Showing papers in "Community Dentistry and Oral Epidemiology in 1980"

Fluoride in drinking water

Abstract: Fluoride occurs naturally in New Hampshire's bedrock. As such, it is frequently present in water samples taken from bedrock (artesian, drilled) wells. Fluoride is seen at high concentrations in bedrock wells in the Mt. Washington-Saco River Valley area, Wolfeboro through Franconia Notch and immediately west of Concord. In the remainder of New Hampshire, high fluoride concentrations occur more irregularly. Fluoride has no taste, color or odor and thus the only way to determine its concentration is by laboratory analysis.

Dental and social effects of malocclusion and effectivenessof orthodontic treatment: a review.

Abstract: The relationship between malocclusion and the health of the masticatory apparatus is reviewed. While there is evidence that certain features such as traumatic deep overbite, unprotected incisors and impacted teeth may adversely affect the longevity of the dentition, the relationship of dental irregularity to periodontal disease, caries and mandibular dysfunction is less certain. Studies in the field of social psychology indicate that an unattractive physical appearance may evoke an unfavourable social response in many facets of social interaction but the place of dentofacial anomalies in this context has not been satisfactorily assessed. The individual's adjustment to his own imperfections in dental alignment is variable and there is no evidence that children with visible irregulaities will in general be emotionally handicapped. Effectiveness studies have yet to be undertaken but the factors which will have to be taken into account in assessing the benefits of orthodontic treatment are the definition of treatment need, treatment standards, the disadvantages of treatment and the influence of other determinants of dental health. The need for further research is underlined.

Prevalence of root surface caries among institutionalized older persons.

Abstract: Fifty-nine residents of a chronic hospital (average age 67.9 years) were examined visually for root surface caries. Root lesions were found to be present in 44 of the residents and were located most frequently on the proximal surfaces of anterior teeth. The number of coronal DF surfaces, age and number of retained teeth were the factors found to be helpful in discriminating between persons with and without root surface caries.

Dental treatment needs and demands of an elderly population in England.

Abstract: A sociodental investigation was conducted among 254 elderly people living at home in Nottingham. A clinical assessment was made of the subjects' dental treatment needs and this was compared with the subjects' felt and expressed needs. Seventy-eight percent of the sample were clinically judged as needing denial treatment, mainly some form of prosthetic treatment. There was, however, a wide discrepancy between the normative and perceived needs of this elderly population. Only 42% of those who were clinically assessed as needing treatment felt that they required it and only 19% had actually tried to obtain it. Many of the elderly mentioned a number of barriers to obtaining dental care; these included the cost of treatment, fear of the dentist, immobility and the feeling that they should not “bother” the dentist.

Effects of supervised daily dental plaque removal by children after 3 years.

Abstract: The benefits of a school-based plaque removal program are presented. Children in grades 5-8 were included in a study which was designed to determine the effect on oral hygiene, gingival inflammation and dental caries of removing dental plaque through supervised daily flossing and toothbrushing in school. A fluoride-free dentifrice was used. Controls did not receive instruction in plaque removal procedures nor did they engage in plaque removal activities at school. For three school years the students in the treatment group practiced daily plaque removal, supervised by trained personnel. All participants were examined initially for plaque (PHP), gingival inflammation (DHC) and dental caries (DMFS). Girls in the treatment group showed a significant reduction (28%) in mean plaque scores and, for girls and boys, the mean changes in gingivitis scores were significantly reduced (40% and 17%, respectively). Adjusted mean incremental DMF surface scores were 13 % lower in the treatment group than in the control group. The difference between groups was not statistically significant and was accounted for entirely by the findings in mesial and distal surfaces (26%). This difference approached statistical significance (P= 0.07).

Panoramic radiographic examination of 704 Danish children aged 9--10 years.

Abstract: Panoramic radiographs of 704 apparently healthy children aged 9–10 years were examined regarding anomalies and pathologic conditions in the maxillofacial area. Almost all findings were mesial to the molars. 1.7% of the children had a supernumerary tooth, 7.7% had hypodontia. Malposition of 631 permanent teeth was recorded. 42 dentigerous cysts were detected. Malformed crown or root was seen on 60 permanent teeth. Caries was found on 224 primary and 32 permanent teeth. 257 primary teeth showed atypical resorption, and 53 had a periapical inflammatory radiolucency. 20 retained roots of primary teeth were detected. 31 maxillary sinuses had an opacity. There were very few other findings.

Test of a method to determine socially acceptable occlusal conditions

Abstract: A method for determining the social acceptability for dental appearance across the full range of occlusal conditions found in a natural population was developed and tested. The strategy used in developing the Social Acceptability Scale of Occlusal Conditions (SASOC) was to present photographs of 100 dental study models to a large sample of high school students (n = 880) and their parents (n = 403) whose responses were measured by a semantic differential instrument. After refinement of the semantic differential instrument scale scores were derived for each study model by computing the mean individual scores. Ranks were assigned to the mean scores. The Pearsonian correlation obtained between parent and student subsamples was 0.95. The reliability and validity of SASOC were assessed. COCSTOC measures of specific occlusal traits for these 100 study models are available. The future task involves the development of a highly reliable regression equation for predicting social acceptability scores from a small number of objective physical measurements.

Age, degree of mental retardation, institutionalization, and socioeconomic status as determinants in the oral hygiene status of mentally retarded individuals

Abstract: Oral hygiene has been implicated as a casual factor in the development of dental caries and periodontal disease in mentally retarded individuals. Little attention, however, has been given to the determinants of oral hygiene status. The present paper assesses the oral hygiene status of institutionalized (I) and noninstitutionalized (NI) mentally retarded (MR) individuals aged 4 through 25, in relation to age, degree of mental retardation, and socioeconomic status. Institutional status was found to be a major determinant in oral hygiene conditions of the study group, as IMR individuals had significantly higher OHI scores than NIMR individuals. Associations of age and OHI were significant only for NIMR. Although differences between I and NI groups, with respect to degree of mental retardation, were seen for mildly, moderately, and severely retarded, no significant difference in OHI scores between I and NI profoundly retarded was seen. Socioeconomic status was not found to be a significant factor in the oral hygiene status of MR individuals. This study emphasizes the need to assess age, degree of mental retardation, and institutional status when implicating oral hygiene in caries and periodontal disease prevalence in MR individuals.

Toothbrushing in relation to other health habits in Finland.

Abstract: The dimensionality of health behavior is disputable. In the present study an effort was made to shed more light on this problem. Interview data were obtained from 3209 13-19-year-old Finnish adolescents concerning the subjects' smoking habits, use of alcohol, physical activity, toothbrushing and dietary habits. A clear positive relationship was observed between tooth-brushing and the use of sugar-containing snacks. Use of alcohol seemed to have slight adverse effect on toothbrushing. Smoking was also weakly related with sporadic toothbrushing. Sports-oriented girls seemed to be regular toothbrushers. It was concluded that the possible comprehensive nature of health behavior should be more appreciated.

Economic aspects of a caries preventive program

Abstract: Cost-benefit and cost-effectiveness analyses (CBA and CEA) have been done on a preventive program. The program included professional toothcleaning, dietary and oral hygiene instruction, topical fluoride application and sealing of pits and fissures in 9--12-year-old children over 2 years. All measures were delivered by a specially trained dental nurse. In spite of a marked reduction in caries activity both CBA and CEA indicated that the preventive program was highly uneconomic compared to traditional dental care (3.73/1). However, when comparing the cost per completely treated child and year in the trial clinic continuing to use the preventive measures described, with that in dental clinics with no special preventive programs the cost seemed to be lower in the trial clinic now markedly interested in prophylaxis.

Caries susceptibility of permanent first and second molars in children aged 5–15 years

Abstract: Clinical examinations of 276 5-year-old children were carried out twice yearly for 2 1/2 years, and a further 1104 11--12-year-old children were examined annually for 3 years. Fifty per cent of permanent first molar teeth had erupted by 6.4 years; the mean age of eruption for permanent second molar teeth was 12.2 years. One year after these mean eruption dates over 10% of first molars and 45% of second permanent molars were already carious. Although development of caries was initially slower in permanent first molars, between the ages of 7.5 and 8.5 years the caries increment rose to 18.8%. By the age of 15 years the DMF was 92% for first and 68% for second molar teeth. The missing and filled proportion of the total DMF rose consistently. This represents the amount of treated caries and exceeded the amount of untreated caries in permanent first molars at all age levels. The rate of caries initiation in the present investigation emphasizes that restorative programmes and preventive regimens for children must be based on frequent recall examinations of not more than 6-monthly intervals.

Oral conditions in Australian children of Aboriginal and Caucasian descent.

Abstract: Oral health parameters were examined for 211 schoolchildren (128 Aborigines and 83 Caucasians) representative of the 6--8 and 10--11 year age groups in the Brewarrina and Walgett areas of western New South Wales (fluoride in water less than or equal to 0.02-0.26 parts/10(6)). Despite similar dietary carbohydrate challenge and tooth eruption patterns, Aboriginal children, most of whom were members of a transitional community within a low socioeconomic stratum, had higher prevalence of caries (DIMFT) and severity rating of carious lesions (SR), poorer oral hygiene (OHI) and more gingivitis (PI) than Caucasian children, in both age groups. Tooth defects were more frequent (2.5 times) and severe in Aborigines than in Caucasians. Outstanding treatment needs were very high in both ethnic groups, but more so in Aborigines.

Prevalence of recurrent headache and mandibular dysfunction in patients with unsatisfactory complete dentures

Abstract: The prevalence of headache and mandibular dysfunction was studied in 43 patients with unsatisfactory complete dentures waiting for prosthodontic treatment at the Dental Clinic of the National Dental Service in Jokkmokk, Sweden. In addition to answering a questionnaire, all patients underwent a clinical-functional examination of the masticatory system. Seventeen patients (40%), 15 women and two men, reported recurrent headache. 63% of the men and 83% of the women showed marked clinical signs of mandibular dysfunction. A significant correlation between headache and mandibular dysfunction was found. The low representation of complete denture wearers in clinical series of patients referred for treatment of mandibular dysfunction may be due to a reduced propensity to seek help and a greater willingness to accept a certain degree of dysfunction compared with other people.

Relation of traumatized permanent anterior teeth to occlusion and lip condition.

Abstract: A comparative epidemiologic study on traumatized permanent anterior teeth was conducted on 6090 Iraqi and 3507 Sudanese primary schoolchildren. A significant relationship was found between the severity of trauma to protrusion of maxillary incisors and amount of lip coverage in Iraqis and a similar tendency was observed for the Sudanese. In a comparison between the two population groups the frequency of traumatized permanent maxillary incisors with greater tooth loss (types 3 + 4) were significantly higher in Iraqi than in Sudanese children with protrusion and inadequate lip coverage.

Measurement of plaque growth following toothbrushing

Abstract: A method measuring plaque by area has been developed which can be used to evaluate the antiplaque effect of agents such as dentifrices when used in combination with toothbrushing. The extent of disclosed plaque 24 hours after treatment on tooth surfaces previously cleaned of all observable plaque was drawn by the examiner onto accurate enlarged scale drawings of the outline of the labial surfaces of all incisors, canines, premolars and 1st molars. Areas were then measured by an electronically recording planimeter. Three separate blind crossover trials were performed using this plaque area measurement in which a minimum of 15 subjects brushed normally on one occasion only, with either a calcium carbonate dentifrice or water. Compared with when subjects brushed with water, a statistically significant reduction of 45%-52% in plaque was observed in subjects 24 hours after brushing with the dentifrice in each of the three trials. In a study with 27 subjects, the periodontal condition of the papillae was found to be related to plaque present on labial surfaces on adjacent teeth as measured by this method. The teeth adjacent to papillae which bled on probing had 77% greater plaque area than teeth adjacent to papillae which did not bleed. Plaque area measured by this method on a continuous scale has a sensitivity advantage over the commonly used four-point plaque indices, especially when comparing effective antiplaque treatments or combination of treatments.

Radiographic survey of periodontal disease in 264 adolescent schoolboys in Lagos, Nigeria.

Abstract: Periapical radiographs were taken of central incisor and first molar teeth in 264 Nigerian boys (12-20 years) from a school in Lagos. From the radiographs, bone loss involving central incisors and first molars was measured. Bone loss was evident in 28.4% of subjects examined. The prevalence of bone loss rose through the age groups from 23.2% at 12-13 years to 34.6% at 18-20 years. Over all ages the prevalence of bone loss involving mandibular central incisors was 14.4%, mandibular first molars 9.8%, maxillary first molars 8.3% and maxillary central incisors 7.6%. Two subjects showed features characteristic of juvenile periodontitis (periodontosis).

Oral health of adolescent and adult Australian aborigines.

Abstract: A pilot survey of oral health included 83 adolescent and adult Aborigines (41 M, 42 F, range 16--70 years, mean age 37.3 years), resident in fringe settlements around the far western New South Wales towns of Brewarrina and Walgett (fluoride in water less than or equal to 0.02--0.26 parts/10(6)). Dental caries prevalence (mean DIMFT per person) increased from 17.1 at 20 years to 10.7 at 35 years and declined to 14.6 by the age of 50 years and over. Oral hygiene (OHI) was poor overall and deteriorated with age. Periodontal status (PI) was significantly correlated with the presence of debris (DI) and calculus (CI). The mean PI increased from 1.7 at 20 years to 4.8 at 43 years and over. Tooth mortality reached 75% by the age of 43 years. Prosthetic needs were correspondingly high, but 95% of denture requirements were unmet. No evidence of effective or sustained oral health care was seen; 38% of subjects needed emergency treatment.

Myofascial pain dysfunction (MPD) syndrome in twins.

Abstract: The Myofascial Pain Dysfunction Syndrome (MPD) was investigated in 94 twin pairs (21 male pairs and 73 female pairs), who had not been selected with respect Lo MPD. The frequency of past and/or present symptoms was found to be 10% in males and 27 % in females. No differences between monozygous (identical) and dizygous (non-identical) female twins was found in pair-wise concordance rates, the concordance rate being higher than expected to occur by chance in both twin types. The findings are compatible with the view that environmental influences give rise to this specific stress-reaction pattern.

Evaluation of a calibration trial to increase interexaminer reliability of radiographic diagnosis of approximal carious lesions

Abstract: Eighteen dentists working in the same School Dental Service participated in a calibration trial with the purpose of reducing interexaminer disagreement on radiographic diagnosis of approximal caries. The calibration program was in two stages: firstly, discussion in small groups and, secondly, the use of a reference standard. The effect of the training programs on interexaminer disagreement was limited, but a statistically significant decrease in the number of D-surfaces recorded per child was observed. The finding that the major part of the error variance was due to random error, rather than systematic error, may explain why the calibration program was unsuccessful at reducing error.

Effect of an instructional motivation program on oral health in Danish adolescents after 1 and 2 years.

Abstract: A 2-year study of the isolated effect of an intensive motivation program in the oral health of 11--15-year-old schoolchildren was carried out in a Danish provincial town. The motivation program consisted of small-group sessions during which maximum effort was made to obtain active engagement from the children. After 1 year the experimental group was supplemented with two new groups of children who in addition to the motivation participated in a competition on dental hygiene. The effect of the motivational program on knowledge and behavior was evaluated. While the program seemed to result in a reinforcement of the already existing positive attitude, the cognitive level was only slightly improved and no change in behavior resulting in improved oral health was registered.

44-year dental health survey of Helsinki schoolchildren.

Abstract: The purpose of the present study was to establish whether the number of intact teeth in Helsinki schoolchildren aged 7-13 years was rationally correlated with the wartime reduction in sugar consumption and, later, with dental health education programs in Finland. The period covered is 44 years. The results show that dental health education is effective in caries prevention and that enforced programs can lead to an improvement similar to that seen during the war.

Epidemiologic study of joined primary teeth in Finnish children.

Abstract: The frequency of germinated and fused primary teeth was studied in a sample of 1141 Finnish children aged 3-4 years. The prevalence was 0.7%. All the joined teeth were found in the anterior area of the mouth. In seven cases the diagnosis was a fusion of two separate teeth, and in one case it was a germination of a single tooth. A correlation between joined teeth in primary dentition and numerical variations of teeth in permanent dentition was noted in three cases.

Three factors predicting irregular versus regular dental attendance: A model fitting to empirical data

Abstract: A tentative theory, based upon the results of a survey that was performed in an urbanized village in the Netherlands, and proposing that the (ir) regularity of dental attendance is predicted by 1) dental anxiety, 2) the family dental health pattern and 3) the preference for preservation of the teeth, has been explored with loglinear models (logit approach). It has been shown that dental anxiety in combination with preference for preservation of the teeth is significantly associated with the (ir)regularity, but the family dental health pattern has a modifying effect. The probabilities of being an irregular dental attender were estimated for the levels discernible in the two predictor variables and with the odds of irregular dental attendance corresponding 95% confidence intervals were approximated. The results were discussed and it seems warranted to conclude that (ir) regular dental attendance dependent on the levels of the variables, mentioned above, is predicted more or less accurately. A further exploration of the theory and the variables involved seems worthwhile.

Dental caries in a group of 20-year-olds after previous participation in public child dental health services in Copenhagen, Denmark

Abstract: The present study was undertaken to investigate the prevalence of dental caries in a group of 20-year-olds who had previously participated in Public Child Dental Health Services. Dental caries was related to social status and preventive vists to the private dentist after termination of school. The study population comprised 389 persons aged 20, out of which 313 (80.5%) were examined clinically and radiographically by one dentist according to standardized criteria. Mean DMFT was 10.4 and mean DMFS 16.7. Differences in relation to sex were not significant. The distribution of subjects according to DMFS was uneven. The 20% with the highest DMFS accounted for about 45% of the total amounts of DS. A consistent pattern with higher mean DMFS in the low social groups was found. Attendance to Regular Youth Dental Service was higher the longer the subjects had been students and higher mean DMFS was found in nonregular attenders. The presence of a high caries risk group is discussed in relation to the dental care system received by the study population.