***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study was to investigate whether DMFS increment can be decreased among children with active initial caries by oral hygiene and dietary counseling and by using noninvasive preventive measures . Except for mentally disabled and h and icapped children attending special schools , all 11- to 12-year-olds in Pori , Finl and , with at least one active initial caries lesion were invited to participate in the study and were then r and omized into two groups . Children in the experimental group ( n = 250 ) were offered an individually design ed patient-centered preventive program aim ed at identifying and eliminating factors that had led to the presence of active caries . The program included counseling sessions with emphasis on enhancing use of the children ’s own re sources in everyday life . Toothbrushes , fluoride toothpaste and fluoride and xylitol lozenges were distributed to the children . They also received applications of fluoride/chlorhexidine varnish .  The children in the control group ( n = 247 ) received basic prevention offered as st and ard in the public dental clinics in Pori . For both groups , the average follow-up period was 3.4 years . A community level program of oral health promotion was run in Pori throughout this period . Mean DMFS increments for the experimental and control groups were 2.56 ( 95 % CI 2.07 , 3.05 ) and 4.60 ( 3.99 , 5.21 ) , respectively ( p < 0.0001 ) : prevented fraction 44.3 % ( 30.2 % , 56.4 % ) . The results show that by using a regimen that includes multiple measures for preventing dental decay , caries increment can be significantly reduced among caries-active children living in an area where the overall level of caries experience is low The aim of this study was to evaluate the effect of maternal use of chewing gums containing combinations of xylitol , sorbitol , chlorhexidine , and fluoride on salivary mutans streptococci ( MS ) counts and caries prevalence in the mothers ' 3-year-old children . After screening 416 women with newborn babies , 173 mothers with high counts of salivary MS were r and omly assigned into 3 experimental chewing gum groups containing ( A ) xylitol ( n=61 ) , ( B ) chlorhexidine/xylitol/sorbitol ( n=55 ) , and ( C ) sodium fluoride/xylitol/sorbitol ( n=57 ) . Mothers with low or medium MS counts formed a reference group ( D ) without any intervention ( n=232 ) . The participants in the experimental groups were instructed to chew one piece of the gum for 5 min 3 times a day . The chewing regimen started when the child was 6 months old and was terminated 1 year later . The outcome measures were salivary MS counts and caries prevalence at the age of 3 years . Bacterial enumeration was carried out with a chair-side technique and caries ( defs ) was scored by clinical examination . Medium and high counts of salivary MS were found in 13 % , 16 % , and 22 % in groups A , B , and C , respectively . The mean defs was 0.1 in group A , 0.2 in group B , and 0.4 in group C. The differences concerning salivary MS and caries were not statistically significant . The MS counts and caries prevalence in children of mothers with low MS counts ( group D ) were similar to those found in groups A and B. In conclusion , lower but non-significant levels of salivary MS and dental decay were observed in 3-year-old children to mothers who used high-content xylitol gums compared with those who used lower amounts of xylitol . The efficiency of this type of targeted intervention in a low-caries community may be question ed PURPOSE This pilot study investigated the reliability of the conventional prosthodontic wisdom that a modified diet ameliorates soreness during the adjustment to new complete dentures .  Tissue ulceration of the bearing mucosa served as the indicator of patient soreness as a function of diet . MATERIAL AND METHODS Fourteen men were r and omly assigned to two equal treatment groups . One group consumed a consistency-gra date d diet and the other ( control ) ate as they wished . New complete dentures were fabricated for both groups by the same provider , technician , material s , and method ; the study was double-blinded . Tissue ulceration was assessed and totaled for the 10 days after denture placement , constituting a soreness score . RESULTS Data analysis identified a significant difference in soreness scores between dietary groups ( p < 0.05 ) . Wearing time had a significant inverse relation to soreness ( p < 0.05 ) in this study . A host of potential explanatory variables of clinical interest failed to relate significantly to the outcome of soreness . CONCLUSIONS The results of this study indicated that a consistency-gra date d diet had a significant effect in diminishing tissue ulceration during the immediate postplacement period for this group of men . Potentially , these findings could contribute to enhanced quality of care and to the more efficient allocation of provider-based re sources Dental caries remains a significant problem for poor children in the United States . One strategy for treating dental caries is to suppress streptococcus mutans , the chief pathogen responsible for the disease . The purpose of this study was to evaluate the effect of xylitol gum in salivary S. mutans levels in preschool children . Sixty-one children were r and omly assigned into the xylitol group and the control group . The xylitol group chewed gum sweetened only with xylitol ( XyliFresh100 % , Hershey Food Corporation , U.S.A. ) three times a day for three weeks . S. mutans counts were tested using the Dentocult-SM Strip Mutans-test ( Orion Diagnostica , Finl and ) at baseline and after three weeks . The shift from higher S. mutans scores to lower was greater in the xylitol group than in the control group ( p;lt0.05 ) . This study supports the suggestion that chewing xylitol gum may reduce salivary S. mutans levels .  Xylitol chewing gum may provide a feasible caries prevention method for preschool children Proper r and omisation means little if investigators can not include all r and omised participants in the primary analysis . Participants might ignore follow-up , leave town , or take aspartame when instructed to take aspirin . Exclusions before r and omisation do not bias the treatment comparison , but they can hurt generalisability . Eligibility criteria for a trial should be clear , specific , and applied before r and omisation . Readers should assess whether any of the criteria make the trial sample atypical or unrepresentative of the people in which they are interested . In principle , assessment of exclusions after r and omisation is simple : none are allowed . For the primary analysis , all participants enrolled should be included and analysed as part of the original group assigned ( an intent-to-treat analysis ) . In reality , however , losses frequently occur . Investigators should , therefore , commit adequate re sources to develop and implement procedures to maximise retention of participants . Moreover , research ers should provide clear , explicit information on the progress of all r and omised participants through the trial by use of , for instance , a trial profile . Investigators can also do secondary analyses on , for instance , per- protocol or as-treated participants . Such analyses should be described as secondary and non-r and omised comparisons . Mish and ling of exclusions causes serious method ological difficulties . Unfortunately , some explanations for mish and ling exclusions intuitively appeal to readers , disguising the seriousness of the issues . Creative mismanagement of exclusions can undermine trial validity A long-term prospect i ve , r and omized dietary intervention to prevent exposure of children to the known atherosclerosis risk factors ( the STRIP baby project ) was started when the age of the children was 7 months . The aim of this sub study was to analyze the oral effects of the dietary intervention in the children and their parents when the children had reached the age of 3 years . Every fifth family of the main study was invited to this sub study ( n = 179 ) . Those studied ( n = 148 ) represented well the intervention and the  control  groups and both genders in terms of intake of saturated fatty acids , the dietary polyunsaturated fatty acid to saturated fatty acid ( PUFA/SAFA ) ration and serum cholesterol and HDL cholesterol concentrations . Though no difference was found in sucrose consumption between the intervention and the control groups , the intervention children received relatively ( in E% ) more energy from carbohydrates than the control children ( p < 0.005 ) , used absolutely ( in g ) and relatively ( in E% ) less fat ( p < 0.05 ) and had a higher PUFA/SAFA ratio in their diet ( p < 0.001 ) . Of the 3-year-old children 93 % were caries free , and dental decay was a prevalent in the intervention as in the control children . Control children brushed their teeth unassisted more often than the intervention children ( p < 0.05 ) . The intervention fathers also received more energy ( in E% ) from carbohydrates ( p < 0.01 ) , the intervention mothers used less fat ( p < 0.05 ) and had a higher PUFA/SAFA ratio in the diet ( p < 0.05 ) than the control fathers and mothers , respectively . Dental and periodontal health of the intervention and control parents ( n = 250 , 84 % attending , mean + /- SD age : 34.2 + /- 54.5 years also showed no differences even though the control parents had more commonly last visited a dentist over 3 years before this examination ( p < 0.05 ) . We conclude that a 29-month period of a low-saturated-fat , low-cholesterol but high-carbohydrate diet as advocated in the STRIP baby trial does not seem to have harmful effects on the oral health of the children or their parents . Minor untoward differences had occurred in the dental health behavior of the control children and their parents Previous in situ and in vitro studies have demonstrated that the chewing of sucrose-free gum after eating reduces the development of dental caries . To investigate the extrapolation of these findings to the clinical setting , we conducted a two-year study on 547 schoolchildren in Budapest , Hungary . Subjects in the " Gum " group were instructed to chew one stick of a commercially available sorbitol-sweetened chewing gum for 20 minutes after meals , three times daily . The " Control " group was not provided with chewing gum . After two years , the " Gum " group exhibited a 38.7 % reduction in incremental caries , excluding white spots , compared with the " Control " group . Including white spots , a corresponding 33.1 % reduction was indicated . These results clearly suggest that even in a moderate caries population practicing normal oral hygiene , including the use of fluoride dentifrices , an after-meal gum-chewing regimen can significantly reduce the rate of caries development OBJECTIVES This single-blind r and omized controlled pilot study evaluated the efficacy of a behavioral intervention program , PRO-SELF : C and idiasis , to reduce time to recurrence of oral c and idiasis over 6 months in susceptible HIV-seropositive persons . The intervention involved instruction by dentists on improving oral hygiene , minimizing sugar intake , and self-diagnosing c and idiasis . METHODS Participants were adults with oral c and idiasis responsive to antifungals who presented to the UCSF Stomatology Clinic between 1997 and 2000 . At 2 - 3 weeks of follow-up visits , a dentist " examiner " , masked to group assignment , quizzed participants as to the presence of c and idiasis , and assessed c and idiasis status . A second , unmasked dentist " instructor " then delivered the program to intervention participants . Participants recorded dietary and oral hygiene practice s in 24-h recall diaries : intervention participants at each visit and controls at initial and final visits . RESULTS At r and omization , CD4 + cell counts ( cells/mm(3 ) ) were 298 + /- 188 among 18 intervention participants and 396 + /- 228 among 17 controls . The c and idiasis recurrence rates at 6 months were 78 % among intervention compared with 88 % among control participants ( hazard ratio 0.72 ; 95 % CI 0.35 - 1.50 ) . Performing oral hygiene after meals/snacks showed the largest relative improvement : intervention-control difference in proportion of meals/snacks affected was 24 % ( 95 % CI -1 to 48 % ) . Self-diagnoses of c and idiasis were inaccurate , possibly because of mild episodes . CONCLUSIONS The results weakly indicate that regular instruction from healthcare professionals helps patients delay c and idiasis recurrence by improving oral hygiene . Among HIV-seropositive persons , those with poor oral hygiene , and high-sugar diets are most likely to benefit A study was conducted to evaluate the effect of a single dental health care instruction and prophylaxis on knowledge , attitude and behavior .  Ninety-six army recruits from two military camps were r and omly allocated to four groups : a control group , a group that received an oral prophylaxis , a group that received a single dental health care instruction , and a group that had both prophylaxis and dental health care instruction . Treatment effects were measured by a question naire 1 month and 3 months after the instruction . A single dental health care instruction improved knowledge , and some areas of behavior . The improvement in attitude was not clear . The improvements were small and showed a tendency to diminish after 1 month Objective To assess the effect of weight loss induced by a very low energy diet on  moderate and severe obstructive sleep apno 
    Output:
    
There is some evidence that one-to-one dietary interventions in the dental setting can change behaviour , although the evidence is greater for interventions aim ing to change fruit/vegetable and alcohol consumption than for those aim ing to change dietary sugar consumption .