sacramento, CA: California Dental Association (CDA). 1994. [4 p.]. Contact: Available from California Dental Association (CDA). P.O. Box 13749, Sacramento, CA 95853. (916) 443-0505; http://www.cda.org/cda. PRICE: Single copy free. Summary: This brochure familiarizes parents with baby bottle tooth decay (BBTD), a pattern of severe and rapid tooth decay in infants and toddlers. For a baby's tooth to decay, three elements are needed: a tooth, plaque, and foods containing sugars and starches. The brochure describes the causes of BBTD and the potential impact of BBTD on the baby's feeding, nutrition, and tooth development. The brochure then focuses on the prevention of BBTD, encouraging parents to be vigilant, to avoid the use of a sugary liquid as a pacifier, not to use a bottle at naptime, to clean their infant's mouth and teeth, and to wean in a timely fashion. The brochure also emphasizes the importance of early and ongoing dental visits. (AA-M).

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Seal Out Tooth Decay: A Booklet for Parents Source: Bethesda, MD: National Institute of Dental and Craniofacial Research (NIDCR), National Institutes of Health (NIH). 2003. [8 p.]. Contact: Available from National Oral Health Information Clearinghouse (NOHIC). 1 NOHIC Way, Bethesda, MD 20892-3500. (301) 402-7364. Fax (301) 907-8830. E-mail: [email protected]. Website: www.nohic.nidcr.nih.gov. PRICE: Single copy free; up to 50 copies free. NIH Publication Number 03-489. Order Number NR-04. Summary: This brochure presents a general introduction to dental sealants and their use in children. Written in a question and answer format, the brochure covers topics including the purpose of sealants, the causes of dental decay, why back teeth decay so easily, who should get sealants, the use of sealants on baby teeth, the cost of sealants, insurance coverage for sealants, how long sealants last, what happens if a small cavity is accidentally covered by a sealant, and other ways to prevent tooth decay. One page of the brochure details, in words and pictures, how sealants are applied.

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You can prevent baby bottle tooth decay Source: Seattle, WA: Seattle-King County Department of Public Health. 1990. 2 pp. Contact: Available from Seattle-King County Department of Public Health, Child Care Health Program, 110 Prefontaine Place South, Suite 500, Seattle, WA 98104. Telephone:

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(206) 296-4613. $0.20 plus 10 percent for postage, minimum postage $0.50; prepayment required; make checks payable to Seattle-King County Department of Public Health. Summary: This brochure provides parents information on baby bottle tooth decay and its health implications for infants and toddlers. It explains what the condition is and how it develops, and the brochure suggests steps to take to prevent the condition. It also suggests ways to modify a child's dependence upon the baby bottle. •

Dental Sealants Help Prevent Tooth Decay: Help Your Child's Teeth Last A Lifetime Source: Augusta, ME: Maine Department of Human Services, Bureau of Health, Division of Dental Health. 1992. 2 p. Contact: Available from Maine Department of Human Services, Bureau of Health, Division of Dental Health. State House Station 11, Augusta, ME 04333. (207) 287-2361 or (207) 287-3121. PRICE: Single copy free. Summary: This brochure reviews basic facts about dental sealants for children. Written to educate parents and other caregivers, the brochure discusses how dental sealants protect the child's teeth from decay; which teeth should be sealed, and when; how sealants are applied; how sealants save money; and other steps to take to keep children's teeth healthy. The brochure is written in clear, easy-to-understand language and includes line drawings of the concepts discussed.

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Preventing Baby Bottle Tooth Decay Source: Lincoln, NE: Nebraska Department of Health. 199x. 2 p. Contact: Available from Nebraska Department of Health. Division of Dental HealthDivision of Nutrition, 301 Centennial Mall South, Lincoln, NE 68509-5007. (402) 4712822. PRICE: Single copy free. Summary: This brochure reviews the importance of preventing baby bottle tooth decay to help ensure healthy, stronger teeth for a lifetime. Topics covered include the causes of baby bottle tooth decay, how to prevent the condition from developing, how to clean the baby's mouth, the role of fluoride, and what can happen to the permanent teeth of a child with baby bottle tooth decay. The brochure concludes with a list of five reminders for parents and caregivers. The brochure is written in clear, easy-to-understand language and includes one full-color photograph of a child with baby bottle tooth decay. The brochure is available in English, Spanish, and Vietnamese versions.

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Dental Health Fact Sheet: Baby Bottle Tooth Decay Source: Madison, WI: Wisconsin Division of Health, Bureau of Public Health. 1992. 2 p. Contact: Available from Wisconsin Division of Health. Oral Health Consultant, Bureau of Public Health, 1414 East Washington Avenue, Madison, WI 53703. (608) 266-5152; Fax (608) 267-3824. PRICE: Single copy free. Reproduction permitted. Summary: This dental health fact sheet provides up-to-date information on baby bottle tooth decay. Topics covered include a definition of the condition, the teeth most likely to be affected by decay, the causes of baby bottle tooth decay, how the teeth decay so rapidly, the incidence of this condition, and how to prevent baby bottle tooth decay. One chart shows the approximate age of eruption of the primary teeth.

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Fact Sheet: Baby Bottle Tooth Decay Source: AGD Impact. Academy of General Dentistry Impact. 26(11): 23. December 1998. Contact: Available from Academy of General Dentistry (AGD). 211 East Chicago Avenue, Suite 1200, Chicago, IL 60611-2670. Fax (312) 440-4300. E-mail: [email protected]. Website: www.agd.org. Summary: This fact sheet alerts parents to the problem of baby bottle tooth decay and describes how to prevent it. Baby bottle tooth decay is caused by the frequent and longterm exposure of a child's teeth to liquids containing sugars. Among these liquids are milk, formula, fruit juice, sodas, and other sweetened drinks. The sugars in these liquids pool around the infant's teeth and gums, feeding the bacteria that cause plaque. The fact sheet outlines the problem of baby bottle tooth decay and encourages parents to never allow children to fall asleep with a bottle containing these liquids. The fact sheet also reminds readers of the importance of keeping the infants gums and teeth clean. The fact sheet offers suggestions for gradually changing a child's diet and habits to include less sugar and changing to a bottle of water, rather than sugary fluids. The fact sheet concludes with a brief description of the importance of primary teeth and the need to protect and retain them. The fact sheet was published in a professional journal; readers are encouraged to duplicate and distribute the fact sheets to their patients. 7 references.

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Keep your baby smiling: Prevent early childhood tooth decay Source: [Ames, IA]: University Extension, Iowa State University; and [Des Moines, IA]: Bureau of Nutrition and WIC, Iowa Department of Public Health. 2000. 2 pp. Contact: Available from Connie Betterley, M. S., R. D, Iowa State University, Extension Distribution Center, 119 Printing and Publications Building, Ames, IA 50011-3171. Telephone: (515) 294-5247 / fax: (515) 294-2945 / e-mail: [email protected] / Web site: www.exnet.iastate.edu. Single copies available at no charge; each additional copy is $0.10 plus shipping and handling. Summary: This fact sheet explains how to prevent early childhood caries. It includes a checklist of risk factors, tips for putting a baby to bed without a bottle, and instructions for protecting children's teeth in infancy and early childhood. Pictures show mild, moderate, and severe tooth decay. One side of the fact sheet is in English, and the other side is in Spanish.

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Baby Bottle Tooth Decay: How to Prevent It Source: Elk Grove Village, IL: American Academy of Pediatrics. 1995. [2 p.]. Contact: Available from American Academy of Pediatrics. Division of Publications, P.O. Box 747, 141 Northwest Point Boulevard, Elk Grove Village, IL 60009-0747. (800) 4339016 or (847) 228-5005; Fax (847) 228-1281; http://www.aap.org. PRICE: $19.95 for pad of 100; $14.95 (for members). Item Number B-HE0187. Summary: This fact sheet from the American Academy of Pediatrics familiarizes parents with baby bottle tooth decay (BBTD), a pattern of severe and rapid tooth decay in infants and toddlers. The fact sheet emphasizes that it is much easier and less costly to prevent tooth decay than to treat it. The author cautions that untreated BBTD can quickly destroy the teeth involved and lead to pain, infection, early loss of baby teeth, and crooked permanent teeth. The fact sheet describes how BBTD develops, why baby teeth are important, and what strategies are used to prevent BBTD. The fact sheet

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concludes by describing the early signs of BBTD and by encouraging parents to start oral hygiene strategies early in the child's life. (AA-M). •

Preventing baby bottle tooth decay: Tips to wean your child away from a bottle Source: Minneapolis, MN: Center for Health Promotion, HealthPartners. 1999. 2 pp. Contact: Available from Susan Hahn, [email protected], HealthPartners, Center for Health Promotion, 8100 34th Avenue South, P.O. Box 1309, Minneapolis, MN 55440-1309. Telephone: (952) 967-6795 / fax: (952) 883-6767 / Web site: http://www.healthpartners.com. Available at no charge. Summary: This fact sheet gives parents and caregivers information on the cause of baby bottle tooth decay and recommends methods for weaning a child from using a bottle or 'at will' breastfeeding at bed and nap time. It also provides information on teaching a child to drink from a cup, the best time to wean a child from a bottle, and why a child older than 12 months should not carry a cup of sweetened liquid around all day.

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Is your child at risk for dental caries (tooth decay)? Source: Minneapolis, MN: Center for Health Promotion, HealthPartners. 2000. 2 pp. Contact: Available from Susan Hahn, [email protected], HealthPartners, Center for Health Promotion, 8100 34th Avenue South, P.O. Box 1309, Minneapolis, MN 55440-1309. Telephone: (952) 967-6795 / fax: (952) 883-6767 / Web site: http://www.healthpartners.com. Available at no charge. Summary: This fact sheet is a check-off form dental health professionals can use to provide information to parents and caregivers about a child's risk for dental caries and ways to reduce the risk of future tooth decay. It also gives anticipatory guidance on actions to take to ensure good oral health in children at ages 3, 4, 6, 8, 10, and adolescence.

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Preventing Tooth Decay and Saving Teeth with Dental Sealants. 2nd ed Source: Washington, DC: National Maternal and Child Oral Health Resource Center. 2003. [2 p.]. Contact: Available from National Maternal and Child Oral Health Resource Center. Georgetown University, Box 571272, Washington, DC 20057-1272. (202) 784-9771. Fax (202) 784-9777. E-mail: [email protected]. Website: www.mchoralhealth.org. PRICE: Single copy free; also available free online. Summary: This fact sheet offers information on preventing tooth decay and saving teeth with dental sealants. Dental sealants are thin plastic coatings that are applied to the chewing surfaces of the molars (back teeth) to prevent tooth decay by creating a physical barrier against bacterial plaque and food. The fact sheet emphasizes that when combined with fluoridated water, dental sealants have the potential to virtually eliminate dental caries. Children and adolescents ages 5 to 15 years benefit most from dental sealants because molars erupt during this period. The fact sheet discusses the need to improve awareness about dental sealants, the cost effectiveness of placing dental sealants, access to dental care, barriers to care, and governmental and other programs that support dental sealant use. On average, the cost for placing one dental sealant is less than half the cost of one silver filling. However, as few as 3 percent of children from families with low incomes have dental sealants, compared to the national average for children of 23 percent. The lack of dental service coverage under many insurance plans,

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and the difficulty of accessing dental care for uninsured, underinsured, and medically indigent groups, make dental sealants hard to obtain for many children. However, the federal Medicaid program provides reimbursement for dental sealants. 15 references. •

Preventing dental caries Source: Atlanta, GA: Centers for Disease Control and Prevention. [2002]. 2 pp. Contact: Available from Centers for Disease Control and Prevention, 1600 Clifton Road, N.E, Atlanta, GA 30333. Telephone: (404) 639-3311 or (404) 639-3312 TTY / Web site: http://www.cdc.gov. Available from the Web site at no charge. Summary: This fact sheet presents a snapshot of efforts to reduce dental caries in children in the United States. A brief statistical overview of dental caries is provided along with an outline of community-based strategies to prevent tooth decay such as water fluoridation and school-based dental sealant programs. Additional information is provided on efforts in Ohio, how these strategies help save money, samples of other effective prevention strategies, and a review of oral health objectives in Healthy People 2010.

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Preventing tooth decay and saving teeth with dental sealants. (2nd ed.) Source: Washington, DC: National Maternal and Child Oral Health Resource Center. 2003. 2 pp. Contact: Available from National Maternal and Child Oral Health Resource Center, Georgetown University, Box 571272, Washington, DC 20057-1272. Telephone: (202) 7849771 / fax: (202) 784-9777 / e-mail: [email protected] / Web site: http://www.mchoralhealth.org. Available at no charge; also available from the Web site at no charge. Summary: This fact sheet provides information on the use and advantages of dental sealants and discusses costs and access. References are provided. [Funded by the Maternal and Child Health Bureau].

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Facts. Sealants: Sealing Out Tooth Decay Source: Chicago, IL: American Dental Hygienists' Association (ADHA). 199x. 1 p. Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Chicago, IL 60611. (800) 243-2342 or (312) 440-8900; Fax (312) 4408929; E-mail: [email protected]; http://www.adha.org. PRICE: Single copy free. Summary: This fact sheet provides parents with basic information about dental sealants. The fact sheet stresses that tooth decay can be reduced or eliminated with a complete oral hygiene preventive program that includes brushing and flossing daily, limiting sugary and starchy snacks, visiting the dental hygienist and dentist regularly, and using two tooth decay deterrents, fluoride and sealant applications. Sealants are applied in minutes without drilling or removing any part of the tooth. First the tooth surface is cleaned, then the sealant is applied, completely filling the pits and grooves of the chewing surface with the plastic material. This protective covering shields the tooth from cavity causing bacteria. The fact sheet also presents recommendations for when sealants should be applied.

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Diet and Tooth Decay Source: Chicago, IL: American Dental Association (ADA). 1994. [2 p.].

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Contact: Available from American Dental Association (ADA). Catalog Sales, P.O. Box 776, St. Charles, IL 60174. (800) 947-4746; Fax (630) 443-9970; http://www.ada.org. PRICE: Single copy free; bulk orders available. Order Number W150. Summary: This mini-brochure, from the American Dental Association, provides basic information about preventing baby bottle tooth decay. Illustrated with full-color photographs, the brochure outlines the causes of baby bottle tooth decay and how parents can prevent it. Specific topics include the role of plaque in tooth decay, what to do between meal bottles, avoiding putting a baby to bed with a bottle, cleaning a baby's teeth, and dental care for infants and young children. •

How to prevent baby bottle tooth decay Source: [Sacramento, CA]: Children's Medical Services, California Department of Health Services. 1997. 4 pp. Contact: Available from Librarian, National Center for Education in Maternal and Child Health, 2000 15th Street, North, Suite 701, Arlington, VA 22201-2617. Telephone: (703) 524-7802 / fax: (703) 524- 9335 / e-mail: [email protected] / Web site: http://www.ncemch.org. Photocopy available at no charge. Summary: This pamphlet describes what baby bottle tooth decay is and how it is caused. Illustrated sections discuss what parents and caregivers can do about baby bottle tooth decay, how to put a baby to bed without a bottle, how to check a baby's teeth, and what parents or caregivers should do if they think their baby has baby bottle tooth decay. This pamphlet is available in English, Spanish, Hmong, Vietnamese, Russian, Chinese, and Cambodian. [Funded by the Maternal and Child Health Bureau].

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Water fluoridation: Natures way to prevent tooth decay Source: Chicago, IL: Council on Access, Prevention and Interprofessional Relations, American Dental Association; Atlanta, GA: Division of Oral Health, Centers for Diseases Control and Prevention, U.S. Department of Health and Human Services. n.d. 2 pp. Contact: Available from Barbara Dubbs, American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611-2678. Telephone: (312) 440-2500 / fax: (312) 440-2800 / Web site: http://www.ada.org. Available at no charge. Summary: This pamphlet presents key points to remember about water fluoridation and explains how fluoridation prevents tooth decay. The pamphlet emphasizes that water fluoridation is a valuable community health measure that is both safe and cost-effective, with benefits for people of all ages. Statements of endorsement from the American Dental Association and the U.S. Surgeon General are included.

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We can stop baby bottle tooth decay Source: Bethel, AK: Women Infants Children Program, Yukon-Kuskokwim Health Corporation. [1996]. 2 pp. Contact: Available from Pauline Palacios, Yukon-Kuskokwim Health Corporation, WIC Program, P.O. Box 528, Bethel, AK 99559. Telephone: (907) 543-6459. Available at no charge. Summary: This pamphlet was designed for Alaska Natives. Baby bottle tooth decay is defined and its causes are presented. Methods of prevention and sources of more information are suggested.

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Sealants Help Prevent Tooth Decay in Children and Adults Source: St. Charles, IL: American Dental Association (ADA). 1997. [2 p.]. Contact: Available from American Dental Association (ADA). Catalog Sales, P.O. Box 776, St. Charles, IL 60174. (800) 947-4746; Fax (630) 443-9970; http://www.ada.org. PRICE: Single copy free; bulk orders available. Summary: This postcard encourages recipients to consider the use of dental sealants to help prevent tooth decay in children and adults. The postcard shows a healthy molar tooth surface before and after the application of a dental sealant. The text explains that dental sealants are a plastic material that is usually applied to the chewing surfaces of the back teeth. This plastic resin bonds into the depressions and grooves of the teeth, shielding teeth from plaque and acids that can cause cavities. The postcard encourages recipients to call their dentist to learn more about sealants. The address side of the postcard includes space for the dentist's telephone number and the caption, 'Seal in a healthy smile.' The postcard is illustrated with full-color photographs of the tooth described above and a group of three adolescents. 3 figures.

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Seal away tooth decay Source: [Richmond, VA]: Division of Dental Health, and Division of Chronic Disease Prevention and Nutrition, Virginia Department of Health. n.d. 1 poster (11 x 17 inches), 1 brochure. Contact: Available from Virginia Department of Health, Division of Dental Health, 1500 East Main Street, Room 136, Richmond, VA 23219. Telephone: (804) 786-3556. Samples available in limited quantities. Summary: This poster and companion brochure are part of a statewide campaign to promote childrens oral health through the use of dental sealants. The poster highlights several benefits of sealants, including the prevention of cavities on the chewing surfaces of the teeth (particularly the permanent 6 year and 12 year molars), ease of application, long-lasting and and economical protection, and greater ease in cleaning the teeth.

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You Can Prevent Baby Bottle Tooth Decay and Your Baby Can Have a Happy Smile Source: Chicago, IL: American Dental Hygienists' Association (ADHA). 199x. [2 p.]. Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Chicago, IL 60611. (800) 243-2342 or (312) 440-8900; Fax (312) 4408929; E-mail: [email protected]; http://www.adha.org. PRICE: Single copy free; $3.50 for a pad of 25 sheets. Summary: This publication is designed to educate parents about baby bottle tooth decay (BBTD). The publication, a flyer shaped like a toddler's drinking cup, encourages parents to prevent BBTD. The flyer lists suggestions to teach a baby alternative ways to settle down to sleep. The flyer also includes full-color photographs of what BBTD looks like and notes the behaviors that most often cause the problem. 3 figures.

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Prevent baby bottle tooth decay = Evite la caries dental causada por la tetera Source: Austin, TX: Texas Department of Human Services. 1992. 2 pp. Contact: Available from Sam Boyd, Texas Department of Human Services, EPSDT Services, 1100 West 49th Street, Austin, TX 78756. Telephone: (512) 338-6931 / fax: (512) 338-6945. Not available.

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Summary: Written for those with a seventh grade reading level, this fact sheet tells how to prevent baby bottle tooth decay. Part of the fact sheet is an educational envelope that was mailed to pregnant women receiving Medicaid, Medicaid clients who were pregnant within the last eight months, and Medicaid families with children under age three. The reverse of the fact sheet answers six questions that clients may ask about baby bottle tooth decay. It was developed with input from the EPSDT Dental Professional Advisory and Review Subcommittee and is produced in English and Spanish. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “tooth decay” (or synonyms). The following was recently posted: •

Altered nutritional status Source: American Medical Directors Association - Professional Association; 2001; 32 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3304&nbr=2530&a mp;string=tooth+AND+decay

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ASHP therapeutic guidelines for nonsurgical antimicrobial prophylaxis Source: American Society of Health-System Pharmacists - Professional Association; 1999 June 15; 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1959&nbr=1185&a mp;string=dental+AND+cavities

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Diagnosis and management of dental caries throughout life Source: National Institute on Dental and Craniofacial Research - Federal Government Agency [U.S.]; 2001 March; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2792&nbr=2018&a mp;string=dental+AND+caries

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Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients Source: American Society for Blood and Marrow Transplantation - Professional Association; 2000 October 20; 126 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2573&nbr=1799&a mp;string=dental+AND+caries

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Management of unerupted and impacted third molar teeth. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2000 March; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2305&nbr=1531&a mp;string=tooth+AND+decay

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Mealtime difficulties for older persons: assessment and management Source: The John A. Hartford Foundation Institute for Geriatric Nursing - Academic Institution; 2003; 23 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3506&nbr=2732&a mp;string=tooth+AND+decay

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Oral health management of children and adolescents with HIV infections Source: New York State Department of Health - State/Local Government Agency [U.S.]; 2003; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3809&nbr=3035&a mp;string=tooth+AND+decay

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Oral health risk assessment timing and establishment of the dental home Source: American Academy of Pediatrics - Medical Specialty Society; 2003 May; 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3839&nbr=3055&a mp;string=tooth+AND+decay

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Oral hygiene care for functionally dependent and cognitively impaired older adults Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 2002 November; 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3611&nbr=2837&a mp;string=tooth+AND+decay

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Parameter on comprehensive periodontal examination Source: American Academy of Periodontology - Professional Association; 1996 October (revised 2000 May); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2322&nbr=1548&a mp;string=dental+AND+caries

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Parameter on periodontal maintenance Source: American Academy of Periodontology - Professional Association; 1996 October (revised 2000 May); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2323&nbr=1549&a mp;string=dental+AND+caries

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Parameter on plaque-induced gingivitis Source: American Academy of Periodontology - Professional Association; 1996 October (revised 2000 May); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2324&nbr=1550&a mp;string=dental+AND+caries

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Preventing dental caries in children at high caries risk. Targeted prevention of dental caries in the permanent teeth of 6 to 16 year olds presenting for dental care. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2000 December; 39 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2913&nbr=2139&a mp;string=tooth+AND+decay

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Prevention of dental caries in preschool children: recommendations and rationale Source: United States Preventive Services Task Force - Independent Expert Panel; 1989 (revised 2004 April 8); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4156&nbr=3184&a mp;string=tooth+AND+decay

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Preventive counseling and education Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1995 May (revised 2003 Jul); 69 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4177&nbr=3202&a mp;string=tooth+AND+decay

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Preventive services for adults Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1995 June (revised 2003 Sep); 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4179&nbr=3204&a mp;string=tooth+AND+decay

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Recommendations for using fluoride to prevent and control dental caries in the United States Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 2001 August; 59 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2919&nbr=2145&a mp;string=tooth+AND+decay

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Recommendations on selected interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 2002 July; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3287&nbr=2513&a mp;string=tooth+AND+decay

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Society of Nuclear Medicine procedure guideline for therapy of thyroid disease with iodine-131 (sodium iodide) Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 2002 February 10; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3191&nbr=2417&a mp;string=dental+AND+caries

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Summary of policy recommendations for periodic health examinations Source: American Academy of Family Physicians - Medical Specialty Society; 1996 November (revised 2003 Aug); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4183&nbr=3208&a mp;string=tooth+AND+decay

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Treatment for stimulant use disorders Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2540&nbr=1766&a mp;string=dental+AND+caries Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Diagnosis and Management of Dental Caries Throughout Life: NIH Consensus Statement Summary: This consensus statement covers the methods for detecting dental caries, indications for the risk of cavities, and prevention, research, and treatment activities in relation to dental caries. Source: National Institutes of Health, U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6379

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Seal Out Tooth Decay Source: National Institute of Dental and Craniofacial Research, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1148 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to tooth decay. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •


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Family Village: http://www.familyvillage.wisc.edu/specific.htm

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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

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Med Help International: http://www.medhelp.org/HealthTopics/A.html

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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

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WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to tooth decay. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with tooth decay. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about tooth decay. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797.

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Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “tooth decay” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “tooth decay”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “tooth decay” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “tooth decay” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

22

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

23

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on tooth decay: •

Basic Guidelines for Tooth Decay Dental caries Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001055.htm

•

Signs & Symptoms for Tooth Decay Toothache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003067.htm

•

Diagnostics and Tests for Tooth Decay Dental X-rays Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003801.htm

•

Nutrition for Tooth Decay Carbohydrate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002469.htm

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Carbohydrates Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002469.htm Starches Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002469.htm Sugars Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002469.htm •

Background Topics for Tooth Decay Oral hygiene Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001957.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

143

TOOTH DECAY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abrasion: 1. The wearing away of a substance or structure (such as the skin or the teeth) through some unusual or abnormal mechanical process. 2. An area of body surface denuded of skin or mucous membrane by some unusual or abnormal mechanical process. [EU] Abscess: A localized, circumscribed collection of pus. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetone: A colorless liquid used as a solvent and an antiseptic. It is one of the ketone bodies produced during ketoacidosis. [NIH] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acridine Orange: Cationic cytochemical stain specific for cell nuclei, especially DNA. It is used as a supravital stain and in fluorescence cytochemistry. It may cause mutations in microorganisms. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adsorption: The condensation of gases, liquids, or dissolved substances on the surfaces of solids. It includes adsorptive phenomena of bacteria and viruses as well as of tissues treated with exogenous drugs and chemicals. [NIH] Adsorptive: It captures volatile compounds by binding them to agents such as activated carbon or adsorptive resins. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Affinity Chromatography: In affinity chromatography, a ligand attached to a column binds

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specifically to the molecule to be purified. [NIH] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Alcohol Dehydrogenase: An enzyme that catalyzes reversibly the final step of alcoholic fermentation by reducing an aldehyde to an alcohol. In the case of ethanol, acetaldehyde is reduced to ethanol in the presence of NADH and hydrogen. The enzyme is a zinc protein which acts on primary and secondary alcohols or hemiacetals. EC 1.1.1.1. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Allogeneic: Taken from different individuals of the same species. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Aluminum Oxide: Al2O3. An oxide of aluminum, occurring in nature as various minerals such as bauxite, corundum, etc. It is used as an adsorbent, desiccating agent, and catalyst, and in the manufacture of dental cements and refractories. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric

Dictionary 145

acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [EU] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anionic: Pertaining to or containing an anion. [EU] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulants: Agents that prevent blood clotting. Naturally occurring agents in the blood

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are included only when they are used as drugs. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-infective: An agent that so acts. [EU] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antimycotic: Suppressing the growth of fungi. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antiserum: The blood serum obtained from an animal after it has been immunized with a particular antigen. It will contain antibodies which are specific for that antigen as well as antibodies specific for any other antigen with which the animal has previously been immunized. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Approximate: Approximal [EU] Aqueous: Having to do with water. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspartate: A synthetic amino acid. [NIH] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Avidity: The strength of the interaction of an antiserum with a multivalent antigen. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or

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bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benzoyl Peroxide: A peroxide derivative that has been used topically for burns and as a dermatologic agent in the treatment of acne and poison ivy. It is used also as a bleach in the food industry. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Binding agent: A substance that makes a loose mixture stick together. For example, binding agents can be used to make solid pills from loose powders. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and

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is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bottle Feeding: Use of nursing bottles for feeding. Applies to humans and animals. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bromodeoxyuridine: A nucleoside that substitutes for thymidine in DNA and thus acts as an antimetabolite. It causes breaks in chromosomes and has been proposed as an antiviral and antineoplastic agent. It has been given orphan drug status for use in the treatment of primary brain tumors. [NIH] Bruxism: A disorder characterized by grinding and clenching of the teeth. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Cacao: A tree of the family Sterculiaceae (or Byttneriaceae), usually Theobroma cacao, or its seeds, which after fermentation and roasting, yield cocoa and chocolate. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Hydroxide: Ca(OH)2. A white powder that has many therapeutic uses. Because of its ability to stimulate mineralization, it is found in many dental formulations. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH]

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Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Check-up: A general physical examination. [NIH] Chelation: Combination with a metal in complexes in which the metal is part of a ring. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Child Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chlorhexidine: Disinfectant and topical anti-infective agent used also as mouthwash to

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prevent oral plaque. [NIH] Cholera: An acute diarrheal disease endemic in India and Southeast Asia whose causative agent is vibrio cholerae. This condition can lead to severe dehydration in a matter of hours unless quickly treated. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Coliphages: Viruses whose host is Escherichia coli. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colostrum: The thin, yellow, serous fluid secreted by the mammary glands during pregnancy and immediately postpartum before lactation begins. It consists of immunologically active substances, white blood cells, water, protein, fat, and carbohydrates. [NIH]

Comatose: Pertaining to or affected with coma. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the

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classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH]

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Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corrosion: Irreversible destruction of skin tissue. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Crowns: A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. [NIH] Cryptosporidiosis: Parasitic intestinal infection with severe diarrhea caused by a protozoan, Cryptosporidium. It occurs in both animals and humans. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Dental Abutments: Natural teeth or teeth roots used as anchorage for a fixed or removable denture or other prosthesis (such as an implant) serving the same purpose. [NIH] Dental Amalgam: An alloy used in restorative dentistry that contains mercury, silver, tin, copper, and possibly zinc. [NIH] Dental Anxiety: Abnormal fear or dread of visiting the dentist for preventive care or therapy and unwarranted anxiety over dental procedures. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

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Dental Cements: Substances used as bonding or luting agents in restorative denistry, root canal therapy, prosthedontics, and orthodontics. [NIH] Dental implant: A small metal pin placed inside the jawbone to mimic the root of a tooth. Dental implants can be used to help anchor a false tooth or teeth, or a crown or bridge. [NIH] Dental Materials: Materials used in the production of dental bases, restorations, impressions, prostheses, etc. [NIH] Dental Plaque: A film that attaches to teeth, often causing dental caries and gingivitis. It is composed of mucins, secreted from salivary glands, and microorganisms. [NIH] Dentifrices: Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Dentition: The teeth in the dental arch; ordinarily used to designate the natural teeth in position in their alveoli. [EU] Dentures: An appliance used as an artificial or prosthetic replacement for missing teeth and adjacent tissues. It does not include crowns, dental abutments, nor artificial teeth. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermatitis: Any inflammation of the skin. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dextrans: A group of glucose polymers made by certain bacteria. Dextrans are used therapeutically as plasma volume expanders and anticoagulants. They are also commonly used in biological experimentation and in industry for a wide variety of purposes. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Diploid: Having two sets of chromosomes. [NIH]

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Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dissection: Cutting up of an organism for study. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Domesticated: Species in which the evolutionary process has been influenced by humans to meet their needs. [NIH] Dross: Residue remaining in an opium pipe which has been smoked; contains 50 % of the morphine present in the original drug. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysentery: Any of various disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequent stools containing blood and mucus. Causes include chemical irritants, bacteria, protozoa, or parasitic worms. [EU]

Ectopic: Pertaining to or characterized by ectopia. [EU] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Egg Yolk: Cytoplasm stored in an egg that contains nutritional reserves for the developing embryo. It is rich in polysaccharides, lipids, and proteins. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH]

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Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emulsify: To convert or to be converted into an emulsion. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endodontics: A dental specialty concerned with the maintenance of the dental pulp in a state of health and the treatment of the pulp cavity (pulp chamber and pulp canal). [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH]

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Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Erbium: Erbium. An element of the rare earth family of metals. It has the atomic symbol Er, atomic number 68, and atomic weight 167.26. [NIH] ERV: The expiratory reserve volume is the largest volume of gas that can be expired from the end-expiratory level. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]

Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Expiratory Reserve Volume: The extra volume of air that can be expired with maximum effort beyond the level reached at the end of a normal, quiet expiration. Common abbreviation is ERV. [NIH] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Facial: Of or pertaining to the face. [EU] Facial Expression: Observable changes of expression in the face in response to emotional stimuli. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli.

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Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flatus: Gas passed through the rectum. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluoridation: The addition of fluorine usually as a fluoride to something, as the adding of a fluoride to drinking water or public water supplies for prevention of tooth decay in children. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluorosis: Discoloration of the tooth enamel due to fluorine. [NIH] Flush: Transient, episodic redness of the face and neck caused by certain diseases, ingestion of certain drugs or other substances, heat, emotional factors, or physical exertion. [EU] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental

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conditions, as moulds or yeasts. [EU] Gangrenous: A circumscribed, deep-seated, suppurative inflammation of the subcutaneous tissue of the eyelid discharging pus from several points. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastritis: Inflammation of the stomach. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Germicide: An agent that kills pathogenic microorganisms. [EU] Gifted: As used in child psychiatry, this term is meant to refer to a child whose intelligence is in the upper 2 per cent of the total population of his age. [NIH] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucans: Polysaccharides composed of repeating glucose units. They can consist of branched or unbranched chains in any linkages. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH]

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Glycidyl: A vinyl monomer. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]

Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Gram-Positive Rods: A large group of rod-shaped bacteria that retains the crystal violet stain when treated by Gram's method. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guinea Pigs: A common name used for the family Caviidae. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research. [NIH]

Halitosis: An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels

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of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Hexanes: Six-carbon saturated hydrocarbon group of the methane series. Include isomers and derivatives. Various polyneuropathies are caused by hexane poisoning. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

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Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incisor: Anything adapted for cutting; any one of the four front teeth in each jaw. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant Care: Care of infants in the home or institution. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues

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caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Initiator: A chemically reactive substance which may cause cell changes if ingested, inhaled or absorbed into the body; the substance may thus initiate a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Iodine-131: Radioactive isotope of iodine. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells.

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This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Irritants: Drugs that act locally on cutaneous or mucosal surfaces to produce inflammation; those that cause redness due to hyperemia are rubefacients; those that raise blisters are vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear gases and mustard gases are also irritants. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Ketoacidosis: Acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids, as in diabetic acidosis. [EU] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Lactose Intolerance: The disease state resulting from the absence of lactase enzyme in the musocal cells of the gastrointestinal tract, and therefore an inability to break down the disaccharide lactose in milk for absorption from the gastrointestinal tract. It is manifested by indigestion of a mild nature to severe diarrhea. It may be due to inborn defect genetically conditioned or may be acquired. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lectins: Protein or glycoprotein substances, usually of plant origin, that bind to sugar moieties in cell walls or membranes and thereby change the physiology of the membrane to cause agglutination, mitosis, or other biochemical changes in the cell. [NIH] Lesion: An area of abnormal tissue change. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and

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strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Lubricants: Oily or slippery substances. [NIH] Lubrication: The application of a substance to diminish friction between two surfaces. It may refer to oils, greases, and similar substances for the lubrication of medical equipment but it can be used for the application of substances to tissue to reduce friction, such as lotions for skin and vaginal lubricants. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Mammary: Pertaining to the mamma, or breast. [EU] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Mastitis: Inflammatory disease of the breast, or mammary gland. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior.

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Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methacrylate: A vinyl monomer. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Miotic: 1. Pertaining to, characterized by, or producing miosis : contraction of the pupil. 2. An agent that causes the pupil to contract. 3. Meiotic: characterized by cell division. [EU] Mitomycin: An antineoplastic antibiotic produced by Streptomyces caespitosus. It acts as a bi- or trifunctional alkylating agent causing cross-linking of DNA and inhibition of DNA synthesis. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH]

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Mouth Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multivalent: Pertaining to a group of 5 or more homologous or partly homologous chromosomes during the zygotene stage of prophase to first metaphasis in meiosis. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Spindles: Mechanoreceptors found between skeletal muscle fibers. Muscle spindles are arranged in parallel with muscle fibers and respond to the passive stretch of the muscle, but cease to discharge if the muscle contracts isotonically, thus signaling muscle length. The muscle spindles are the receptors responsible for the stretch or myotactic reflex. [NIH] Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing myocardial reperfusion injury. [NIH] Myocardial Reperfusion Injury: Functional, metabolic, or structural changes in ischemic heart muscle thought to result from reperfusion to the ischemic areas. Changes can be fatal to muscle cells and may include edema with explosive cell swelling and disintegration, sarcolemma disruption, fragmentation of mitochondria, contraction band necrosis, enzyme washout, and calcium overload. Other damage may include hemorrhage and ventricular arrhythmias. One possible mechanism of damage is thought to be oxygen free radicals. Treatment currently includes the introduction of scavengers of oxygen free radicals, and injury is thought to be prevented by warm blood cardioplegic infusion prior to reperfusion. [NIH]

Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myristic Acids: 14-carbon saturated monocarboxylic acids. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH]

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Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Oropharynx: Oral part of the pharynx. [NIH] Orthodontic Brackets: Small metal or ceramic attachments used to fasten an arch wire. These attachments are soldered or welded to an orthodontic band or cemented directly onto the teeth. Bowles brackets, edgewise brackets, multiphase brackets, ribbon arch brackets, twin-wire brackets, and universal brackets are all types of orthodontic brackets. [NIH] Orthodontics: A dental specialty concerned with the prevention and correction of dental and oral anomalies (malocclusion). [NIH] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH]

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Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Particle: A tiny mass of material. [EU] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pediatric Dentistry: The practice of dentistry concerned with the dental problems of children, proper maintenance, and treatment. The dental care may include the services provided by dental specialists. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Fragments: Partial proteins formed by partial hydrolysis of complete proteins. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal Pocket: An abnormal extension of a gingival sulcus accompanied by the apical migration of the epithelial attachment and bone resorption. [NIH] Periodontics: A dental specialty concerned with the histology, physiology, and pathology of the tissues that support, attach, and surround the teeth, and of the treatment and prevention of disease affecting these tissues. [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied

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to each other. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenytoin: An anticonvulsant that is used in a wide variety of seizures. It is also an antiarrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Pilocarpine: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Pilocarpine is used as a miotic and in the treatment of glaucoma. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pit and Fissure Sealants: Agents used to occlude dental enamel pits and fissures in the prevention of dental caries. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Platelet Count: A count of the number of platelets per unit volume in a sample of venous blood. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH]

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Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polyneuropathies: Diseases of multiple peripheral nerves. The various forms are categorized by the type of nerve affected (e.g., sensory, motor, or autonomic), by the distribution of nerve injury (e.g., distal vs. proximal), by nerve component primarily affected (e.g., demyelinating vs. axonal), by etiology, or by pattern of inheritance. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Preventive Dentistry: The branch of dentistry concerned with the prevention of disease and the maintenance and promotion of oral health. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Professional Practice: The use of one's knowledge in a particular profession. It includes, in the case of the field of biomedicine, professional activities related to health care and the actual performance of the duties related to the provision of health care. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential

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component of collagen and is important for proper functioning of joints and tendons. [NIH] Promotor: In an operon, a nucleotide sequence located at the operator end which contains all the signals for the correct initiation of genetic transcription by the RNA polymerase holoenzyme and determines the maximal rate of RNA synthesis. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propolis: Resinous substance obtained from beehives; contains many different substances which may have antimicrobial or antimycotic activity topically; its extracts are called propolis resin or balsam. Synonyms: bee bread; hive dross; bee glue. [NIH] Propylene Glycol: A clear, colorless, viscous organic solvent and diluent used in pharmaceutical preparations. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protozoan: 1. Any individual of the protozoa; protozoon. 2. Of or pertaining to the protozoa; protozoal. [EU] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Purifying: Respiratory equipment whose function is to remove contaminants from otherwise wholesome air. [NIH] Quality of Life: A generic concept reflecting concern with the modification and

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enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radar: A system using beamed and reflected radio signals to and from an object in such a way that range, bearing, and other characteristics of the object may be determined. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiosensitization: The use of a drug that makes tumor cells more sensitive to radiation therapy. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regulon: In eukaryotes, a genetic unit consisting of a noncontiguous group of genes under the control of a single regulator gene. In bacteria, regulons are global regulatory systems

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involved in the interplay of pleiotropic regulatory domains. These regulatory systems consist of several operons. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Reinfection: A second infection by the same pathogenic agent, or a second infection of an organ such as the kidney by a different pathogenic agent. [EU] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Response Elements: Nucleotide sequences, usually upstream, which are recognized by specific regulatory transcription factors, thereby causing gene response to various regulatory agents. These elements may be found in both promotor and enhancer regions. [NIH]

Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of

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developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Root Canal Therapy: A treatment modality in endodontics concerned with the therapy of diseases of the dental pulp. For preparatory procedures, root canal preparation is available. [NIH]

Rotavirus: A genus of Reoviridae, causing acute gastroenteritis in birds and mammals, including humans. Transmission is horizontal and by environmental contamination. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self-Injurious Behavior: Behavior in which persons hurt or harm themselves without the motive of suicide or of sexual deviation. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Septicaemia: A term originally used to denote a putrefactive process in the body, but now usually referring to infection with pyogenic micro-organisms; a genus of Diptera; the severe type of infection in which the blood stream is invaded by large numbers of the causal. [NIH] Serotypes: A cause of haemorrhagic septicaemia (in cattle, sheep and pigs), fowl cholera of

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birds, pasteurellosis of rabbits, and gangrenous mastitis of ewes. It is also commonly found in atrophic rhinitis of pigs. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skilled Nursing Facilities: Extended care facilities which provide skilled nursing care or rehabilitation services for inpatients on a daily basis. [NIH] Smiling: A facial expression which may denote feelings of pleasure, affection, amusement, etc. [NIH] Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Fluoride: A source of inorganic fluoride which is used topically to prevent dental caries. [NIH] Sodium Iodide: Sodium iodide (NaI). A compound forming white, odorless deliquescent crystals and used as iodine supplement, expectorant or in its radioactive (I-131) form as an diagnostic aid, particularly for thyroid function determinants. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of

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dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sorbitol: A polyhydric alcohol with about half the sweetness of sucrose. Sorbitol occurs naturally and is also produced synthetically from glucose. It was formerly used as a diuretic and may still be used as a laxative and in irrigating solutions for some surgical procedures. It is also used in many manufacturing processes, as a pharmaceutical aid, and in several research applications. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spices: The dried seeds, bark, root, stems, buds, leaves, or fruit of aromatic plants used to season food. [NIH] Stabilization: The creation of a stable state. [EU] Stagnation: The slowing down or stoppage of the flowing of any fluid. [NIH] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Strained: A stretched condition of a ligament. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococcal Infections: Infections with bacteria of the genus Streptococcus. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Streptococcus mutans: A polysaccharide-producing species of Streptococcus isolated from human dental plaque. [NIH]

Dictionary 177

Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue. These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Tartar: A mass of calcium and magnesium salts deposited around the teeth and upon artificial dentures. [NIH] Teichoic Acids: Bacterial polysaccharides that are rich in phosphodiester linkages. They are the major components of the cell walls and membranes of many bacteria. [NIH] Tenesmus: Straining, especially ineffectual and painful straining at stool or in urination. [EU] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrush: A disease due to infection with species of fungi of the genus Candida. [NIH] Thymidine: A chemical compound found in DNA. Also used as treatment for mucositis. [NIH]

Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH]

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Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tooth Loss: The failure to retain teeth as a result of disease or injury. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH]

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Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Triclosan: A diphenyl ether derivative used in cosmetics and toilet soaps as an antiseptic. It has some bacteriostatic and fungistatic action. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Veterinarians: Individuals with a degree in veterinary medicine that provides them with training and qualifications to treat diseases and injuries of animals. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and

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treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

181

INDEX A Abrasion, 69, 118, 143 Abscess, 99, 143 Accommodation, 59, 143 Acetone, 76, 143, 163 Acidity, 67, 68, 143 Acne, 143, 147 Acridine Orange, 50, 82, 143 Acrylonitrile, 143, 174 Adenosine, 143, 169 Adipose Tissue, 12, 143 Adolescence, 90, 124, 143 Adsorption, 62, 143 Adsorptive, 143 Adverse Effect, 9, 143, 169, 175 Affinity, 56, 65, 75, 143, 144, 175 Affinity Chromatography, 65, 143 Agar, 144, 169 Age Groups, 8, 144 Aged, 80 and Over, 144 Agonist, 144, 169 Alcohol Dehydrogenase, 72, 144 Algorithms, 144, 147 Alimentary, 144, 168 Alkaline, 25, 48, 84, 144, 145, 148 Alkaline Phosphatase, 25, 144 Allogeneic, 13, 144 Alpha Particles, 144, 172 Alternative medicine, 35, 43, 103, 144 Aluminum, 70, 144 Aluminum Oxide, 70, 144 Alveolar Process, 144, 173 Alveoli, 144, 153 Amino acid, 144, 145, 146, 160, 168, 170, 171, 173, 177, 179 Amino Acid Sequence, 145 Ammonia, 145, 179 Anaesthesia, 145, 161 Anaesthetic, 71, 145 Analogous, 49, 81, 145, 178 Anaphylatoxins, 145, 151 Anatomical, 98, 145, 149, 155, 161 Anemia, 5, 145 Anesthesia, 19, 66, 118, 145 Animal model, 9, 145 Anionic, 73, 145 Anions, 145, 162 Anomalies, 145, 167

Antibacterial, 35, 37, 40, 54, 145 Antibiotic, 51, 145, 165, 168 Antibodies, 13, 15, 16, 35, 54, 64, 80, 81, 86, 145, 146, 156, 159, 160, 164, 165, 169 Antibody, 14, 15, 51, 52, 54, 63, 64, 86 Anticoagulants, 145, 153 Anticonvulsant, 146, 169 Antigen, 14, 15, 63, 64, 143, 145, 146, 151, 156, 160, 161 Antigen-Antibody Complex, 146, 151 Antihypertensive, 62, 146 Anti-infective, 146, 149, 160, 162, 175 Antimetabolite, 146, 148 Antimicrobial, 51, 56, 76, 81, 128, 146, 171 Antimycotic, 146, 171 Antineoplastic, 146, 148, 165 Antiseptic, 143, 146, 179 Antiserum, 146 Antiviral, 146, 148 Anxiety, 91, 146, 152 Approximate, 122, 146 Aqueous, 61, 62, 70, 78, 84, 146, 147, 152, 155, 160 Aromatic, 146, 176, 177 Arrhythmia, 102, 146 Arteries, 146, 147, 152, 165 Artery, 146, 147, 152, 166, 173 Aspartate, 86, 146 Aspartic, 86, 146 Aspartic Acid, 86, 146 Autologous, 13, 146 Avidity, 13, 146 B Bacterial Infections, 88, 147 Bactericidal, 147, 156 Bacteriophage, 49, 81, 88, 147, 169 Bacteriostatic, 147, 179 Bacterium, 38, 39, 49, 72, 81, 147 Base, 53, 80, 147, 163 Benzoyl Peroxide, 53, 147 Bilateral, 26, 147 Binding agent, 57, 147 Bioavailability, 56, 75, 76, 147 Biochemical, 146, 147, 163 Biological Transport, 147, 153 Biotechnology, 13, 16, 103, 113, 147 Bladder, 147, 151 Blood Coagulation, 147, 148

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Blood pressure, 146, 147, 175 Blood vessel, 147, 149, 163, 175, 177, 179 Body Fluids, 74, 147, 154, 175 Bone Marrow, 147, 161, 164, 177 Bone Resorption, 13, 148, 168 Bottle Feeding, 3, 39, 148 Brachytherapy, 148, 162, 163, 172, 180 Branch, 139, 148, 168, 170, 171, 176, 177 Breakdown, 9, 148, 158 Bromodeoxyuridine, 50, 82, 148 Bruxism, 92, 148 Buccal, 148, 176 Burns, 147, 148 C Cacao, 52, 61, 62, 148 Calcium, 50, 55, 73, 76, 78, 79, 84, 148, 151, 166, 177 Calcium Hydroxide, 50, 148 Candidiasis, 96, 148 Candidosis, 148 Capsules, 87, 148, 157 Carbohydrate, 11, 12, 53, 67, 78, 141, 148, 170 Carbon Dioxide, 64, 148, 173, 179 Carcinogenic, 149, 162 Cardiac, 102, 149, 155, 158, 166 Cardiovascular, 62, 149 Catheter, 149, 162 Catheterization, 149, 162, 166 Cations, 149, 162 Cell Division, 146, 149, 165, 169 Cellobiose, 149 Cellulitis, 6, 149 Cellulose, 73, 149, 157, 169 Cerebral, 92, 149, 157 Cerebral Cortex, 149, 157 Cerebral Palsy, 92, 149 Cerebrum, 149 Check-up, 74, 149 Chelation, 56, 70, 75, 77, 149 Chemotactic Factors, 149, 151 Chemotherapy, 4, 149 Child Psychiatry, 149, 158 Chin, 149, 164 Chlorhexidine, 35, 149 Cholera, 150, 174 Chromatin, 150 Chromosomal, 63, 150 Chromosome, 150, 159, 164 Chronic, 73, 74, 89, 127, 150, 161, 177 Clinical Medicine, 150, 170 Clinical trial, 9, 10, 113, 150, 172

Cloning, 147, 150 Cohort Studies, 21, 150 Coliphages, 147, 150 Collagen, 61, 144, 150, 171 Collapse, 148, 150 Colloidal, 150, 155 Colon, 150, 154, 163 Colostrum, 54, 150 Comatose, 57, 150 Complement, 81, 145, 150, 151 Complementary and alternative medicine, 35, 43, 151 Complementary medicine, 35, 151 Compliance, 8, 151 Computational Biology, 113, 151 Conjugated, 56, 75, 151 Connective Tissue, 148, 149, 150, 151, 173, 177 Constipation, 91, 151 Consultation, 4, 151 Consumption, 4, 38, 40, 51, 96, 151, 153, 158, 167, 173 Contamination, 151, 174 Contraindications, ii, 151 Conventional therapy, 152 Conventional treatment, 79, 152 Coronary, 152, 165 Coronary Thrombosis, 152, 165 Corrosion, 55, 152 Cortex, 37, 152 Crowns, 152, 153 Cryptosporidiosis, 54, 152 Curative, 152, 177 Cutaneous, 148, 152, 163 Cytoplasm, 152, 154, 155, 159, 173 D Data Collection, 152, 157 Databases, Bibliographic, 113, 152 Deamination, 152, 179 Dental Abutments, 152, 153 Dental Amalgam, 65, 152 Dental Anxiety, 91, 152 Dental Care, 4, 5, 9, 59, 60, 71, 80, 85, 90, 92, 124, 126, 130, 152, 168 Dental Cements, 144, 153 Dental implant, 91, 153 Dental Materials, 9, 153 Dental Plaque, 11, 19, 49, 55, 61, 69, 74, 78, 80, 81, 83, 85, 90, 153, 176 Dentifrices, 73, 153 Dentists, 4, 7, 9, 35, 89, 91, 118, 153 Dentition, 10, 36, 87, 153

183

Dentures, 91, 153, 177 Deprivation, 25, 27, 30, 102, 153 Dermatitis, 9, 153 Deuterium, 153, 160 Developed Countries, 8, 153 Developing Countries, 32, 153 Dextrans, 49, 81, 153 Diabetes Mellitus, 27, 153, 158, 159 Diagnostic procedure, 47, 103, 153 Diarrhea, 91, 102, 152, 153, 163 Diffusion, 70, 79, 147, 153 Digestive system, 153, 166 Digestive tract, 72, 153 Dilatation, 153, 170 Diploid, 153, 169 Direct, iii, 9, 65, 105, 150, 154, 172 Disinfectant, 149, 154, 156 Dissection, 11, 154 Dissociation, 143, 154, 162 Distal, 154, 155, 170 Domesticated, 154, 159 Dross, 154, 171 Drug Interactions, 106, 154 Drug Tolerance, 154, 178 Duct, 149, 154, 174 Dura mater, 154, 164, 167 Dyes, 87, 154 Dysentery, 54, 154 E Ectopic, 13, 154 Effector, 14, 72, 80, 150, 154 Efficacy, 8, 10, 13, 35, 73, 84, 154 Egg Yolk, 15, 154 Ejaculation, 154, 174 Elastic, 155, 177 Elastin, 150, 155 Electrode, 65, 155 Electrolysis, 70, 78, 145, 149, 155 Electrolyte, 155, 170, 175 Electrophoresis, 63, 64, 70, 77, 78, 155 Embryo, 154, 155, 161 Emergency Treatment, 90, 155 Emulsify, 73, 155 Emulsion, 155 Enamel, 8, 48, 49, 55, 57, 61, 67, 69, 70, 75, 76, 77, 78, 79, 82, 83, 84, 85, 87, 118, 119 Endocarditis, 148, 155 Endodontics, 155, 174 Endotoxins, 151, 155 Enhancer, 155, 173 Environmental Health, 19, 112, 114, 155

Enzymatic, 55, 56, 75, 144, 148, 151, 152, 155 Enzyme, 51, 52, 61, 88, 144, 154, 155, 157, 163, 166, 171, 177, 180 Epidemiological, 29, 155 Epithelial, 147, 155, 156, 168 Epithelium, 156, 158 Epitopes, 86, 156 Erbium, 27, 156 ERV, 32, 114, 156 Erythrocytes, 145, 148, 156 Esophagus, 72, 153, 156, 159, 169, 176 Ethanol, 62, 76, 144, 156, 157 Ether, 73, 156, 179 Evacuation, 151, 156, 163 Excitation, 64, 156, 167 Exogenous, 143, 156 Expectorant, 156, 175 Expiratory, 156 Expiratory Reserve Volume, 156 External-beam radiation, 156, 162, 172, 180 Extracellular, 151, 156, 167, 175 Extracellular Matrix, 151, 156, 167 Extraction, 6, 91, 156 F Facial, 156, 175 Facial Expression, 156, 175 Family Planning, 113, 156 Fat, 143, 147, 150, 156, 163, 164, 173, 175, 177 Fatigue, 90, 156 Fatty acids, 68, 157, 175 Feces, 151, 157 Fermentation, 53, 144, 148, 157 Filler, 15, 16, 53, 69, 157 Fissure, 9, 24, 85, 95, 119, 157 Flatus, 157, 158 Fluorescence, 58, 143, 157 Fluoridation, 22, 23, 27, 29, 30, 32, 125, 126, 157 Fluorine, 55, 64, 87, 157 Fluorosis, 8, 36, 37, 157 Flush, 71, 157 Focus Groups, 121, 157 Fold, 157 Friction, 157, 164 Fructose, 12, 157 Fungi, 146, 157, 165, 177, 180 Fungistatic, 157, 179 Fungus, 148, 157

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G Gangrenous, 158, 175 Gas, 49, 145, 148, 153, 156, 157, 158, 160, 161, 179 Gastric, 14, 73, 158, 159 Gastric Mucosa, 73, 158 Gastritis, 54, 158 Gastroenteritis, 158, 174 Gastrointestinal, 54, 156, 158, 163, 177 Gastrointestinal tract, 54, 156, 158, 163 Gels, 70, 77, 78, 158 Gene, 11, 12, 63, 147, 158, 172, 173 Gene Expression, 11, 12, 158 Genetics, 7, 11, 158 Germicide, 51, 158 Gifted, 52, 158 Gingivitis, 10, 42, 50, 54, 83, 91, 130, 153, 158 Gland, 158, 164, 174, 176, 178 Glucans, 52, 86, 94, 158 Glucose, 12, 149, 153, 158, 159, 176 Glucose Intolerance, 153, 158 Glycidyl, 53, 159 Glycolysis, 70, 77, 159 Glycoprotein, 159, 163 Governing Board, 159, 170 Grade, 121, 128, 159 Grading, 8, 62, 159 Graft, 159, 160, 166 Gram-positive, 83, 159, 176 Gram-Positive Rods, 83, 159 Granulocytes, 159, 180 Growth, 48, 53, 56, 67, 75, 76, 79, 102, 143, 145, 146, 147, 153, 157, 159, 169, 178, 179 Guinea Pigs, 9, 159 H Halitosis, 50, 90, 91, 159 Haploid, 159, 169 Haptens, 143, 159 Health Status, 11, 159 Heartburn, 90, 159, 161 Hemoglobin, 145, 156, 159 Hemorrhage, 160, 166, 177 Hereditary, 89, 95, 160 Heredity, 158, 160 Heterogeneity, 143, 160 Hexanes, 84, 160 Histology, 160, 168 Hormone, 160, 162, 173, 178 Host, 72, 83, 147, 148, 150, 160, 161, 179, 180 Hydration, 70, 77, 78, 160

Hydrogen, 84, 143, 144, 147, 148, 153, 160, 165, 167, 171 Hydrogen Peroxide, 84, 160 Hydrolysis, 69, 146, 149, 160, 168, 171 Hydroxylysine, 150, 160 Hydroxyproline, 144, 150, 160 Hypersensitivity, 160, 173 Hypoplasia, 77, 160 I Id, 33, 41, 128, 129, 130, 131, 132, 138, 140, 160 Immune response, 81, 86, 146, 159, 160, 161, 177, 179, 180 Immune Sera, 160, 161 Immune system, 80, 81, 92, 160, 161, 164, 179, 180 Immunity, 14, 49, 81, 86, 160, 161, 178 Immunization, 14, 15, 161, 170 Immunodeficiency, 92, 161 Immunodeficiency syndrome, 92, 161 Immunogenic, 86, 161 Immunoglobulin, 15, 16, 145, 161, 165 Immunologic, 94, 149, 161, 172 Immunology, 35, 143, 161 Impairment, 161, 164 Implant radiation, 161, 162, 163, 172, 180 In vitro, 12, 35, 161 In vivo, 13, 161 Incision, 161, 162 Incisor, 99, 161 Indicative, 93, 161, 168, 179 Indigestion, 161, 163 Induction, 50, 82, 161 Infancy, 90, 123, 161 Infant Care, 59, 161 Infant, Newborn, 144, 161 Infarction, 152, 161, 165, 173 Inflammation, 72, 74, 83 Ingestion, 38, 52, 80, 87, 157, 159, 162, 170 Initiation, 7, 86, 162, 171, 178 Initiator, 53, 162 Inlay, 162, 173 Inorganic, 25, 53, 62, 162, 166, 175 Inpatients, 162, 175 Internal radiation, 162, 163, 172, 180 Interstitial, 148, 162, 163, 180 Intestinal, 152, 162 Intestine, 160, 162, 163, 176 Intoxication, 162, 180 Intracellular, 161, 162, 170 Intramuscular, 162, 168 Intravenous, 162, 168

185

Intrinsic, 143, 162 Intubation, 14, 149, 162 Invasive, 66, 160, 162 Iodine, 5, 131, 162, 175 Iodine-131, 131, 162 Ionization, 70, 77, 162 Ions, 70, 76, 78, 143, 147, 154, 155, 160, 162 Irradiation, 64, 162, 180 Irritants, 154, 163 Ischemia, 163, 166, 173 J Joint, 13, 90, 163 K Kb, 112, 163 Keratolytic, 152, 163 Ketoacidosis, 143, 163 Ketone Bodies, 143, 163 L Labile, 150, 163 Lactation, 150, 163 Lactose Intolerance, 91, 163 Large Intestine, 153, 162, 163, 172 Laxative, 144, 163, 176 Lectins, 68, 163 Lesion, 7, 66, 163, 166, 179 Library Services, 138, 163 Life cycle, 104, 157, 163 Ligament, 163, 176 Linkage, 11, 149, 164 Lipid, 79, 164 Liver, 153, 155, 157, 164, 179 Localized, 143, 152, 161, 164, 166, 169, 179 Locomotion, 164, 169 Lubricants, 164 Lubrication, 72, 164 Lymphatic, 161, 164, 177 Lymphocyte, 146, 164 Lymphoid, 145, 164 Lytic, 49, 81, 88, 164 M Mammary, 150, 164 Mandible, 144, 149, 164, 173 Mastication, 92, 164 Mastitis, 164, 175 Medical Records, 164, 173 MEDLINE, 113, 164 Membrane, 143, 151, 156, 163, 164, 166, 168, 169, 173 Meninges, 154, 164 Meningitis, 26, 164 Mental, iv, 8, 92, 112, 114, 131, 149, 154, 156, 164, 170, 171, 174

Mental Disorders, 149, 164, 170 Mental Health, iv, 8, 112, 114, 131, 164, 170, 171 Mental Retardation, 92, 164 Mercury, 152, 165 Metabolite, 69, 165 Methacrylate, 53, 165 MI, 142, 165 Microbe, 165, 178 Microorganism, 63, 83, 165, 168, 180 Micro-organism, 49, 84, 152, 165, 169, 174 Migration, 165, 168 Mineralization, 13, 148, 165 Miotic, 165, 169 Mitomycin, 50, 82, 165 Mitosis, 163, 165 Modification, 144, 165, 171 Molecular, 9, 11, 15, 63, 64, 86, 113, 115, 147, 151, 165, 174, 178 Molecule, 64, 144, 146, 147, 151, 154, 156, 160, 165, 172, 179 Monoclonal, 15, 64, 80, 163, 165, 172, 180 Monoclonal antibodies, 15, 64, 80, 165 Motion Sickness, 165, 166 Mouth Ulcer, 57, 166 Mucins, 153, 166, 174 Mucosa, 73, 74, 158, 166, 176, 177 Mucositis, 72, 90, 166, 177 Mucus, 154, 156, 166 Multivalent, 146, 166 Muscle relaxant, 166, 169 Muscle Spindles, 166, 169 Myocardial Reperfusion, 166, 173 Myocardial Reperfusion Injury, 166, 173 Myocardium, 165, 166 Myristic Acids, 68, 166 N Nausea, 91, 158, 161, 166 Need, 3, 4, 60, 71, 87, 89, 91, 94, 96, 97, 104, 107, 123, 124, 133, 166, 178 Neonatal, 14, 166 Nerve, 71, 145, 149, 166, 167, 170, 176, 178 Nervous System, 166, 168 Neurotransmitter, 143, 144, 146, 167, 177 Neutrons, 144, 162, 167, 172 Nuclei, 143, 144, 165, 167, 171 Nucleus, 150, 152, 153, 167, 171 Nursing Care, 167, 175 Nutritional Status, 128, 167 O Opportunistic Infections, 128, 167

186

Tooth decay

Oral Health, 3, 4, 6, 10, 68, 90, 91, 95, 97, 98, 119, 120, 121, 122, 124, 125, 126, 127, 167, 170 Oral Hygiene, 4, 10, 37, 39, 48, 50, 57, 67, 68, 80, 83, 90, 95, 99, 124, 125, 159, 167 Oropharynx, 72, 167 Orthodontic Brackets, 9, 167 Orthodontics, 90, 91, 153, 167 Osteoblasts, 12, 167 Otitis, 42, 54, 167 Otitis Media, 42, 54, 167 Ovary, 167, 177 Overdose, 87, 167 Ovum, 163, 167 P Pachymeningitis, 164, 167 Palate, 167, 176 Palliative, 168, 177 Palsy, 92, 168 Parasite, 168 Parasitic, 74, 152, 154, 168 Parenteral, 65, 168 Particle, 69, 168 Pathogen, 12, 72, 168 Pathogenesis, 26, 80, 168 Pathologic, 148, 152, 160, 168, 173 Patient Compliance, 8, 168 Patient Education, 118, 136, 138, 142, 168 Pediatric Dentistry, 3, 5, 6, 32, 92, 95, 168 Penicillin, 84, 88, 168 Peptide, 14, 86, 88, 144, 168, 171 Peptide Fragments, 88, 168 Periodontal disease, 49, 68, 70, 73, 81, 83, 90, 92, 168 Periodontal Pocket, 68, 168 Periodontics, 7, 168 Periodontitis, 27, 68, 83, 91, 158, 168 Peripheral Nervous System, 167, 168, 177 Peroxide, 53, 84, 147, 168 Pharmaceutical Preparations, 149, 156, 169, 171 Pharmacologic, 5, 145, 169, 178 Pharynx, 167, 169 Phenytoin, 92, 169 Phosphorus, 25, 79, 148, 169 Physical Examination, 149, 169 Physiologic, 11, 144, 169, 172, 173 Physiology, 11, 91, 94, 163, 168, 169 Pigments, 53, 169 Pilocarpine, 90, 96, 169 Pilot study, 5, 24, 169 Pit and Fissure Sealants, 95, 169

Plants, 62, 80, 146, 148, 158, 169, 176, 178, 179 Plasma, 145, 153, 158, 159, 169, 174 Plasma cells, 145, 169 Platelet Count, 4, 169 Platelets, 169 Pneumonia, 151, 170 Poisoning, 158, 160, 162, 165, 166, 170 Polymers, 50, 153, 170, 171, 177 Polyneuropathies, 160, 170 Polysaccharide, 11, 61, 63, 73, 83, 146, 149, 170, 176 Potassium, 73, 76, 170, 175 Practice Guidelines, 114, 128, 170 Precursor, 12, 154, 155, 170, 179 Prevalence, 6, 8, 10, 15, 22, 24, 26, 32, 37, 39, 95, 170 Preventive Dentistry, 8, 32, 170 Primary Prevention, 7, 170 Private Sector, 10, 170 Probe, 25, 65, 68, 170 Professional Practice, 8, 170 Progression, 7, 80, 145, 170 Progressive, 65, 154, 159, 170 Proline, 150, 160, 170 Promotor, 171, 173 Prophylaxis, 52, 88, 128, 171, 179 Propolis, 38, 171 Propylene Glycol, 76, 171 Protein C, 145, 147, 171, 179 Protein S, 147, 171, 173 Proteins, 13, 35, 87, 88, 144, 145, 146, 150, 154, 165, 168, 169, 170, 171, 175, 178 Proteolytic, 151, 171 Protons, 144, 160, 171, 172 Protozoa, 154, 165, 171 Protozoan, 152, 171 Psychic, 164, 171, 174 Psychoactive, 171, 180 Public Health, 7, 8, 10, 17, 18, 21, 22, 24, 26, 32, 33, 36, 114, 121, 122, 123, 171 Public Policy, 113, 171 Publishing, 7, 13, 90, 171 Pulmonary, 147, 151, 171, 177 Purifying, 52, 63, 171 Q Quality of Life, 92, 171 R Radar, 85, 172 Radiation, 58, 79, 156, 157, 162, 172, 180 Radiation therapy, 156, 162, 163, 172, 180

187

Radioactive, 160, 161, 162, 163, 165, 172, 175, 180 Radiography, 25, 90, 172 Radiolabeled, 163, 172, 180 Radiology, 7, 172 Radiosensitization, 50, 82, 172 Radiotherapy, 148, 163, 172, 180 Randomized, 10, 11, 154, 172 Randomized clinical trial, 10, 172 Receptor, 13, 146, 172 Recombinant, 72, 172, 179 Rectum, 150, 153, 157, 158, 163, 172 Recur, 63, 172 Refer, 1, 148, 150, 157, 158, 164, 167, 172, 178 Regimen, 154, 168, 172 Regulon, 11, 172 Regurgitation, 159, 173 Reinfection, 72, 173 Reperfusion, 56, 75, 166, 173 Reperfusion Injury, 56, 75, 173 Research Design, 10, 173 Resorption, 13, 173 Respiration, 148, 173 Response Elements, 11, 173 Restoration, 61, 65, 66, 80, 91, 95, 152, 166, 173 Retrospective, 6, 10, 173 Retrospective study, 6, 173 Rheumatism, 173 Rheumatoid, 54, 173 Rheumatoid arthritis, 54, 173 Rhinitis, 173, 175 Ribosome, 173, 179 Rigidity, 169, 173 Risk factor, 7, 17, 23, 32, 40, 123, 173 Rod, 147, 159, 174 Root Canal Therapy, 91, 153, 174 Rotavirus, 54, 174 Rubber, 59, 67, 143, 174 S Saliva, 4, 19, 40, 50, 59, 72, 73, 74, 77, 81, 85, 96, 104, 174 Salivary, 10, 13, 14, 15, 16, 25, 70, 77, 89, 96, 153, 174, 180 Salivary glands, 153, 174 Schizoid, 174, 180 Schizophrenia, 174, 180 Schizotypal Personality Disorder, 174, 180 Screening, 5, 7, 150, 174 Secretion, 163, 166, 174 Seizures, 169, 174

Self Care, 80, 174 Self-Injurious Behavior, 92, 174 Semen, 92, 154, 174 Senile, 57, 174 Septicaemia, 174 Serotypes, 51, 174 Serous, 150, 175 Serum, 13, 16, 145, 146, 150, 160, 175 Sex Characteristics, 143, 175 Shock, 175, 179 Side effect, 4, 9, 84, 89, 91, 105, 107, 143, 175, 178 Skeletal, 17, 166, 175 Skeleton, 163, 175 Skilled Nursing Facilities, 57, 175 Smiling, 123, 175 Soaps, 175, 179 Social Environment, 172, 175 Sodium, 34, 55, 56, 59, 64, 69, 73, 76, 83, 106, 131, 175 Sodium Bicarbonate, 69, 175 Sodium Fluoride, 34, 59, 106, 175 Sodium Iodide, 131, 175 Soft tissue, 58, 147, 175 Solvent, 52, 76, 143, 156, 171, 175 Somatic, 143, 165, 168, 176 Sorbitol, 48, 59, 176 Specialist, 132, 176 Species, 63, 83, 144, 154, 158, 159, 165, 168, 176, 177, 179, 180 Specificity, 143, 176 Spices, 62, 176 Stabilization, 169, 176 Stagnation, 71, 176 Statistically significant, 5, 176 Stimulant, 131, 176 Stimulus, 155, 156, 176 Stomach, 153, 156, 158, 160, 166, 169, 176 Stomatitis, 72, 176 Strained, 73, 176 Streptococcal, 14, 15, 26, 50, 82, 176 Streptococcal Infections, 26, 176 Streptococci, 14, 15, 38, 50, 61, 82, 84, 85, 86, 104, 176 Stress, 7, 25, 40, 90, 95, 158, 166, 173, 174, 177 Stroke, 57, 112, 177 Stromal, 12, 177 Stromal Cells, 12, 177 Styrene, 174, 177 Subacute, 161, 177 Subclinical, 161, 174, 177

188

Tooth decay

Subcutaneous, 12, 149, 158, 168, 177 Subspecies, 176, 177 Substance P, 165, 174, 177 Substrate, 61, 177 Supplementation, 39, 177 Suppression, 55, 177 Surfactant, 73, 177 Synergistic, 55, 177 Systemic, 106, 147, 148, 161, 163, 172, 175, 176, 177, 178, 180 T Tartar, 50, 60, 177 Teichoic Acids, 159, 177 Tenesmus, 154, 177 Therapeutics, 58, 69, 106, 177 Thrombosis, 171, 177 Thrush, 148, 177 Thymidine, 148, 177 Thymus, 161, 164, 177 Thyroid, 131, 162, 175, 178 Tin, 152, 178 Tinnitus, 167, 178 Tissue, 12, 48, 58, 69, 71, 84, 143, 146, 147, 149, 151, 152, 154, 155, 157, 158, 159, 160, 161, 162, 163, 164, 166, 167, 173, 175, 176, 177, 178, 179 Tolerance, 11, 158, 178 Tone, 167, 178 Tonic, 62, 178 Tooth Loss, 26, 69, 178 Topical, 5, 27, 64, 95, 149, 156, 160, 175, 178 Toxic, iv, 118, 160, 177, 178 Toxicity, 55, 154, 165, 178 Toxicology, 114, 178 Toxin, 178 Toxins, 50, 146, 155, 161, 165 Trace element, 157, 178 Trachea, 156, 169, 178 Transcription Factors, 173, 178 Transfection, 147, 178 Transfer Factor, 161, 178 Translation, 10, 144, 179

Transplantation, 12, 128, 161, 179 Trauma, 71, 90, 92, 178, 179 Trees, 174, 179 Triclosan, 56, 76, 179 Tryptophan, 150, 179 Tunica, 166, 179 U Ulcer, 149, 179 Ulceration, 72, 179 Unconscious, 160, 179 Urea, 69, 179 Urinary, 179 V Vaccination, 23, 81, 179 Vaccine, 28, 63, 64, 86, 95, 101, 179 Vagina, 148, 179 Vaginal, 90, 92, 164, 179 Vaginitis, 148, 179 Vascular, 161, 179 Vector, 70, 77, 78, 179 Venous, 169, 171, 179 Venous blood, 169, 179 Vertigo, 167, 179 Veterinarians, 60, 179 Veterinary Medicine, 113, 179 Viral, 54, 180 Virulence, 11, 178, 180 Virus, 50, 82, 92, 147, 155, 169, 180 Vitro, 13, 35, 180 Vivo, 13, 180 W Weight Gain, 91, 180 White blood cell, 4, 145, 150, 164, 166, 169, 180 Windpipe, 169, 178, 180 Withdrawal, 73, 180 X Xenograft, 145, 180 Xerostomia, 72, 89, 180 X-ray, 80, 90, 141, 157, 162, 172, 180 X-ray therapy, 163, 180 Y Yeasts, 84, 148, 157, 180

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