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The article, "The long term effects of Plague control program on Tooth mortality, caries and periodontal disease" by doctor Axelsoon is an investigation on to the maintenance of tooth hygiene. The article reviews the studies taken by the famous doctor on the prevention of periodontal disease in adults. It is important to note that although the article is scientifically accurate, it is not a Hemmingway piece of literature. This expose is a review and not a criticism of the article, so this author is not going to dwell on the complexes of writing. The author is going to dwell on the main points of the article under review (Axelsson, Nystrum & Lindhe, 2004).
First and foremost, it is useful to point out that Dr Axelsson is a medical researcher who has dedicated his life to the study of dental complications. His specialty is periodontal disease, and he has been in the field since the early seventies. His findings were conducted over a period of over thirty years. Sweden is the country in which ha has been carrying out his research among adults, observing senior citizens dental discipline until they are over eighty years old. Dr Axelsson is best remembered for an excellent study dubbed the two week dental hygiene for school children (Axelsson, Nystrum & Lindhe, 2004). The research that promoted him to the international limelight was a resounding success. It helped in the prevention of tooth caries and Gingivitis in the said school children in Sweden (Axelsson, Nystrum & Lindhe, 2004).

The first key observation is that, in 1972, Dr Axelsson entered a group of adults into long term maintenance study. This is a study that observes over a long period, in order to come to its conclusions. The group, comprising 375 adults, was based in Sweden. A control group of 180 adults was also established. A control group in medical and other scientific studies is used as the yardstick of the group under investigation. In accordance with medical research procedure, the control group received no treatment. Also, after six years the researchers disbanded the control group (Axelsson, Nystrum & Lindhe, 2004).

The test group continued to receive dental care and maintenance for the next thirty years. The subjects were examined at the end of the thirty year program. The test group was treated using essential dental and restorative care hygiene visits every two months. This was during the first two years of the study. The test group was subdivided at the end of six years based on risk. The subgroups were recalled at intervals that were regulated by needs. The main group was the group that was considered low risk. It comprised 60% of the total group. The other group was considered moderate, and it comprised 30% of the total group. The high risk group comprised only 10% of the group, and it was seen every three months. The low risk group was seen every year, while the moderate group was seen every six months (Axelsson, Nystrum & Lindhe, 2004).

When the study was completed in 2002, only 257 subjects were remaining. One of the main observations is that the plague in the surfaces of the teeth of the participants diminished with regular dental care. At the start of the study, 50-60% of the subject's teeth had plague. By the end of the thirty year period, the plague had diminished to 20%. Another notable observation is that, remarkably few teeth were lost over the period when the subjects were under the study. The teeth loss averages were below 1%. It is essential to note that the main reason for teeth loss was the fracture of the root. A remarkable observation is that only 21 teeth were lost during the whole period of the study. These were lost to periodontal disease and dental caries (Axelsson, Nystrum & Lindhe, 2004).
The clinical implications are obvious. Proper dental hygiene is compulsory for long lasting teeth. Regular visits to dental hygienist control dental problems like dental caries and periodontal disease (Axelsson, Nystrum & Lindhe, 2004).

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