Browsing by Author "Brinkmane, Anda"

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    Caries experience in relation to oral hygiene, salivary cariogenic microflora, buffer capacity and secretion rate in 6-year olds and 12 year olds in Riga
    (2008) Gudkina, Jekaterina; Brinkmane, Anda; Rīga Stradiņš University
    OBJECTIVE: The aim was to assess possible relationship between oral hygiene, salivary cariogenic microflora, buffer capacity, secretion rate and caries experience in 6 year olds and 12 year olds in Riga, and to evaluate these variables in relation to caries risk. MATERIALS AND METHODS: 50 children aged 6 and 71 children aged 12 were examined clinically and by bitewing X-ray for caries diagnosis. Green-Vermillion oral hygiene index, stimulated salivary flow rate and buffer capacity were estimated (CRT-buffer; Ivoclar, Vivadent, Liechtenstein). Salivary mutans streptococci (MS) and lactobacilli (LB) (CRT-bacteria; Vivadent) were determined only for children with dmft/DMFT>4: 60% at age of 6, 54,9% at age of 12. All data were statistically analyzed using frequency tables, Pearson chi2test and ANOVA analysis. RESULTS: Mean DMFT was 0.12 in 6 year olds, and 4.6 in 12 year olds. Mean Green-Vermillion index was 0.75 in 6 year olds and 0.99 in 12 year olds. Caries experience and Green-Vermillion index were associated only in 6 year olds (p=0.024). Salivary MS was associated with Green-Vermillion index only in 12 year olds (p=0.086). Salivary MS and caries experience were associated only in 12 year olds (p=0.010). Salivary LB was associated with stimulated saliva's secretion rate only in 12 year olds (p=0.027). Salivary cariogenic microflora level and buffer capacity were associated in 6 year olds (p for MS=0.010; p for LB=0.052). Same association was observed only between salivary MS and buffer capacity in 12 year olds (p=0.081). Stimulated saliva's secretion rate and buffer capacity were associated only in 12 year olds (p=0.004). CONCLUSIONS: Information of caries risk factors should be used to work effectively on caries reduction in 6 year olds and 12 year olds in Riga.
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    Caries Increment and Oral Hygiene Changes in 6-and 12-Year-Old Children in Riga, Latvia : A 3-Year Follow-Up Report Using ICDAS II and RADKE Criteria
    (2019) Gudkina, Jekaterina; Amaechi, Bennett T.; Abrams, Stephen H.; Brinkmane, Anda; Jelisejeva, Ieva; Department of Conservative Dentistry and Oral Health
    Objectives: The purpose of this study was to investigate the caries increment and oral hygiene changes over a 3-year period and also compare the sensitivity and specificity of Radke's caries assessment method to ICDAS II among 6-and 12-year-old children in Riga, Latvia. Materials and Methods: Thirty-eight 6 and thirty-nine 12-year-old children were examined visually and with bitewing (BW) radiographs for dental caries at baseline and after a 3-year period. Decayed, missing, and filled surfaces (dmfs/DMFS) in all teeth were scored by one calibrated examiner using the Radke's caries scoring criteria. Oral hygiene level was determined using Green-Vermillion index (G-V ind.) at baseline and after 3 years. ICDAS II was used to assess all children only at the 3rd-year time point. The parents of the 6-and 12-year-old children responded to a questionnaire on oral hygiene at baseline and at the 3-year mark. Statistical Analysis: The data were analyzed using t-test, Chi-square test, Wilcoxon test (α= 0.05), and sensitivity and specificity tests. Results: The mean (SD) values of G-V ind. and caries experience at baseline/3-year period in 6-versus 12-year-old children were as follows. G-V ind.: 1.14(0.80)/1.48(0.89) [p = 0.4768] versus 0.99(0.45)/1.45(1.22) [p = 0.0337]. DMFS: 0.72(1.02)/3.13(3.13) [p = 0.0000] versus 6.79(5.14)/14.79(9.86)[p = 0.0000]; dmfs: 11.26(8.71)/7.74 (4.86) [p = 0.0780] versus 3.57 (2.03)/1.5(0.71)[p = 0.3173].The sensitivity and specificity of Radke to ICDAS II of caries-affected surfaces was: in proximal surfaces-0.57 and 0.98, on occlusal surfaces-0.83 and 0.98, on buccal/lingual surfaces-0.43 and 0.99. Conclusions: The result of the present study suggests that the increased caries experience over a 3-year period among the 6-and 12-year-old children in Riga may be due to the concurrent decreased level of oral hygiene, suggesting that ICDAS II instead of Radke's criteria should be used to detect and monitor dental caries.
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    Caries prevalence and severity for 12-year-old children in Latvia
    (2021-06-01) Maldupa, Ilze; Sopule, Anete; Uribe, Sergio E.; Brinkmane, Anda; Senakola, Egita; Department of Conservative Dentistry and Oral Health
    Objectives: To study caries prevalence/severity in 12-year-old children in Latvia and potential risk indicators. Methods: A cross-sectional oral-health national survey of 12-year-old children was conducted in 2016. A nationally representative stratified-cluster probabilistic sample of 2,138 pupils in 92 schools was selected. Children were examined by seven calibrated examiners (kappa inter-examiner, intra-examiner scores of 0.71–0.77, 0.81–0.97, respectively) at school. Enamel-non-cavitated decay (D1), enamel cavitation (D3), dentine cavitation (D5), missing (M) or filled (F) status at the tooth (T)/surface (S) levels were evaluated, and decayed, missing, and filled (DMF) index scores for severity, along with the Significant Caries Index (SiC), were calculated. An associated caries factor questionnaire was completed by participants. Results: The prevalence of caries was 98.5% for D1MFT, 79.7% for D3MFT, and 71.9% for D5MFT. The means (standard deviations) for severity were 9.2 (5.3) for D1MFT, 3.3 (3.0) for D3MFT, and 2.4 (2.4) for D5MFT, and 5.6 (2.1) for the SiC. Indicators associated with a lower risk of caries (D5MFT) were irregular dental visits (prevalence odds ratio POR = 0.45, 95% confidence interval (CI): 0.36, 0.56) and irregular use of mouthwashes (POR = 0.73, 95% CI: 0.60, 0.89). Conclusions: We found a high caries prevalence and severity in 12 year-old children in Latvia. Although the WHO target for 2010 (D5MFT ≤ 3) is met, the values for caries prevalence (D5MFT > 0 = 71.9%) and severity (D5MFT = 2.5) in 12-year-old Latvian children are higher than the European averages (D5MFT > 0 = 52%, D5MFT = 1.1).
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    Clinical effectiveness/child-patient and parent satisfaction of two topical fluoride treatments for caries : a randomised clinical trial
    (2024-04-07) Maldupa, Ilze; Innes, Nicola; Viduskalne, Ilona; Brinkmane, Anda; Senakola, Egita; Krūmiņa, Karīna; Uribe, Sergio E; Department of Conservative Dentistry and Oral Health
    Knowledge gaps exist regarding optimal silver diammine fluoride (SDF) regimens and the efficacy of new products for arresting dental caries in young children. We evaluated the effectiveness of 38%-SDF (SDI-RivaStar), Tiefenfluorid (TF) comparing with Placebo (P), all in conjunction with behavioural modification (BM), in preventing major complications (endodontic/extractions/pain)-a patient-centred outcome-due to early childhood caries over 12 months in children under 71-months. A six-arm, patient/parent-blinded, superiority, placebo-controlled randomised control trial at the university clinic in Riga, Latvia, from 1/9/20-31/8/22 (Protocol registration ISRCTN17005348). The trial tested six protocols, using three compounds (P/SDF/TF) under two regimes: annual and biannual (P1/P2/TF1/TF2/SDF1/SDF2) for major complications. Secondary outcomes included minor complications and parental satisfaction. All groups received BM. 373/427 randomised children (87.3%) completed the study. SDF2 had a significantly lower rate and risk of major (21.5%, OR = 0.28, 95%CI [0.11, 0.72], p < 0.05) and minor complications (OR = 0.16 (95%CI [0.05, 0.50], p = 0.002). Overall satisfaction was 96% (p > 0.05). SDF biannual application with BM effectively prevented major complications of early childhood caries and was well accepted by children and their parents. Trial registration number: ISRCTN17005348, principal investigator: Ilze Maldupa, registration date: 30/06/2021.Clinical trial registration number: ISRCTN registry: ISRCTN17005348, https://doi.org/10.1186/ISRCTN17005348 , registration date: 30/06/2021.
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    Comparative analysis of CRT Buffer, GC saliva check buffer tests and laboratory titration to evaluate saliva buffering capacity
    (2011) Maldupa, Ilze; Brinkmane, Anda; Mihailova, Anna; Department of Conservative Dentistry and Oral Health
    OBJECTIVE. The purpose of this study is to evaluate the ability of two commercial strip tests and laboratory titration to detect saliva buffer capacity. MATERIALS AND METHODS. Sixty-four patients were examined. Stimulated saliva was collected and buffer capacity was determined with two different chair-side strip tests in addition to immediate transportation to the laboratory to check the buffering ability by titrating with 0.005 M HCl and measuring pH by digital pH/Ion meter, used as a gold standart. The correlation were analyzed using the Spearman Rank Correlation Test, Cohen's Kappa coefficient and Pearson's Correlation test, p < 0.01. Sensitivity and specificity were used to measure precision of these tests. RESULTS. The response rate was 80%. High buffer capacity was found in 23.4% of cases, medium in 62.5%, and low in 14.1%. The Spearman Rank Correlation coefficient between the titration method and CRT Buffer test was 0.685 and the GC Saliva Check Buffer was 0.837. The Kappa coefficient for the CRT Buffer test was 0.508, while the coefficient for the GC Saliva Check Buffer was 0.752. The Pearson Correlation for the GC Saliva Check was 0.675. The difference is found in the buffer capacity at initial pH and at pH value 3. CONCLUSIONS. Both colorimetric tests correlate with the acid titration method in laboratory and are usable for saliva buffer capacity detection in dental offices. Buffer capacity detected in laboratory at different pH values can provide more information regarding caries risk.
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    COVID-19 as an opportunity for minimally-invasive dentistry : a national cross-sectional survey
    (2022-09-12) Maldupa, Ilze; Sļepcova, Olga; Viduskalne, Ilona; Brinkmane, Anda; Senakola, Egita; Uribe, Sergio E; Department of Conservative Dentistry and Oral Health
    BACKGROUND: During the COVID19 pandemic, the Latvian government issued first absolute restrictions (elective treatments prohibited, only emergency care) and later relative restrictions (preference for non-aerosol-generating procedures (AGP) and emergency care) on dental care. This study aims to assess the impact of these restrictions on the decision made by Latvian dentists about caries treatment. METHODS: A Survey-based cross-sectional study was used. A minimum sample size of 174 dentists was estimated for national representativeness (N = 1524). The questionnaire was developed by experts and sent three times via email to Latvian dentists from July to September 2020 and was also delivered in printed form at two national conferences in September and October 2020. Descriptive statistics were calculated. RESULTS: We received 373 completed questionnaires, with a total response rate of 24.5%. Under the recommendation to reduce AGP for the treatment of uncomplicated caries, 10% of the dentists stated that they would stop attending, 54% would only attend emergencies, and 36% would attend as usual. Under prohibition, the percentages are 15%, 74%, and 11%, respectively. Regarding the type of treatment, more than 75% would opt to proceed with selective caries removal for both primary and permanent teeth and 10% for extraction. CONCLUSION: Latvian dentists are willing to treat patients with caries during the pandemic and state that they prefer to use non- or minimally invasive and less aerosol-generating methods for caries treatment.
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    Dentalni status i parodontološko zdravlje pacijenata s fenilketonurijom u Latviji
    (2022-06) Abola, Iveta; Emulina, Darta Elizabete; Skadins, Ingus; Brinkmane, Anda; Gailite, Linda; Auzenbaha, Madara; Scientific Laboratory of Molecular Genetics; Department of Conservative Dentistry and Oral Health; Department of Biology and Microbiology
    Objectives: Phenylketonuria (PKU) is an autosomal recessive inherited disorder of phenylalanine metabolism resulting from a deficiency of phenylalanine hydroxylase. The aim of this study was to evaluate the dental status and periodontal health of PKU patients in Latvia. Material and Methods: Fortyfive PKU patients and age/sex-matched controls were recruited for this cross-sectional study. Their anamnestic data, periodontal health and dental status were assessed by one experienced dentist. Results: Dental and periodontal clinical evaluation revealed that the median number of filled teeth was significantly smaller among PKU patients compared to the control group (p=0.021). PKU patients had a significantly larger median number of carious teeth than their healthy counterparts (p<0.001). Significant differences between the PKU and control groups were observed for several oral hygiene indices (p<0.001): Silness-Löe plaque index, OR=29.3 (95% CI: 3.7–232.4); CPITN index, OR=35.2 (95% CI: 4.5–278.3); Greene-Vermillion index, OR=10.2 (95% CI: 2.8–38.0); calculus removal necessity, OR=12.3 (95% CI: 3.3–45.4). Conclusion: Dental status and periodontal health of PKU patients was found to be significantly inferior compared to healthy controls. This is likely due to the regular consumption of PKU formula and the difficulties which mentally and/or physically disabled PKU patients experience with their oral hygiene. To prevent tooth decay and periodontal disease, PKU patients should visit a professional oral hygienist every three to six months. Furthermore, they should adopt the habit of rinsing their mouth with water immediately after consuming PKU formula to counteract the acidity in their oral cavity.
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    Effect of COVID-19 on Coverage of Dental Services in Latvia
    (2024-03-04) Maldupa, Ilze; Senakola, Egita; Brinkmane, Anda; Ķīvīte-Urtāne, Anda; Uribe, Sergio E.; Department of Conservative Dentistry and Oral Health; Institute of Public Health; Department of Public Health and Epidemiology; Bioinformatics Group
    This study aimed to describe the impact of the COVID-19 pandemic and related public health decisions on dental services. A retrospective study was conducted using secondary data on dental services (2019–2021). Data were obtained from the Latvian National Health Service and the Centre for Disease Prevention and Control and analysed using descriptive statistics and data visualisation methods. In the first wave of COVID-19, the frequency of routine dental services decreased by 81.6% at the patient level, which coincided with the restrictions imposed as public health measures. The amount of regular dental manipulations returned to its previous level immediately after lifting restrictions. Still, they decreased to a more moderate extent (not exceeding 25% decline) with the beginning of the second wave. We observed a decrease in all manipulations, regardless of their aerosol-generating risk, and no increase in preventive manipulations that could be performed without any physical contact. We conclude that the most significant decrease in the availability of services was directly linked to existing public health measures. It seems that these measures allowed time to adapt the clinics to the new sanitary requirements, further ensuring continuity of service provision.
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    The Effect of MI Varnish™ on Caries Increment and Dietary Habits among 6- and 12-Year-Old Children in Riga, Latvia : A 3-Year Randomized Controlled Trial
    (2022-06-01) Gudkina, Jekaterīna; Amaechi, Bennett T.; Abrams, Stephen H.; Brinkmane, Anda; Petrošina, Eva; Department of Conservative Dentistry and Oral Health; Statistics Unit
    Aims: This randomized controlled trial investigated the effect of MI Varnish™ (5% NaF/ CPP-ACP) on caries increment in 6- and 12-year-old children in Riga, Latvia within 36 months. Methods: Forty-eight 6-year-old children (Group 1) and forty-seven 12-year-old children (Group 3) received quarterly varnish application, while forty-eight 6-year-old children (Group 2) and thirty-seven 12-yearold children (Group 4) did not have varnish applied. All children/parents received the same preventive advice. All children were visually examined using ICDAS-II criteria. Questionnaires on dietary habits were completed by the children/parents at baseline and after 36 months. DMFS and dfs were calculated from ICDAS data. The statistical analysis was performed (α = 0.05) using a Chi-squared test, paired t-test (Welch test) and the Pearson correlation coefficient. The trial registration number is ISRCTN10584414. Results: In Group 1 versus Group 2, the DMFS(SD) (Baseline/36 months) values were 5.02(5.85)/13.21(6.67) (p < 0.001) versus 2.65(4.54)/10.81(6.14) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 36.75(12.96)/24.04(12.9) (p < 0.001) versus 33.67(12.74)/23.88(11.91) (p < 0.001), respectively. In Group 3 versus Group 4, the DMFS(SD) (Baseline/36 months) values were 48.62(23.18)/70.96(23.28) (p < 0.001) versus 34.73(17.99)/54.95(16.09) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 1.7(4.4)/0 (p < 0.05) versus 2(6.39)/0 (p = 0.06), respectively. The prevalence of caries (dfs + DMFS) decreased by 4.52 (p < 0.001) and 1.63 (p < 0.001) in Groups 1 and 2, respectively, but increased by 20.64 (p < 0.001) and 18.22 (p < 0.001) in Groups 3 and 4, respectively. An analysis of the questionnaires indicated the habitual, frequent consumption of a sugary diet by all the children. A significant correlation (r = 0.321; p < 0.05) was observed between caries increment and the frequency of daily intake of sugary snacks, soft drinks and tea with sugar at baseline only in Group 1. Conclusions: A quarterly application of MI varnish (CPP-ACP/fluoride) reduced caries increment in 6- and 12-year-old children in Riga, Latvia.
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    Evidence based toothpaste classification, according to certain characteristics of their chemical composition
    (2012-03) Maldupa, Ilze; Brinkmane, Anda; Rendeniece, Inga; Mihailova, Anna; Rīga Stradiņš University
    Toothpastes are daily oral care products, the chemical composition of which is constantly changing due to manufacturer's competition. It becomes more and more difficult for dentists to recommend the best toothpaste and for patients to choose one. The objective of this paper was to draw out recommendations based on the best evidence available and to propose a new classification of toothpastes. Publications were searched in PubMed database (published between 1991-2011, limited to English language articles in dental journals). Recommendations for toothpaste choice and usage were developed from the best evidence available.
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    Factors influencing the caries experience of 6 and 12 year old children in Riga, Latvia
    (2016) Gudkina, Jekaterina; Brinkmane, Anda; Abrams, Stephen H.; Amaechi, Bennett T.; Rīga Stradiņš University
    AIM: Authors assessed the influence of drinking tea with sugar, level of cariogenic microflora and use of fluoride toothpaste and tablets on caries experience of 6 and 12 year old children in Riga, Latvia. METHODS: 141 six and 164 twelve year old children were examined clinically and with bitewing radiographs to determine their dmft/DMFT and dmfs/DMFS. Children or their parents responded to questionnaire on number teaspoons of sugar (TS) used per cup of tea, number of cups of tea consumed daily, using fluoride or non-fluoride toothpaste (TP), frequency of toothbrushing, using fluoride tablets or not (ft). Salivary mutans streptococci (MS) and lactobacilli (LB) levels were measured in children with dmft/DMFT>4.0 for age of 6 (73% (n=103)), and for age of 12 (54% (n=88)). Impact of variables in caries status was determined using frequency tables and ANOVA, while proportion differences were tested using chi-square test. RESULTS: In 6 year olds, statistically significant associations were observed between the salivary microflora (MS, LB) and dt/DT (p=0.032; dt=3.71, DT=0.42), use of F-toothpaste (p=0.020), and TS (p<0.001). In 12 year olds, statistically significant (p<0.01) associations were observed between salivary microflora and dt/DT, ds/DS and dmft/DMFT. In both age groups, significant (p<0.001) association was demonstrated between dmfs/DMFS and salivary microflora, F-toothpaste and TS. CONCLUSIONS: The present study indicated that the caries development in Latvian children was associated with consumption of sugary tea and use of non-fluoride toothpaste.
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    The Impact of IL1B rs1143634 and DEFB1 rs11362 Variants on Periodontitis Risk in Phenylketonuria and Type 1 Diabetes Mellitus Patients in a Latvian Population
    (2024) Emulina, Darta Elizabete; Ābola, Iveta; Brinkmane, Anda; Isakovs, Aleksejs; Skadiņš, Ingus; Moisejevs, Georgijs; Gailīte, Linda; Auzenbaha, Madara; Scientific Laboratory of Molecular Genetics; Department of Conservative Dentistry and Oral Health; Department of Biology and Microbiology
    Objectives: Periodontitis is a multifactorial disease that affects approximately 11% of the global population. The objective of this study was to examine whether, among individuals with phenylketonuria and type 1 diabetes mellitus, those with the IL1B rs1143634 and/or DEFB1 rs11362 genetic variants exhibit a higher periodontitis risk compared to healthy controls. Materials and Methods: In all, 43 phenylketonuria patients (aged 12–53), 28 type 1 diabetes mellitus patients (aged 11–40), and 63 healthy controls (aged 12–53) were included. The evaluation of periodontitis risk was conducted using the Silness–Löe plaque index, the Greene–Vermillion index, and an assessment for the necessity of calculus removal. Genetic variants rs1143634 and rs11362 were genotyped from salivary samples using restriction length polymorphism analysis. Results: The DEFB1 rs11362 variant was associated with higher Silness–Löe and Greene–Vermillion index scores in phenylketonuria patients (p = 0.011 and p = 0.043, respectively). The IL1B rs1143634 variant was associated with lower calculus removal necessity in type 1 diabetes mellitus patients (p = 0.030). Clinical examination showed the worst oral hygiene index scores for PKU patients. PKU patients also reported the least consistent tooth brushing and flossing habits. Conclusions: Genetic associations between DEFB1 rs11362 and IL1B rs1143634 variants and oral hygiene indices were observed in the PKU and T1DM groups, suggesting that genetic factors may contribute to periodontal health differences in these populations. Further research with a larger sample size is needed to confirm these findings and develop targeted oral health interventions.
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    Inadequacy of Self-Implemented Preventive Measures to Control Caries Increment due to Poor Dietary Habits in 6 and 12 Years Old Children in Riga, Latvia
    (2022-09-23) Gudkina, Jekaterīna; Amaechi, Bennett T.; Abrams, Stephen H.; Brinkmane, Anda; Jelisejeva, Ieva; Rīga Stradiņš University
    Aim. This study investigated whether the self-implemented preventive measures practiced among the 6 and 12 years olds in Riga, Latvia can control the caries increment due to poor dietary habits among this age groups. Material and methods. Caries examination was performed on Thirty-eight 6 and thirty-nine 12 years olds by visual and bitewing radiographic examination at baseline and after 3 years. All participants and/or their parents completed dietary habits questionnaires. The data was analyzed using t-test, chi-square test, ANOVA and frequency tables, Wilcoxon and Fisher’s tests (α=0.05). Results. The mean (SD) values of caries experience at baseline/3-year period in 6- vs.12- year olds were as follows. DMFS: 0.72 (1.02)/3.13 (3.13) (p=0.0000) vs. 6.79 (5.14)/14.79 (9.86) (p=0.0000); dmfs: 11.26(8.71)/7.74 (4.86) (p=0.078) vs. 3.57 (2.03)/1.5 (0.71) (p=0.317). The statistical significance was reported only for the consumption of soft drinks (p=0.032) and sugared tea (p=0.018) for the 6 years olds, and for sugared tea (p=0.017) and number of teaspoons of sugar added to tea (p=0.0095) for the 12-years olds. There was positive caries increment in all the 6 and 12 years olds that reported significant increase in consumption of soft drinks and sugared tea, and increase daily number of teaspoons of sugar used in tea. Conclusions. The present study demonstrated high cariogenic diet among the children in Riga, which is associated with increased caries experience that the currently practiced self-implemented oral hygiene measures was not capable of controlling.
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    Kariesa riska noteikšanas metožu loma profilakses programmu izstrādē augstas kariesa intensitātes reģionā. Promocijas darba kopsavilkums
    (Rīgas Stradiņa universitāte, 2013) Maldupa, Ilze; Brinkmane, Anda
    Pasaulē kariess joprojām ir visas sabiedrības problēma, arī Latvijā. Kaut jau gandrīz gadsimtu ir labi zināmi kariesa izsaucēji, zobārstniecības speciālistiem nav izdevies izskaust šo problēmu nevienā valstī. Darba mērķis bija novērtēt kariesa riska metožu lomu profilakses programmas ieviešanā augsta kariesa riska reģionā. Skola ir atzīta par ideālu vidi kariesa profilakses programmām, tādēļ pētījumam tika izraudzīti skolas vecuma pusaudži, kuriem ir visaugstākais kariesa risks – 12-13 gadu vecums, kad formējas pastāvīgais sakodiens, rodas jaunas zobu virsmas, kas pakļautas kariesu izraisošo faktoru darbībai. Nejauši tika atlasīta pētījuma dalībnieku grupa, kas sastādīja ~30% no Gulbenes novada 12-13 gadus vecu skolēnu populācijas. Pētījums ietvēra trīs dažādas sadaļas – epidemioloģisks pētījums kariesa izplatības, intensitātes un riska faktoru izvērtējumam 12-13 gadus veciem skolēniem Gulbenes novadā, kohortas dizaina pētījums kariesa riska noteikšanas metožu precizitātes un izmaksu efektivitātes novērtējumam, pielietojot Cariogram, CAMBRA un eksperimentālu 4 faktoru modeļus Gulbenes novada skolēniem un randomizēts kontrolēt klīnisks pētījums zobu tīrīšanas kā skolu profilakses programmas efektivitātes novērtējumam Gulbenes novada skolēniem. Pēc atbilstošas metodikas pielietošanas, ņemot vērā pētījuma rezultātus un ierobežojumus var secināt, ka, plānojot kariesa riska noteikšanu ieviest valsts programmā kā standarta pacientu izmeklēšanas procedūru, nepieciešams izstrādāt konkrētai populācijai atbilstošu metodi, iepriekš analizējot kariesa riska faktorus un to ietekmes proporcijas ilgtermiņa garengriezuma pētījumā, bet, tā kā Gulbenes novadā 12-13 gadus vecu pusaudžu vidū kariesa izplatība, intensitāte un incidence ir ļoti augsta, un zema kariesa riska grupa ir nenozīmīga, nav nepieciešamības pēc augsta riska stratēģijas, ieviešot kariesa profilakses programmas, tā vietā jāpielieto uz populāciju vērstas metodes, piemēram, zobu tīrīšanas ar fluorīdus saturošu pastu nodrošināšana skolās.
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    Kariesa riska noteikšanas metožu loma profilakses programmu izstrādē augstas kariesa intensitātes reģionā. Promocijas darbs
    (Rīgas Stradiņa universitāte, 2013) Maldupa, Ilze; Brinkmane, Anda
    Pasaulē kariess joprojām ir visas sabiedrības problēma, arī Latvijā. Kaut jau gandrīz gadsimtu ir labi zināmi kariesa izsaucēji, zobārstniecības speciālistiem nav izdevies izskaust šo problēmu nevienā valstī. Darba mērķis bija novērtēt kariesa riska metožu lomu profilakses programmas ieviešanā augsta kariesa riska reģionā. Skola ir atzīta par ideālu vidi kariesa profilakses programmām, tādēļ pētījumam tika izraudzīti skolas vecuma pusaudži, kuriem ir visaugstākais kariesa risks – 12-13 gadu vecums, kad formējas pastāvīgais sakodiens, rodas jaunas zobu virsmas, kas pakļautas kariesu izraisošo faktoru darbībai. Nejauši tika atlasīta pētījuma dalībnieku grupa, kas sastādīja ~30% no Gulbenes novada 12-13 gadus vecu skolēnu populācijas. Pētījums ietvēra trīs dažādas sadaļas – epidemioloģisks pētījums kariesa izplatības, intensitātes un riska faktoru izvērtējumam 12-13 gadus veciem skolēniem Gulbenes novadā, kohortas dizaina pētījums kariesa riska noteikšanas metožu precizitātes un izmaksu efektivitātes novērtējumam, pielietojot Cariogram, CAMBRA un eksperimentālu 4 faktoru modeļus Gulbenes novada skolēniem un randomizēts kontrolēt klīnisks pētījums zobu tīrīšanas kā skolu profilakses programmas efektivitātes novērtējumam Gulbenes novada skolēniem. Pēc atbilstošas metodikas pielietošanas, ņemot vērā pētījuma rezultātus un ierobežojumus var secināt, ka, plānojot kariesa riska noteikšanu ieviest valsts programmā kā standarta pacientu izmeklēšanas procedūru, nepieciešams izstrādāt konkrētai populācijai atbilstošu metodi, iepriekš analizējot kariesa riska faktorus un to ietekmes proporcijas ilgtermiņa garengriezuma pētījumā, bet, tā kā Gulbenes novadā 12-13 gadus vecu pusaudžu vidū kariesa izplatība, intensitāte un incidence ir ļoti augsta, un zema kariesa riska grupa ir nenozīmīga, nav nepieciešamības pēc augsta riska stratēģijas, ieviešot kariesa profilakses programmas, tā vietā jāpielieto uz populāciju vērstas metodes, piemēram, zobu tīrīšanas ar fluorīdus saturošu pastu nodrošināšana skolās.
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    Oral health care knowledge among Phenylketonuria patients in the Latvian population
    (2024-12) Ābola, Iveta; Intlere, Nikola Anna; Brinkmane, Anda; Laktina, Sabine; Zariņa, Agnese; Vasilevska, Lauma; Skadiņš, Ingus; Moisejevs, Georgijs; Gailīte, Linda; Auzenbaha, Madara; Department of Conservative Dentistry and Oral Health; Scientific Laboratory of Molecular Genetics; Department of Biology and Microbiology
    BACKGROUND: Phenylketonuria (PKU) is an autosomal recessive inherited disorder of phenylalanine (Phe) metabolism that results from a deficiency of phenylalanine hydroxylase (PAH). Patients with PKU rely on amino acid mixtures and low-protein diets, which often exhibit an acidic nature and pose various challenges to oral health. The objective of the study was to evaluate oral care habits of PKU patients in Latvia and the impact of the recommendations developed on improving oral care. MATERIALS AND METHODS: In this study, during a one-month interval before and after the implementation of oral hygiene recommendations, questionnaires were distributed to all patients with PKU diagnosed in Latvia, with a response rate of 78 % (79 of 101). RESULTS: The group older and 18 years of age showed a poorer understanding of oral care even after receiving recommendations, 82 % brushing their teeth twice a day (92 % in the group <18 years of age), continuing 57 % rinsing their mouth after using amino acid formula (75 % in the younger group). Significant improvements were observed only in the respondent group younger than 18 years of age - including increases in toothbrushing twice a day by 25 % ( p = 0.001), dental flossing by 23 % ( p = 0.001), mouth rinsing after amino acid-based formula by 13 % ( p = 0.020). CONCLUSION: This study concludes that PKU patients older and 18 years of age have a poor understanding of maintaining oral hygiene and the use of the necessary supplements to improve it. Activities are needed in the future that would regularly remind and motivate PKU patients to take care of their oral health.
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    Oral Microbiome Traits of Type 1 Diabetes and Phenylketonuria Patients in Latvia
    (2023-05-31) Abola, Iveta; Gudra, Dita; Ustinova, Maija; Fridmanis, Davids; Emulina, Darta Elizabete; Skadins, Ingus; Brinkmane, Anda; Lauga-Tunina, Una; Gailite, Linda; Auzenbaha, Madara; Scientific Laboratory of Molecular Genetics; Department of Conservative Dentistry and Oral Health; Department of Biology and Microbiology
    Some metabolic disorder treatments require patients to follow a specific diet or to consume supplements that, over time, can lead to oral microbiome alterations. Well-known disorders requiring such treatment are phenylketonuria (PKU), an inborn error of amino acid metabolism, and type 1 diabetes (T1D), a metabolic disorder that requires a specific diet regimen. Therefore, the aim of this study was to investigate the oral health and microbiome characteristics that might contribute to caries activity and periodontal disease risk in PKU and T1D patients. In this cross-sectional study, 45 PKU patients, 24 T1D patients, and 61 healthy individuals between the ages of 12 and 53 years were examined. Their anamnestic data and dental status were assessed by one dentist. Microbial communities were detected from saliva-isolated DNA using 16S rRNA gene V3–V4 sequencing on Illumina MiSeq sequencing platform. Results revealed that the PKU patient group displayed the highest number of extracted teeth (on average 1.34), carious teeth (on average 4.95), and carious activity (44.44% of individuals) compared to the T1D and CTRL groups. The lowest numbers of filled teeth (on average 5.33) and extracted teeth (on average 0.63) per individual were observed in T1D patients. Gingivitis appeared more often in the T1D group; however, possible risk of periodontal disease was seen in both the T1D and PKU patient groups. The highest number of differentially abundant genera was detected in the PKU group (n = 20), with enrichment of Actinomyces (padj = 4.17 × 10−22), Capnocytophaga (padj = 8.53 × 10−8), and Porphyromonas (padj = 1.18 × 10−5) compared to the CTRL group. In conclusion, the dental and periodontal health of PKU patients was found to be significantly inferior compared to T1D patients and healthy controls. T1D patients showed early signs of periodontal disease. Several genera that correlate with periodontal disease development were found in both groups, thus suggesting that T1D and PKU patients should seek early and regular dental advice and be educated about proper oral hygiene practices.
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    Prevention Program Development and Evaluation of Advancement of Caries in Pregnant Women and Their Children. Summary of the Doctoral Thesis
    (Rīga Stradiņš University, 2016) Rendeniece, Inga; Care, Rūta; Brinkmane, Anda
    Young children caries is a topical problem in Latvia as well as worldwide. Several studies have been carried out fully describing causes of caries, as well as a number of preventive programs have been developed, however there are no countries in the world where young children caries would not be a topical issue. Several studies have shown that education of pregnant women and young mothers has significantly reduced development of caries in children. A number of the world’s leading associations have developed guidelines on how to protect children from caries by educating pregnant women and new mothers. Through assessment of oral health of pregnant women or new mothers and evaluation of their knowledge on the child’s oral care, a dentist or a hygienist is able to assess the child’s risk of caries, and to take all necessary preventive measures to protect the child from tooth decay. The paper was targeted at development and assessment of dental disease prevention program for children starting from the pregnancy of a mother. The main objective of the paper was to develop a child’s oral health passport and guidelines on oral health for pregnant women and their young children. The study involved a survey of pregnant women and an assessment of their knowledge on their own and the future child’s oral health. Pregnant women were advised on their daily oral care. Pregnant women were explained what regimen should be followed when feeding an infant with breast milk or infant formula, especially at night. Recommendations were given on times when the child should be taught drinking from a bottle and a cup, advising to avoid sweetened beverages, especially at night. The expectant mothers were explained that the child can be infected with caries-causing bacteria via saliva which can be passed from the mother or any other carer by kissing the child, licking the child’s spoon or soother. The pregnant women were explained how to properly take care of the child’s mouth. The young mothers with children were surveyed when the child reached the age of one and two years. At the end of the study, the mothers were asked to fill out a questionnaire about the child’s eating and dental care habits. As the result, the children involved in the study whose parent had followed the above instructions, showed lower caries prevalence compared to children of the control group. Having analysed the results of the study and scientific literature, as well as having considered experiences of other countries, an oral health passport and guidelines for children residing in Latvia were developed, taking into account various caries risk factors.
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    Profilakses programmas izstrāde un kariesa attīstības novērtējums grūtniecēm un viņu bērniem. Promocijas darba kopsavilkums
    (Rīgas Stradiņa universitāte, 2016) Rendeniece, Inga; Care, Rūta; Brinkmane, Anda
    Latvijā, tāpat kā citviet pasaulē, mazu bērnu kariess ir aktuāla problēma. Ir veikti vairāki pētījumi, kas pilnībā apraksta kariesa attīstības iemeslus, ir izstrādātas vairākas profilakses programmas, taču nav nevienas valsts, kur mazu bērnu kariess nav aktuāla problēma. Vairāki pētījumi ir pierādījuši, ka grūtnieču un jauno māmiņu izglītošana būtiski samazina mazu bērnu kariesa attīstību. Vairākas pasaules vadošās zobārstu un bērnu zobārstu asociācijas ir izstrādājušas vadlīnijas, kā pasargāt bērnus no kariesa, izglītojot grūtnieces un jaunās māmiņas. Nosakot grūtnieču vai jauno māšu mutes veselību un izvērtējot viņu zināšanas par bērna mutes kopšanu, zobārsts vai zobu higiēnists spēj novērtēt bērna kariesa risku un veikt visus nepieciešamos profilakses pasākumus, kas pasargās bērnu no zobu bojāšanās. Darba mērķis bija izstrādāt un novērtēt stomatoloģisko slimību profilaktisko programmu bērniem, kas uzsākta mātes grūtniecības laikā. Darba galvenais uzdevums bija izstrādāt bērna mutes veselības pasi un mutes veselības vadlīnijas grūtniecēm un bērniem. Pētījuma laikā tika apsekotas grūtnieces un novērtētas viņu zināšanas par sava un topošā bērna mutes veselību. Grūtniecēm tika sniegtas rekomendācijas par savu mutes kopšanu ikdienā. Grūtniecēm tika izskaidrots, kāds režīms būtu jāievēro, barojot bērnu ar krūts pienu vai mākslīgiem maisījumiem, it īpaši naktīs. Tika sniegtas rekomendācijas par bērna ēšanas un dzeršanas režīma ievērošanu. Topošajām mātēm tika paskaidrots, ka bērna inficēšana ar kariesu izraisošiem mikroorganismiem notiek ar siekalām, bērnu noskūpstot, aplaizot karoti vai māneklīti. Grūtniecēm tika paskaidrots, kā pareizi kopt bērna muti. Jaunās māmiņas ar bērniem tika apsekotas, kad bērns sasniedza gada un divu gadu vecumu. Pētījuma beigās mātēm bija jāaizpilda anketa par bērna ēšanas un zobu kopšanas paradumiem. Rezultātā pētījumā iesaistītiem bērniem, kuru vecāki ievēroja iepriekš dotos norādījumus, bija zemāka kariesa izplatība, salīdzinot ar kontroles grupas bērniem. Analizējot pētījuma rezultātus un zinātnisko literatūru, kā arī izskatot citu valstu pieredzi, tika izveidota Latvijā dzīvojošiem bērniem piemērota mutes veselības pase un izstrādātas vadlīnijas, ņemot vērā kariesa riska faktorus.