bluuebunny/crossref_metadata_2025 huggingface dataset:
Opinions of different subgroups of dentists and patients about the ideal dentist and the ideal patient
Authors: Lahti Satu , Tuutti Heikki , Hausen Hannu , Kääriäinen Risto
Published: May 2006

Abstract The aim was to study whether subgroups of lay people and dentists differ in their opinions about the ideal dentist and the ideal patient. This was done by analyzing further a data set containing responses on single statements regarding different aspects of dentist‐patient relationship that have been reported previously. A questionnaire containing 124 five‐class Likert scale statements and questions about the background of the respondents was sent in November 1988 to a representative sample of lay people and to all dentists in Kuopio and North Karelia Provinces in Finland. To extract areas of interdependence for both dentists and patients, factor analyses were applied to the data and factor scores were calculated for further analyses. Differences in the opinions were studied between dentists and patients as well as among subgroups of patients and dentists. The power of the selected factors in discriminating between dentists and patients, and different subgroups of dentists and patients was evaluated by means of logistic regression analyses. The expectations of dentists and patients were similar about the ideal patient. About the ideal dentist, dentists and patients agreed only on one of the five factors, i.e. communicativeness and informaliveness. Differences, especially in the opinions about the ideal patient, were found between following subgroups of patients: non‐regular and regular attenders, males and females, old and young, patients with low and high education and different occupational status: and between private practitioners and community dentists.
Changes in dental attitude and behavior among Dutch adults wearing complete dentures
Authors: Willemsen Werner L. , de Baat Cees , Truin Gert‐Jan , Burgersdijk Rob C. W. , Mulder Jan , Bronkhorst Ewald M.
Published: May 2006

Abstract In 1992 a follow‐up on the Dutch National Dental Survey of 1986 (DNDS) was performed. The main objective was to detect and analyze changes in oral self care, dental attendance, and oral health status. This paper will focus on the DNDS adults wearing complete dentures. Changes over a 6‐yr period will be presented of: dental attendance, denture satisfaction and wearing of the complete dentures, and denture treatments. A postal questionnaire was used: 232 persons (64%) participated in the study. Analysis of Variance (ANOVA) was used to study the effect of dental and social variables on observed changes since 1986. Risk ratios (RR) were computed to clarify the actual effects of these variables. With respect to dental attendance, a shift towards visits for denture check‐ups was found, thought to reflect the respondents' concern for their complete dentures (RR=1.6). A small shift towards more visits because of denture problems was found. This was attributed to denture treatments that had taken place between 1986 and 1992 (RR=2.8). With respect to changes in denture satisfaction, no influence of denture treatments could be noted, but a relation was found with a variable indicating the imperfection of the complete dentures as felt by the respondents (RR=2.8). In 31% of the respondents some denture treatment had been performed since 1986. No objective dental criteria of complete dentures and denture bearing areas had influenced these denture treatment decisions, but only respondents' subjective criteria (RR= 1.9–2.9).
Occupational health problems among dental hygienists
Authors: Jacobsen Nils , Hensten‐Pettersen Arne
Published: May 2006

Abstract A questionnaire survey on work‐related health complaints was performed among dental hygienists. Valid information was received from 189 hygienists, representing about half of all active members of the Norwegian Association of Dental Hygienists. Parallel information was received from similar number of female and male control persons in other occupations. The present report presents data on the nature and etiology of the chemically induced health complaints. About half of the hygienists had experienced one or more health problem of dermal, systemic, sensory (eye) or respiratory nature during the last year, as compared to 37% of the female and 19% of the male control group. The most frequent complaint was dermatoses of hands and fingers (37%), caused by different chemical, work‐related factors. Latex gloves were responsible for 1/3 of these reactions. The role of immunological and irritant latex reactions were discussed and the prevalence of non‐dermatological reactions compared with similar findings among women in other occupations.
Stability of Dental Anxiety Scale scores: a longitudinal study of older adults
Authors: Locker David , Liddell Andree
Published: May 2006

Abstract With the exception of studies of children, how dental anxiety changes with aging has not been the topic of research. Studies of non‐patient populations have been cross‐sectional in design and no truly longitudinal data have been reported. In this study, 272 adults aged 50 yr and over completed the Dental Anxiety Scale at baseline and at a 3‐yr follow‐up. The main finding was that DAS scores showed a high degree of stability in this group of subjects. At baseline the mean DAS score was 7.6 and at follow‐up it was 7.4. The proportion classified as having high levels of anxiety declined marginally from 7.0% to 5.4%. While 9.0% of subjects showed changes in DAS scores of 4 or more, it is not certain that this represents real change or a degree of unreliability in the measure. The only subject characteristic associated with change in scores was gender. The mean scores for men decreased while the mean scores for women increased. Overall, the magnitude of these changes was very small. However, for a minority of subjects more substantial changes were observed which may be clinically significant.
Dental caries among children from Solntsevsky – a district in Moscow, 1993
Authors: Kuzmina Irina Nikolævna , Kuzmina Edith , Ekstrand Kim Rud
Published: May 2006

Abstract In order to provide a baseline for planning a caries preventive program for children in a district in Moscow, samples of 6‐, 8‐, 10‐, 12‐, and 14‐yr‐old children were examined. The initial examination included recording of plaque on selected surfaces using a classification from 0 to 2 (thick plaque). After supervised tooth brushing, the children were examined for caries. Each tooth surface was examined and classified in progressive stages of caries involving opaque enamel lesions, increasing stages of cavity formation, fillings with and without caries and extractions due to caries. Gingival status in selected locations was classified from 0 to 2 (severe inflammation). More than 2/3 of the children had surfaces covered with thick plaque (score 2). Gingivitis was observed in one or more places in 2/3 of the children. Caries experience in the primary dentition was high, and low to moderate in the permanent dentition. However, the average number of surfaces with deep dentin cavitation, indicating pulpal involvement in 14‐yr‐olds, was 1.7. Caries on primary molar teeth accounted for about 80% of the accumulated caries experience among the 8‐yr‐olds. Caries on permanent first molars accounted for about 70% of the accumulated caries experience among the 14‐yr‐olds. The occlusal surface on permanent first molars was the most prone to caries in the permanent dentition.
Social and behavioural indicators of caries experience in 5‐year‐old children
Authors: Schou L. , Uitenbroek D.
Published: May 2006

Abstract The aim of this study was to investigate the relative influence of socio‐economic status and behaviour on dental health of 5‐yr‐old children. Dental data from a representative sample of 5‐yr‐old children from Lothian, Scotland, were analysed in combination with reported behavioural data collected by standardised telephone interviews of the mothers. Dental data was established for 520 children. A total of 324 mothers of these children were interviewed giving a response rate in relation to the original sample frame of 62.3%. Caries experience increased with both decreasing toothbrushing behaviour and a more manual occupational status. The relationship between the parent's occupation and the child's dental health was almost two times as large as the relationship between reported toothbrushing behaviour and the child's dental health. Caries experience increased with both increasing sweet consumption and a more manual occupational status. The relationship between the parent's occupation and the child's dental health was almost four times as large as the relationship between reported sweet consumption and the child's dental health. In conclusion, dental health in 5‐yr‐old children is related to parent's occupation and toothbrushing and sweet consumption. Occupational status is a much stronger factor than behaviours as reported by mothers.
Water fluoridation, bone density and hip fractures: a review of recent literature
Authors: Raheb Joseph
Published: May 2006

Abstract A review of recent scientific reports that investigated an association between exposure to fluoride in drinking water and the incidence of hip fractures in the aged found inconsistent results. Although some studies suggest that exposure to fluoridated water is associated with an increased risk of hip fracture, others found no association or a decreased risk of hip fracture associated with exposure to fluoridated water. The inconsistent findings could in part be attributed to the limitations of the ecological study design used in many of the studies. This design is useful for formulating hypotheses but, to test these hypotheses, analytical studies conducted among individuals are required. Recent studies conducted on individuals found that exposure to high fluoride levels (3.5–4.0 mg/1) in the drinking water was associated with reduced radial bone mass. Few individuals studies included communities with low fluoride levels in their drinking water, so the effects on bone from exposure to optimum levels of fluoride (ca. 1.0 mg/1) could not be determined. The number of reported hip fractures in several studies was too small to enable conclusions to be drawn about hip fracture risk. Osteoporosis is a major contributor to fractures in the aged, so it is important in hip fracture studies to collect data about the known risk factors for osteoporosis as well as history of exposure to fluoride. This enables control of the effects of confounding factors in the statistical analyses. Further research to determine a cause and effect relationship between fluoridation and hip fracture incidence is warranted.
Relationships between free smooth surface and proximal caries in the young permanent dentition
Authors: Bjarnason Sibilla , Grondahl Hans‐Goran
Published: May 2006

Abstract Cross‐sectional relationships between free smooth surface and proximal caries were assessed in 3 age groups, comprising 252 subjects aged 12 yr, 301 aged 15–16 yr and 102 aged 18–19 yr. Caries diagnosis was clinically on while spot and radio graphically on enamel lesion level. Fair correlation between buccallingual and proximal caries observed among 12‐yr‐olds (r=0.47) declined in the older subjects (r=0.24). While statistically significant the variability in proximal caries, explained by buccal‐lingual lesions, was low (range 6–22%). Sensitivity and specificity for buccal‐lingual lesions as an indicator for proximal caries in the same tooth ranged from 0.37–0.44 and 0.84–0.91, respectively, with associated Pv+ and Pv– ranging from 0.41–0.44 and 0.84–0.91, respectively. Sensitivity and specificity for buccal‐lingual caries in identifying subjects with proximal caries ranged from 0.33–0.44 and 0.67–0.98, respectively. Pv+ ranged from 0.94–0.99 and Pv‐ from 0.06–0.35. ROC curve analysis yielded Az‐values of about 0.76 in the two younger age groups and 0.57 in the oldest. The results imply that information obtained from visual examination should be applied with caution when inferences about current caries status on proximal surfaces are made from the presence of buccal‐lingual caries.
Incremental susceptibility of individual tooth surfaces to dental caries in Scottish adolescents
Authors: Chestnutt Ivor G. , Schäfer Fred , Jacobson Alyson P. M. , Stephen Kenneth W.
Published: May 2006

Abstract This study reports on the caries susceptibility of tooth surfaces in 4294 adolescents (mean age 12.5 yr) during a 3‐yr, double‐blind clinical caries trial, conducted in Lanarkshire, Scotland, between 1988 and 1992. Children were selected on the grounds of dental maturity and past caries experience. Clinical examinations with mirror, CPITN probe and fibre optic trans‐illumination were carried out on the permanent dentition, with the buccal pits of mandibular molars and palatal pits of maxillary molars being recorded as separate sites. At baseline 6061 surfaces were decayed (1.0% of 601 160 surfaces examined), 20 160 (3.4%) filled, and 10 909 (1.8%) missing due to caries. The number of surfaces recorded as sound at baseline in subjects completing the study was 454 663. Of these 8176 (1.8%) new surfaces were decayed, 14 832 (3.3%) filled and 4000 (0.9%) missing at the final examination. Molar occlusal surfaces showed greatest susceptibility to attack, 35.8% of those at risk becoming carious in the course of the study. All buccal and lingual smooth surfaces showed a low susceptibility, but 8.8% of buccal and palatal pits developed caries. At the final clinical ‐ only examination, pit and fissure caries accounted for 48%, inter proximal surfaces for 39%, and smooth surfaces for 13% of caries prevalence. However, overall the contribution of these surfaces to 3‐yr increments was, 40%, 47%, and 13%, respectively.
Improving dental health status indicators for evaluation
Authors: Lewis Jenny M.
Published: May 2006

Abstract Central to the evaluation of any dental health programme is the dental status of the population it serves. The DMFT index has been widely used to indicate dental status in evaluations, however, there are a number of characteristics of the DMFT index which undermine its value in evaluating programmes. The aim of this study was to compare DMFT, live utility weighted versions of this index, and single measures of caries experience, in order to determine their relative validity. The indices were investigated in terms of two criteria: 1) the percentage of variance explained by a set of antecedent and behavioural variables in a series of multiple regression analyses; and 2) percentage changes in the indices following re‐examination of the population after live years. Results show that the variance explained by the different composite indices ranged between 29% and 46%, while it varied between 16% and 49% for the single measures. The size of percentage changes after five years ranged between 0% and 4.5%, and indicated that utility weighted indices were generally not more sensitive than the DMFT, but that some single measures were. Where composite indices are required, a lull quality adjusted tooth years (QATY) approach, rather than utility weighting the DMFT index, may be required to improve the validity of dental health status indicators. Single rather than composite measures also provide valid information for evaluating dental programmes.
Salivary flow and risk of tooth loss in an elderly population
Authors: Caplan Daniel J. , Hunt Ronald J.
Published: May 2006

Abstract To investigate the relationship between salivary How and tooth loss, SIS randomly selected dentate people aged 65 and older and living in North Carolina were administered a dental health interview and examination. A single parafinstimulated whole saliva sample of 3 ml was collected and flow rate was calculated. Three years later, 490 people were re‐examined and tooth loss was determined. Thirty‐five percent of the participants had salivary flow rates of 1.0 ml/min or less at baseline and 41% lost at least one tooth over the 3‐yr follow‐up. A logistic regression model controlling The marital status, race, and socioeconomic status showed that those with low salivary flow were more likely to lose at least one tooth during the 3‐yr study period than were those with normal How (odds ratio=1.52, 95% CI= 1.02–2.24). Results from this representative study of community‐dwelling older adults support the concept that compromised salivary How is related to tooth loss. This finding should be considered in the management and prevention of oral diseases.
Expectancy‐value approach to drinking of non‐sugared mineral water among adolescents
Authors: Åstrøm Anne nordrehaug , Rise Jostein
Published: May 2006

Abstract This study set out to predict the intention to drink non‐sugared mineral water and the performance of this behavior in a group of Norwegian adolescents using the theories of reasoned action and planned behavior. The empirical data stem from The Norwegian Longitudinal Health Behavior Study, and a comprehensive questionnaire survey was performed in September and October 1992. The study group comprised 970, 15‐yr‐old adolescents, considered to be representative of this age group in the county of Hordaland. After a 4‐week period actual behavior was assessed in a subgroup (n= 170). The theories posit that a person will probably perform a behavior if she/he intends to perform the behavior and has actual control with its performance. Behavioral intention is in turn governed by three types of predictors: altitudes, subjective norms and perceived behavioral control. Multiple regression analysis showed that the intention to drink non‐sugared mineral water was primarily governed by perceived behavioral control and altitudes while subjective norms had less impact. Invention alone turned out to be The immediate determinant of drinking of non‐sugared mineral water, which implies that performance of this behavior presents few problems regarding actual control.
Two‐center clinical trial of implant–retained mandibular overdentures versus complete dentures – chewing ability
Authors: Geertman Maria E. , Boerrigter Elisabeth M. , Van't Hof Martin A. , Van Waas Marinus A. J. , van Oort Rob P. , Boering Geert , Kalk Warner
Published: May 2006

Abstract This study is a two‐center clinical trial with the aim to assess the treatment effects of implant‐retained mandibular overdentures versus conventional complete dentures. Treatment had been assigned according to a balanced allocation method. The following criteria were used to enhance the comparability of the treatment groups: age, gender, the edentulous period of the mandible, the number of previously made mandibular dentures, the number of years having worn the present mandibular denture and the symphyseal bone height. 151 patients with severely resorbed mandibles participated in the study, they were treated at two centers. Ninety‐one patients received an implant‐retained mandibular overdenture (IRO) and 60 patients a conventional complete denture (CD). Since some patients refused the allocated treatment the “Intention To Treat” principle was applied. This implies that patients are evaluated in the originally allocated treatment group regardless of the actual treatment they received. Patient's experiences were evaluated before treatment and I yr after insertion of the new dentures. Results before treatment showed that both treatment groups were comparable: they were dissatisfied with their mandibular denture and they could hardly chew tough or hard foods. One year after insertion of the new dentures the IRO‐group was satisfied with their mandibular denture, whereas only one third of the CD‐group was satisfied. With respect to the chewing ability the IRO‐group scored significantly better than the CD‐group (P0.0001).
Self‐assessed bleeding in monitoring gingival health among adolescents
Authors: Kallio Pekka
Published: May 2006

Abstract The purpose of this descriptive, cross‐sectional community‐based investigation was to assess the self‐assessment of bleeding and plaque as methods to monitor gingival health among adolescents. Two study groups (n=184 each) of 14‐year‐old Finnish school children performed either of self‐assessment plaque or bleeding. Prior to that they were clinically examined by 10 dentists from the community dental service who recorded bleeding on probing from four surfaces of all teeth (BOP%) and Community Periodontal Index of Treatment Needs (CPITN) status. The self‐assessment of plaque was not significantly correlated with a clinical bleeding on probing measurement (BOP%). The self‐assessment of bleeding, based on observed bleeding after toothbrushing and after interproximal cleaning with toothpicks, exhibited statistically significant correlation with BOP% (r=0.54, P<0.001). Percent agreement was 75%, kappa agreement 0.33, sensitivity 31% and specificity 71%. respectively. In conclusion, the preliminary results suggest that the self‐assessment of bleeding does not have sufficient validity for screening individuals but it could be a useful method for monitoring gingival health of populations, in particular, if the concurrent aim is to enhance periodontal awareness.
Profile of work‐related health complaints among Swedish dental laboratory technicians
Authors: Jacobsen Nils , Derand Tore , Hensten‐Pettersen Arne
Published: May 2006

Abstract The purpose of the present investigation was to assess the prevalence and nature of occupation‐related health problems among Swedish dental laboratory technicians. A 4‐page questionnaire listing seven groups of health complaints was completed by 489 male and 242 female technicians, representing 56% of the active members of their organization. Similar information from 163 males and 160 females with other occupations was used for comparison. The biannual prevalence of health problems among the technicians was 79%, comprising musculoskeletal (68%), dermal (34%), respiratory (31%), neurological (26%), systemic (19%) and eyesight/hearing problems (15%). Job‐specific ergonomic and stress factors were responsible for museuloskeletal and neurological (finger) reactions, whereas chemical insults, grinding dusts and indoor climate caused dermal, respiratory and systemic reactions. There was no age prevalence as regards health complaints, but female technicians consistently showed a larger prevalence of museuloskeletal, dermal, systemic and neurological complaints than their male counterparts (P<0.05, x2). A similar sex difference was also present in the control group. A considerable part of the reactions were perceived to be of minor importance, bringing the total biannual prevalence down to 57%. However, the prevalence of job‐related health complaints was still higher among the technicians than in the control groups for all indicators except systemic and eyesight/hearing problems. The profile of health complaints among dental laboratory technicians was characterized by musculoskeletal, neurological and dermal reaction, underlining the importance of job‐specific ergonomic and chemical hazards. Only a few of the technicians had consulted medical personnel.
Number of mutans streptococci or lactobacilli in a total dental plaque sample does not explain the variation in caries better than the numbers in stimulated whole saliva
Authors: Sullivan Å. , Borgström M. K. , Granath L. , Nilsson G.
Published: May 2006

Abstract For practical reasons the numbers of mutans streptococci (MS) and lactobacilli (LB) in plaque are commonly estimated from saliva samples. The saliva counts are considered to be a reasonable indicator of the entire dentition's total microbial load. However, the value of salivary counts for explaining and predicting caries have been found to be low. There was therefore reason to compare the relationships between caries on the one hand and, on the other, the number of MS or LB in plaque and in saliva, respectively, in order to assess their relative merits for explaining the variation in caries, both in a total material and in subgroups with less favourable oral hygiene. Sixty children aged 14–15 years participated in the study. Caries and plaque were registered and the number of MS and LB was estimated in total plaque and in stimulated saliva samples. The results showed that the number of MS or LB in plaque did not explain the variation in caries to a greater degree than did the salivary counts. For both bacteria the explanatory values increased, as expected, in subgroups with less favourable oral hygiene, but not even at this higher level of explanation was there any difference between plaque and saliva. The LB count was a stronger explanatory variable than the MS count. It was concluded that the number of MS and LB, estimated in total plaque as well as in saliva samples, is not a useful tool in prediction.
Dental caries in relation to diet, saliva and cariogenic microorganisms in Tanzanians ot selected age groups
Authors: Mazengo Mazengo C. , Tenovuo Jorma , Hausen Hannu
Published: May 2006

Abstract The relationship between diet and dental caries in a Tanzanian population was studied. Mutans streptococci, lactobacilli. yeasts, salivary flow rate as well as buffer effect were also analyzed. A random sample of 12‐, 35–44‐ and 65‐ to 74‐year olds was drawn from Msongola (rural) and Ukombozi (urban), Dar‐es‐Salaam. The mean of two 24‐h recalls was used for the assessment of food intake. The percentage of those with at least one carious tooth ranged from 30% in the 12‐year‐olds to 80% in the oldest age group. The mean number of decayed teeth (DT) increased significantly with age (p=0.000) but was not significantly associated with the area of residence. DT increased significantly (p=0.048) with the number of snacks per day and was also associated with dietary sucrose (P=0.025). total carbohydrates (p=0.002) and fiber (p=0.002). Among salivary variables lactobacilli (p.000) correlated positively with DT. Our study did not reveal any strong association between total energy intake and dental caries in rural or urban populations in Tanzania but snacking and sucrose intake were significantly associated with caries, in particular in the urban area.
Patterns of and reasons for tooth extractions in general dental practice in Ontario, Canada
Authors: Murray H. , Locker D. , Kay E. J.
Published: May 2006

Abstract While substantial proportions of the population of Ontario, Canada continue to have teeth extracted, little is known about the reasons for this loss. In this survey of Ontario general dental practitioners. 128 dentists provided information on 6143 patients they saw during a reference week. Approximately one‐in‐seven of these patients had or were going to have one or more extractions as part of their current course of treatment. The mean number of extractions for patients having at least one tooth taken out was 2.3 (SD=2.5). Emergency patients were more likely than regular patients to have at least one extraction but, on average, had fewer teeth taken out. Orthodontic considerations were the main reason for tooth loss in childhood, caries continued to be an important cause of tooth loss at all ages and periodontal disease accounted for more teeth lost after 40 years of age than caries. This study differs from almost all others in finding that, overall, more permanent teeth were extracted because of periodontal disease than because of caries. The former accounted for 35.9% of teeth lost and the latter for 28.9%. While this may be due to methodological differences between this and other studies, it is consistent with epidemiological data on periodontal disease in the Ontario population and data showing that Ontarians receive little in the way of periodontal care.
Caries experience and fluorosis prevalence in Chilean children from different socio‐economic status
Authors: Villa Alberto E. , Guerrero Sonia
Published: May 2006

Abstract Caries experience and enamel fluorosis prevalence in 8‐year‐old children belonging to different socio‐economic classes were determined in two Chilean twin cities that are served by optimally fluoridated community water from the same waterworks facility. Low socio‐economic status (LSES) children had a higher mean dm ft and DMFT indices (P<0.001) than high socioeconomic status (HSES) children. Prevalence of enamel fluorosis in the permanent teeth of LSES children was 0.79, significantly higher (X2= 9.0; P<0.003) than the value 0.59 found in HSES children. The proportion of Dean's scores 2. 3, 4 and 5 in first molars, mandibular and maxillary incisors in LSES children was higher than in HSES children (P<0.001). Differences in prevalence and seventy of enamel fluorosis between both groups are tentatively attributed lo a different pattern of tap water and tea consumption at pre‐school ages. Suggestions are advanced to minimize the undesirable prevalence and severity of enamel fluorosis.
Structural comparison of a translated dental attitude questionnaire: a factor analytic study
Authors: Timmerman E. M. , Hoogstraten J. , Nauta M. , Meijer K.
Published: May 2006

Abstract In 1984 the Dental Attitude Questionnaire (DAQ). an instrument for assessing various aspects of a person's attitude toward oral health care, was presented by Stockwi‐xl & Banting. The DAQ consists of six content scales. Cynicism. Health Concern, Motivation, Oral Function, Social Aesthetic and Susceptibility, and two validity scales, Halo and Infrequency. A Dutch translation was presented in 1986 by Key index words: Hoogstraten & Broers. In order to replicate the factor analysis on the original DAQ as reported by Stockwell & Banting the present study was undertaken. The results show a change in factor structure from a three factor solution to a two factor solution. A confirmatory factor analysis shows that the original three factor structure of the DAQ is not present in the data collected with the translated version. To account for this change, some possible reasons are discussed.
Patients' expectations of an ideal dentist and their views concerning the dentist they visited: do the views conform to the expectations and what determines how well they conform?
Authors: Lahti Satu , Tuutti Heikki , Hausen Hannu , Kaarianen Risto
Published: May 2006

Abstract A convenience sample of patients (n=271) from community health centres and private clinics in different parts of Finland were recruited for this study through their dental clinic. Equal numbers of regular and irregular clients were invited to participate. Before the treatment procedure, each patient filled out a questionnaire with forty Likertian statements dealing with their expectations of an ideal dentist, and nine about their own background, i.e., age. sex, regularity of dental visits, basic and professional education, and occupation. After the treatment subjects described their treating dentists' behaviour using similar statements. In the analyses two approaches were applied. First, factor analyses with orthogonal varimax rotation were conducted with the data about the ideal and actual dentist. For the ideal dentist, five factors were extracted: 1) mutual communication, 2) fair support, 3) personal appearance, 4) preferred type of practice, and 5) blaming; and for the actual dentist 5 factors were extracted: 1) mutual communication, 2) pain control, 3) fair support, 4) personal appearance, and 5) preferred type of practice. The factor structures were found to be similar when they were compared with transformation analysis. This justified the second analysis where the differences between the ideal and the actual factor scores were compared. The expectations of the patients were met on all the other dentist characteristics except mutual communication and fair support. There were not many differences between subgroups of patients. In further studies, other background variables, such as previous experiences of the patients, should be considered in order to obtain a more complete explanation of the variation in satisfaction. More attention should be paid to the communication skills of the dentists.
Oral health and family characteristics of children attending private or public dental clinics
Authors: Woodward Graham L. , Leake James L. , Main Patricia A.
Published: May 2006

Abstract The City of North York Public Health Department (NYPHD) operates a school‐based dental programme that provides preventive and treatment services to children according to evidence‐based practice guidelines. This programme and private dental practices (PDP) represent the only sources of dental care for children in North York. The purpose of our study was to compare the oral health and family characteristics of clients from the NYPHD and PDP using a dental examination and a parent interview. Results showed that NYPHD and PDP clients had similar levels of lluorosis, calculus, and periodontal health, but NYPHD clients had experienced greater levels of decay. Clients of the NYPHD and PDP also had significantly different family characteristics, many of which were significantly associated with the presence of one or more decayed primary or permanent teeth. Multivariate logistic regression identified mother's immigration history, past caries experience, and parents' rationale for scheduling their child's dental appointments as the principle risk makers for dental decay. When compared with PDP clients, the NYPHD serves higher‐needs children who otherwise might not receive care.
Dutch dentists' conceptions of dental silver amalgam
Authors: Schuurs Albert H. B. , Hoogstraten Johan , Eijkman Michiel A.J.
Published: May 2006

Abstract A sample of 468 dentists completed a questionnaire on their conceptions of amalgam. A minority (1–3%) reported that amalgam often causes toxic, galvanic and/or allergic side‐effects. A considerably larger number (10–30%) stated that such side‐effects ‘sometimes’ occur, while less respondents (6–11%) said they did not know. 60–80% said that such side‐effects do not exist, or rarely. If a patient requested the removal of amalgam, one‐third of dentists would do so often for cosmetic or toxic reasons, but only one‐fifth in the case of a proven allergy. A very substantial percentage would not remove amalgam except for cosmetic reason. Substantial minorities thought that amalgam should not be used for pregnant women or children, or admitted that they did not know. The use of amalgam was rejected by 5%, while 9% could not decide whether they were for or against its use. Multivariate analysis reveals the existence of two dimensions in the data. The first dimension, referred to as “acceptance‐of‐amalgam”, makes it possible to distinguish a subsample (about 9%) consisting of “rejectors‐of‐amalgam”. On the second dimension, referred to as “conviction”, a subsample (almost 20%) of “doubters” can be discerned, alongside “convinced adversaries” (about 4%) and “convinced advocates” (some 25%). The majority of the respondents are thought to be more or less in favour of the use of amulfljiim.
Adjustment of the M‐component of the DMFS index for prevalence studies of older adults
Authors: Lawrence Herenia P. , Beck James D. , Hunt Ronald J. , Koch Gary G.
Published: May 2006

Abstract Cross‐sectional studies of caries in older adults report a substantial number of missing teeth, making it difficult to estimate caries experience accurately. The goal of this study was to improve the method of estimating caries experience as expressed by the DMFS index in population groups with missing teeth. The adjustment was demonstrated with reference to the Piedmont 65+ Dental Study conducted on a random sample of 363 community‐dwelling older adults in North Carolina who were followed for 5 years. These older dentate adults had a mean (±SE) of 11.7±0.5 teeth missing at baseline, 56.1±2.5 missing surfaces and a DMFS of 86.7±2.0. A predicted caries prevalence was determined from the DFS at 5 yrs plus the 5‐yr DFS incidence and the baseline DFS of teeth lost during the study period. Then a formula was developed that would estimate the predicted caries prevalence as a function of the observed 5‐yr DMFS. This formula provided a good estimation of caries prevalence at 5 yrs (DMFSadj) when compared with the predicted prevalence (paired t‐test, p>0.05), while prevalence was underestimated by the DFS and greatly overestimated by the traditional DMFS index. Subgroup analyses by race, sex. and periodontal status also indicated that the DMFSadj resulted in patterns of estimates similar to the predicted prevalence, while the DFS and the DMFS were likely to result in different findings. The DMFS from the time of tooth eruption also was adjusted using this formula. The resulting analyses of subgroup differences in caries were not different from the previous estimates based on the 5‐yr historical data, indicating that the adjustment of all M surfaces avoids the biases inherent in the traditional DMFS and DFS indices. This study showed that predicted caries prevalence could be estimated by adjusting the M component of the DMFS. It appears that this adjustment formula can be used without obvious bias, but additional studies are needed to provide adjustment figures for populations with different caries prevalences.
The relationship between restorative treatment provided and a one year increment of the F component in the DMF index
Authors: Clarkson Janet E. , Worthington Helen V. , Holloway Philip J. , Davies Robin M.
Published: May 2006

Abstract There is considerable debate over the estimate of true increment of caries in an adult population derived from a conventional epidemiological study. The purpose of this investigation was to compare the increment of restorative treatment provided by dentists for caries with an estimate of what would have been recorded in a conventional epidemiological study as FT(S). The two types of increment were calculated from data collected for 3,920 regularly attending adults over the age of 25 years receiving dental treatment from 24 general dental practitioners. The adults were treated by their dentists prior to baseline so that, in the dentists' opinions, there were no caries lesions requiring restoration. All treatment carried out over the next 12 months together with the reasons for this, were recorded by the dentists. The increments for all restorative treatments and those considered by the dentist to be related to caries were calculated and compared with the conventional epidemiological FT and FS increments, calculated as changes from sound at baseline to restore for both teeth and surfaces. The results showed that the epidemiological FT and FS increments under‐estimated both the total restorative treatment and that provided for caries by the dentists.
Survey of reasons for extraction of permanent teeth in Italy
Authors: Angelillo Italo F. , Nobile Carmelo G. A. , Pavia Maria
Published: May 2006

Abstract The purpose of the study is to collect information on the reasons given by dentists, randomly selected from the Italian Dental and Maxillo‐Facial Association's, for extracting permanent teeth in Italy. From the 164 dentists responding, 1056 teeth in 839 patients were extracted during two weeks of working activity. More than two‐thirds of the teeth were extracted for dental caries (34.4%) and periodontal disease (33.1%). The mean number of teeth extracted per patient showed a significant increasing trend with increasing age, being 1.09 in those from 16 to 39 yr, 1.25 in the 40–59‐yr‐old group, to 1.54 in those over 59 yr of age (F = 21.44; P<0.0001). The third molar was the most frequently extracted tooth and 41.3% were removed due to impaction reasons, in particular from the mandible. The first and second molars and the premolars were extracted most often because of caries; more than half of the incisors and the canines were extracted for periodontal reasons; the majority of the teeth removed for prosthetic reasons, 57.1%, were incisors and canines, especially in the mandible; of the teeth extracted for orthodontic reasons, 47.4% were first and second premolars. The prevalence of subjects with at least one tooth extracted for dental caries and for orthodontic reasons were respectively significantly higher in the irregular than the regular attenders (chi‐square=46.55; P<0.0001), and in the regular than the irregular dental attenders (chi‐square=63.12; P<0.0001). Dental practitioners should promote targeted initiatives for prevention and treatment of diseases in order to reduce in particular the incidence of tooth extraction because of caries and periodontal disease.
Using the DMF gender difference to assess the “major” role of fluoride toothpastes in the caries decline in industrialized countries: a meta‐analysis
Authors: Haugejorden Ola
Published: May 2006

Abstract The regular use of fluoridated toothpastes has been ascribed a major role in the observed decline in caries prevalence in industrialized countries during the last 20 to 25 years, but only indirect evidence supports this claim. The purpose of this study was to test the hypothesis that the more frequent use of fluoride toothpastes by girls than by boys has reduced the relative age‐specific D(M)FT gender difference, and that this difference should decrease with increasing age and fluoride toothpaste exposure among adolescents. The material comprised 8,777 subjects 12 to 17 years of age from the pre‐fluoride toothpaste era (1946–1959) and 39,903 from the period when use of fluoride toothpaste had become common (1983–1993) in industrialized countries. Meta‐analyses were done using the relative age‐specific mean D(M)FT difference between girls and boys. Separate analyses were carried out for subgroups of studies/countries to check for confounding. Regardless of analytical approach, no evidence was found to support the hypothesis. It is concluded that the gender difference in fluoride exposure due to tooth brushing frequency is too small to matter, that the study lacked power, or that the role of fluoride toothpastes in the caries decline has been overrated.
Incidence of root caries in an older Canadian population
Authors: Locker D.
Published: May 2006

Abstract This paper reports the results of a longitudinal study of Canadians aged 50 years and over which was designed to estimate the three‐year incidence of root caries. At baseline, 699 randomly selected dentate subjects were clinically examined and 493 were examined again after three years. Over this period 27.4% had one or more root DFS increments and the mean DFS increment was 0.6 per person. Because DFS increments overstate root caries incidence DS increments were also calculated. Relatively few baseline variables were associated with either DFS or DS increments. In logistic regression analyses, age was the only variable associated with one or more root DFS increments, while age, dental visiting pattern and wearing a partial denture were associated with one or more root DS increments. In both cases, the predictive power of the models was poor but improved marginally when baseline root caries experience was also entered as an independent variable.
Clinical diagnosis of precavitated carious lesions
Authors: Ismail Amid I.
Published: May 2006

Abstract During the 20th century, dental caries was usually diagnosed using tactile‐visual criteria that detected the presence of cavitation rather than measured the disease process as a continuum that starts from the appearance of micro‐porosity, as a result of demineralization, to the occurrence of cavitation. With increasing understanding of the dental caries process and the role of primary and secondary prevention in arresting it, sensitive and specific diagnostic systems are needed that could enable dentists to detect signs of early demineralization and possible progression of precavitated carious lesions before the occurrence of cavitation. In this review of the literature, published validity studies of diagnosis of precavitated lesions were reviewed. Overall, the current clinical diagnostic systems have low sensitivity and moderate specificity. Good reliability of diagnosing precavitated carious lesions could be obtained for diagnosing pits and fissures but for smooth tooth surfaces the reliability is poor. As our diagnostic capability of precavitated lesions improves, there is a need for a significant change in dental education, dental insurance, and dental practice to reward dentists for promoting oral health and preserving tooth structure. In this paper, a new model for classifying carious lesions based upon the type of intervention strategies is proposed to assist in this new approach of caries management.
Clinical correlates of changes in self‐perceived oral health in older adults
Authors: Locker D.
Published: May 2006

Abstract Although numerous investigators have reported on self‐perceived oral health status in adult and older adult populations, few have examined how these perceptions change over time. This paper uses data from a longitudinal oral health survey of community‐dwelling Canadians aged 50 years and over to explore this issue. Data were collected at baseline and after 3 years. Change was assessed using a global transition judgement and change scores on four subjective oral health status indicators. These indicators addressed chewing capacity, oral and facial pain symptoms, other oral symptoms, and the psychosocial impact of oral disorders. Overall, 23.0% reported that their oral health had worsened over this period, 66.5% that it had remained the same and 10.5% that it had improved. Change scores on the four indicators showed a similar pattern and were significantly associated with these global judgements. Over the same period, substantial proportions lost one or more teeth, acquired new coronal or root DPS increments or experienced loss of periodontal attachment. An additional 17% complained of dry mouth. However, the only clinical indicator associated with changing perceptions of oral health was tooth loss. Of interest was the fact that rates of tooth loss were equally high among those who reported a worsening of oral health and those who reported an improvement. This suggests that the impact of tooth loss on health status may be positive or negative depending upon the condition of the teeth lost.
A comparison of patient satisfaction and dentist evaluation of overdenture therapy
Authors: Ettinger Ronald L. , Jakobsen Jane R.
Published: May 2006

Abstract It has been argued that the retention of some teeth in the jaws as overdenture abutments prevents negative feelings about the loss of natural teeth. This study set out to evaluate how satisfied a group of patients were with wearing overdentures, and to compare their subjective evaluations with those of a dentist using objective criteria to examine the prostheses. A questionnaire was developed using questions adapted from several other studies. It was pretested, modified and used on all patients who were members of a longitudinal study of overdentures that started in 1974, and who returned on recall. At the end of 9 months, 101 subjects had completed the questionnaire and examination. The mean age of the patients was 65.9 years with an age range of 35 to 88 years. There were 68 men and 33 women in this study and 62 of them were satisfied with their dentures; 33 were satisfied, but felt they had some faults. Only 6 were unhappy about wearing the overdentures. The average length of time the dentures had been worn was 6.9 years, with a range of 1 to 15 years. The most frequent complaints were loss of retention (65.4%) and discomfort (62.2%) of the mandibular dentures. A number of correlations were evaluated and some significant relationships were found between dentist and patient evaluation of the dentures. The best predictor of patient satisfaction with denture wearing was the patient's perception of retention and appearance. In the maxilla the patient's ability to chew and the dentist's evaluation of occlusion were also significant predictors. In the mandible the only other factors apart from retention and appearance were patient comfort and age.