F OGORVOSI SZEMLE n 101. évf. 5. sz. 2008.
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global goal for the 12-year-old was reached. Promoting the Hungarian population’s oral health, widening their dental knowledge, and improving their attitude and behaviour represent a task requiring very much time and staff effort.
CARIES RISK GROUPS AND PERIODS OVER TIME – CHILDREN AND ADOLESCENTS
INFLUENCE OF THE GENETIC BACKGROUND ON THE PERIODONTAL CONDITION
Risk assessment is an essential component in the decision-making process for the correct prevention and management of dental caries in childhood. There is a strong body of evidence in the literature to support that past caries experience is the single best predictor for future caries development. In young children, prediction models which include a variety of risk factors may increase the accuracy of the prediction while the usefulness of additional risk factors for prediction purposes is, at best, questionable in schoolchildren and adolescents. The fact that the disease is actually manifested before it can be accurately predicted is a major concern in today’s non-operative dentistry. Therefore, an alternative strategy has emerged in paediatric dentistry with the focus on risk ages. The background thinking is that practically all children are exposed to an increased caries risk at certain key ages linked to the eruption of teeth: i) 1-3 yrs (primary molars); ii) 5-7 years (1st permanent molars), and iii) 12-15 yrs (2nd molars, premolars and cuspids). The presentation focuses on evidence-based preventive methods tailored to the specific age groups. The cornerstone for all ages is daily tooth-brushing with fluoridated toothpaste which is beyond doubt the most cost-effective homebased way to prevent caries. The remaining questions are: when to start tooth-brushing; and which is the fluoride concentration that is optimal. Recent studies suggest that a regular application of fluoride varnish is the best professional method to control caries in schoolchildren. Application of fissure sealants is an effective but expensive adjunct to fluoride. On the basis of existing evidence, clinical recommendations will be discussed and suggested.
Tóth Vilmos University of Pécs, Faculty of Medicine, School of Dentistry, Pécs, Hungary Severe periodontitis occours in 10–15% of the population. The pattern of disease inheritance revealed the genetic background of severe and chronic periodontitis. The disease process is a multifactorial one gene rated by opportunistic bacteria. The disposition and severity of the disease strongly correlates with the environmental circumstances and the reactions of the patient. The latter is determined by genetic constitution of the organisms. Major disease gene associated with periodontitis was revealed to this time only at the chromosome 11, the Cathepsin-C gene R allel. Minor genetic alterations are generated very often in the human genom that lead to genetic polymorphism. Certain minor alterations remain sound clinically during the lifetime and others can predispose to or/and aggravate the disease process. The genetic background of the immunologically competent molecules was investigated currently, namely the genoms of the immunoglobulins and cytokins coding for the cinetics of the inflammatory process. The results draw attention to the alteration in the genoms of IL-1, TNF-α, Il10 and FcγR. Further investigations are needed to unveil other Single Nucleotid Polymorphisms (SNP) and their role in the development of periodontitis. It must be kept in mind that the effect and frequency of certain genetic alterations strongly differ by race and geographical distribution.
Twetman Svante Department of Cariology and Endodontics, University of Copenhagen, Denmark