bluuebunny/crossref_metadata_2025 huggingface dataset:
Dental health and functional ageing
Authors: Österberg Tor , Mellström Dan , Sundh Valter
Published: May 2006

AbstractFunctional ageing, including dental health, was studied in the gerontological population study in Gothenburg. This study was based on three 70‐yr‐old cohorts, born in 1901–2, 1906–7, and 1911–12 (n= 1380). The Eichner index was used as a measurement of deterioration in dental state and dental functional impairment. This impairment was significantly associated with a lower capacity in cognition, visual ability, hearing ability, lung volume, heart volume, muscle strength, and bone mineral content as well as a lower self‐assessment of health. A multiple regression model showed that an index of seven functional capacities was the most predictive factor for dental status independent of confounding factors such as socio‐economic factors, tobacco smoking, and the most incapacitating diseases. These associations were more marked in men and the survival rate between 70 and 79 years of age was higher among men with a well preserved dental state of the age of 70. The co‐variation between impairment in dental function and other functional variables and survival indicate a common functional ageing.
Salivary levels of mutans streptococci, Lactobacillus, Candida, and Veillonella species in a group of Scottish adolescents
Authors: Russell Joyce I. , MacFarlane T. Wallace , Aitchison Thomas C , Stephen Kenneth W. , Burchell Charles K.
Published: May 2006

Abstract Salivary levels of mutans streptococci, Lactobacillus, Candida, and Veillonella species were investigated on three occasions at annual intervals in a group of 372 Scottish adolescents. Counts of the micro‐organisms studied were logarithmically distributed, with Candida spp. being isolated from approximately half the subjects. Counts of lactobacilli, mutans streptococci, and Candida were significantly intercorrelated, while veillonella were associated consistently with mutans streptococci alone. Levels of each of the four micro‐organisms were significantly correlated over the three examinations, with levels of the Candida spp. being the most stable over the period studied.
Value of the teeth
Authors: Schuurs Albert H. B. , Duivenvoorden Hugo J. , van Velzen Sijo K. Thoden , Verhage Frans , Makkes Peter C.
Published: May 2006

Abstract A random sample of 542 respondents answered questions concerning the value assigned to the teeth, dental attendance pattern, oral health status, and dental anxiety. Non‐linear multivariate analysis showed the data regarding value attached to the teeth to contain two dimensions, of which the second one was deleted due to extreme answer patterns (skewed distributions) on the pertinent variables. Repetition of the analysis, including a plot of the respondents, made it possible to discern four subsamples, characterized by specific answer patterns. In the discussion attention was given firstly to the separate variables estimating the value attached to the teeth, and next to the four subsamples, taking into consideration the dental attendance pattern, oral health status, and dental anxiety. It was concluded that the multivariate approach reveals that the respondents are of a rather high heterogeneity.
Determinants of dental health behaviors in Nordic schoolchildren
Authors: Rise Jostein , Wold Bente , Aarö Leif E.
Published: May 2006

Abstract As part of the comprehensive study “Health Behavior in Schoolchildren. A WHO Cross National Survey”, this paper set out to identify determinants of four dental health behavioral dimensions in Finnish. Norwegian, and Swedish schoolchildren aged 11, 13, and 15. The data were collected by means of self‐administered questionnaires, and the results are considered to be representative of each country. The total sample size approximated 3000 pupils in each country. The four dependent variables, fluoride, interdental cleaning, sugar, and brushing behavior, were all based upon sum‐scores of several questions, and were subsequently regressed upon five predictors: school achievement, sex, time spent with friends, educational plans, and family meal pattern. This model provided a far better fit to the data on sugar and brushing behavior than to fluoride and interdental cleaning behavior. However, brushing seems to be different from sugar behavior, being influenced by different factors. While brushing is closely linked to the prevailing sex‐role pattern, sugar behavior is stronger related to peer group norms. Thus, the symbolic function of sweet consumption of the youth culture should have implications for the design of intervention strategies. For example, the provision of alternative behaviors will only be successful if the behaviors serve the same function as sugar consumption.
Improved sensitivity in caries clinical trials by selection on the basis of baseline caries experience
Authors: Burchell Charles Kasper , Stephen Kenneth William , Schäfer Friedrich , Huntington Eric
Published: May 2006

Abstract As caries prevalence in some countries declines, and panel sizes for discriminating anti‐caries clinical trials inevitably increase, the need for participant pre‐selection grows to avoid escalating cost and manpower problems. Hence, retrospective analyses of data were undertaken, from a 3‐yr double‐blind caries clinical trial where a linear fluoride dose‐response had been obtained. As a result, it was demonstrated that the eruption status of permanent second molars, in 3005 participants aged 11–12 yr at outset, when coupled with their baseline clinical DMFT values, provided a sound basis for panellist size prediction without loss of sensitivity. Thus, had only those subjects with DMFT >4, with al least three of their permanent second molars erupted been selected following clinical baseline examination, the same sensitivity would have been achieved with 52% fewer subjects. Furthermore, using these criteria, selection can be made on site, in real time, and a child informed whether its immediate participation in a trial is possible.
Five‐year incidence of tooth loss in lowans aged 65 and older
Authors: Hand Jed S. , Hunt Ronald J. , Kohout Frank J.
Published: May 2006

Abstract The prevalence of missing teeth has been described for US adults, but little is known about the incidence of tooth loss in any segment of the population. This study investigated the 5‐yr incidence of tooth loss in a random sample of Iowans aged 65 yr and older residing in two rural counties. These people had an average of 20 teeth at baseline and approximately 40% lost at least one tooth in the subsequent 5 yr. The incidence of tooth loss was highest for mandibular molars and lowest for mandibular canines. Men were more likely than women to lose teeth. Although we were able to identify a number of statistically significant potential risk factors for tooth loss, the muitivariate models that incorporated all these factors were not good predictors of which people were at highest risk for tooth loss.
Caries‐preventive effect on primary and permanent teeth and cost‐effectiveness of an NaF tablet preschool program
Authors: Widenheim Jan , Birkhed Dowen
Published: May 2006

Abstract The aim was to assess restorative care, approximal caries, and cost‐effectiveness in children at the ages of 8 and 17 yr in relation to NaF tablet intake between 1/2 and 7 yr of age. Based on interview data, 304 subjects (born 1967 in Lund, Sweden) were divided into five groups with different periods of consumption and one group with no intake. A statistically significant difference was found in fs at 8 yr (P < 0.001) and in FS at 17 yr (P < 0.01) between children who had taken the tablets regularly from the first year of life to age 5–7 yr (fs = 1.9; FS = 3.8) and the non‐consumers (fs = 5.2; FS = 5.9). In the other four tablet groups, both the fs and the FS values tended to decrease with increasing duration of intake. The prevalence of approximal caries also tended to decrease, as regards both dfs and DFS, with increasing duration of tablet consumption, with a statistically significant difference (P < 0.001) in primary teeth between children with the longest intake (dfs = 1.4) and non‐consumers (dfs = 4.9). The cost‐effectiveness ratio was approximately 1:1 for both dentitions. Most of the effect was obtained in the primary dentition.
Prevalence of impacted teeth and associated pathology in middle‐aged and older Swedish women
Authors: Ahlqwist Margareta , Gröndahl Hans‐Göran
Published: May 2006

Abstract A representative sample comprising 1418 women from five age strata was examined by means of panoramic radiography. The prevalence of impacted teeth and the frequency and type of pathology associated with the impacted teeth were assessed. About 8% of the total sample had one or more impacted teeth. Among those, pathological conditions were found in 16%. Most were moderate and consisted in most cases of a slightly widened follicle or resorption of the crown. A new examination 12 yr later revealed unchanged conditions in 85% of the cases. The changes that had occurred were generally small.
Cohort comparisons of dental status in the adult Swedish population between 1975 and 1981
Authors: Österberg Tor , Carlsson Gunnar E. , Mellström Dan , Sundh Walter
Published: May 2006

Abstract The aim was to describe and analyze changes in dental status in Sweden over a 6‐yr period, and to establish a baseline for a subsequent investigation. Representative samples of the Swedish population in 1975, 1977, and 1981 were investigated by means of interviews. The participation rate varied between 81 and 86% and the number of participants between 11 582 and 14 964. Dental status, based on a question about natural teeth and/or removable denture(s), was analyzed in relation to demographic, socio‐economic, social support and life style factors. The prevalence of edentulism in the age group 16 74 years decreased during the observation period from 12.7% to 9.9% in men and from 15.5% to 11.2 in women. Besides age, urbanisation, occupation and tobacco smoking had the highest explanatory value for edentulism. The findings are discussed with respect to the increasing life expectancy and possible changes in the need and demand for dental care.
Tooth surface loss and exposure to organic and inorganic acid fumes in workplace air
Authors: Tuominen Maija Leena , Tuominen Risto Juhani , Fubusa Frank , Mgalula Nigodemus
Published: May 2006

Abstract The effect of inorganic and organic acid fumes on teeth was explored in a cross‐sectional study using blind dental examinations. A sample of 180 workers from two factories was randomly drawn. Among the 169 workers who participated in the survey, 88 were exposed to acid fumes and 81 were controls. The percentage of inorganic acid workers with tooth surface loss was 63.2%, while that for the controls was 37.7% (P < 0.005). The corresponding figures in the organic acid company were 50.0% and 14.3% (P < 0.02). In both companies the acid workers had significantly more often teeth with surface loss in the maxilla than their controls (P < 0.02). Both anteriors and posteriors were affected. On the basis of the findings, it can be concluded that acid fumes at work are strongly associated with tooth surface loss.
Recent changes in health related dental behaviors in Norway
Authors: Sogaard Anne Johannes , Grytten Jostein , Holst Dorthe
Published: May 2006

Abstract There has been a substantial decrease in the prevalence of caries in younger age groups in the western world during the last 15 years. A corresponding increase has been reported regarding use of preventive remedies. Since prevention and control of dental disease is highly dependent upon personal behavior, investigations of dental health behaviors within subgroups of the population are important for future preventive strategies. Occurrence and changes in individual dental health behaviors in Norway were studied through lour sets of cross‐sectional data collected in 1981, 1983, 1985, and 1987. Personal interviews performed by trained interviewers were held with probability samples, each of about 1400 persons, covering the Norwegian population aged 15 and above. During the 6‐yr period the proportion of individuals who brushed their teeth and used fluoride dentifrice every day increased. The number of people who used toothpicks or dental floss every day also increased from 1981 to 1985. A marked decrease was, however, observed in use of interdental remedies from 1985 to 1987. Daily use of dental floss was reduced by 10 percent points. Logistic regression showed that the reduction in the probability of using interdental aids was most pronounced among (hose with few teeth. Lower importance attached to dental health education, at all levels, combined with difficult economic limes since 1987, might account for the decrease in daily use of interdental aids in Norway.
Measures of dental disease occurrence
Authors: Hujoel P. P. , Weyant R. J. , DeRouen T. A.
Published: May 2006

Abstract The purpose of the paper is to relate standard epidemiologic and statistical methods for measures of disease occurrence to the description of prevalence proportions and incidence rates of dental diseases. No new concepts are introduced but the choice of the unit of analysis of numerator and denominator is discussed, and the biological interpretation of the within‐patient correlation coefficient is discussed.
Periodontal status of individuals in early stages of human immunodeficiency virus infection
Authors: Drinkard Carol R. , Decher Laurel , Little James W. , Rhame Frank S. , Balfour Henry H. , Rhodus Nelson L. , Merry Jean W. , Walker Paul O. , Miller Corinne E. , Volberding Paul A. , Melnick Sandra L.
Published: May 2006

Abstract The purpose of this study was to evaluate the association of periodontal health and human immunodeficiency virus infection among individuals in the early stages of disease who were participating in randomized placebo‐controlled clinical trials of zidovudine. Previous reports have described a rapidly progressive periodontitis and atypical gingivitis associated with late stages of infection by the human immunodeficiency virus. A health history was completed by each subject. Baseline oral examinations were completed on 97 asymptomatic patients and nine with AIDS‐related complex (ARC) during their regular clinic visit. Follow‐up examinations were conducted at 3‐month intervals throughout the 48 weeks of the oral study. Evaluations of plaque, calculus, gingival abnormalities, caries, and periodontal disease were conducted. Periodontal measurements included plaque index (PI), gingival index (GI), bleeding index (BI), probing depth (PD), and observation for cratering, necrosis, and tooth mobility on six teeth in each patient. More than half of the subjects had visited their dentist during the previous year and had had an oral prophylaxis; less than 25% of them had had either restorative work or extractions. The mean scores for periodontal indices averaged over the course of the study in asymptomatic and ARC respectively were: PI: 0.9 (SE 0.04) and 0.9 (SE 0.08), P = 0.818; GI: 1.0 (SF. 0.04) and 0.9 (SF 0.07). p= 0.412; BI: 0.6 (SE 0.04) and 0.4 (SF 0.07). p= 0.278; PD: 2.9 (SE 0.05) and 2.6 (SE 0.10). p= 0.140. There was no evidence of cratering, necrosis, or tooth mobility in either group. Few had calculus or dental caries. There were no clinically significant differences detected between ARC versus asymptomatic patients. Dental histories and oral examinations showed that two groups of patients in early stages of HIV‐disease were in good periodontal health.
Evaluation of a radiographic partial recording system assessing the extent and severity of periodontal destruction
Authors: Papapanou Panos N. , Wennström Jan L. , Johnsson Tommy
Published: May 2006

Abstract The purpose of the present study was to evaluate the validity and reliability of a partial radiographic bivariate index system (PESI‐2). The principles of the index were applied to data from a random sample of 192 industrial employees aged 30–65 yr. Estimates of Extent and Severity of radiographic bone loss provided by the PESI‐2, as well as adjusted estimates by means of simple regression models, were compared to values obtained by a full mouth radiographic examination. It was shown that the values provided by the PESI‐2 were of rather high validity and reliability. The use of the adjusting models resulted in increased validity of the severity estimates and enhanced reliability of both components of the bivariate. The results verified the applicability of the PESI‐2 in epidemiologic research of destructive periodontal disease.
Primary reasons for extraction of permanent teeth in Norway: changes from 1968 to 1988
Authors: Klock Kristin Solveig , Haugejorden Ola
Published: May 2006

Abstract The purpose of the present study was to investigate time trends in primary reasons for extraction of permanent teeth in Norway from 1968 to 1988. Johansen (2) studied reasons for extraction of 8757 teeth in 4216 patients during a 3‐Week period in 1968. Twenty years later a random sample of 500 Norwegian dentists provided particulars about all extractions carried out during a 2‐week period. 350 dentists (70%) replied in 1988 but 96 of them had not extracted any teeth during the observation period. Reasons for extraction of 985 teeth from 692 patients were available for analysis. Caries and its sequelae accounted for 35%, periodontitis for 19%, and orthodontic reasons for 20% of extractions in 1988. A comparison of the distribution of extraction according to reasons for patients over 20 yr of age revealed a highly significant difference between 1968 and 1988 (P < 0.001) mainly due to a decrease in the role of caries and an increase in extractions for other reasons. Caries and its sequelae accounted for a higher proportion of extractions than periodontitis at all ages over 20 yr in 1968, only up to 45 yr of age in 1988. Thus it is concluded that the observed time trend in primary reasons for extraction corroborates expectations based on declining caries prevalence, increasing retention of teeth and a rise in dental attendance in Norway during the last 20 yr.
Accessibility of Norwegian dental services according to family income from 1977 to 1989
Authors: Grytten Jostein
Published: May 2006

During the last 10–20 yr there has been a marked increase in demand for dental services in most western countries. An important issue is how this increase in demand has influenced inequalities in use of services among different income groups in the population. It is of particular interest to study this in Norway, as almost all the costs for dental care among adults are borne by the patient. The aim of the present study was to examine how the effect of family income on demand for dental services has changed over time. The analyses were performed on three sets of national data from 1977, 1983 and 1989. The samples were representative of the non‐institutionalized Norwegian population aged 20 yr and above. Inequalities in use of dental services among different income groups have decreased between 1977 and 1989. However, separate analyses on the data from 19S9 showed that some inequalities still exist. A non‐selective subsidizing policy for dental care is unlikely to have any great effect in reducing these inequalities. Subsidized dental care is likely to raise the total amount of dental care demanded. However, it is difficult to assess accurately the size of this increase as the elasticity of demand for dental care in Norway with respect to price is unknown.
Reasons preventing regular dental care
Authors: Syrjälä Anna‐Maija H. , Knuuttila Matti L. E. , Syrjätä Leena K.
Published: May 2006

The aim was to determine what reasons restrict people's daily cleaning of their teeth and yearly attendance for a dental check‐up, using as a theoretical background the ideas of Eichholz & Rogers on the rejection of innovation. The series consisted of young and middle‐aged persons, 207 women and 183 men, who filled in a questionnaire on the above topics. The questions were phrased so as to cover different reasons for rejecting innovations. Factors analysis revealed the following factors: reasons preventing daily brushing, practical reasons, unpleasant experiences of dental care, laziness, and lack of appreciation. The reliability of the questionnaire was found to be good. Sex showed a significant correlation with reasons preventing daily brushing. Those for whom a long lime had elapsed since the last visit to a dentist had more barriers relating to daily brushing, unpleasant experiences and laziness. The more educated the participants were, the fewer barriers they had in relation to the factors appreciation, unpleasant experiences, and daily brushing.
Multifactorial modeling for root caries prediction
Authors: Scheinin Arje , Pienihäkkinen Kaisu , Tiekso Jaakko , Holmberg Stig
Published: May 2006

The study was pan of a series of investigations aiming at the development of diagnostic caries tests for screening of risk subjects. The material consisted of 100 adult subjects (x̄ 62 yr. range 47–79 yr), 50 of these under chronic medication. The series of tests included two chair side registrations, i.e. incipient demineralization of exposed root surfaces without cavitation (RD I) and quantitation of possible plaque (VPT%). three microbiological tests for mutatis streptococci, lactobacilli. and Candida/yeasts and three tests on stimulated saliva, i.e. secretion rate, buffering capacity and sucrase activity. A thorough clinical examination was conducted at the baseline and 1‐yr registration phases, caries being registered at a tooth surface level according to WHO recommendations separately for coronal and root caries. Considerably more root caries than coronal caries developed during the observation period. For coronal caries increment, the predictive value of any of the tests was not significant. For root caries, however, the association between several tests and prospective caries increment was significant. Subsequent multifactorial modeling yielded the highest predictive value to the combination of Past Root Caries Experience (OR 25.0. Visible Plaque (OR 4.2). Candida (OR 8.0) and lactobacilli (OR 5.8). A positive finding of Past Root Caries (RDFS) or the combination of the other three tests (Can. LB. VPT%) as criteria for selection in screening for root caries produced good accuracy (84.0) and a relative risk of 5.5.
An epidemiological study of temporomandibular disorders in university students of Taiwan
Authors: Shiau Yuh‐Yuan , Chang Chueh
Published: May 2006

A total of 2033 university students were surveyed for the prevalence of TMD in Taiwan. It was found that 42.9% of the students had one or more signs related to TMD. and females were slightly more frequently found. Clicking of the joint was the most common sign. Occlusal factors such as balancing contact, dental restoration, molar guidance in eccentric movement, etc., were more often found in the TMD group. Scores on stress, general anxiety, emotion and anger were higher in the TMD group while tension, ambition, depression, competition and test anxiety were not as significant. Although the prevalence of TMD in this population is high, the severity and treatment demands are low.
Progression of proximal caries in primary teeth in relation to radiographic scoring codes
Authors: Solanki Geetesh C. , Sheiham Aubrey
Published: May 2006

The posterior bitewing radiographs of 50 children From a Duraphat clinical trial were re‐examined to compare the information provided on progression of caries of two scoring systems, that of Murray & Majid (1) and that of Pitts (2). Pitts’scoring system (Method 1), by recording the disease process at an earlier stage, and by avoiding the unnecessary loss of data. provided a more complete overall picture of the carious process than the scoring system used by Murray & Majid (Method 2). The progression rates were found to be significantly faster with Method 2 (P<0.05). With Method 1, a mean of 60% of enamel lesions per subject had remained confined to enamel 12 months later, the corresponding figure for Method 2 was 37%. Method 2, by excluding outer enamel lesions and overlapped surfaces, introduces biases which favour overestimating the proportion of lesions deemed to have progressed. The diagnostic criteria used by Murray & Majid lead to an overestimation of the rate of progression of caries in primary teeth.
Intrinsic motivation in dental care
Authors: Syrjälä Anna‐Maija H. , Knuuttila Matti L. E. , Syrjälä Leena K.
Published: May 2006

The aim of this work was to develop a method based on the idea of intrinsic motivation for analyzing motivation problems in dental care. A questionnaire dealing with intrinsic motivation was filled in by 207 women and 183 men. Factor analysis of the scale revealed the following dimensions of internal‐external motivation: independence, responsibility, vs. non‐independence, interest in preserving one's own teeth as long as possible vs. preference for tooth extraction, satisfaction from brushing teeth vs. brushing for others’sake, and critical evaluation of diet vs. improper diet with carbohydrates. The reliability of the questionnaire was good (standardized item alpha 0.69). The individual's own sense of independence and responsibility and the idea of preserving one's own teeth for as long as possible were found to be more important for die women than for the men. A longer education was also found to be related to preserving one's own teeth as long as possible. The time of the last dental visit was positively related to independence, responsibility and the far‐reaching idea of preserving one's own teeth. It can be concluded that aspects of intrinsic motivation can give additional information when trying to understand dental health behavior.
Dental caries and its determinants among recent immigrants from rural Ethiopia
Authors: Sgan‐Cohen Harold D. , Steinberg Doron , Zusman Shlomo P. , Sela Michael N.
Published: May 2006

Adults (35–45 yr old) and children (5 and 12 yr old) recently arrived in Israel from rural areas in Ethiopia were examined. Caries levels were low: e.g. DMFT = 0.31 among 12‐yr‐olds olds, and 1.27 amongst adults. The 5‐yr‐olds were 86.8% caries‐free, while 12‐yr‐olds were 81.8% and adults 54% caries‐Tree respectively. According to interview data, the diet in Ethiopia had been based on local agricultural products and was almost sugar‐free. The mean total count of salivary bacteria, as determined on blood agar, was 3.4 × 108; mean count of Streptococcus viridans. on mitis salivarius, was 6.7 × 107; and mean count of S. mutans. as determined on mitis salivarius with bacitracin, was 1.7 × 107. These levels were all high and were not significantly different from a control group of 20 Israelis. The mean number of lactobacilli, on Rogosa agar, was 2.75 × 104, which was significantly higher than among the controls (3.6 × 103). Salivary pH levels were generally similar between the Ethiopian group and the controls. Salivary How was significantly higher for the Ethiopians (1.93 ml/min) than for controls (1.16 ml/min). Low levels of caries in this population can be attributed to an almost sugar‐free diet and high salivary flow, but not to the composition of oral microflora.
Development of a Dutch version of the Dental Visit Satisfaction Scale
Authors: Stouthard M. E. A. , Hartman C. A. , Hoogstraten Joh.
Published: May 2006

A Dutch version of the Dental Visit Satisfaction Scale has been developed. The DVSS consists of 10 items, measuring three aspects of patient satisfaction with the dentist. Hem and scale characteristics of the Dutch version and the English version compared rather well. Likewise, the factor structure of the Dutch and the English version of the DVSS was very similar. A suggestion for modification of the DVSS was made.
Determining optimal levels of fluoride in drinking water for hot, dry climates ‐a case study in Sri Lanka
Authors: Warnakulasuriya K. A. A. S. , Balasuriya S. , Perera P. A. J. , Peiris L. C. L.
Published: May 2006

The prevalence of dental caries and dental fluorosis was examined in 380 14‐yr‐ofd children living in four geographic areas of Sri Lanka with water F levels of 0.09‐8.O ppm. A reduction in caries prevalence by 43% was recorded in children consuming 0.6 0.79 ppm F compared to those in tow fluoride areas (<0.4 ppm). Among those consuming drinking water containing < 1.0 ppm F however, 32% of the children had mild forms and 9% severe forms of dental fluorosis (Dean's index). Although other sources of F may contribute to this effect, the prevalence and severity of dental fluorosis seen in tow fluoride areas was confirmed to be high in rural Sri Lanka. Our data are comparable with recent findings from other tropical countries, e.g. Kenya and Senegal, and reaffirm that WHO guidelines for the upper limit of F in drinking water may be unsuitable for developing countries with a hot, dry climate. Current knowledge now enables us to recommend 0.8 ppm as an appropriate upper limit for F in drinking water supplies for these populations.
Oral self‐care behaviours in older dentate adults
Authors: Payne Barbara J. , Locker David
Published: May 2006

Defining oral self‐care as activities undertaken by individuals to maintain or promote dental health, this paper examines the distribution of oral self‐cure behaviours in a sample of dentate adults, age 50 and over, living in Ontario, Canada (n= 713). Results are presented separately for two older cohorts, respondents ages 50–64 and those 65 and older, and for females and males. Six oral self‐care behaviours were examined: toothbrushing, flossing, use of an interdental device, extra fluoride use, frequency of between meal snacks and ingestion of cariogenic foods. High males of self‐care occurred only for tooth brushing. Age groups differed significantly for use of interdental devices, consumption of cariogenic foods and snacking between meals while gender differences were found for tooth brushing, flossing and consuming sweet foods. The need to target older adults and especially older males for oral hygiene information and instruction in order to counteract possible misleading beliefs learned before the advent of current Dental hygiene practices is apparent from these data.
Variation in restorative treatment decisions: application of Receiver Operating Characteristic curve (ROC) analysis
Authors: Kay Elizabeth Jane , Knill‐Jones Robin
Published: May 2006

It has been evident for many years that dentists, when planning treatment for patients, do not act in a standard manner, and previous research has shown there to be wide variations in treatment planning amongst groups of dentists. Signal detection theory and Receiver Operating Characteristic (ROC) analysis allows measurement of an observer's ability to detect a lesion, while at the same time allowing examination of how a lesion, once perceived, is judged to be in need of treatment. An ROC curve is constructed by plotting the sensitivity (or true positive rate) of decisions made, against the false positive rate (equivalent to 1‐specificity) when various decision attitudes, from interventionist to non‐interventionist, are held. Fifteen pairs of simulated bitewing radiographs were shown to 20 dentists, who were asked to specify, for each approximal lesion, whether or not they would place a conventional restoration. The 7200 decisions made by the dentists were validated by sectioning and microscopically examining the teeth. The mean sensitivity of the dentists' decisions, when the strictest operating thresholds were held and caries into dentine was the validating criterion, was 0.26 and the mean specificity was 0.96. ROC analysis shows that when operating at the strictest threshold, the dentists were implying that specificity was weighted as being 2.7 times more important than sensitivity. ROC analysis leads to insight into how dentists differentially weight the true and false, positive and negative, outcomes of their decisions and thus allows explanation of why two dentists would rarely make exactly the same treatment plan for one patient, and also why different treatments might be offered to two patients exhibiting the same levels of disease.
Extending recall intervals ‐effect on resource consumption and dental health
Authors: Wang Nina , Marstrander Peter , Holst Dorthe , Øvrum Lelf , Dahle Torill
Published: May 2006

The dental health of children has improved in recent years. This has stimulated more flexible planning and implementation of public dental care programs. The aim of the study was to compare lime required for dental care and changes in dental health over a 2‐yr period for patients examined and treated every 12 months and patients examined and treated every 24 months. The material comprised 185 children aged 3, 16 and 18 yr. Children with high caries prevalence were not included in the material. Time used for examination and treatment and dental health parameters were recorded. The data were analyzed using multiple linear regression analysis. Mean time used for examinations and mean total time used by the dental health service over the 2‐yr period were significantly less for patients examined every 24 months than for patients examined every 12 months, while the treatment times did not differ between the groups. The longer recall interval was associated with greater DMFS increment but this was not statistically significant. The study indicates that the dental health service in Norway could save resources, i.e. increase the productivity in the short term by extending the intervals between examinations.
Evaluation of appropriate use of dietary fluoride supplements in the US
Authors: Szpunar Susan M. , Burt Brian A.
Published: May 2006

Recent epidemiologic and related evidence suggests the following trends: 1. the prevalence of caries continues to decline in children of the US and several other developed countries; 2. the prevalence of mild dental fluorosis is increasing: 3. the majority of the cariostatic effects of fluoride are topical; and 4. dietary fluoride supplements are a risk factor for dental fluorosis. These trends, and the scientific evidence on fluoride and fluorosis, suggest that it is time ro re‐evaluate the use of dietary fluoride supplements. This paper examines the evidence for each of the four trends and the use of fluoride supplements in caries prevention today.
Oral health conditions and denture treatment needs in institutionalized elderly people in Japan
Authors: Miyazaki Hideo , Shirahama Ryuji , Ohtani Ichiroh , Shimada Naoko , Takehara Tadamichi
Published: May 2006

Oral health conditions, including dental conditions, temporomandibular joint (TMJ) conditions, denture status, and oral hygiene status, were assessed on 1908 institutionalized elderly people 65 yr of age and older at 29 of the 30 existing institutions in the city of Kitakyushu, Japan. The percentage of edentulous people was 27% in the65–74‐yr‐old group, and increased with age to 56%, in the 85 yr and older group. In dentate persons, the mean number of remaining teeth and DF teeth were 13.4 and 8.6, 9.5 and 6.8, and 8.4 and 6.5 in the groups aged65–74 yr old.75–84 yr old and 85 yr and older, respectively 81% of all the persons examined had no unusual symptoms in their TMJ. A clicking sound was the most frequent symptom (17%). Hygiene of both their teeth and dentures was very poor. Of all the subjects 36% needed new full and/or partial denture(s) and 41%, needed only repair. When the institutionalized elderly people were compared according to their general health condition, no clear differences were observed in percentage edentu‐lousness, mean number of remaining teeth and DF teeth, and TMJ conditions. However, a higher level of both untreated teeth and denture treatment needs, and poorer oral hygiene, was found in elderly people having poor general health than was observed in those with better health. These findings indicate that dental care systems for institutionalized elderly people, especially disabled elderly people, should be planned, and that the importance of oral health programs among younger generations should be stressed, because (a) dental care for the elderly becomes more difficult with increasing age and (b) dental health care is provided too late for most people.
Prognosis of overdenture abutments in the aged: effect of denture wearing habits
Authors: Budtz‐Jörgensen Ejvind
Published: May 2006

The effect of denture wearing habits was studied in 35 overdenture wearers (20 day‐and‐night wearers. 15 day‐wearers) during a period of 3 yr with controlled oral hygiene. Prior to prosthetic treatment intensive instruction and motivation in oral hygiene were carried out and the patients were recalled 24 times yearly during the study period. Before treatment mean Plaque Index (PH) and Gingival Index (GI) were 1.5 and 1.6, respectively, in both groups of patients. At day 0, 1 yr, 2 yr and 3 yr mean PII and GI were 0.3 0.5 and 0.6 0.8, respectively, in the group of day‐wearers and 0.5–1.0 and 1.0–1.2, respectively, in the group of day–and–night wearers. This difference was statistically significant. Furthermore, during the study period 16% of the abutment tooth surfaces showed attachment loss (1 4 mm) in the group of day‐and‐night wearers against 7% of the tooth surfaces in the group of day‐wearers. This difference was statistically significant. During the 3 yr 36 carious lesions developed in the group of day‐and‐night wearers, but none in the group of day‐wearers. The results of this study have shown that day–and–night wearing of dentures is a major periodontitis and caries risk factor in complete overdenture wearers with controlled oral hygiene.
Factors influencing the likelihood of successful decisions to treat dentin caries from bitewing radiographs
Authors: Mileman Philip Anthony , Mulder Erik , van der Weele Leo
Published: May 2006

The purpose of this study was to describe the role played by the ability to estimate caries depth in successfully deciding to treat dentin caries when making use of bitewing radiographs as a diagnostic test. A 10% random sample (n= 444) of Dutch dental practitioners was sent a two‐wave questionnaire concerning radio‐graphic caries diagnosis and restorative treatment decision making. The second wave consisted of simulated bitewing radiographs of 105 tooth surfaces with and without dentin caries according to two measuring standards: (a) a micro‐radio‐graphic “gold” standard and (b) a norm of expert observers. The dentists were asked to diagnose caries at 4 depths of penetration using a 5‐point certainty scoring system to measure diagnostic ability; and to make a treatment decision for each surface. The overall response was 61% (273). A regression analysis was carried out using the chance per dentist of correctly deciding to treat dentin caries as the dependent variable. The degree of agreement with the experts diagnosis of radio‐graphic caries depth was used to create variables measuring diagnostic ability. Five significant (P <0.05) variables explained 60% (R2= 0.60) of the variation in decision making. The best diagnostic ability variable explained 47% of the variation while the treatment criterion reportedly used explained 3%. We conclude that the ability of practitioners to interpret radiographs plays a major role in treatment decision making and that their reported treatment decision making criteria should not be taken at face value.
Treatment times of amalgam restorations
Authors: Advokaat J. G. A. , Van't Hof M. A. , Akerboom H. B. M. , Borgmeijer P. J.
Published: May 2006

The aim of this study was to present information about treatment times for amalgam restorations and the factors influencing them. The study was carried out as part of a clinical trial. Following a written treatment protocol, 1044 class II restorations with two surfaces and 1433 restorations with three surfaces were made by seven operators. The statistical method consisted of an ANOVA after log. transformation of the treatment times. The mean total treatment time for two‐surface restorations was 24 min and for three‐surface restorations 30 min. The mean finishing and polishing time was 6.3 min. A significant effect on the treatment time was noted for: (1) operator, (2) size of the restorations, and (3) type of tooth (molar/premolar). The results of this study may be useful for cost‐benefit analysis and for efficient planning in dental practice.
Attitudes and perceptions of adults towards orthodontic treatment in an Asian community
Authors: Lew Kenneth K.
Published: May 2006

Abstract – A retrospective survey of 358 local Chinese adult orthodontic patients was undertaken to determine the motivating factors behind orthodontic treatment and the discomfort caused by fixed orthodontic appliances. From the completed questionnaires of 203 patients, the principal conclusions were that the improvement in dento‐facial aesthetics following orthodontic treatment enhanced their self‐confidence and self‐esteem in a majority of patients; discomfort in oral soft tissues and teeth were transient and did not exceed 7 days; transient pain from teeth was experienced by 91% of patients and in 39% of these patients the discomfort to teeth was experienced with each new archwire or elastic force application. These results may be useful in relating discomfort levels to prospective orthodontic patients. It was also evident in the study that several cross‐cultural differences existed in the attitudes of our patients compared to those reported in Caucasians.
A panoramatomographic study of the teeth and jaws of Finnish university students
Authors: Peltola Jaakko Sakari
Published: May 2006

Abstract – A random sample of panoramic radiographs was taken of 1027 (386 male and 641 female) university students. All the students were born between 1965 and 1971. The following were examined: caries, apical radiolucencies, endodontically treated teeth, marginal and vertical bone loss, third molars, supernumerary, missing, and persisting teeth, bone structure, condyles, maxillary sinuses and soft tissue calcifications. In the inter‐ (of two examiners) and intra‐examiner variation Kappa indices varied between 0.15 and 1.00, and agreement percentages from 52, to 100. Kappa index was poor (0.15) in evaluation of the bone structure. The mean DM FT index for the students was 8.4. A sound dentition was found in 6.6%, and 48.4% of the students were free of caries. The mean number of carious lesions was 1.1. There were 50 retained roots (49 from primary teeth). 76.6% of the students had one or more unerupted wisdom teeth and 22.7% had radioiogic changes typical of pericoronitis in the region of the mandibular third molars. 16.2% of the students had at least one missing wisdom tooth. Bone structure was normal in 92.4% of the students, idiopathic osteosclerosis being the most common divergence (3.5%). Arthrotic changes in the condyles were found in 9% of the students. In eight cases there was erosion of the condyles, which was diagnosed as arthritis. Styloid ligament calcifications were found in 21.5% of the students. In the maxillary sinuses, male students exhibited changes 1.7 times more often than female students (26.3% in males and 15.1% in females).
Number of amalgam fillings in relation to cardiovascular disease, diabetes, cancer and early death in Swedish women
Authors: Ahlqwist Margareta , Bengtsson Calle , Lapidus Leif
Published: May 2006

Abstract – Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were initially examined in 1968–69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The incidences of myocardial infarction, stroke, diabetes, cancer and overall mortality were determined during a 20‐yr follow‐up period. Women with few amalgam tooth fillings had increased incidence of myocardial infarction, stroke, diabetes and early death compared with women with a large number of fillings. However, the significant inverse correlations between number of amalgam tooth fillings and the endpoints studied disappeared when number of teeth and socioeconomic group were included in a multivariate analysis. The study thus did not provide any evidence for a correlation between amalgam fillings and cardiovascular disease, diabetes, cancer or early death.
Long‐term evaluation and rerestoration of amalgam restorations
Authors: Akerboom H. B. M. , Advokaat J. G. A. , Van Amerongen W. E. , Borgmeijer P. J.
Published: May 2006

Abstract – In this study, 1544 class‐II amalgam restorations were made and evaluated for 10 yr and the reasons for rerestoration were registered. Two categories of failure could be established: failures due to poor restorative technique (true failures) and those not due to poor restorative technique (false failures). After 10 yr, 1415 restorations were evaluated. Only 120 restorations (8.5%) had been replaced, most of these replacements being true failures (105 = 87.5%), which could be divided into: isthmus fracture (37), fracture of the enamel cusp (25), recurrent caries (16), partial fracture of the restoration (9), severe marginal breakdown (5), pulpal pathology (7) and others (6). The false failures (15) could only be classified into: caries elsewhere in the tooth (15). Origins of the true failures were the operator, the material (amalgam) and the type and size of the restoration. In this study, there were significantly more replacements of larger restorations than of smaller ones and more replacements in molars than in premolars. There is also a significant difference among the replacements by the various operators but not between the various types of amalgam. Origins of the false failures seem to be more related to patient factors like caries activity, caries susceptibility and oral hygiene, but chewing habits (bruxism) may also play a role.
Oral health problems and needs of nursing home residents
Authors: Kiyak H. Asuman , Grayston M. Nan , Crinean Carol Lowe
Published: May 2006

Kiyak HA, Grayston MM, Crinean CL: Oral health problems and needs of nursing home residents.

Abstract – The problem of dental neglect and high levels of unmet dental needs among elderly residents of long term care facilities has been widely documented in literature. A survey was conducted of 1063 residents in 31 nursing homes throughout Washington (representing 11% of all facilities in the slate). The greatest single need among dentate elderly was for routine oral hygiene (72%), while for denture wearers adjustment of loose dentures was the primary need (46.4%). Periodontal problems were slightly more prevalent than root caries (43%) and 36% respectively) among dentate elderly. Dry mouth was found in 10% of residents. Oral conditions were worse in larger facilities located in rural and moderate size communities, and those under a proprietary corporation. These results suggest that daily oral hygiene and regular check‐ups by a dental professional are most needed by frail elderly, especially in large, proprietary homes in rural and moderate size communities. Education of nursing home staff and the elderly themselves in the importance and methods of home care are also critical needs.