bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbiological assessment of denture hygiene among patients in longstay and daycare community places
Authors: Blair Yvonne , Bagg Jeremy , MacFarlane T. Wallace , Chestnutt Ivor
Published: May 2006

Abstract A simple, inexpensive microbiological assay for objective measurement of denture hygiene has been devised. Small individual filter paper discs were applied to the fitting surface of dentures for 20 seconds, eluted in phosphate buffered saline and bacterial counts on blood agar plates performed on the eluate. There was a strong positive correlation between denture cleanliness (graded on a scale of 0 to 4) and both total anaerobic count (r = 0.829; P < 0.00l) and total aerobic count (r = 0.786; P 0.00l) following logarithmic transformation. Yeasts in the eluted disc specimens could be used as an aid to diagnose oral candidiasis. The method provided an objective measure of denture hygiene among elderly patients in long‐stay hospitals and daycare community places. It may be applicable to audit studies following implementation of new oral health care policies.
General and local contraindications for endosseal implants ‐ an epidemiological panoramic radiograph study in 65‐year‐old subjects
Authors: Oikarinen Kyösti , Raustia Aune M. , Hartikainen Maija
Published: May 2006

Abstract In order to evaluate general and local contraindications for implantation for 65‐yr‐old subjects from a medium‐sized Finnish city, 431 such persons were examined anamnestically and by means of panoramic radiographs. The population represents 61% of the total age group in the city (born in 1923). It was shown that several degrees of cardiac problems and increased blood pressure followed by pulmonary diseases and diabetes were the most commonly encountered relative contraindications for implantation. Eleven percent of the patients said that they smoked regularly and the bone quality was estimated to be less suitable for implantation in 21% of the cases. Implantation was evaluated according to the Bonefit® system (implant lengths between 6 and 16 mm) in 10 regions in the maxilla and 6 regions in the mandible and was shown to be possible in 38% of the regions in the partially edentulous maxillae and 50% of those in the partially edentulous mandibles, the corresponding figures for the edentulous jaws were 55% in the maxilla and 61% in the mandible.
Dutch students' dental anxiety and occurrence of thoughts related to treatment
Authors: de Jongh Ad , ter Horst Guusje
Published: May 2006

Abstract The present study was intended to explore the relationship between individuals' level of dental anxiety and thoughts (both self‐statements and mental images) related to dental treatment. Subjects were 210 psychology students (75 males, 135 females). The results showed that 98% of the subjects reported one or more negative or catastrophic thoughts. A significant positive relationship was found between reported severity of anxiety (S‐DAI scores) and frequency of thoughts. The results indicate that dental anxiety is associated with the tendency to experience negative or threatening thoughts concerning treatment.
Calibration of dentists in the use of occlusal indices
Authors: Richmond S. , Buchanan I. B. , Burden D. J. , O'Brien K. D. , Andrews M. , Roberts C. T. , Turbill E. A.
Published: May 2006

Abstract Dentists' opinions as to both need for and outcome of orthodontic treatment show wide variation. Within the profession there is an opportunity to reduce subjective bias and standardise criteria by the use of occlusal indices. The results of this study demonstrate that a group of dentists can easily be trained to record the Aesthetic and Dental Health Components of the Index of Orthodontic Treatment Need and the PAR index to a satisfactory level.
Dental care of infectious patients in Denmark, 1986–1993: theoretical considerations and empirical findings
Authors: Scheutz Flemming , Langebæk Jørgen
Published: May 2006

Abstract Changes in infection control and behavior and attitudes towards HIV‐infected patients from 1986 to 1992/93 were studied among a random sample of 335 Danish dentists; previous studies among random samples of Danish dentists served as references. 249 (74.3%) returned a mailed questionnaire together with a time, steam, temperature (TST) control indicator strip processed in their steam autoclaves. 3.4% of the autoclaves had not sterilized properly, which was an insignificant decrease compared to 1986. Overall, infection control had improved since 1986. In 1992/93 17.3% of dentists surveyed reported use of gloves always: in 1986 0.8% did so. Many (60.2%) reported at least one needlestick or cut accident within the last year. The number of dentists who were willing to treat HIV‐infected patients and the number of clinics that found they could treat infectious patients safely had increased from 56.1%, to 78.7%, and from 43.0% to 66.8%, respectively. Other attitudinal dimensions, for example views on secrecy of HIV test results and HIV screening policy, had not changed. A conceptual model based on the theory of reasoned action formed the framework for multiple logistic regression analysis with two different outcomes: Willingness to treat HIV‐infected individuals and Treatment of HIV‐infected patients. In particular, expected staff problems turned out to have a high explanatory value (odds ratio = 18.2) if HIV‐infected patients were received. In both models Certainty about hygienic precautions had some explanatory value. The findings may give some clues about how to plan and implement future continuing education on infection control and attitudinal and behavioral aspects of caring for infectious patients.
Prognosis of and factors associated with dental status in the adult Swedish population, 1975–1989
Authors: Österberg Tor , Carlsson Gunnar E. , Sundh Walter , Fyhrlund Alf
Published: May 2006

Abstract The aim was to describe changes in dental status in the Swedish population during the period 1975–89 and to make a prognosis based on these data for the year 2000. This study is based on investigations of the living conditions in 1975, 1977, 1980/81 and 1988/89 performed by The National Central Bureau of Statistics. The samples varied for each year from 11 500 to 15 000 participants and a response rate from 80 to 86%. The odontological questions of the interview were focused on dental status, utilization of dental services and chewing ability. The prevalence of edentulism in age group 16–74 yr decreased from 15% in 1975 to 6% in 1988/89. In 1988/89 19% of the 65–74‐yr‐old inhabitants of the big cities were edentulous and 45% in rural populations, indicating a 15–20‐yr delay of the development in rural areas. The prognosis for the year 2000 indicates a further decrease of edentulism to 3–4% in age groups 45–64 yr and in age 75–84 yr more than 60% will be dentate. As a consequence of the reduction in edentulism and changes in populations the number of dentate inhabitants in age group 25–74 yr increased by about 800 000 from 1975 to 1989 and a further increase of 400 000 will occur up to the year 2000. The consequences of these changes for the dental care services are discussed.
Retention and caries preventive effects of a GIG and a resin‐based fissure sealant
Authors: Arrow Peter , Riordan Paul J.
Published: May 2006

Abstract Fissure sealing using partially filled resins is an established caries preventive practice. Glass ionomer cement (GIC) sealants may offer additional advantages due to their ability to bond chemically to enamel and release fluoride. The aim of this study was to compare the caries preventive effect and retention of a GIC and a resin‐based sealant. Ketac‐fil® was tested against a chemically cured resin‐based material (Delton®) using a split mouth design. Perth (Western Australia) schoolchildren (n= 465), mean age 7 yr±0.72 (S.D.), received sealants on the occlusal surfaces of sound homologous permanent first molar pairs. Test (GIC) and control (resin) sealants were systematically allocated to left and right sides based on the child's month of birth, and were placed by dental therapists. After 3.64±0.11 yr, 415 children were examined by different clinicians, and the clinical status of the teeth and the extent of sealant retention recorded. Sealants were deemed retained when at least 2/3 of the fissure pattern was still sealed. In 252 tooth pairs, neither sealant was retained to this extent. In 71 pairs, the GIC was not retained and the resin sealant retained. In 40 pairs the reverse occurred (McNemar's test, χ2= 8.66, P < 0.005). Net gain (additional lesions prevented by the test agent per 100 treatments) was 6.1%(95% CI 3.3%, 8.9%). Effectiveness of the GIC was 80.6% (95% CI 59.6%, 90.7%). The relative risk of caries in test teeth was 0.19 (95% CI 0.09, 0.40). The study suggests that complete retention of GIC sealant is not necessary for caries prevention in newly erupted permanent first molars.
Incidence of attachment loss over 3 years in older adults – new and progressing lesions
Authors: Beck James D. , Koch Gary G. , Offenbacher Steven
Published: May 2006

Abstract Researchers attempting to identify and quantify risk factors have not paid adequate attention to whether or not they actually are identifying risk factors (exposures related to the onset of disease) and prognostic factors (characteristics related to the progression of established disease). The purpose of this paper is to present the incidence of attachment loss in people who have attachment loss in sites previously without disease and people who experience further progression of sites with disease, and to compare and contrast the characteristics of people with the two types of attachment loss. The subjects used for this study are a random sample of community‐dwelling older adults residing in five contiguous North Carolina counties who were followed for 3 yr. The subjects were categorized into four groups according to the type of clinical attachment loss (change of 3 or more mm) experienced, those who only had attachment loss in previously undiseased sites, those with progression of attachment loss in previously diseased sites, those who experienced both types of attachment loss, and those who had no new sites of attachment loss. A bivariate logistic model was developed to identify the characteristics associated with “new” disease onset as compared to “progression of disease”. Just over 40% of the people had no change in their baseline attachment level, 27.5% of the people experienced only new lesions. 11.1% of the people only experienced clinical attachment loss in sites that had clinical attachment loss at baseline, and 20.1% experienced both kinds of clinical attachment loss. Low income, taking medications associated with soft tissue reactions, smokeless tobacco users and those who experience a history of oral pain were at greater risk for new lesions. People at higher risk for disease progression were low income, taking medications that may result in soft tissue reactions, cigarette smokers, BANA positive, P. gingivalis positive, and had worsening financial problems. The model indicates that the characteristics are different enough that periodontitis may be like other diseases in which risk factors and prognostic factors are not the same.
Jaw function status in an elderly community sample
Authors: Bibb Carol A. , Atchison Kathryn A. , Pullinger Andrew G. , Bittar Geber T.
Published: May 2006

Abstract The purpose of this study was to assess jaw function status and disability in an elderly population. The sample consisted of 429 Medicare recipients dwelling in the community (mean age = 74.4±5 yr; 58% female and 42% male) who were enrolled in an HCFA‐sponsored prevention demonstration project. An evaluation of TMJ and jaw muscle status was conducted at the completion of a general dental examination. This included assessment of joint sounds (clicking or crepitus), joint and jaw muscle tenderness to palpation, and measurement of maximum opening. Pain or disability during jaw use and history of TMD problems were assessed by self‐report. The prevalence of TMJ clicking was 16%, crepitus 19%, TMJ tenderness 8%, jaw muscle tenderness 13%, and opening < 40 mm 22% Pain on jaw use was reported by 6.5%, and 12% reported a history of TMD problems. There was no significant relationship between TMD signs and symptoms and dental status. The lack of consistent relationship between TMD signs and symptoms and health status measures suggests that TMD is a localized disease process and not an extension of a general condition such as arthritis or depression, nor does it have major impact on activities of daily living. Examiner referral for treatment was low (1%) indicating that TMD was not a significant treatment concern in this sample of the elderly.
Relative contribution of dental services to the changes in caries levels of 12‐year‐old children in 18 industrialized countries in the 1970s and early 1980s
Authors: Nadanovsky Paulo , Sheiham Aubrey
Published: May 2006

Abstract The contribution of health services to improvements in health is contentious. The main aim of the present study was to assess the relative contribution that dental services may have made to the changes in dental caires (decayed, missing or filled permanent teeth) level of 12‐year‐old children in some industrialized countries in the 1970s and early 1980s. A secondary aim was an analysis of the association of the changes in caries levels with broad socioeconomic factors. In this study aggregate (ecological) data from 18 industrialized countries were analyzed at a national level. Data were obtained from published papers and official publications and included 3 kinds of variables: caries, presence of dental service and broad socioeconomic factors (including fluoridated toothpastes). Dental services explained 3% of the variation in changes in 12‐year‐old caries levels in the 1970s and early 1980s period whereas broad socioeconomic factors (including or excluding fluoridated toothpastes) explained 65%. The findings suggest that dental services were relatively unimportant in explaining the differences in changes in 12 year‐old caries levels in the 1970s and early 1980s in the 18 countries. The view that fluoride in toothpaste was the only important cause of the declines in decayed, missing or filled permanent teeth in industrialized countries was questioned. A possible important contribution of the dental services to the declines was a change in the diagnostic and treatment criteria of caries.
Predictors of fixed orthodontic treatment in 15‐year‐old adolescents in South Australia
Authors: Spencer A. John , Allister Joan H. , Brennan David S.
Published: May 2006

Abstract An understanding of the determinants of the provision of fixed orthodontic treatment would be beneficial in the planning of any system aimed at rationalising supply. The aim of this longitudinal study was to determine those factors which were predictive of the provision of fixed orthodontic treatment in adolescents. Baseline data, at age 13 years, on oral health, the history of orthodontic consultation and interceptive orthodontic care, a dental appearance score (DAI), socio‐demographic characteristics and self and parental perceptions of both dental appearance and need for fixed orthodontic treatment were obtained from 2793 adolescents under the care of the South Australian School Dental Service who had not undergone fixed orthodontic treatment. Data on the orthodontic care provided to these adolescents in the ensuing 2 years were collected. At the end of the 24‐month period 433 adolescents (15.5%) had undergone fixed orthodontic treatment. Significant bivariate associations were found between the provison of fixed orthodontic treatment and the DAI score, sex of the adolescent, familial history of fixed orthodontic treatment, income, private insurance, orthodontic consultation and interceptive orthodontic care before the age of 13 years and self and parental perceptions of both dental appearance and the need for fixed orthodontic treatment. Logistic regression was used to produce a predictive model of fixed orthodontic treatment. The model explained 30.2% of the variance, with a specificity of 0.94, a sensitivity of 0.49 and a hit rate of 0.84%. Odds ratios greater than one were found for the DAI score, private insurance, females, self and parental perception of need, higher incomes and orthodontic consultation and interceptive orthodontic care before the age of 13 years.
Dental health and treatment needs in institutionalized psychiatric patients in Italy
Authors: Angelillo Italo Francesco , Nobile Carmelo Giuseppe A. , Pavia Maria , De Fazio Pasquale , Puca Maurizio , Amati Amato
Published: May 2006

Abstract The caries prevalence, oral hygiene status, periodontal health and the treatment needs were assessed in a group of institutionalized psychiatric patients in Catanzaro, Italy. Of the total sample of 297 subjects, 165 (55.6%) were males, the mean age was 55.1 yr, the great majority (90.6%) was able to care for themselves, on average they had been institutionalized for 12.9 yr, and almost two‐thirds were schizophrenic (65%). They did not receive any assistance in daily oral hygiene procedures, only 7.4% had visited a dentist and exclusively for emergency care. A total of 33 (11.1%) patients were edentulous, and the multiple logistic regression analysis showed a highly significant increase of edentulousness with increasing age (P < 0.001). No caries‐free subjects were found and among the dentate the DMFT and DMFS scores for all age groups were respectively 15.5 and 88.6. The stepwise linear regression analysis showed that the mean DMFT index increased with age (t = 6.86; P < 0.00l), and in the partly or totally helpless patients it was significantly higher than in the self‐sufficient patients (1=2.78; P= 0.006). Of the 264 dentate subjects, only 25 (9.5%) had no need of dental treatment: 213 (80.7%) required extractions with a mean number per person of 6.3 and the need for conservative dental care was recorded in 154 (58.3%) patients with a mean need for patient of 2.8. Mean OH1‐S score was 4.2 and the stepwise linear regression analysis showed that it increased with age (t = 5.73; P < 0.01) and with the length of institutionalization (t =3.42; P < 0.001). Only 0.9% of the entire sample was found with healthy periodontal tissue; bleeding on probing or a higher score was found in 4.6% of examined sextants; calculus in 10.1%; shallow pockets and deep pockets in 19.6%. and 64.8% of all sextants. The results of the multiple logistic regression analysis indicated that the number of subjects with deep pockets as highest score increased with increasing age (P < 0.001), and with the increasing length of institutionalization (P=0.005). The findings of this study demonstrate high caries prevalence, poor oral hygiene and periodontal health, and extensive unmet needs for dental treatment. More coordinated efforts between the social and dental care sector must be maintained to serve adequately the need of this disadvantaged group.
Comparison of ideal and actual behavior of patients and dentists during dental treatment
Authors: Lahti Satu , Tuutti Heikki , Hausen Hannu , Kääriäinen Risto
Published: May 2006

Abstract The ideal behavior of dentists and patients has seldom been studied with the aim of determining whether it is similar to the actual behavior of the two groups. Thus, the purpose of this study was to compare whether the ideal behavior of dentists and patients differed from their actual behavior. Thirty‐three volunteering dentists and 271 of their patients from the public and private sectors in different parts of Finland participated in the study. The dentists first filled out a questionnaire with 5‐scale Likert‐type statements about the ideal patient and questions concerning their own background variables. In connection with normal dental practice their denial nurses selected 10 patients, who before treatment filled out a questionnaire containing statements about the desired behavior of an ideal dentist and their own background variables. Immediately after the treatment, both dentists and patients filled out another questionnaire containing similar statements, which this time indicated whether the dentist/patient actually behaved according to the ideal. Differences between each individual and the independent ideal and actual scores were compared by cross‐tabulation and percentage agreement. With regard to the ideal behavior that was directly related to the treatment procedure, the expectations of both dentists and patients were usually met. In general, the patients did not disrupt the procedures and the dentists were able to concentrate on the treatment. The discrepancies most often found between the ideal and the actual behavior concerned the level of communication. The patients often would like to have been talked to more and wanted to be encouraged. The dentists were not sure whether their patients were interested in or motivated about the treatment or whether they followed the home care instructions. In general, there evidently is a clear gap in communication between dentists and patients, which may lead to frustration on both sides. It is thus suggested that when dentists are trained, more emphasis be placed on communication skills.
Dental caries, fluoride levels and oral hygiene practices of school children in Matebeleland South, Zimbabwe
Authors: Sathananthan Kangaratnam , Vos Theo , Bango Gordon
Published: May 2006

Abstract 1386, 5–6‐yr‐old and 1326, 12‐yr‐old schoolchildren in the mainly rural province of Matabeleland South, in Zimbabwe, were examined for dental caries and interviewed about their oral hygiene practices. Fluoride contents of the drinking water source of the schools were determined and were found to be in the range 0.05–2.5 ppm. Among 5–6‐yr‐old children, 25.2% were affected with caries and the mean dent score was 0.6 whereas 19.8% of the 12‐yr‐old children had caries, and the mean DMFT score was 0.3. In both age groups low fluoride levels in drinking water (<0.8 ppm) were associated with higher prevalence of caries (5–6‐yr‐olds: OR 2.47: 12‐yr‐olds: OR 2.09). Chewing sticks were the most commonly applied oral hygiene practice. Children who reported using chewing slicks had fewer carious lesions than children who reported the use of toothbrush and toothpaste.
Prevalence of dental fluorosis in children in Singapore
Authors: Lo Geok Lam , Bagramian Robert A.
Published: May 2006

Abstract Prevalence and severity of dental fluorosis was assessed in 1739 Singaporean children aged 9, 12 and 16 yr in three different ethnic groups. All subjects had resided since birth in Singapore, which has a tropical climate. The water supply was fluoridated in 1957 at a level of 0.7 ppm. In this sample, mouth prevalence was 82.6%, tooth prevalence was 66.9%, the community fluorosis index was at 1.96; 9.2% of children had severe fluorosis and 26.2% had moderate fluorosis. There were no significant gender or racial differences. Prevalences were higher than those reported in most other studies. Due to differences in indices used and methodology, comparisons could not be made directly with other studies.
Quality of dental care: the view of regular attenders
Authors: Goedhart H. , Eijkman M.A.J. , ter Horst G.
Published: May 2006

Abstract Patients' perceptions play an important role in assessing the quality of dental treatment. This study investigated 56 possible quality aspects on their importance as judged by regular attenders. A nationwide sample of 5000 Dutch people was contracted, 1328 persons meeting our selection criteria tilled out the questionnaire and responded. The results show that hygiene of instruments and the availability of the dentist in case of emergency were considered the most important. It was concluded that in general these patients judged technical and functional aspects of dental care to be of more importance than communicative and informative aspects. Differences in perceptions were found according to sex and, to a lesser extent, to education, means of insurance and place of residence. But, on the whole, response patterns were homogeneous.
Effectiveness of visible light fissure sealant (Delton) versus fluoride varnish (Duraphat): 24‐month clinical trial
Authors: Bravo Manuel , Llodra Juan Carlos , Baca Pilar , Osorio Estrella
Published: May 2006

Abstract The present study compares visible‐light Delton with Duraphat fluoride varnish for the prevention of occlusal caries in permanent first molars. A clinical trial was carried out in three groups of 6–8‐yr‐old schoolchildren: a sealant group (100 children), in which Delton light‐polymerized fissure sealant was applied to permanent first molars; a varnish group (98 children), in which Duraphat was applied to permanent first molars; and a control group (116 children). Replacement (sealant) and reapplication (varnish) was carried out every 6 months. Percent effectiveness at 24 months (percentage of saving from caries taking molars as analysis unit) for those molars initially healthy and with complete occlusal eruption was analyzed. 272, 252 and 238 molars met the inclusion criteria in the control, varnish and sealant groups, respectively. Of these, 45.2%, 28.2% and 10.5% developed caries after 24 months. The effectiveness was greater in the sealed molars than in the varnished molars (62.7%i).
Using crowns to prevent tooth fracture
Authors: Bader James D. , Shugars Daniel A. , Roberson Theodore M.
Published: May 2006

Abstract Placing crowns to prevent tooth fracture is thought to be a common but infrequently documented treatment procedure. Two studies are described that provide information about dentists’ use of crowns to prevent tooth fracture. North Carolina general dentists indicated that 44% of the crowns they placed were for the principal reason of fracture prevention. However, when groups of dentists examined the same patients, there was little agreement about which teeth should be crowned due to risk of fracture. These results suggest that the placing of crowns to prevent fracture merits a careful determination of effectiveness and appropriateness.
Oral health of representative samples of Germans examined in 1989 and 1992
Authors: Micheelis Wolfgang , Bauch Jost
Published: May 2006

Abstract This paper presents selected results of two recent representative cross‐sectional studies of oral health in the German population, conducted by the IDZ (Institute of German Dentists) for the old Federal States (the former Federal Republic of Germany) in 1989 (n=174l) and the new Federal States (the former German Democratic Republic) in 1992 (P=1519). Each epidemiological study reported both clinical and sociological data. The following average DM FT values were determined: for the children aged 8/9 yr: 1.4; for the adolescents aged 13/14 yr: 4.9; for the adults aged 35–44 yr: 16.1; and for the adults aged 45–54 yr: 17.9. These are the overall averages for “Germany West” and “Germany East” combined. The overall results for periodontal health in adults were as follows: CPITN 0: 4.9%; CPITN 1: 11.2%; CPITN 2: 24.6%; CPITN 3: 42.7%; and CPITN 4: 16.6% for the adults aged 35–44 yr and CPITN 0: 2.4%; CPITN 1: 8.1%; CPITN 2: 20.4%; CPITN 3: 46.8%; and CPITN 4: 22.3% for the adults aged 45–54 yr. The following average tooth loss figures were calculated for Germany as a whole: age group 35–44 yr: 3.9 missing teeth; age group 45–54 yr: 7.7 missing teeth. In addition, all the morbidity data determined have been analysed for statistical significance in the comparison between “West” and “East” Germany. The prevalences presented are also differentiated according to the socioeconomic status (SES) of the subjects, with the lower social strata as a whole showing higher morbidity prevalences. Comparisons show that caries has declined significantly among children and adolescents in Germany in the last 10–15 yr. Finally, the authors recommend the inclusion of qualitative research techniques when studying the differential causation of the inverse correlation between oral morbidity and social status.
Initial development of a scale to measure dental indifference
Authors: Nuttall Nigel M.
Published: May 2006

Abstract Lack of concern about dental health contributes significantly to the reluctance of people to attend for dental check‐ups and to implement preventive dental measures. The aim of this study was to develop and assess a questionnaire method of detecting this attitude which was described as dental indifference. The questionnaire was tested on 910 dentate adults in Scotland. A 62% response rate was obtained. Five hundred of the respondents were then sent a second copy of the questionnaire to assess its reliability, a 67% response rate was obtained. The Pearson correlation coefficient between the first and second completion of the dental indifference questionnaire was 0.79. The internal consistency measured by Chronbach's alpha was 0.71. High scores on the dental indifference questionnaire were significantly associated with being young, male and a manual worker. High scorers had fewer teeth, on average, than the rest of the sample and more than half of them had no record of attending for denial care within 4 years. Those who did attend a dentist were more likely to have teeth filled or extracted. The dental indifference questionnaire may be useful for targeting groups who require oral health promotion activity and may prove to be a reliable means of identifying individuals who display behaviours which could be expected to be associated with a lack of interest in dental health, such as lack of compliance with oral care instructions and failing to complete courses of treatment.
Dentist service rates and distribution of practice styles over time
Authors: Brennan David S. , Spencer A. John , Szuster Fearnley S. P.
Published: May 2006

Abstract Studies of dentist service rates have identified clusters of dentists with particular styles of practice, but these practice styles need to be investigated to determine whether patterns of care become established and remain characteristic among dentists. The aims of this study were to establish dentist practice styles and to assess the distribution of these styles of practice between 1983 and 1988. A total of 202 private general practitioners who provided service rate data in both 1983 and 1988 were used in a cluster analysis to group dentists into practice styles. For both 1983 and 1988 three clusters of dentists were obtained, characterized by‐service rates as “High Restorative”, “Low Total Rates”, and “High Diagnostic and Preventive”. However, the distribution of cluster membership changed over time. The percentage of dentists in the “High Restorative” cluster decreased from 27.9%, in 1983 to 16.6% in 1988. the “Low Total Rates” cluster decreased from 60.7%, in 1983 to 49.2% in 1988, while the “High Diagnostic and Preventive” cluster increased from 11.4% in 1983 to 34.2% in 1988. The distribution of dentists between those practice styles may be related to ageing of dentists, practice maturation, population demographics, need or demand changes, or involve subtle differences in cluster classification over time.
Salivary mutans streptococci and dental caries patterns in pre‐school children
Authors: Thibodeau Edward A. , O'Sullivan David M.
Published: May 2006

Abstract Recent studies have suggested that the identification of caries as discrete patterns may be valuable in describing and predicting caries experience on an individual basis. The purpose of this study was to assess the association between levels of salivary mutans streptococci and the prevalence, incidence and distribution of caries patterns in the primary dentition. A cohort of pre‐school children (n=146, mean age 3.8 yr) were examined for dental caries and sampled for salivary mutans streptococci (SMS) at baseline and once annually for 2 yr. Children's tooth surfaces were categorized into four patterns: pit/fissure, maxillary anterior, posterior proximal, and buccal/lingual smooth surface. Salivary mutans streptococci were enumerated using a tongue blade technique, and were categorized as low (0 CPU), moderate (1–50 CPU) and high (>50 CPU). At year 2, children with high baseline SMS had the 1) highest prevalence of caries (87%) and the highest dmfs (9.15); 2) highest prevalence of each pattern, and 3) greatest number of patterns. Among children with the pit/fissure pattern, those with high baseline SMS had the greatest pit/fissure dmfs after 2 yr. Results show that baseline SMS levels were associated with both cross‐sectional and longitudinal caries experience, numbers of caries patterns, and the prevalence and severity of those patterns.
A two‐centre study to determine dentists' agreement with current guidelines on the frequency of bitewing radiography
Authors: Rushton V. E. , Horner K. , Worthington H. V.
Published: May 2006

Abstract The main aim of this study was to compare the intervals between initial and recall bitewing radiography recommended by general dental practitioners (GDPs) with those advocated in published guidelines. A questionnaire containing eight clinical scenarios was distributed to GDPs in two areas of England, Birmingham (fluoridated) and Manchester (non‐fluoridated). The response rate was 70.8% There was considerable agreement (>66.0%) with recommended guidelines for all low caries risk scenarios, but in three out of the four high caries risk scenarios a minority of dentists were in agreement (<49.5%). In high caries risk scenarios there was a tendency to over prescription with adult patients and under‐prescription for patients in the mixed dentition. For all low risk scenarios except the youngest patient, there was a significantly greater agreement with the guidelines amongst Birmingham dentists, with the Manchester group having a greater tendency to over‐prescription. This difference may be related to the effects of fluoridation of the water supply in the Birmingham area. There was generally greater agreement with the guidelines amongst younger dentists, with their older colleagues tending to tinder‐prescription. The results suggest that greater emphasis on selection criteria in continuing education of dentists is required.
Equality in satisfaction, perceived need, and utilization of dental care in a 50‐year old Swedish population
Authors: Unell Lennart , Soderfeldt Björn , Hailing Arne , Solén Göran , Paulander Jörgen , Birkhed Dowen
Published: May 2006

Abstract Satisfaction with dental care, perceived need for dental care, and dental care utilization were analyzed as to equality in geographical, socio‐economic, and gender distributions. The study base was a cross‐sectional mail questionnaire sent in 1992 to all 50‐year old persons (totally 8890) in Örebro and Östergötland counties in Sweden. Measures of the variables were all based on self‐assessments. The response rate was 71.3%. The results showed no large inequalities as to satisfaction, except the aspect travel time for rural residents. They also had higher perceived need for dental care. For utilization of dental care, workers were relatively fewer among “high” consumers. Controlling for socio‐economic group, there were twice as many men than women among “low” consumers. In conclusion, there was relative equality in the dental care delivery in this 50‐year old Swedish population, with some remaining social differences, primarily socio‐economically contingent.
Factors influencing the frequency of bitewing radiography in general dental practice
Authors: Rushton V. E. , Horner K. , Worthington H. V.
Published: May 2006

Abstract The aim of this study was to determine the influence of a range of patient and dentist factors on the prescription of bitewing radiography. A postal questionnaire of general dental practitioners working in the Birmingham and Manchester areas of England was used. Dentists were requested to score the influence of 15 factors upon their decision whether or not to take bitewing radiographs. Some of these factors were chosen to represent accepted “high caries risk” factors, some “low risk” factors, while others were chosen as they should be irrelevant to prescription of bitewing radiographs. There was a questionnaire response of 70.8%. Dentists recognized accepted high caries risk factors as being an indicator for bitewing radiography but the influence of low caries risk factors was less clear. Only “good oral hygiene” and the presence of “few restorations” were perceived as relevant to bitewing prescription, while fissure sealants were seen as an influence in favour of radiography by almost one third of dentists. Dentists tended to be influenced in their radio‐graphic practice by the opinions of patients and fears of medico‐legal consequences. Pregnancy was seen as contra‐indicatory for bitewings by almost all dentists. These results suggest that greater emphasis should be placed upon radiographic selection criteria in dental education.
Sociodemographic and dietary factors in relation to dental health among Greek adolescents
Authors: Petridou Eleni , Athanassouli Thessalia , Panagopoulos Haralambos , Revinthi Katharine
Published: May 2006

Abstract In the context of a project aiming to assess risk factors affecting health status of Greek adolescents, 380 adolescents aged 12–17 years were randomly selected from two rural high schools of similar socioeconomic status, and from two urban schools of different socioeconomic level, namely urban/lower and urban/higher. Dental examinations were carried out according to WHO diagnostic criteria: oral hygiene habits were recorded through personal interviews; and diet was assessed through interviewer‐administered, semi‐quantitative food frequency questionnaires. The percentage of caries‐free adolescents varied from 24.3 in the age group of 12–13 years to 13.2 in the age group 16–17 years: mean (SE) DMFT values were 3.7 (0.3) in the younger age group and 5.9 (0.4) in the older age group whereas mean (SE) DMFS values were respectively 5.6 (0.5) and 9.9 (0.9). Multiple regression analysis‐derived results showed that dental health, measured through either DMFT or DMFS indices, was significantly better among younger and male adolescents: among higher socioeconomic class urban residents; among those brushing their teeth at least once per day: and among those who had better school performance. There was evidence that intake of vegetables and milk products was associated with lower DMFS and DMFT indices, whereas there was a non‐significant tendency for sugar intake to be associated with higher values of these indices. In contemporary Greek society there‐are substantial social inequalities with respect to dental health: these are due, in part, to differences in oral hygiene habits and patterns of dietary intakes. High risk groups should be identified among the underprivileged for targeted health education efforts and delivery of more intensive dental care services.
Trends and fluctuations in the impact of oral conditions among older adults during a one year period
Authors: Slade Gary D. , Hoskin Greg W. , Spencer A. John
Published: May 2006

Abstract While longitudinal epidemiological studies document the rate of disease progression in populations, it is not known how people's lives are affected by oral conditions over a period of time. This study aimed to describe patterns of change in the reported impact of oral conditions among community‐dwelling persons aged 61 + years in South Australia. A self‐complete questionnaire, the Oral Health Impact Profile, obtained data about 49 impacts of oral conditions on everyday activities. Questionnaires were issued to 90 people once a month for 12 months and 67 people provided usable responses for at least nine months. The number of reported impacts per month formed the dependent variable for analyzing patterns of change. An increase or decrease of at least two impacts from one month to the next was categorized as a fluctuation. Year‐long trends of increase or decrease in at least two impacts were identified using linear regression. Most people (86.5 per cent) experienced no trend, although nearly one half of them reported fluctuations in at least one month. Trends were more likely among denture wearers and people with 16+ missing teeth (P<0.05), although the associations were confounded by initial impact scores which were higher for both groups. Impacts concerning eating and oral pain were subject to the greatest amount of change. The findings demonstrate that many older adults experience short‐term impacts of oral conditions during longer periods of temporal stability in perceived impact of oral health.
Dangerousness and dentistry: an explanation of dentists' reactions and responses to the treatment of HIV‐seropositive patients
Authors: Gibson Barry , Freeman Ruth
Published: May 2006

Abstract Factors which influence health professionals' willingness to treat HIV seropositive patients have been explained in terms of the concept of dangerousness. Can this concept be used as a vehicle to explain dentists' responses? All dentists currently in practice in Northern Ireland (n= 664) were invited lo take part in the study. A final valid response rate of 73.3% was achieved. Altitudes and behavioural aspects of dental practice were examined in relation to whether they had or had not treated and HIV seropositive patients. In addition correlation and factor analyses were conducted. The results indicated that the concept of ‘dangerousness’ provides a useful framework to explain dentists' attitudes and behaviours with respect to the provision of dental care for this patient group.
Testing a child dental neglect scale in South Australia
Authors: Thomson William Murray , Spencer Andrew John , Gaughwin Anne
Published: May 2006

Abstract The concept of dental neglect may allow a better understanding of the complex relationship between individual behaviour, environmental factors and dental caries in children. Dental neglect has been previously explored among elderly people, but little is known of its occurrence among children. A study of children's use of dental services in South Australia provided demographic and attitudinal data from parents of each of a stratified sample of 2659 children from age groups 10–11 and 14–15 years. Dental examinations were undertaken of a random sub‐sample of 769 children. Parental responses were sought to seven statements on different aspects of dental neglect. Factor analysis revealed two factors, one of which confirmed a general “dental neglect” phenomenon (which was significantly associated with all seven items); the other revealed an “avoidance of care” phenomenon which involved only two of the items. The internal consistency of responses across all seven items was confirmed (Cronbach's α=0.74), and the scores for the seven were summed to create a composite dental neglect variable. Linear regression analysis revealed that dental neglect was greater among males, younger children, those whose mothers had had less education, children who had not received dental care in the previous two years, and those for whom the responding parent's last dental visit was symptom‐driven rather than for a routine examination. The dental neglect variable was then dichotomised in order to examine its association with caries experience. Among the older children, those in the higher dental neglect group had significantly higher overall permanent caries experience (DMFS), and greater numbers of decayed permanent tooth surfaces (ANOVA, P<0.05). The outcome of this study indicates that the Dental Neglect Scale may have utility in predicting and understanding variation in dental health, and in designing and targetting dental health promotion strategies.
The oral health status of Omani 12‐year‐olds–a national survey
Authors: Al‐lsmaily M. , AI‐Khussaiby A. , Chestnutt I. G. , Stephen K. W. , AI‐Riyami A. , Abbas M. , Knight M.
Published: May 2006

Abstract This study reports the first ever national oral health survey of Omani 12‐year‐olds. Conducted in October 1993, of the 3,435 children examined, 1,438 (41.9%) were caries‐free, although regional variations ranged from 24.8% to 61.9%. Overall, the national DMFT averaged 1.53, the majority of caries experienced being in the form of untreated decay, with occlusal surfaces of first permanent molars being the most commonly involved site. Oral hygiene was poor, only 11% of those examined being scored as plaque‐free.
CPITN and the epidemiology of periodontal disease Commentary
Authors: Baelum Vibeke , Papapanou Panos N.
Published: May 2006

Abstract This paper discusses the purposes of collecting epidemiological data on periodontal disease, and concludes that the severe shortcomings of the CPITN makes it unsuited as a tool for assessing the prevalence and severity of periodontal disease.
Gender differences in characteristics, infection control practices, knowledge and attitudes related to HIV among Ontario dentists
Authors: McCarthy Gillian M. , MacDonald John K.
Published: May 2006

Abstract We surveyed 5,997 dentists in Ontario to investigate gender differences in the characteristics, infection control practices, knowledge and attitudes regarding the treatment of HIV‐infected patients. The response rate was 70.3%. Reports indicated that female dentists are younger and more likely to work in larger urban centres (P<0.00001), and in general practice (P<0.0001) than their male counterparts. Multiple logistic regression analyses indicated that many significant gender differences in the univariate analyses could be explained by the confounding influence of age, practice location, and specialty; however, some differences remain significant: Women were more likely than men to report attending continuing education dealing with HIV/AIDS in the past two years (P<0.001), and to use masks and eye protection (P<0.00001). Men reported more economic concerns than women: they were more concerned about the financial burden of infection control costs (P<0.00001), and losing patients from their practice if it is known that they treat patients with HIV (P<0.05). However, there were no significant differences in willingness to provide treatment for patients with HIV. We conclude that there is little evidence to show that access to oral care for patients with HIV is affected by gender differences.
Concepts of dental caries and their consequences for understanding the disease
Authors: Fejerskov O.
Published: May 2006

Abstract The way in which we conceptually consider dental caries determines our choice of preventive and treatment strategy. In this paper the definition of dental caries is discussed and the related problems concerning causality are addressed. Dental caries reflects symptoms of ongoing and past disease – not the disease itself. As such, it is important to record early stages of signs of the disease, i.e. non‐cavitated stages of lesion development. The dynamic nature of the processes leading to net loss of mineral (hence a lesion) is emphasized, and appreciating that caries is ubiquitous in populations around the world and initiation and progression of lesions continues lifelong leads to the logical conclusion that we can control dental caries through a variety of measures – but not truly prevent the disease. We can prevent cavities by controlling the pathophysiological events which may result in a net loss of mineral. The relative role of dental plaque in caries control is discussed in relation to the role of the many determinants which influence the likelihood for lesion development. It is concluded that several paradigms about the nature of dental caries should be reconsidered to provide the most cost–effective dental services.