bluuebunny/crossref_metadata_2025 huggingface dataset:
Reproducibility of examiner performance for muscle and joint palpation in the temporomandibular system following training and calibration
Authors: Goulet Jean‐Paul , Clark Glenn T. , Flack Virginia F.
Published: May 2006

Abstract – The purpose of this investigation was to assess examiner ability to consistently perform specific tasks related to muscle and joint palpation. Four trained and calibrated examiners were asked 1) to deliver index finger pressures within a high (1.5‐2.1 kg) and low (0.5‐1.1 kg) target pressure range and 2) to precisely locate one joint palpation and four muscle sites. After passing a calibration test, the performance of the examiners was monitored during the course of a replicability study assessing the consistency of clinical findings during repeated exams for TM disorders. (1) Index finger pressure was regularly tested over a 3‐month period with a hand held pressure algometer, and the reading of each trial was recorded. Data analysis showed a high proportion of trials within the pressure range (overall 89.5%). Examiner performance across target range of pressures was statistically different for success rate and mean pressure delivered. The differences in the mean finger pressure delivered by each examiner (intraexaminer variation) was low and varied from 0.12 to 0.22 kg/cm2 for the desired range of pressures. (2) Paired examiners were asked to independently and sequentially mark palpation sites over the forehead, superficial and deep masseter, anterior temporalis, and lateral capsule of the temporomandibular joint. Replicability of site locations was assessed by measuring, with a boley gauge, the distance between sites selected by the paired examiners. Except for the superficial masseter and the anterior temporalis, the paired examiners selected palpation sites within a distance of 7 mm more than 85% of the time. The mean distance between guessed palpation sites was the lowest for the forehead (3.6 mm; sd = 3.0) and the highest for the anterior temporalis (5.9 mm; sd = 3.5). Overall, this study clearly shows the ability of trained examiners to consistently perform technical tasks critical to the replicability of manual palpation procedures.
Relationship between epidemiologic coronal caries assessments and practitioners' treatment recommendations in adults
Authors: Bader James D. , Shugars Daniel A. , Rozier R. Gary
Published: May 2006

Abstract – Caries incidence determinations in adults reflect dentists' treatment decisions as well as epidemiologists' caries assessments because many patients receive treatment between the two assessments that are required to determine incidence. Yet knowledge of the relationship between epidemiologically assessed caries and practitioners' treatment recommendations is poor. In this study, the proportions of practitioners recommending treatment for a tooth, and the reasons for those recommendations, were compared across teeth grouped by their caries status as determined from an epidemiologic assessment. On average, for a tooth deemed carious by epidemiologic assessment, a mean of almost 90% of examining practitioners recommended treatment. Most but not all of these recommendations for treatment of teeth with epidemiologically determined caries were for caries‐related reasons. Among teeth classified as sound by epidemiological assessment, the mean proportion of dentists recommending treatment was 11%. For restored, non‐carious teeth a mean of 35% of examining dentists recommended treatment. Across all noncarious teeth, 25% of all treatment recommendations were related to caries. The mean patient F increment (number of newly filled surfaces) that would result from treatment recommendations practitioners indicated as being associated with caries was slightly less than one‐half of the total F increment. Thus, F increments may substantially overestimate caries incidence.
Should the drinking water of Truro, Nova Scotia, be fluoridated? Water fluoridation in the 1990s
Authors: Ismail Amid I. , Shoveller Jeannie , Langille Donald , MacInnis William A. , McNally Mary
Published: May 2006

Abstract – An epidemiological assessment of differences in caries and fluorosis prevalences between children in Truro (< 0.1 ppm) and Kentville (fluoridated at 1.1 ppm in 1991), Nova Scotia, Canada, was completed in 1991. Out of a total of 429 children, in grades 5 and 6, in the two towns in 1991, 219 (51%) were examined. Parents answered a self‐administered questionnaire investigating the sources of drinking water used by the children since birth, residence history, use of fluoride supplements, dentifrices, and other fluoride products during the first 6 yr of the life. The examination criteria differentiated between non‐cavitated and cavitated carious lesions. Dental fluorosis was measured using the TSIF index. Examiner agreement was excellent. Of the children examined, 80 (36.5%) drank water (fluoridated or non‐fluoridated) from municipal water systems during the first 6 yr of life. The children were assigned into five groups based upon residence history and exposure to fluoridated water during the first 6 yr of life. The percentage difference in mean DMFS scores between children in the fluoridated and non‐fluoridated groups is 17% (delta DMFS1 =0.7) when non‐cavitated carious lesions are included and 39% (delta DMFS2= 1.1) when they are excluded. The differences are not statistically significant. The significant risk factors associated with the DMFS1 and DMFS2 scores identified by a stepwise multiple regression analysis are: education level of the father, gender, and number of years of reported use of toothpaste during the first 6 yr of life. Dental fluorosis (mainly TSIF score of 1) was present in 41.5% and 69.2% of the children in the non‐fluoridated and fluoridated groups, respectively. Residence in a fluoridated area and the educational status of the mothers were positively associated with fluorosis status. It was concluded that water fluoridation be recommended as a part of an overall plan to educate the public and the medical and dental professions with respect to the proper and safe use of fluoride products. Determination of an optimal concentration of fluoride to be added to the water should take into account all potential major sources of systemic fluoride intake during the first 6 yr of life, including foods and beverages.
Association between untreated caries and age, gender and dental attendance in adults
Authors: Clarkson Janet Elizabeth , Worthington Helen Victoria
Published: May 2006

Abstract – The aim of the study was to examine the association between untreated caries on the crown and root of the tooth with the age, gender and dental attendance in a group of adult. Six general practitioners in the Greater Manchester area agreed to take part. Over a 6‐week period they collected clinical and personal data on 270 of their adult patients. No association was found between the mean number of coronal surfaces with caries and age; however, there was more root caries in people over 55 yr. More recurrent caries associated with a restoration was diagnosed than primary caries. There were proportionally more female than male regular attenders, and once attendance has been taken into account there were no gender differences for either coronal or root caries. Both coronal and root caries were associated with attendance, with irregular attenders experiencing more. Irregular attenders were three and a half times more likely to have caries on the root surfaces than regular attenders.
Perceived need and use of oral health services among adolescents and adults in Tanzania
Authors: Mosha Hiasinti Joseph , Scheutz Flemming
Published: May 2006

Abstract – The perceived need and use of oral health services among adolescents and adults in Tanzania were studied. One region from each of the country's five zones was chosen at random. Final sample selection (n= 1061) was done in the main towns of the selected regions. Participants were interviewed using a structured questionnaire which dealt with perceived need for dental treatment and use of oral health services and several demographic variables. Frequency tables were computed and analyzed. Odds ratios were calculated based on 2 × 2 tables and logistic regression models. The majority, 82% (95% CI: 79‐85%) had sought treatment due to pain or for tooth extraction. Perceived need, dissatisfaction with own oral health status and use of oral health services were slightly more frequent among women. Bleeding gums had no explanatory value on the dependent variables. The strongest explanatory variable in a logistic regression model for perceived need and dissatisfaction with own oral health status was previous dental treatment with an estimated odds ratio of 6.4 (95% CI: 4.7‐8.7) and 7.2 (95% CI: 5.3‐9.9), respectively. People living nearest a treatment facility tended to use the services more [odds ratio 1.3 (95% CI: 0.8‐2.1)]. A very strong relation between previous dental problems and use of oral health services was found, namely an odds ratio of 68.8 (95% CI: 39.0‐121.4). The findings in the study may be useful in the attempts to implement Tanzania's National Plan for Oral Health.
Concern for dental appearance among Norwegian young adults in region with low uptake of orthodontic treatment
Authors: Espeland Lisen V. , Grønlund Geir , Stenvik Arild
Published: May 2006

Abstract – The purpose of the present study was to examine orthodontic concern among orthodontically untreated young adults living in an area where the relative number of children receiving treatment was only 15–20% and to compare orthodontic concern among these individuals with that of untreated persons from an area with a higher treatment frequency. All the subjects were clinically examined and impressions for dental study casts, radiographs and photographs were taken. The subject's occlusion was classified according to two methods: 1) allocation to one of four groups according to the national Need for Orthodontic Treatment Index (NOTI), and 2) allocation to one of three groups according to presence or absence of six Anterior Occlusal Traits (AOT). Frequencies of NOTI scores demonstrated that in the study group more individuals were in need of treatment relative to the comparison group. Reported concern was at the same level in both groups, and significantly related to NOTI and AOT scores. The individuals in the area with the low treatment frequency were generally less aware of their anterior traits compared to the individuals in the area with a higher treatment frequency. The results indicated that a long‐term low uptake of orthodontic treatment among children in the particular area was not accompanied by a similar increase in concern about own dental appearance in early adulthood.
Gingival and periodontal health in systemic lupus erythematosus
Authors: Mutlu Serdar , Richards Andrea , Maddison Peter , Scully Crispian
Published: May 2006

Abstract – This study compared the periodontal health of patients with SLE with that of healthy controls. Patients with systemic lupus erythematosus had significantly lower periodontal probing depths compared with healthy controls. It is possible that systemic drugs such as corticosteroids and NSAIDS may be responsible for these reduced probing depths but this study did not reveal a statistically significant effect of drugs. There is thus no evidence for a predisposition to increased periodontal disease in SLE.
CPITN, DMFT, and treatment requirements in a Nicaraguan population
Authors: Smith Aric Clyde , Lang Walter Paul
Published: May 2006

Abstract – WHO basic methods were used to assess CPITN, DMFT, and treatment requirements in a population of 178 persons aged 12–64 yr living in urban and rural areas of Nicaragua. Two groups were examined: individuals presenting for dental treatment at health clinics (30%) and subjects chosen randomly at other locations (70%). Mean ages of both groups were similar although females were found in higher percentages among those presenting for dental care. With the exception of one young individual, all subjects had calculus in at least one sextant. About 26% of the subjects who presented for treatment had a 6 millimeter pocket compared to about 14% of the remainder of subjects. The mean DMFT for health clinic subjects was 16.1 compared to 10.3 for subjects from other locations. Subjects presenting for treatment had twice as many missing teeth and a mean of 0.5 filled teeth compared to 2.4 filled teeth for other subjects. Subjects at the clinics were in greater need of restorative care and extractions, while subjects from other locations were found to have more teeth that did not require any treatment. Health clinic subjects reported more visits to the dentist in the last year than other subjects. Only 80% of those presenting for treatment owned a toothbrush compared to 97% of those examined in other locations, and the latter group reported brushing their teeth more frequently. Attrition was a commonly encountered tooth disorder with 53% of all subjects exhibiting this condition.
Caries experience in Icelandic 12‐year‐old urban children between 1984 and 1991
Authors: Bjarnason Sibilla , Finnbogason Stefán Y. , Holbrook Peter , Köhler Birgitta
Published: May 2006

Abstract – In order to evaluate trends in caries experience, a 20% random sample of 12‐yr‐old residents of Reykjavik, Iceland (252 children) was examined clinically and radiographically in 1991 under conditions consistent with those of the survey conducted in 1984. In addition to caries data, frequency of toothbrushing and use of fluoride dentifrice were recorded. The mean DFT and DPS were 3.0 and 4.1, respectively. The decrease in caries experience reached 60% with an annual fall in DPS of nearly 10%. During the 7‐yr period between examinations the decline in DFT and DFS scores averaged 5.2 and 8, respectively, the annual reduction amounting to 0.7 DF teeth or 1.1 DF surfaces per child. The ratio of approximal/occlusal caries and the proportion of approximal caries were similar in both surveys. Fourteen percent of the children were free from manifest caries in 1991, but only 2% in 1984. Polarization between low and high prevalence individuals had intensified. Ninety‐five percent of the children brushed their teeth regularly and 97% reported using a fluoride dentifrice.
Characteristics and treatment outcome of diagnostic subgroups of CMD patients: retrospective study
Authors: Scholte Agnes M. , Steenks Michel H. , Bosman Frederik
Published: May 2006

Abstract – The records of 193 randomly chosen patients with CMD referred 2.5 yr previously were examined retrospectively for anamnestic, clinical and radiological findings and observations related to treatment. These data were supplemented with information from questionnaires sent to all treated patients in which their opinion on the treatment outcome was asked. Within the patient group, four diagnostic subgroups were distinguished. Three subgroups consisted of patients with the diagnoses CMD with a mainly myogenous component, osteoarthrosis and internal derangement respectively, whereas the fourth subgroup consisted of patients who did not fit into one of these categories. Differences between the four groups were found concerning mean age, the prevalence of a limited range of motion, headache, psycho‐social factors, loss of posterior tooth support and objective treatment outcome. The patients with CMD with a mainly myogenous component showed the highest percentages of CMD associated disorders, the least successful treatment outcome and the highest percentage of renewed treatment. The patients with internal derangement showed the lowest mean age, the highest prevalence of a limited range of motion and the best treatment outcome. The patients in the osteoarthrosis group showed the highest mean age and the highest percentage of loss of posterior tooth support. It may be concluded that the evaluation of diagnostic subgroups of CMD patients has to be preferred in the assessment of a heterogeneous group of patients with CMD.
What do anxious patients think? An exploratory investigation of anxious dental patients' thoughts
Authors: de Jongh Ad , ter Horst Guusje
Published: May 2006

Abstract – According to Beck's cognitive model of emotional disorders (1976) anxiety is associated with negative and threatening thoughts concerning the likelihood of personal danger. In the present study the content of thoughts of 32 anxious dental patients was investigated. Patients' mean score for the Dental Anxiety Scale was 17.1 (SD = 2.0). The average time period patients had not visited a dentist was 9.1 yr (SD = 8.7). Using semi‐structured interviews 132 thoughts were explored. The mean number of thoughts reported per patient was 4.1 (SD=1.6). Almost all patients reported thoughts in some way related to their fear. All patients except one reported self‐verbalizations of a negative or catastrophizing nature. Nine different categories of the content of the thoughts were identified. Nine percent of the thoughts consisted of visual images. The largest category (23%) consisted of catastrophic thoughts about the patient's own functioning during dental treatment, e.g., thoughts about losing control, panicking and dying. Fifty‐nine percent of the patients reported thoughts of this type. The findings provide support for Beck's cognitive model of emotional disorders.
Oral health care for nursing home residents in The Netherlands – a national survey
Authors: de Baat Cees , Bruins Hubert , van Rossum Ger , Kalk Warner
Published: May 2006

Abstract – In order to be able to develop adequate oral health care programs for nursing home residents in The Netherlands, currently available arrangements and problems experienced by dentists participating in this field of dentistry were evaluated in a national survey. One questionnaire was mailed to the managements of all nursing homes and a second to all dentists known to be involved in nursing home dentistry. The response rates were very high. The study indicated that, in almost every nursing home, dental care for residents was available, at least in cases of dental emergency. On average the dentists were spending only limited time on nursing home dentistry. The majority of dentists examined or treated the residents only when either the patients or others experienced or discovered an oral health problem. In delivering this kind of care the dentists experienced a lot of problems. These findings suggest that the oral health care for nursing home residents in The Netherlands must be evolved by research, special training of dentists, and through development of special care programs.
Assessment of reports by dentists of their restorative treatment thresholds
Authors: Nuttall Nigel M. , Pitts Nigel B. , Fyffe Hazel E.
Published: May 2006

Abstract – Questionnaires have been used to determine the point when dentists think a filling ought to be placed (restorative treatment threshold). This study assesses the method. 211 general dental practitioners were interviewed and asked to identify the point at which they would instigate restorative treatment in a 12‐yr‐old patient from a list of descriptions of lesions affecting buccal/lingual, occlusal and approximal surfaces. They were also asked to judge the likely depth and lateral spread of the lesion they chose and to identify a photograph resembling it (buccal/lingual and occlusal surfaces) or a line drawing and description of its expected surface appearance (approximal surfaces). The Pearson correlation coefficients between reported treatment threshold and the characteristics expected to be associated with them were poor. This suggests that there may be considerable variation in opinion between dentists about the underlying condition of carious lesions of similar surface appearance. There was no evidence that the treatment opinions of these dentists have changed markedly between 1987 and early 1991.
Epidemiological aspects of lip cancer in Scotland
Authors: Macfarlane Gary J. , Boyle Peter , Evstifeeva Tatiana , Scully Crispian
Published: May 2006

Abstract – The purpose of this paper is to present the descriptive epidemiology of lip cancer in Scotland. The incidence and mortality of lip cancer are found to be higher in men than in women and to have fallen remarkably among men. This decline has been the result of cohort effects indicating that the risk of lip cancer is decreasing among successively younger people.
Prevalence and characteristics of dental anxiety in Danish adults
Authors: Moore Rod , Birn Herluf , Kirkegaard Eigil , Brødsgaard Inger , Scheutz Flemming
Published: May 2006

Abstract – Prevalence, characteristics and consequences of dental anxiety in a randomly selected sample of 645 Danish adults were explored in telephone interviews. Participation rate was 88%. Demographics, fear of specific procedures, negative dentist contacts, general fear tendency, treatment utilization and perceived oral conditions were explored by level of dental anxiety using a modified Dental Anxiety Scale (DAS). A Seattle fear survey item and a summary item from the Dental Fear Survey (DPS) were also included for fear description comparisons. Correlation between these indices (DAS‐DFS: rs= 0.72; DAS‐Seattle item: rs= 0.68) aided semantic validation of DAS anxiety intensity levels. Extreme dental anxiety (DAS ≥ 15) was found in 4.2% of the sample and 6% reported moderate anxiety (DAS scores 14–12). Bivariate (B) and logistic regression (L) odds ratios (OR) showed that high dental anxiety was associated with gender, education and income, but not with age. Extreme dental anxiety for dentate subjects was characterized by fear of drilling (ORL= 38.7), negative dentist contacts (ORL= 9.3), general fear tendency (ORL= 3.4), avoidance of treatment (ORL= 16.8) and increased oral symptoms (ORB= 4.4). Moderate dental anxiety was also related to drilling (ORL= 22.3), but with less avoidance due to anxiety (ORL= 6.8) compared with low fear subjects.
How Swedish dental hygienists apply their training program in the field
Authors: Axelsson Per , Rolandsson Margot , Bjerner Bo
Published: May 2006

Abstract – The purpose of this study was to evaluate how clinical practice by Swedish dental hygienists was related to type of dental delivery system, period of training, educational institution attended and patient category. Dental hygienists from 14 different dental hygiene schools were represented. Of these schools. 11 are still in operation. A specially designed questionnaire was posted to all dental hygienists in Sweden (n= 1857). A total of 1399 questionnaire (75.3%) were completed and returned, providing data on 15546 dental appointments. 37.2% of the Swedish dental hygienists are presently working in private practices, 45.8% in the public dental health service and 6.2% in both. Of the patients treated by hygienists, 88.7% were adults: 99.5% in private practice and 78.4% in the public dental health service. 42.0% of all dental hygienists were trained in 1980–84. The mean treatment time per appointment in private practice was 49.7 min and 45 min in the public dental health service. Scaling, root‐planing and removal of overhangs took 27 min per visit in private practice and 22 min in the public dental health service. However, there were no significant differences in methods in the two delivery systems with respect to examinations, self‐care training, professional mechanical toothcleaning (PMTC), topical fluoride application, or salivary and oral microbiology tests. The adult patient categories were periodontal risk (45.1%), caries risk (9.1%) and hygiene (34.6%). In periodontal risk patients, scaling, root‐planing and removal of overhangs took 28 min per appointment and 14 min in caries risk patients.
Access to dental care – experiences of men with HIV infection in the United Kingdom
Authors: Robinson Peter G. , Croucher Raymond
Published: May 2006

Abstract – A piloted self‐complete questionnaire enquiring about dental experiences was administered to a consecutive sample of men with asymptomatic HIV infection attending a dedicated clinic in London. Forty‐seven men completed questionnaires. Despite a high level of dental attendance before diagnosis of HIV infection, 60% of the men had not visited a general dental practitioner since diagnosis. Nineteen men had visited a dentist since diagnosis; 15 had been refused or deterred by members of the dental team and 5 had attended without disclosing their HIV status. These data indicate that despite professional guidance to dentists, the perceptions of dentists held by people with HIV and the behaviours of dentists act as barriers to care. Dedicated dental clinics act as an important safety‐net for people with HIV infection.
Study of the dental health of children in remission from acute lymphoblastic leukaemia in Northern Ireland
Authors: Fleming Padraig , Kinirons Martin J.
Published: May 2006

Abstract – The dental health of 54 children in remission from acute lymphoblastic leukaemia was compared with a similar number of matched healthy control subjects. Frequency of dental attendance was similar in both groups but most children in remission from leukaemia attended a hospital dentist, whereas children in the control group visited a dentist in general practice or in the public health service. Children in remission from leukaemia used fluoride supplements significantly more frequently than their controls. There was no difference in plaque or gingivitis scores between groups. Children in remission from leukaemia had a significantly lower number of decayed primary teeth (d) than their matched controls but there were no significant differences between study and control groups of m, for Dmft values. There was a significantly greater number of extracted teeth (M) and a significantly greater overall decay experience (DMFT) in the permanent dentition of children in remission from leukaemia compared to their controls. There were no significant differences between study and control groups for D or F values. The mean number of sealed teeth per patient was significantly higher in the study than in the control group.
Prevalence of tongue lesions in 1013 Jordanian dental outpatients
Authors: Darwazeh Azmi Mohammad‐Ghaleb , Pillai Kamala
Published: May 2006

Abstract – Over a period of 10 months, 1013 consecutive dental outpatients attending the Screening Clinic in Faculty of Dentistry, Jordan University of Science and Technology, in the city of Irbid were investigated for the presence of tongue lesions. All subjects were seeking treatment for caries and periodontal diseases and none was complaining of oral mucosal disorder. The results showed that 240 subjects (23.7%) had one or more tongue lesions. Geographic tongue and fissured tongue were detected in 6.8% and 11.4% of the examined population respectively, and an association of the two conditions was observed in 2.9% of the subjects. Hairy tongue was diagnosed in 3.4% of the subjects with significantly higher prevalence in males (P < 0.0005). A strong correlation was found between hairy tongue and smoking.
Appraisal of dental anxiety and fear questionnaires: a review
Authors: Schuurs Albert H. B. , Hoogstraten Johan
Published: May 2006

Abstract –This article reviews and assesses six dental anxiety and fear questionnaires. The construct aimed at by the questionnaires, the data collected, their reliability, validity and normative scores are considered. Some attention is given to the correlations between the questionnaires, their ambiguity, the presence of manuals, and whether the questionnaires tap the three segments distinguishable on theoretical ground in dental anxiety/fear. All questionnaires are open to criticism. In the final assessment Kleinknecht's Dental Fear Survey is preferred to Corah's Dental Anxiety Scale. The latter, however, appears useful in getting a quick impression of anxiety and in evaluative studies. Three recently developed questionnaires, Stouthard's Dental Anxiety Inventory, Weiner's Fear Questionnaire and Morin's Adolescents’Fear of Dental Treatment Cognitive Inventory are considered promising, but for the last two instruments more data, in particular with regard to their validity, are needed. H is concluded that in dental anxiety research more than one questionnaire should be used and that it may be worthwhile to include other, non‐anxiety questionnaires as well.
Sociodental approach to the identification of dental treatment‐need groups
Authors: Maizels Joan , Maizels Alfred , Sheiham Aubrey
Published: May 2006

Abstract – The aim of this study was to propose a method that could be used to distinguish significantly different dental treatment‐need groups, to assist in planning more appropriate preventive dental health programmes than are now generally available. This involved the use of alternative new measures of dental status in conjunction with an indicator of people's potential, or “propensity” to adopt appropriate dental self‐care measures. One important finding, based on a detailed questionnaire and dental examination of a sample population, is that substantial groups have relatively low or medium levels of dental status even though they possess relatively high propensity for self‐care measures. A cross‐classification of oral health status with the propensity indicator is used to define different treatment‐need groups. Significant differences among these groups emerge in relation to various social indicators like age group, gender, region and dental history, and in relation to preventive dental health measures such as dental attendance and efficacy of teeth cleaning. The methodology proposed for identifying such different treatment‐need groups could be valuable in devising effective community dental health strategies.
Validity of CPITN's assumptions of hierachical occurrence of periodontal conditions in a Kenyan population aged 15–65 years
Authors: Baelum Vibeke , Manji Firoze , Fejerskov Ole , Wanzala Peter
Published: May 2006

Abstract – In order to study the validity of the hierachical principle of the CPITN we used data originating in a cross‐sectional study of periodontal disease in a random sample comprising 1131 Kenyans aged 15‐65 yr to determine, for each tooth present in each individual, the absence or presence of gingival bleeding, of dental calculus, of a pocket of 4–5 mm or a pocket of 6+ mm, such that each tooth had a separate recording for bleeding, calculus, pocket 4–5 mm and pocket 6+ mm. According to the hierachical principle of CPITN a tooth with pockets as the most severe finding is assumed positive also for calculus and bleeding, and a tooth with calculus as the most severe finding is assumed positive also for bleeding. Our analysis showed that calculus as the most severe finding of a tooth overestimates the occurrence of bleeding by up to 18%, depending on age of the individuals and the set of teeth examined. Pockets as the most severe finding in a tooth overestimates the occurrence of bleeding by up to 13%, and overestimates calculus by up to 54%, most pronounced in the younger age groups. The effect of these over estimations on prevalence and severity estimates was the most pronounced for the severity measures, particularly regarding the severity of bleeding, whereas prevalence estimates remained relatively unaffected. Undoubtedly, this result should be seen in the light of a very high prevalence and severity of both bleeding and calculus in this population.
Influence of CPITN partial recordings on estimates of prevalence and severity of various periodontal conditions in adults
Authors: Baelum Vibeke , Fejerskov Ole , Manji Firoze , Wanzala Peter
Published: May 2006

Abstract – This study compares the results of a lull mouth examination with the results of examining only the CPITN selection of 10 index teeth 17/16, 11, 26/27, 47/46, 31 and 36/37 for estimates of prevalence and severity of the conditions assessed with the CPITN, i.e. gingival bleeding, dental calculus, pockets 4–5 mm deep and pockets 6+ mm deep. The mean number of sextants recorded with bleeding or with calculus was generally overestimated when examinations were based on the CPITN selection of index teeth, whereas the mean number of sextants with pockets, whether moderate or deep, were generally underestimated. Similarly, the prevalence of pockets, whether moderate or deep, was underestimated in virtually all age groups while the prevalence of calculus was overestimated in all age groups and the prevalence of bleeding was overestimated among persons below 30 yr of age. We conclude that the partial recording approach of the CPITN methodology is reasonably well suited for identifying persons who are relatively healthy according to the hierarchy of the CPITN parameters. There is, however, a considerable risk that persons presenting with the more severe conditions, i.e. pockets, will be overlooked if only partial recordings are performed.
Aesthetic concerns of children and parents in relation to different classifications of the Tooth Surface Index of Fluorosis
Authors: Clark D. Christopher , Hann H. Jack , Williamson Malcolm F. , Berkowitz Jonathan
Published: May 2006

Abstract –Increasing prevalence of dental fluorosis for children both from fluoridated and non‐fluoridated communities are now well documented. Along with recent studies purporting possible adverse health effects from fluorides, this proven public health intervention is again being challenged. This study was undertaken to determine the prevalence of dental fluorosis for children from fluoridated and non‐fluoridated areas in British Columbia. In addition, children and parents were provided with an opportunity to express concerns about the aesthetics of the child's anterior teeth. Children from representative schools in two communities were surveyed using the Tooth Surface Index of Fluorosis (TSIF). Questionnaires were sent home to parents to detail their child's use of various fluoride preventive practices and residence histories. Completed questionnaires were returned and exams were performed on 1131 children. Of those examined, 60% had dental fluorosis on at least two tooth surfaces, only 8% had scores ranging from “2” to “6”, and 52% were classified with a score of “1”. Parental and child ratings on the aesthetics or color of the child's teeth suggests that there are few children with aesthetic problems in the TSIF category of “1”. While concerns of parents were more common, the actual source of those concerns was not assessed in the questionnaire. Not unexpectedly, children with fluorosis on anterior teeth ranging between TSIF scores of “2” to “6” appear to have increased concerns about tooth color. Data from children with confirmed residence histories from fluoridated communities suggest that the occurrence of aesthetic problems in these children is rare.
Prevalence and characteristics of areca nut chewers among junior high school students in Changhua county, Taiwan
Authors: Lu Chun‐Tai , Lan Shou‐Jen , Hsieh Chung‐Cheng , Yang Ming‐Jen , Ko Ying‐Chin , Tsai Chi‐Cheng , Yen Yea‐Yin
Published: May 2006

Abstract – Some studies indicate that betel quid and its ingredients chewing can produce cell mutagenicity and tumorigenicity. In Taiwan studies, betel quid chewing is the main cause of submucous fibrosis and oral cancer. Understanding the distribution and characteristics of the areca nut chewing population is one of the first steps in the effort to prevent these oral diseases. A stratified cluster random sample of 2442 junior high school students in Changhua county, Taiwan, were surveyed for the habit of areca nut chewing. Significantly more male students chewed areca nut than female students (9.2% vs 0.9%). The proportion of students who were chewing areca nuts increased with increasing (seventh to ninth) grades. Areca nut was used by junior high school students at a higher rate in village (rural) areas as compared to town (semi‐urban) and city (urban) areas (6.4%, 3.7% and 3.0%, respectively). More students in the ordinary achievement classes were chewing areca nuts than those in the high achievement classes (8.4% vs 1.6%). Areca nut chewing students tended to have users in their families. Cigarette smoking and alcohol drinking were positively associated with areca nut chewing. More than half (53.6%) of the areca nut chewing students first experimented with this habit with a family member, most often the father or grandfather.
A note concerning the caries preventive effect of Duraphat
Authors: Helfenstein Ulrich , Steiner Marcel
Published: May 2006

Abstract – In a previous article (I) we analyzed a series of eight studies concerned with the effect of Duraphat in the prevention of dental caries by means of meta‐analysis. A random effects model was used to estimate an overall effect size of caries reduction R and the corresponding confidence interval. In the present short communication we complement this previous study by neglecting the within study variation to the overall variation which is dominated by between study variation. This allows us to include a larger number of studies and thus make fuller use of the available information. We estimate non‐parametrical confidence intervals for effect sizes (caries reduction) by means of the “bootstrap method”. The overall caries reduction R on permanent teeth (14 studies) was estimated to be: R = 0.38 (95%‐CI: 0.25–0.50).
Four‐year study of caries inhibition of intensive Duraphat application in 11–15‐year‐old children
Authors: Sköld Lars , Sundquist Bertil , Eriksson Bo , Edeland Christer
Published: May 2006

Abstract – The purpose of the study was to evaluate the caries preventive effect and cost of an intensive application of Duraphat varnish, added to the regular preventive program for 11–15‐yr‐old children in a Swedish Dental Community Clinic. In 1987, the 134 11‐yr‐old children in Floda were divided into two groups, every second child to each. Children with fixed orthodontic appliances were excluded. The test group received three applications of Duraphat varnish during 1 week, once a year, by a dental nurse. The control group received one application at the annual check‐up. Both groups were included in the regular preventive program at the clinic. The total time cost for the clinic was estimated and used to calculate the cost per hour for dentists and nurses. The caries increment and progression were estimated both by routine diagnosis and by a careful study of radiographs taken at the beginning and end of the study period. There was a smaller caries increment and progression in the lest group as compared to the control group. The difference was statistically significant for all aspects studied. The costs were about the same in both groups but more time was used in the test group. The administrative effort for the staff was considerable for the intensive Duraphat application.
Social factors and self‐assessed oral health in South Africa
Authors: Gilbert Leah
Published: May 2006

Abstract – The question of what determines the dental needs of a population has been widely debated in the dental literature. Although there is no full agreement, the consensus is that substantial consideration should be given to the people's perceptions of what their needs are, based on self‐assessment of their oral health and satisfaction with the appearance of their teeth. These perceptions (self‐assessments) are likely to be shaped by their previous experiences with the dental service, their understanding of “normality” and knowledge of oral care, which are determined by social factors such as culture, class and race. The purpose of this paper is to examine self‐assessed oral health in South Africa according to relevant social factors. In 1988/89 a National Oral Health survey, which included a social survey, was conducted. The data were collected by means of a structured interview, based on a questionnaire, with a sample of 4652 adults aged 20–64 yr. The variables examined in this paper formed part of the items in the questionnaire. There is a higher level of identification that “something is wrong with teeth” in (a) lower educational levels (53%‐no formal education; 20%‐standard 10+); (b) lower income categories (43%‐lowest; 16%‐highest); (c) among Xhosa (66%), S. Sotho (58%) and Zulu (53%) speaking groups and (d) among Black people (54%). Similar trends are evident in the degree of satisfaction with the appearance of teeth. The results reveal differences in self‐assessed oral health among people with different educational standards, income levels, linguistic/cultural characteristics as well as racial groups as defined by the Population Registration Act of 1950. Thus suggesting that these factors should be considered in determining “dental needs” for future planning.
Public knowledge/perceptions about AIDS transmission: concerns about use of dental services
Authors: Grace Edward G. , Cohen Leonard A. , Ward Michael A.
Published: May 2006

Abstract – This telephone survey of 739 adults living in the State of Maryland (response rate 68.9%) examined the association between public perceptions and knowledge about the routes of transmission of AIDS, and concerns about contracting AIDS in a dental office and attitudes toward confidentiality of AIDS infected dentists and patients. The greatest areas of inaccuracies related to the risk of giving and receiving blood. Associations were demonstrated between public knowledge and concern about AIDS. Racial differences were found in both knowledge and concerns. Accurate dissemination of information to the public about AIDS is essential for the maintenance of public confidence and trust in the safety of dental offices and dental treatment.
A comparative study of costs for dental services and dentists’incomes in the United States and Norway*
Authors: Helöe Leif A. , Grytten Jostein , Warren Galen B. , Brown L. Jackson
Published: May 2006

Abstract – The United States and Norway have approximately the same per capita Gross Domestic Product (GDP) and average personal income, but their per capita health spending patterns are quite different. In 1982, the US spent 6.5% of its total health expenditures on dental services while Norway spent 5.4%. A higher percentage of Norwegian adults see a dentist annually as compared to US adults. In 1984, the mean net income of dentists in private practice was $66940 in the US and 27 125 in Norway; this is respectively 5 and 1 3/4 times the average per capita income in those countries. The American publicly‐employed dentist earned approximately two‐thirds of what the American private practitioner made, while still earning approximately 50% more than his Norwegian counterpart. Some basic information concerning the ratios of dentists, specialists, and dental hygienists to the population is given. The relative proportion of women dentists in the two countries is contrasted. Finally, data on graduates from the dental schools, enrollment cuts, and estimated dentist to population ratios by the year 2000 are described to compare future manpower that will be available to the two countries. Several dissimilarities in the political and social systems are described and discussed. It is emphasized that caution should be used when interpreting and comparing data about countries with different dental delivery, political, and social systems.
Restorative caries treatment patterns in Danish 20‐year‐old males in 1986 and 1991
Authors: Ekstrand Kim Rud , Carvalho Joana Cristina , Thylstrup Anders
Published: May 2006

Abstract – This study examines the restorative caries treatment pattern in Danish 20‐year‐old military conscripts in 1986 and 1991. The study groups comprised 85 and 164 males born in 1966 and 1971, respectively. The examination was performed as a part of the routine for each conscript according to directions from Dental Service, Danish Defense Forces and included surface recording of fillings on all teeth except third molars. Two bitewing radiographs were taken of all conscripts in the 1986‐group and of those who gave permission (59) in the 1991‐group. The mean number of filled surfaces was 10.2 and 8.8 in 1986 and in 1991, respectively. 80% of the occlusal surfaces on permanent first molars were filled in the 1986‐group and filled or sealed in the 1991‐group in contrast to 45% of permanent second molars. Data from maxillary molars indicated a tendency to placement of fillings related to tooth specific morphology whereas extended fillings involving the entire occlusal surface dominated on mandibular molars. The X‐ray examination disclosed that the majority of approximal molar surfaces were classified as sound in both study groups. Less than 1% of the approximal molar surfaces were recorded as having lesions penetrating deep into the dentin. In 1981 and in 1986 the participants in the study groups were 15 yr old. In these years the mean number of filled surfaces in Danish children amounted to 11.0 and 6.9 respectively, which indicates that very few lesions in need of operative treatment developed from age 15 to age 20 in both study groups.
Oral health status among schoolchildren in Romania, 1992
Authors: Petersen P. E. , Danila I. , Delean A. , Grivu O. , Ionita G. , Pop M. , Samolia A.
Published: May 2006

Abstract – In Romania, systematic information on the occurrence of oral diseases in children is scarce. The purpose of the present study was to describe the prevalence and the pattern of dental caries in schoolchildren, and to use the data to provide a baseline for planning and evaluation of oral health care. A national sample of children at grade I (n= 729) and grade 6 (n= 660) was chosen consistent with the WHO pathfinder principle. Clinical examinations were carried out according to the recording system for the Danish Municipal Dental Service and the following results were obtained. In children of grade 1 (7‐yr‐olds) the prevalence proportion of caries in primary teeth was 86% and in permanent teeth 39%. The mean caries indices were 11.4 dels and 1.3 DMFS. At grade 6 (12‐yr‐olds) the prevalence proportion of caries in primary teeth was 17% and in permanent teeth 90%. The mean caries experience was 0.8 defs and 6.5 DMFS, and a mean of 4.1 DMFT was observed. In both groups, the D‐component of the caries index was dominant. The children were also classified by caries severity zone. At grade 1, 61% had a very severe pattern of caries in the primary teeth, i.e. caries in pits/fissures, proximal surfaces, smooth surfaces, and incisors. Forty‐three percent of the children at grade 6 showed this pattern in permanent teeth. In Romanian schoolchildren the present level and pattern of dental caries are most severe and the implementation of oral health promotion and prevention at the community level is urgently needed.
Dental caries in preschool Beijing and Connecticut children as described by a new caries analysis system
Authors: Douglass Joanna M. , Yr Wei , Xue Zhang Bo , Tinanoff Norman
Published: May 2006

Abstract – A total of 625 children, 3‐4 yr old, 426 from Connecticut Head Start programs and 199 from Beijing area nursery schools, were clinically examined for dental caries. Results were analyzed using the traditional dmfs index as well as a new “Caries Analysis System”. This new system differentiated between caries patterns and examined the percentage of affected children (Prevalence), the degree to which these children were affected (Severity) and the proportion of total caries each disease pattern represented (Distribution). The Caries Analysis System revealed differences in caries experience and patterns among the racial/ethnic groups that the dmfs index did not. The Beijing children experienced the greatest Prevalence of all caries patterns; however, the Severity and Distribution of the caries patterns were similar to those of the Connecticut children. Within the group of Connecticut children, White children had the lowest Prevalence but the greatest Severity when compared with the Black and Hispanic children.