W J Loesche's research while affiliated with Concordia University–Ann Arbor and other places

Publications (225)

Article
Background: The validity of using pretreatment Periodontal Screening and Recording (PSR) index sextant scores to estimate periodontal access surgery needs was evaluated in chronic periodontitis patients both before and after the completion of non-surgical periodontal therapy. Methods: In 110 adults, pretreatment probing data identified 486 sexta...
Article
Objectives: To test the efficacy of 10% chlorhexidine (CHX) dental varnish applied to the mothers' dentition in preventing caries in American Indian children. Methods: This was a placebo-controlled, double-blind, randomized clinical trial. Mother-child pairs were enrolled when the child was 4.5-6.0 months. Mothers received 4 weekly applications...
Article
Full-text available
Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5% of the populations. The etiological chain of halitosis relates to the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VS...
Article
Full-text available
The use of systemic antimicrobials such as doxycycline, metronidazole, and azithromycin in conjunction with debridement has achieved results superior to those produced by debridement alone. The purpose of the present study was to determine if previous results could be improved upon by administering repeated doses of azithromycin during the hygiene...
Article
Both dental decay and periodontal disease are diagnosable and treatable bacterial infections. They are distinctly different infections, with dental decay occurring on the supragingival surfaces of the teeth and periodontal infections occurring in the gingival tissue approximating the subgingival plaque. The bacteria involved and the pathophysiology...
Article
Full-text available
Periodontal disease is an inflammatory reaction to the bacteria in dental plaque. The present study compared the prevalence of periodontal disease in patients using as a diagnostic either probing depth measurements, an inflammatory marker such as numbers of white blood cells in plaque samples, or microbiological markers such as the microscopic coun...
Article
In vivo pulpal responses in monkeys and in vitro bacterial inhibition studies were completed on new copper amalgams, Sybraloy, ® Dispersalloy, ® Tytin® and a conventional Spheraloy® amalgam. Amalgams were placed in cavities lined with ZOE and in unlined cavities. Silicate and ZOE were used as controls. A total of 165 adult monkey teeth were evaluat...
Article
Full-text available
Our aim was to assess, systematically, the effect of flossing on interproximal caries risk. Six trials involving 808 subjects, ages 4 to 13 years, were identified. There were significant study-to-study differences and a moderate to large potential for bias. Professional flossing performed on school days for 1.7 years on predominantly primary teeth...
Article
Full-text available
The oral microbial flora is unique, and available evidence indicates that it is passed vertically from parents to children. In this investigation, we used a chairside assay for the N-benzoyl-DL-arginine-2-naphthylamide (BANA)-sensitive enzyme found in Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythensis, to determine the preva...
Article
Abstract Patient compliance with the unsupervised usage of prescription medication can be poor. In the treatment of periodontal infections with systemic antimicrobial agents, in situations where the efficacy of the antimicrobial agent is being evaluated, non-compliance could underestimate the true efficacy of the agent. Metronidazole is an agent wi...
Article
Objective Because the increase in the bacterial load on the tongue is paramount in the etiology of malodor, we sought to reduce this load by debriding the tongue in combination with short-term usage of antimicrobial mouthrinses. Methods Subjects with oral malodor had an OR score >2, had whole mouth volatile sulfur (VSCs) levels ≥200 ppb (Halimeter®...
Article
Evidence on the role of plaque control in periodontitis is required for several reasons. First, there are increasing pressures to make medical and dental decisions evidence-based. Behavior changes should not be recommended unless evidence exists to support their effectiveness. Personal oral hygiene instruction can create frustrations on the part of...
Article
The many thousands of individuals who experience oral malodor that stems from the overgrowth of proteolytic, anaerobic bacteria on their tongue surfaces can be successfully treated by a regimen that includes tongue brushing and tooth brushing, often in combination with a mouthrinse containing an antibacterial agent. Several candidate mouthrinses co...
Article
Full-text available
The primary purpose of the present study was to compare the microbial profiles of the tongue dorsa of healthy subjects and subjects with halitosis by using culture-independent molecular methods. Our overall goal was to determine the bacterial diversity on the surface of the tongue dorsum as part of our ongoing efforts to identify all cultivable and...
Article
Periodontal disease is perhaps the most common chronic infection in adults. Evidence has been accumulating for the past 30 years which indicates that almost all forms of periodontal disease are chronic but specific bacterial infections due to the overgrowth in the dental plaque of a finite number of mostly anaerobic species such as Porphyromonas gi...
Article
To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population. Prospective enrollment of subjects with retrospective analysis of data. Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home. 358 veterans age 55 and older; 50 subjects with aspiration pneumonia. Demograp...
Article
Poor oral hygiene that leads to dental infections could contribute to adverse medical outcomes such as cardiovascular disease. Twelve studies of varying degrees of design rigor have associated dental conditions, such as periodontal disease, missing teeth, and edentulousness, with either coronary heart disease or a cerebral vascular accident. Six of...
Article
Very little information exists on minor salivary gland output (MSGO) in health and disease. We investigated the minor salivary gland output of elderly subjects with different medical backgrounds and the relationship of that output with life practices, demographic variables, complaints of dry mouth, medication usage, functional status, medical treat...
Article
Evidence is increasing that oral health has important impacts on systemic health. This paper presents data from the third National Health and Nutrition Examination Survey (NHANES III) describing the prevalence of dental caries and periodontal diseases in the older adult population. It then evaluates published reports and presents data from clinical...
Article
Smoking has been identified as a risk factor for development of periodontal disease and a strong indicator for treatment failure in periodontal patients. This study examined 172 patients categorized as current smokers (n=55), previous smokers (n=38) or individuals that had never smoked (n=79). A total of 670 interproximal plaques collected with a w...
Article
To improve reliability of salivary bacterial cultures as a surrogate for plaque levels of cariogenic bacterial species by reporting the salivary CFUs of these organisms as a function of the number of teeth. Cross-sectional collection of data in a convenience sample of adults over 60 years of age. Hospital Dental clinic, University bacteriology labo...
Article
Objectives:To improve reliability of salivary bacterial cultures as a surrogate for plaque levels of cariogenic bacterial species by reporting the salivary CFUs of these organisms as a function of the number of teeth. Design:Cross-sectional collection of data in a convenience sample of adults over 60 years of age. Setting:Hospital Dental clinic, Un...
Article
This study was undertaken to review the rationale behind the usage of antibacterial mouthrinses to control oral malodor and to evaluate the claims made for antibacterial mouthrinses against the statements of US Food and Drug Administration regulations. The literature from 1960 to August 1997, found in a MEDLINE search on oral malodor, halitosis, an...
Article
The effect of a chlorhexidine varnish delivery system on the levels of selected oral microorganisms was evaluated in caries active pediatric patients, ages 4 to 12 years old. Forty-six patients were enrolled into the study when they had multiple carious surfaces and salivary mutans streptococci (MS) levels higher than 10(4) colony forming units (CF...
Article
Advanced forms of periodontal disease are associated with the overgrowth of a limited number of gram-negative anaerobic species in plaques found in periodontal pockets. Double-blind clinical trials of metronidazole and doxycycline, combined with debriding of the tooth surfaces, have significantly reduced the need for periodontal surgery. Epidemiolo...
Article
Over the last 100 years, methods of surgical periodontal treatment have enjoyed a history of success in improving oral health. The paradigm of care is based on the "non-specific plaque hypothesis"--that is, the overgrowth of bacterial plaques cause periodontal disease, and the suppression of this overgrowth reduces disease risk. The central feature...
Article
Advanced forms of periodontal disease are associated with the overgrowth of a limited number of gram-negative anaerobic species in plaques found in periodontal pockets. Double-blind clinical trials of metronidazole and doxycycline, combined with debriding of the tooth surfaces, have significantly reduced the need for periodontal surgery. Epidemiolo...
Article
Dental infections are the most common infections in humans, and periodontal disease is the primary dental problem for older individuals. Current management relies on periodic debridement of tooth surfaces for prevention and on surgery for advanced cases of periodontal disease. A new treatment paradigm is based on evidence that periodontal disease i...
Article
We report here information obtained from a cross-sectional study of 401 veterans, who were at least 60 years of age, which showed that several dental/oral conditions can be significantly associated with the diagnosis of a cerebral vascular accident (CVA), when included in a multivariate logistic regression model with and without many of the known r...
Article
Several recent studies have shown a link between dental disease and coronary heart disease. The authors studied 320 U.S. veterans in a convenience sample to assess the relationship between oral health and systemic diseases among older people. They present cross-sectional data confirming that a statistically significant association exists between a...
Article
Inappropriate use of antibiotics by clinicians leads to development of antibiotic resistance. For the most part, antibiotics are prescribed in dental practice for prophylactic and therapeutic reasons. Prophylactic antibiotics are prescribed to prevent diseases caused by members of the oral flora introduced to distant sites in a host at risk or intr...
Article
Full-text available
Aspiration pneumonia is a major cause of morbidity and mortality among the elderly who are hospitalized or in nursing homes. Multiple risk factors for pneumonia have been identified, but no study has effectively compared the relative risk of factors in several different categories, including dysphagia. In this prospective outcomes study, 189 elderl...
Article
Porphyromonas gingivalis, Treponema denticola and Bacteroides forsythus have been implicated in periodontal disease and each possesses an enzyme capable of hydrolyzing the synthetic trypsin substrate, BANA. We have used a chairside test for BANA hydrolysis to diagnose an anaerobic periodontal infection in patients with advanced forms of clinical di...
Article
The number of teeth in the dentition was compared with the number and types of dental functional units (opposing tooth pairs) to correlate the number of functional units with complaints about chewing and swallowing in the elderly. Complaints of oral pharyngeal function and food avoidance practices were compared with the number and types of function...
Article
Access surgery may be recommended to about 80% of patients who present with advanced forms of periodontal disease. In this report, a multivariate logistic regression analysis which incorporated several clinical parameters for each tooth examined, i.e., tooth type, furcation involvement, bleeding on probing, attachment level, probing depth, mobility...
Article
The prevailing treatment paradigm in periodontal disease relies on debriding the tooth surfaces to keep the bacterial load below the level that triggers tissue loss. When debridement cannot be easily accomplished because of deep pocketing, access surgery is recommended. The debridement approach that involves access surgery is successful in 80% to 8...
Article
Recently, there have been case-control and epidemiologic investigations that strongly associate poor dental health with cardiovascular disease, preterm low birth weight infants, and early death from any cause. In a 7-year prospective study, dental disease was a significant predictor of coronary events leading to death after controlling for known co...
Article
Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/67020/2/10.1177_00220345960750070101.pdf
Article
To determine whether the short-term use of systemic antimicrobials (metronidazole or doxycycline) and locally delivered antimicrobials (metronidazole, chlorhexidine) in patients with advanced forms of periodontal disease could prevent the normally necessary access surgery. Ninety-four patients were randomly assigned with the use of a double-blind p...
Article
The most commonly measured bacterial parameters in saliva are the levels of the mutans group streptococci and lactobacilli, which have diagnostic implications for the incidence of dental decay. Diagnostic guidelines which are applicable to children and young adults in whom most, if not all, teeth are present and in whom the rate of stimulated saliv...
Article
Research suggests that the tongue plays an important role in the production of oral malodor. To investigate the role of tongue surface characteristics and oral bacteria in halitosis development, the authors tested associations between odor measurements, volatile sulfur compound levels, periodontal parameters, tongue surface characteristics, presenc...
Article
Full-text available
To determine whether there is a difference in the oral/dental health in older persons with different life styles and medical status. Survey (cross-sectional study) included four groups: (1) subjects (n = 123) living in a residential retirement home or community dwelling; (2) subjects (n = 218) seeking dental treatment at a Veterans Affairs Dental O...
Article
Full-text available
To study the relationship between complaints of xerostomia and salivary performance and food avoidances in four geriatric groups chosen to reflect a broad spectrum of individuals along the health-disease continuum. To determine whether xerogenic medications taken by these individuals could be associated with either complaints of xerostomia or with...
Article
An endo-acting oligopeptidase (OPase) was purified to homogeneity from the cells of Treponema denticola ATCC 35405--a human oral spirochete--by a procedure that comprised a mild Triton X-100 extraction (which disintegrates the outer membrane but leaves the cells morphologically intact) and four successive fast protein liquid chromatographic steps o...
Article
Full-text available
Considerable evidence exists suggesting that periodontal disease is due to the overgrowth of a finite number of specific bacteria such as Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Treponema denticola, Bacteroides forsythus, and Prevotella intermedia, among others. Three of these organisms-P. gingivalis, T. denticola, and B. fo...
Article
Two previous double-blind studies have shown that 1 week of metronidazole, plus scaling and root planing, can significantly reduce the number of teeth per patient that require periodontal surgery, when compared to a positive-control treatment that consisted of 1 week of placebo treatment plus scaling and root planing. The only difference between th...
Article
Many individuals with cardiovascular disease appear from epidemiologic studies to have either periodontal disease or to be edentulous. A Finnish group has provided evidence that after conventional risk factors for stroke and heart attacks have been accounted for, there still remains a significant relationship between dental disease and cardiovascul...
Article
Full-text available
The purpose of the present investigation was to test the association between the BANA test (Perioscan, Oral-B), and oral malodor parameters. The subject population consisted of 52 Israeli adults, 43 of whom complained of oral malodor. Oral malodor measurements consisted of peak and steady-state volatile sulphide measurement by a portable sulphide m...
Article
The aim of this study was to obtain measurements of oral malodor, as measured by volatile sulfur compounds (VSC), in periodontally healthy individuals without any complaints of bad breath, and to compare the results with data obtained from patients with complaints of oral malodor. The quality of the mouth air was assessed organoleptically and a por...
Article
There are few objective assays for studies of the epidemiology of periodontal diseases. The PerioScan™ is an assay capable of detecting three periodontal pathogens, namely T. denticola, P. gingivalis, and B. forsythus, which have been associated with adult periodontitis. The PerioScan™ was tested in a sample of 301 Brazilians. Clinical indices—blee...
Article
Full-text available
A previous multi-center study examining patients diagnosed as having at least four periodontally diseased teeth showed that when BANA (N-Benzoyl-DL-Arginine-Naphthylamide) hydrolysis by periodontal pathogens such as Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus was evaluated versus clinical parameters such as clinical jud...
Article
Periodontal disease is the general description given to the inflammatory response of the gin-giva and underlying connective tissue to bacterial accumulations (dental plaque) on the teeth. A limited number of cultivable species are usually associated with periodontal disease. The majority of putative periodontal pathogens are gram-negative anaerobic...
Article
The purpose of this study was to evaluate in a double-blind placebo-based study the effects of fluoxetine over a period of 16 weeks on the frequency of binging and purging and on fluctuations in the levels of cariogenic organisms and saliva secretion rate of patients (n = 30) with bulima nervosa. Profile analysis suggested that, over the course of...
Article
The hydrolysis of BANA by subgingival plaque samples is associated with the presence of either Treponema denticola, Porphyromonas gingivalis, and/or Bacteroides forsythus. A protocol in which pure cultures were incubated for 15 min at 55 degrees C detected about 5 x 10(5) CFU of P. gingivalis and 1 x 10(6) CFU of T. denticola. Clinical studies indi...
Article
Patient compliance with the unsupervised usage of prescription medication can be poor. In the treatment of periodontal infections with systemic antimicrobial agents, in situations where the efficacy of the antimicrobial agent is being evaluated, non-compliance could underestimate the true efficacy of the agent. Metronidazole is an agent with report...
Article
Recent research in periodontology has indicated that a finite number of bacterial species are associated with periodontal disease. This has generated the hypothesis that periodontal disease is essentially an infection due to one or more of the putative periodontopathogens; i.e., the specific plaque hypothesis (SPH). This microbial specificity parad...
Article
Caries examination and collection of paraffin wax-stimulated saliva samples were performed in 37 children, 3-6 years old, in a child-care facility at the Vidigal slum, Rio de Janeiro, Brazil. The levels of mutans streptococci and lactobacilli in saliva were estimated by the Cariescreen and by the Dentocult tests and the saliva secretion rate was de...
Article
According to the specific plaque hypothesis a measurable amount of periodontal disease is due to the overgrowth of specific bacterial types. The author advocates the theory and discusses treatment. This includes techniques for diagnosing the predominant bacterial types, antibiotic therapy and the relevance of regular debridement.