bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibition of PTEN by peroxynitrite activates the phosphoinositide‐3‐kinase/Akt neuroprotective signaling pathway
Authors: Delgado‐Esteban Maria , Martin‐Zanca Dionisio , Andres‐Martin Laura , Almeida Angeles , Bolaños Juan P.
Published: February 2007

Peroxynitrite is usually considered as a neurotoxic nitric oxide‐derivative. However, an increasing body of evidence suggests that, at low concentrations, peroxynitrite affords transient cytoprotection, both in vitro and in vivo. Here, we addressed the signaling mechanism responsible for this effect, and found that rat cortical neurons in primary culture acutely exposed to peroxynitrite (0.1 mmol/L) rapidly elicited Akt‐Ser473 phosphorylation. Inhibition of phosphoinositide‐3‐kinase (PI3K)/Akt pathway with wortmannin or Akt small hairpin RNA (shRNA) abolished the ability of peroxynitrite to prevent etoposide‐induced apoptotic death. Endogenous peroxynitrite formation by short‐term incubation of neurons with glutamate stimulated Akt‐Ser473 phosphorylation, whereas Akt shRNA enhanced the vulnerability of neurons against glutamate. We further show that Akt‐Ser473 phosphorylation was consequence of the oxidizing, but not the nitrating properties of peroxynitrite. Peroxynitrite failed to nitrate or phosphorylate neurotrophin tyrosine kinase receptors (Trks), and it did not modify the ability of brain‐derived neurotrophic factor (BDNF), to phosphorylate its cognate receptor, TrkB; however, peroxynitrite enhanced BDNF‐mediated Akt‐Ser473 phosphorylation. Finally, we found that peroxynitrite‐stimulated Akt‐Ser473 phosphorylation was associated with an increased proportion of oxidized phosphoinositide phosphatase, PTEN, in neurons. Moreover, peroxynitrite prevented the increase of apoptotic neuronal death caused by over‐expression of PTEN. Thus, peroxynitrite exerts neuroprotection by inhibiting PTEN, hence activating the anti‐apoptotic PI3K/Akt pathway in primary neurons.
NSF binds calcium to regulate its interaction with AMPA receptor subunit GluR2
Authors: Hanley Jonathan G.
Published: February 2007

N‐ethylmaleimide‐sensitive fusion protein (NSF) is essential for numerous Ca2+‐triggered vesicle trafficking events. It functions as a molecular chaperone to regulate trafficking protein complexes such as the soluble NSF attachment protein (SNAP) receptor complex and the α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid receptor (AMPAR)‐protein interacting with C‐kinase (PICK1) complex. AMPAR trafficking is fundamental to processes of synaptic plasticity, which may underlie learning and memory. Changes in synaptic strength brought about by AMPAR trafficking are triggered by a post‐synaptic influx of Ca2+, which may have numerous molecular targets including PICK1. NSF binds AMPAR subunit glutamate receptor subunit 2 (GluR2) and functions to maintain receptors at the synapse. In this study, it was showed that NSF is a Ca2+‐binding protein and that GluR2–NSF interactions are inhibited by the presence of 15 μmol/L Ca2+. NSF Ca2+‐binding is reciprocally inhibited by the presence of GluR2 C‐terminus. Mutant of NSF that binds Ca2+ with reduced affinity and binds GluR2 with reduced sensitivity to Ca2+ was identied. In addition, the interaction of βSNAP with PICK1 is sensitive to Ca2+. This study demonstrates that the GluR2‐NSF‐βSNAP‐PICK1 complex is regulated directly by Ca2+, allowing for the transduction of Ca2+ signals into concerted alterations in protein–protein interactions to bring about changes in AMPAR trafficking during synaptic plasticity.
p45, an ATPase subunit of the 19S proteasome, targets the polyglutamine disease protein ataxin‐3 to the proteasome
Authors: Wang Hongfeng , Jia Nali , Fei Erkang , Wang Zhiming , Liu Chao , Zhang Tao , Fan Jun , Wu Mian , Chen Lin , Nukina Nobuyuki , Zhou Jiangning , Wang Guanghui
Published: February 2007

Machado–Joseph disease (MJD) is an autosomal dominant neurodegenerative disorder caused by an expansion of the polyglutamine tract near the C‐terminus of the MJD‐1 gene product, ataxin‐3. Ataxin‐3 is degraded by the proteasome. However, the precise mechanism of ataxin‐3 degradation remains to be elucidated. In this study, we show direct links between ataxin‐3 and the proteasome. p45, an ATPase subunit of the 19S proteasome, interacts with ataxin‐3 in vitro and stimulates the degradation of ataxin‐3 in an in vitro reconstituted degradation assay system. The effect of p45 on ataxin‐3 degradation is blocked by MG132, a proteasome inhibitor. In N2a or 293 cells, overexpression of p45 strikingly enhances the clearance of both normal and expanded ataxin‐3, but not alpha synuclein or SOD1, implying a functional specificity of p45 in this proteolytic process. The N‐terminus of ataxin‐3, which serves as a recognition site by p45, is necessary for the proteolytic process of ataxin‐3. We also show that other three ATPases of the 19S proteasome, MSS1, p48, and p56 have no effect on ataxin‐3 degradation. These data provide evidence that p45 plays an important role in regulating ataxin‐3 degradation by the proteasome.
Fluorosis in relation to fluoride levels in water in central Nigeria
Authors: El‐Nadeef May Ahmed Ismail , Honkala Eino
Published: February 2007

Abstract–
Objectives: This study was conducted to examine the prevalence of dental fluorosis in relation to fluoride levels in water among children aged 12–15 years in the states of Plateau and Bauchi, Nigeria. Methods: Children (N=203) were examined using WHO criteria. The children were from two schools and permanent residents of the communities in which the schools are located (Tilden Fulani and Kanadap). Intra‐examiner reliability for determining fluorosis scores was 80%. Results: Fluoride levels in the water ranged from 0.0–0.4 mg/L. Prevalence of dental fluorosis in the sample was 51%. Forty‐one percent had very mild fluorosis, 7% had mild fluorosis and 3% had moderate to severe fluorosis. The lowest DMFT was observed in the school where the fluoride level of the water ranged between 0.0 and 0.4 mg/L, and in the group with very mild fluorosis. Conclusion: Fluoride levels in water for central Nigeria were appropriate for oral health. In the areas where the children were permanent residents, factors other than the fluoride levels of the water contributed to the severity of dental fluorosis.
Statistical aspects of measuring change in oral health status of older adults
Authors: Worthington Helen V.
Published: February 2007

Abstract–
There are many statistical aspects involved in the measurement of change and some of these are discussed in this paper. First, a general overview of the three types of index, discriminative, predictive and evaluative, is presented. Each type of index should be developed in a different manner and this will depend on its use. For example, the reliability of an evaluative index is different from that of the other types of index and would depend on the observations on each individual remaining stable over time, and having a large change score when the dental status improves or deteriorates. Second, the issue of when we should be measuring change as opposed to just using the final measurement, or to using an analysis of covariance, is discussed. Thenal section of the paper looks at some of the fallacies which occur in the measurement of change and discusses whether or not we should try to correct for these.
Comments on a commentary: statistical evaluation of split mouth caries trials
Authors: Væth Michael , Poulsen Sven
Published: February 2007

Abstract –

When results of split mouth caries trials are reported, the most frequently used outcome measures are “effectiveness” and “net gain”. In a recent review by Riordan & FitzGerald (Community Dent Oral Epidemiol 1994;22:192–7) of the statistical analysis of data from such trials, the close connection between effectiveness and the traditional epidemiological outcome measure, relative risk, was pointed out and the latter measure was recommended. The condence intervals for these parameters were, however, incorrect. This note provides valid condence intervals for net gain, effectiveness and relative risk based on data from split mouth trials and presents examples of the calculations.
Impact of diagnostic criteria on the prevalence of dental caries in Norwegian children aged 5, 12 and 18 years
Authors: Amarante Eliana , Raadal Magne , Espelid Ivar
Published: February 2007

Abstract –

The study aimed to investigate caries prevalence in children using a severity grading diagnostic system, and to evaluate the influence of different diagnostic thresholds on the caries data. A group of 513 children, aged 5, 12 and 18 years, were examined clinically, and with available bitewing radiographs, by four calibrated examiners. The inter‐ and intra‐examiner reliability, assessed by a weighted kappa, varied between 0.80 and 0.95. The mean dmft/DMFT values were 3.8, 5.8 and 11.0 for the three age groups respectively, and the corresponding dmfs/DMFS values were 5.4, 9.9 and 22.6. The d/D‐component constituted the major part of the dmf/DMF index in all age groups, and enamel lesions accounted for 59%, 89% and 86% of the d/D‐component in the three age groups respectively. It is concluded that enamel or initial caries lesions contributed substantially to the total caries prevalence, illustrating the importance of using diagnostic criteria that include all stages of clinical caries if a total picture of the caries situation is needed.
Tooth and tooth surface survival rates in birth cohorts from 1965, 1970, 1975, and 1980 in Lahti, Finland
Authors: Suni Jorma , Helenius Hans , Alanen Pentti
Published: February 2007

Abstract –

Differences in the tooth and tooth surface survival rates between four cohorts born in 1965, 1970, 1975, and 1980 were analysed in a historical cohort study including data on the permanent teeth of children aged 5–7 years at base‐line and 19 years at the end of the study. A statistically signicant reduction in caries occurrence inssured surfaces in the three oldest cohorts was seen during the 3 years after the eruption of the teeth. Caries occurrence in the cohorts born in 1975 and 1980 did not differ from each other. The occurrence of caries in smooth surfaces was low in all age cohorts. Therefore, despite a systematic decrease in caries occurrence towards the younger cohorts, no signicant differences were found between the cohorts in smooth surface decay. After the 3 first posteruptive years, practically no differences in survival rates between the cohorts were observed. In the two youngest cohorts, thegures during the 3 first years after eruption did not differ from thegures for the later years. Throughout the study, caries occurrence was symmetric and no gender differences were observed. No postponement of decay was found by the end of the follow‐up time.
Does dental service utilization drop during economic recession? The example of Finland, 1991–94
Authors: Suominen‐Taipale Liisa , Widström Eeva
Published: February 2007

Abstract –

After enjoying rapid economic growth in the 1980s, Finland suffered a deep economic recession that began in 1990. It has been claimed that recession and uneven subsidies influence the use of dental services negatively. Finnish adults born after 1956 and world war veterans are entitled to subsidized dental care either in the Public Dental Service (PDS) or in the private sector. Other adults pay their treatment costs. Objectives: The purpose of this paper is to determine whether the economic recession in Finland during the early 1990s affected the use of dental services. Methods: The data were collected by the National Research and Development Centre for Welfare and Health using a method called CATI (Computer Assisted Telephone Interview). The target population was non‐institutionalized persons aged 25–79 years. Results: About one‐third of those interviewed had visited a dentist during the previous 6 months and this proportion was stable during the years studied. Number of teeth, length of education, income and sex had the highest predictive values for use of dental services as analyzed by multiple logistic regression. Two‐thirds had visited a private practitioner, one‐third a PDS clinic and a small percentage some other dentist or denturist. Conclusions: The results showed that the dental service utilization by Finns was stable during this period of economic downturn and only minor changes occurred in the mean number of visits. The most prominent change was seen in the youngest age group, among whom dental utilization decreased by almost 10%. The study indicated that subsidies do not strongly affect dental utilization today.
Approximal caries and sugar consumption in Icelandic teenagers
Authors: Árnadottir I. B. , Rozier R. G. , Sæmundsson S. R. , Sigurjóns H. , Holbrook W. P.
Published: February 2007

Abstract –

The aim of this study, conducted in 1994, was to examine the association between approximal caries and sugar consumption in teenagers residing in three fluoride‐deficient areas in Iceland while controlling for a number of behavioral, residential and microbiological factors. One hundred and fifty subjects (mean age 14 years) selected from the Icelandic Nutritional Survey (INS) were examined radiographically and they completed questionnaires about sugar consumption frequency. Total grams of sugar intake were obtained from the INS for each subject. Caries experience on approximal surfaces, diagnosed from radiographs, was used as the dependent variable in the analyses. Altogether 45.2% of subjects were caries free on approximal surfaces. The overall sample was found to have a mean DFS on approximal surfaces of 2.73 (s= 4.36) per subject. Average daily total sugar intake was 170 g per subject and the mean number of sugar‐eating occasions between meals was 5.32 (s= 6.29) per subject. The regression model indicated that the frequency of between‐meal sugar consumption was associated with approximal caries, with frequency of candy consumption being the most important of the sugar variables. In multivariate analysis, no relationship was found between dental caries and total daily intake of sugar, although a significant relationship between total sugar consumption and presence of caries was seen in bivariate analysis. Between‐meal consumption of sugar remains a risk factor for the occurrence of dental caries, especially in populations with moderate‐to‐high levels of dental caries experience.
Stability of dental health behavior: a 3‐year prospective cohort study of 15‐, 16‐ and 18‐year‐old Norwegian adolescents
Authors: Åstrøm Anne Nordrehaug , Jakobsen Reidar
Published: February 2007

Abstract –

There is a need for a descriptive epidemiology of patterns of dental health behavior through adolescence. Objectives: The purpose of this study was to assess the tracking (degree of stability) of several categories of self‐reported dental health behavior in adolescence over a 3‐year period. Methods: In 1992, a representative sample of 970 15‐year‐old adolescents of Hordaland county, Norway, completed questionnaires under supervision at school. Postal follow‐up studies 1 and 3 years later provided 709 and 781 answers, respectively. The present analyses included 581 adolescents who participated on all three occasions and 670 adolescents who replied in 1992 and 1995. Paired sample t‐tests, cross‐tabulations and Pearson's correlation coefficients were used to assess stability. For use in the cross‐tabulations all variables were transformed into binary categories (active and inactive). Results: A substantial proportion of adolescents remained consistently in the same behavioral category for all 3 survey years. Toothbrushing (80%) and use of dental floss (64%) were the most stable activities, while consumption of sugared mineral water (53%), intake of chocolate/sweets (52%) and use of F‐rinse (54%) were less stable. However, Pearson's correlations between corresponding behaviors assessed in 1992 and 1995 were moderate and varied from 0.59 (toothbrushing) to 0.22 (F‐rinse) (P < 0.001). Conclusion: The results do not conclusively indicate a pattern of tracking. The tendency is, however, clear enough to support the assumption that dental health behavior continues during adolescence into adulthood.
Changes in the oral health of adolescents treated by the Finnish public dental services between the ages of 13 and 15 years
Authors: Utriainen Pekka , Pahkala Kimmo , Kentala Jukka , Laippala Pekka , Mattila Kari
Published: February 2007

Abstract –

Oral cavity health was monitored in 2422 young people aged 13–15 years attending four health centres in Finland between 1992 and 1995. Assessments were made in terms of DMF, D and CPITN indices at clinical examinations. Of those who had no carious teeth at the initial examination, 60% did not develop cavities during the whole period, whereas half of those who had at least two carious teeth at the initial examination developed at least three new carious teeth The treatment time needed by the latter accounted for half of the total time expended by the researchers until the end of the period. Costs can be saved or new patients brought into the dental care system by reorganizing the treatment of the patients who suffer from abundant caries and by reducing the resources devoted to the treatment of healthy patients.
The relationship between socio‐dental indices of handicap, felt need for dental treatment and dental state in a group of frail and functionally dependent older adults
Authors: Lester Vivienne , Ashley Frank P. , Gibbons David E.
Published: February 2007

Abstract –

The present study was designed to investigate the relationship between self‐reported oral handicap as measured by socio‐dental indicators and both dental state and felt need for dental treatment in a group of frail and functionally dependent older adults. A total of 263 housebound adults over the age of 60 years were investigated with regard to their self‐reported dental handicap using the socio‐dental indices derived by Locker (Community Dent Health 1992;9:109–24) Of these, 117 were in long‐stay residential facilities, 67 in sheltered housing and 79 in private housing. The majority were female (76%) and the largest age group comprised 81–90‐year‐olds (44%), while only 8% were in the youngest group of 60–70‐year‐olds. A high level of handicap was recorded. In the previous 4 weeks, 74% of the group experienced difficulty in chewing, 54% some other functional handicap, 22% oral pain, 72% some incident of discomfort and 30% some social problem related to their oral condition. The socio‐dental indices related more to the number of teeth than to age or gender. Ability to chew five index foods was related directly to the number of teeth present (P < 0.001) but unless there were more than 20 teeth present, subjects with natural teeth were more dissatisfied with their appearance than those with complete dentures (P=0.002). The 57 subjects (29%) who expressed a desire for treatment had significantly higher handicap scores (P < 0.001). Thus the results indicate that there are high levels of oral handicap in frail and functionally dependent older adults that are related to both the number of natural teeth retained and desire for treatment
Factors associated with caries incidence in an elderly population
Authors: Powell L. Virginia , Leroux Brian G. , Persson Rigmor E. , Kiyak H. Asuman
Published: February 2007

Abstract –

The purpose of this paper was to identify baseline factors associated with future caries development in older adults (age 60) during a 3‐year study period. Poisson regression analysis was used to determine the association between potential risk factors and disease incidence. The significant factors associated with high coronal caries incidence rates were high baseline root DMFS (P < 0.001), high counts of mutans streptococci and lactobacilli (P=0.036), male geder (P=0.007), and Asian ethnicity (P < 0.002). These factors had small to moderate effects on incidence rates, with relative risk values of approximately 1.2 to 2 The significant factors associated with higher disease incidence on root surfaces were baseline coronal DMFS (marginally significant, P=0.078), high bacterial counts (P=0.002), and Asian ethnicity (P=0.009). The predictive value of the models was low for both coronal and root caries. This result may be because this population had a higher than usual caries incidence rate, making discrimination among these caries‐active individuals difficult. The current study affirmed the value of baseline DMFS and salivary variables to modeling caries incidence and introduced ethnicity as a variable useful for the study of dental caries in older adults.
Oral health status of Canadian‐born and immigrant adolescents in North York, Ontario
Authors: Locker D. , Clarke M. , Murray H.
Published: February 2007

Abstract –

Studies from a number of countries, including Canada, have demonstrated that the oral health status of immigrants is worse than that of their native‐born counterparts and that they make less use of dental services. To date, however, little information is available which documents changes in immigrant oral health following immigration. This paper reports the results of a study conducted in the City of North York, Ontario, that examined the oral health status of Canadian‐born and immigrant adolescents aged 13 and 14 years. The former had better oral health than the latter on all parameters assessed and made more use of dental services. Within the immigrant population, there was a signicant association between oral health and time since immigration. Those who had been in Canada 6 or more years were signicantly healthier than those who had arrived within the preceding 2 years. While changing patterns of immigration may account for part of these differences, the data suggest that access to dental public health programs, delivered to students between the ages of 4 and 14 years, have been effective in improving the oral health of those born outside Canada. Since these programs cease at age 13 or 14 years, barriers to accessing the private dental care sector may mean that the residual inequities and inequalities evident in the data widen as these individuals age.
Cross‐cultural comparison of attitudes and opinions onuorides anduoridation between Australia and Japan
Authors: Tsurumoto A. , Wright F. A. C. , Kitamura T. , Fukushima M. , Campain A. C. , Morgan M. V.
Published: February 2007

Abstract –

This paper reports on two studies exploring similarities and contrasts in knowledge, attitudes and opinions onuorides anduoridation of two culturally different population groups. Therst study compares the attitudes and opinions of parents of primary (elementary) schoolchildren in Melbourne, Australia, and Yokohama, Japan, and the second study compares the attitudes and opinions of dentists drawn from the same geographic areas. A self‐administered questionnaire collected data on 517 parents and 629 dentists. The questionnaires were of similar design and content for both parents and dentists. They included a series of knowledge and attitudinal statements on preventive dentistry and use ofuorides. Attitudinal responses were measured on a 5‐point agree‐disagree Likert scale. Data were analyzed using both bivariate and multivariate techniques. Australian parents appeared better informed on the benets of wateruoridation and held more favorable opinions onuorides anduoridation than their Japanese counterparts. Similarly, Australian dentists held more positive attitudes toward the use of fluorides and fluoridation than their Japanese peers. Cultural norms and experiences appear to shape parental attitudes, whereas the focus of dental education and dental practice on restorative treatments in Japan appears to be a substantial inuence on the attitudes and opinions held by Japanese dentists.
The use of clinical dental auxiliaries as examiners in caries prevalence surveys in the United Kingdom: a feasibility study
Authors: Kwan Stella Y. L. , Prendergast Michael J.
Published: February 2007

Abstract –

Objectives: This study investigated the use of clinical dental auxiliaries as examiners in caries prevalence surveys of 5‐ and 12‐year‐old children in the United Kingdom. Methods: A random sample of four therapists and four hygienists was drawn from 23 clinical dental auxiliaries employed in the Community Dental Service in Yorkshire, United Kingdom. Training and calibration were carried out according to national guidelines for caries prevalence surveys. Sixteen 5‐year‐old and sixteen 12‐year‐old children were examined in the calibration exercise. Agreement was assessed using 95% condence intervals of mean dmft/DMFT of the group, sensitivity and specicity values, and kappa statistics on dft/DFT. Results: For 5‐year‐old children, a good level of agreement with the standard examiner was achieved with sensitivity scores ranging from 0.84–0.98, specicity scores from 0.93–0.97, and kappa scores from 0.80–0.89. For 12‐year‐old children, sensitivity scores ranged from 0.56–0.95; specicity scores from 0.93–0.99; and kappa scores from 0.66–0.83. Four examiners failed to achieve the minimum scores on all measurements. Conclusion: It was concluded that clinical dental auxiliaries could be used as examiners in caries prevalence surveys of 5‐year‐old children. However, in order to attempt to meet the national standard for agreement in surveys of 12‐year‐old children, four of the eight examiners in the present study would require further training. Possible reasons for this difference are discussed.
Increasing number of teeth present in a quasi‐longitudinal study in adults: a methodological note
Authors: Schuller Annemarie A. , Holst Dorthe
Published: February 2007

Abstract –

This paper discusses the impossible result of an increase in the number of teeth present in a quasi‐longitudinal study of an adult population. In 1983 and 1994, random samples were drawn from birth cohorts 1939–48 and 1930–38. The paradoxical result that adults acquired new teeth in the quasi‐longitudinal study gave rise to questions about the comparability of the two samples. Four main sources of failure in comparability are described and discussed: instrumental stability, criteria consistency, response bias, and compositional change in aging cohorts. The lower response rate among persons with two edentulous jaws, and possibly among persons with one dentate jaw, was concluded to be the main reason for the increase in the overall group median and mean number of teeth present. In general, in studies with a similar study design, problems of comparability between the samples demand ones attention and should therefore be carefully evaluated. Compositional change of the population as a source of failure in sample comparability cannot be avoided, while the other three sources (instrumental stability, criteria consistency, response bias) can largely be avoided by careful planning and efficient use of resources.
Factors associated with adult periodontitis in a dental teaching clinic population
Authors: Gelskey Shirley C. , Young T. Kue , Singer David L.
Published: February 2007

Abstract– Exposure to a number of environmental, behavioral and sociodemographic variables has been associated with increased prevalence and severity of adult periodontitis. However, it is not possible easily to identify the individuals most susceptible to this chronic disease. A case control study was conducted among a population of adults to determine what factors were associated with increased prevalence of moderate to advanced periodontitis. Clinical and radio‐graphic data were obtained from dental charts and structured interviews were conducted by telephone to collect sociodemographic and behavioral data. Statistical modeling was completed for the total study population (35–87‐year‐olds) and for two age‐stratified subpopulations. Significant crude disease associations were observed between periodontitis and numerous explanatory variables. However, after adjustment for age and gender, few variables remained significant. Age stratification indicated that young adults (35–54 years) were affected differently from older adults (≧55 years) by exposures to certain variables. Young moderate smokers had a 3.15 times increased risk of periodontitis and young heavy smokers had a 7.33 times increased risk compared to never‐smokers. Older single adults had a 3.07 times increased risk compared to those with partners.
Evaluation for an observation effect in a prospective cohort study of oral health outcomes
Authors: Gilbert Gregg H. , Duncan R. Paul , Campbell Anna M.
Published: February 2007

Abstract– Objectives: Evaluation for changes in behavior due to research participants' knowledge that behavior is being observed (also referred to as a Hawthorne effect or reactivity) has received little attention in the dental literature. The Florida Dental Care Study, a prospective, non‐randomized, longitudinal study of oral health outcomes, provides some inferential power to evaluate for an effect on dental care use due to participants' knowledge that this behavior was being observed. The purpose of this paper is to document that an observation effect can occur in dental studies, and to estimate its magnitude in four groups that were defined by their typical approach to dental care as stated at baseline: consistent regular attenders (CRAs); inconsistent regular attenders (IRAs); consistent problem‐oriented attenders (CPOAs); and inconsistent problem‐oriented attenders (IPOAs). Methods: At baseline, 873 respondents with at least one natural tooth and who were 45 years of age or older participated for an interview and clinical dental examination. Respondents were asked about their dental care use in general and check‐up use in particular at 6‐month intervals over a period of 24 months. Results: Dental care use in general and check‐up use in particular varied across time points and across the four groups of the sample. There was some stimulation in dental care use for the sample overall, but by the 18‐to‐24‐month period, use had returned to baseline levels. In a direction opposite from that hypothesized, results from the CRAs suggested decreased use of dental care over the course of the 24 months of observation. No consistent pattern was evident for the IRAs, CPOAs, or IPOAs. Conclusions: An observation effect was evident, but was modest in magnitude and differed within and between sub‐groups of the sample. While self‐selection into dental care user groups is an expected and desirable feature of this design, the size of the user/non‐user groups was affected for some sub‐groups. We conclude that dental care studies with the potential for an observation effect should evaluate for this effect by distinguishing sub‐groups of the sample based on their propensity (as stated at baseline) to use dental care. These differential effects across sub‐groups should be taken into account as inferences are made.
Fluorosis risk from early exposure to fluoride toothpaste
Authors: Mascarenhas Ana Karina , Burt Brian A.
Published: February 2007

Abstract– Swallowed fluoride toothpaste in the early years of life has been postulated to be a risk factor for fluorosis, but the epidemiological evidence is weakened by the fact that most of the relevant studies were done in developed countries where an individual is exposed to multiple sources of fluoride. Objectives: To quantify the risk of fluorosis from fluoride toothpaste in a population whose only potential source of fluoride was fluoride toothpaste. Methods: Case‐control analyses were conducted to test the hypothesis that fluoride toothpaste use before the age of 6 years increased an individual's risk of fluorosis. Data came from a cross‐sectional clinical dental examination of schoolchildren and a self‐administered questionnaire to their parents. The study was conducted in Goa, India. The study group consisted of 1189 seventh grade children with a mean age of 12.2 years. Results: The prevalence of fluorosis was 12.9% using the TF index. Results of the crude, stratified, and logistic regression analyses showed that use of fluoride toothpaste before the age of 6 years was a risk indicator for fluorosis (OR 1.83, 95% CI 1.05–3.15). Among children with fluorosis, beginning brushing before the age of 2 years increased the severity of fluorosis significantly (P < 0.001). Other factors associated with the use of fluoride toothpaste, such as eating or swallowing fluoride toothpaste and higher frequency of use, did not show a statistically significant increased risk for prevalence or severity of fluorosis. Conclusions: Fluoride toothpaste use before the age of 6 years is a risk indicator for fluorosis in this study population.
Caries frequency in permanent teeth before and after discontinuation of water fluoridation in Kuopio, Finland
Authors: Seppä Liisa , Kärkkäinen Sakari , Hausen Hannu
Published: February 2007

Abstract– The piped water of Kuopio, Finland, was fluoridated in 1959. Owing to strong opposition by different civic groups, water fluoridation was stopped at the end of 1992. Objectives: The aim of this study was to examine the consequences of the discontinuation on dental health. Methods: In 1992 and 1995, independent random samples of all children aged 6, 9, 12 and 15 years were drawn from Kuopio and Jyväskylä, a nearby low fluoride town whose distribution of demographic and socio‐economic characteristics was fairly similar to Kuopio's. The total number of subjects examined was 550 in 1992 and 1198 in 1995. Caries was registered clinically and radiographically by the same two calibrated dentists in both towns. Results: In 1992, the mean DMFS values were lower in the fluoridated town for the two older age groups, the percentage differences for 12‐ and 15‐year‐olds being 37% and 29%, respectively. For the two younger age groups no meaningful differences could be found. In 1995, the only difference with possible clinical significance was found in the 15‐year‐olds in favor of the fluoridated town (18%). In 1995, a decline in caries was seen in the two older age groups in the nonfluoridated town. In spite of discontinued water fluoridation, no indication of an increasing trend of caries could be found in Kuopio. The mean numbers of fluoride varnish and sealant applications decreased sharply in both towns between 1992 and 1995. In spite of that caries declined. Conclusions: These findings suggest that the decline of caries has little to do with professional preventive measures performed in dental clinics.
Caries preventive services for children and adolescents in Denmark, Iceland, Norway and Sweden: strategies and resource allocation
Authors: Wang Nina J. , Källestål Carina , Petersen Poul Erik , Arnadottir Inga B.
Published: February 2007

Abstract– According to the dental acts of Denmark, Iceland, Norway and Sweden, emphasis is placed on preventive dental care. The purpose of this study was to describe and compare two aspects of the caries preventive services: the strategies and the resource allocation for preventive dental care of children and adolescents in Denmark, Iceland, Norway and Sweden. Questionnaires were sent to samples of dentists and other dental personnel who provided preventive care to children during 1995 and 1996. Comparisons between the countries showed significant differences in recall routines and in implementation of risk‐based and population‐based preventive strategies. Multivariate analyses showed that the time used for preventive care varied by country and was not associated with the DMFT of the children. More time was allocated for prevention when more operating dental auxiliaries were available at the clinic, when the recall interval was shorter, when the time used for routine examination was longer and when the clinician was an auxiliary rather than a dentist. In conclusion, resource allocation and strategies used for prevention were not consistent between the countries.
Cost and productivity analysis of orthodontic care in Finland
Authors: Pietilä Terttu , Sintonen Harri , Pietilä Ilpo , Widström Eeva , Varrela Juha , Alanen Pentti
Published: February 2007

Abstract– The aim of the study was to investigate the costs of orthodontic care provided for children and adolescents up to the age of 18 by municipal health centers in Finland, and to study the productivity of these services. The data were gathered by a questionnaire sent to all health centers; 96% responded. The majority of respondents estimated the share of orthodontic care as 10% of the total gross costs of dental care, given that 14% of all dental visits were for orthodontic reasons. To study the productivity in individual health centers, the output was measured by the estimated number of completely treated patients. The cost of orthodontic treatment per completely treated patient was, on average, FIM 7358, ranging from FIM 1299 to FIM 24 751. The strongest explanatory factor for the average total costs of orthodontic clinics was the number of general dentists with little experience in providing orthodontic treatment. Other explanatory factors were the number of orthodontists or experienced dentists, the percentage of orthodontic tasks performed by auxiliary personnel, and the timing of treatment. Savings might be obtained by devolving treatment to orthodontists or experienced dentists in‐stead of to dentists with little orthodontic experience, and by starting treatment early. The estimated optimal size for an orthodontic clinic was found to be a unit with 830 completely treated patients per year, but most of the orthodontic clinics were in fact much smaller with, on average, 133 completely treated patients per year.
Patient satisfaction with emergency oral health care in rural Tanzania
Authors: Ntabaye M. K. , Scheutz F. , Poulsen S.
Published: February 2007

Abstract –

Emergency oral health care, as conceived in Tanzania, is an on‐demand service provided at a rural health center or dispensary by a Rural Medical Aide. The service includes: simple tooth extraction under local anesthesia, draining of abscesses, control of acute oral infection with appropriate drug therapy, first aid for maxillo‐facial trauma, and recognition of oral conditions requiring patient referral for further care at the district or regional hospital dental clinic. The objective of the present study was to describe patient satisfaction with emergency oral health care services in rural Tanzania and determine the relative importance of factors influencing patient satisfaction. The study was carried out as a cross‐sectional interview survey between April 1993 and May 1994 using a patient satisfaction questionnaire in rural villages in the Rungwe district of Tanzania. It included 206 patients aged 18 years or more who had received emergency oral health care between April 1993 and March 1994. Overall, 92.7% of the respondents re‐ported that they were satisfied with the service. Patients who were married, had no formal education and lived more than 3 km from the dispensary were more likely to be satisfied with treatment. In a logistic regression model, a good working atmosphere at the dispensary, a good relationship between care provider and patients (art of care) and absence of post‐treatment complications significantly influenced patient satisfaction with odds ratios of 10.3, 17.4 and 6.2, respectively.
Korean dental hygienists' knowledge and opinions about etiology and prevention of dental caries
Authors: Moon Hyock‐Soo , Jung Jae‐Yeon , Horowitz Alice M. , Ma Deuk‐Sang , Paik Dai‐Il
Published: February 2007

Abstract –

Objectives: Because of their formal education Korean dental hygienists have the potential to be the primary source of information on caries prevention for patients and the general public, and inuence the use and adoption of caries preventive procedures. The purposes of this study were to determine the knowledge and opinions about caries etiology and prevention among Korean dental hygienists, and to describe associated factors. Methods: A pre‐tested, 20‐item questionnaire was mailed to 1120 dental hygienists selected by stratied d random sampling and allocated proportionately. A postcard reminder was sent to all dental hygienists after 1 week. Non‐respondents were sent additional complete mailings after 3 and 7 weeks. The response rate was 77% (n=863). Results: Analysis of six factors thought to be related to knowledge about caries etiology and prevention showed that dental hygienists who were taught to provide oral health education and believe that it is desirable to practice oral health education during dental hygiene school and those employed in health centers were likely to be more knowledgeable about caries etiology and prevention than other hygienists (P < 0.05). In regression analysis of the perceived effectiveness of caries preventive procedures, hygienists who provided oral health education during their formal training tended to rate caries preventive procedures as being more effective than other dental hygienists (P < 0.05). Conclusions: Overall, the results of this study suggest that most dental hygienists do not have up‐to‐date information on the etiology and prevention of dental caries, mechanisms of action ofuoride e and effectiveness of preventive procedures. Efforts to increase the level of knowledge of Korean dental hygienists about caries prevention should focus on strategies to educate dental hygienists who have not been taught to provide oral health education, who do not have favorable opinions about the desirability of oral health education, and who had no experience with providing oral health education as part of their work, especially hygienists working in private clinics. Further, these efforts should include the revision of dental hygiene curricula and continuing education courses.
Comparison between the DMF indices and two alternative composite indicators of dental health
Authors: Benigeri Mike , Payette Martin , Brodeur Jean‐Marc
Published: February 2007

Abstract –

The DMFT and DMFS indices employed in the majority of oral epidemiological studies have several limitations. In response to this problem, Sheiham et al. (Community Dent Health 1987;4:407–14) proposed two alternative dental health indicators: the number of functioning teeth (hereafter referred to as FS‐T) and tissue health (T‐Health). Using data from an epidemiological study on the dental health status of adults aged 35–44 from Quebec (N=2110), this article compares the alternative indices with the conventional DMFT and DMFS indices. By comparing Pearsons correlation coefcient for the four indices in this study with the number of decayed, missing andlled surfaces, it is noted that the FS‐T index bears the strongest correlation to the three variables. It is also the only index whose correlation coefcient is greater than 0.3 for each of the three DMFS components. A risk group was created for each index, composed of the 18% of people demonstrating the poorest index. The risk groups's FS‐T index results in an average of 4.3 decayed surfaces (compared with 2.6 for the DMFT), 92.7 missing surfaces (74.4 for the DMFT) and 9.0 filled surfaces (compared with 26.9 for the DMFT). Using linear regression analysis with each index as a dependent variable, and peoples socio‐demographic characteristics, regular use of dental services and perception of dental health as independent variables, it appears that the percentage of the explained variance (R2) is 21.2% for the FS‐T index, 13.8% for the T‐Health index, 12.3% for the DMFS index and only 7.6% for the DMFT index.
Dental fluorosis in Chilean children: evaluation of risk factors
Authors: Villa Alberto E. , Guerrero Sonia , Icaza Gloria , Villalobos Jaime , Anabalón Mireya
Published: February 2007

Abstract –

The purpose of this case‐control study was to determine the association between very‐mild‐to‐moderate enamel fluorosis and exposure during early childhood to fluoridated water, mainly through ingestion of powdered milk. Analysis was performed on 136 residents of the optimally fluoridated community of San Felipe in the Chilean Fifth Region, who were categorised into one of three groups according to their age when water fluoridation was introduced in 1986: Group I was born after 1986; Group II was 16–24 months old in 1986; and Group III was >24 months of age. The case and control subjects were selected on the basis of a clinical examination given in July 1996. Dean's scoring system was used to determine fluorosis status. Risk factor exposure was ascertained by a questionnaire used in interviews with mothers of participating children. Logistic regression analysis, after adjustment for confounding variables, revealed that very‐mild‐tomoderate enamel fluorosis of permanent central maxillary incisors (CMI) was strongly associated both with the age of the subjects when water fluoridation began and with breast‐feeding duration for children belonging to Group I. Subjects in Group I were 20.44 times more likely (95% CI: 5.00–93.48) to develop CMI fluorosis than children who were older than 24 months (Group III) when fluoridation began. Subjects who were between 16 and 24 months old when water fluoridation began were 4.15 times more likely (95% CI: 1.05–16.43) to have CMI fluorosis than children older than 24 months. An inverse association was found with breast‐feeding duration (OR=0.86, 95% CI: 0.75–0.98) among Group I subjects but not in Groups II and III. Results obtained suggest that the current fluoride concentration in drinking water may be contributing to fluorosis. Further studies will be necessary to determine the relative competing risks of dental fluorosis and dental caries in Chilean children in order to establish the most appropriate water fluoridation level in Chile.
Urinary fluoride levels and prevalence of dental fluorosis in three Brazilian cities with different fluoride concentrations in the drinking water
Authors: Heintze Siegward D. , Bastos José Roberto de Magalhães , Bastos Roosevelt
Published: February 2007

Abstract –

Urine samples from three daytime periods were collected from 545 5–50‐year‐old residents of three different Brazilian cities: Garça had fluoridated drinking water since 1973, Bauru since 1975 and Itápolis was not fluoridated. Dental fluorosis was examined in 985 5–24‐year‐olds using the Thylstrup‐Fejerskov index (TF). The subjects were asked to estimate their daily intake of liquids and frequency of beverage consumption. The analysis of 94 water samples showed high variations in the fluoride content of the drinking water. The mean fluoride concentration of the water samples in Garça was 0.9 mg/L (range 0.75–1.2), in Bauru 0.64 mg/L (range 0.01–1.3), and in Itápolis 0.02 mg/L. Mean urinary fluoride concentration was 1.31 mg/L (s 0.61) in Garça, 0.88 mg/L (s 0.49) in Bauru, and 0.39 mg/L (s 0.21) in Itápolis. Self‐reported daily liquid intake was not related to urinary fluoride concentration. The mean prevalence of fluorosis was 13.3% in Garça, 6.8% in Bauru, and 1.7% in Itápolis, with mainly categories TF 1 and TF 2 being recorded. Subjects with dental fluorosis tended to show a higher mean urinary fluoride concentration but the difference was not statistically significant. The study showed that fluoride exposure measured by urinary fluoride excretion was within the range expected for the level of fluoride concentration in the drinking water. However, enamel fluorosis tended to be markedly lower than expected. This study revealed that fluoride levels in the two cities with fluoridated drinking water were variable. To optimise anticaries benefits and minimise the risk of fluorosis greater control of the fluoride dosing of the drinking water is required.