bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing for Asymmetric Information in the Automobile Insurance Market Under Rate Regulation
Authors: Saito Kuniyoshi
Published: May 2006

Abstract

This article examines whether adverse selection or moral hazard could be induced by rate regulation, which prohibits insurance companies from considering some attributes of drivers in setting premiums. Using an individual data set from a heavily regulated automobile insurance market, we arrived at several conclusions, as follows. First, no evidence of adverse selection or moral hazard is found in general: conditional on all the variables observed by insurer, the null hypothesis of independence between risk and coverage is not rejected at reasonable levels of statistical significance. Second, this result is robust in the sense that it holds under several empirical procedures and different definitions of risk and coverage. Third, we find that unobserved variables do not induce adverse selection: the null hypothesis that consumers in risky regions are more likely to purchase insurance is tested against the alternative and rejected. Our study supports the view that the adverse selection phenomenon exists only to a very limited extent in this market.
Cellular Identity of a Novel Small Subunit rDNA Sequence Clade of Apicomplexans: Description of the Marine Parasite Rhytidocystis polygordiae n. sp. (Host: Polygordius sp., Polychaeta)
Authors: LEANDER BRIAN S. , RAMEY PATRICIA A.
Published: May 2006

ABSTRACT. A new species of Rhytidocystis (Apicomplexa) is characterized from North American waters of the Atlantic Ocean using electron microscopy and phylogenetic analyses of small subunit (SSU) rDNA sequences. Rhytidocystis polygordiae n. sp. is a parasite of the polychaete Polygordius sp. and becomes the fourth described species within this genus. The trophozoites of R. polygordiae were relatively small oblong cells (L=35–55 μm; W=20–25 μm) and distinctive in possessing subterminal indentations at both ends of the cell. The surface of the trophozoites had six to eight longitudinal series of small transverse folds and several micropores arranged in short linear rows. The trophozoites of R. polygordiae were positioned beneath the brush border of the intestinal epithelium but appeared to reside between the epithelial cells within the extracellular matrix rather than within the cells. The trophozoites possessed a uniform distribution of paraglycogen granules, putative apicoplasts, mitochondria with tubular cristae, and a centrally positioned nucleus. The trophozoites were non‐motile and lacked a mucron and an apical complex. Intracellular sporozoites of R. polygordiae had a conoid, a few rhoptries, micronemes, dense granules, and a posteriorly positioned nucleus. Phylogenies inferred from SSU rDNA sequences demonstrated a close relationship between R. polygordiae and the poorly known parasite reported from the hemolymph of the giant clam Tridacna crocea. The rhytidocystid clade diverged early in the apicomplexan radiation and showed a weak affinity to a clade consisting of cryptosporidian parasites, monocystids, and neogregarines.
Contrast sensitivity and disability glare in patients with dry eye
Authors: Puell María C. , Benítez‐del‐Castillo José M. , Martínez‐de‐la‐Casa José , Sánchez‐Ramos Celia , Vico Eva , Pérez‐Carrasco María J. , Pedraza Constanza , Del‐Hierro Almudena
Published: May 2006

Purpose:  To evaluate contrast sensitivity and disability glare in patients with dry eye using the Contrast Glaretester 1000.

Methods:  Contrast sensitivity and disability glare were determined in 33 eyes of 33 patients with dry eye and 30 eyes of 30 healthy control subjects for six target sizes with a visual angle of 6.3–0.7 degrees using the Contrast Glaretester 1000, whose working mechanism is similar to that of the conventional perimetry instrument.

Results:  Contrast sensitivity was significantly worse in dry eye group when viewing all target sizes (reduction of 0.10–0.25 log contrast units, p < 0.01) except at 6.3 degrees. In the presence of glare, differences in log contrast sensitivity between the groups (0.10–0.25 units) were significant (p < 0.01) for all target sizes, with the dry eye group showing worse results. The reduction in contrast sensitivity induced by glare (disability glare) was significantly worse in the dry eye group versus the control group but only for the 2.5‐degree size target, where 0.14 log contrast units were lost.

Conclusions:  Contrast sensitivity with and without glare was significantly reduced in patients with dry eye compared with control subjects, but the number of log contrast units lost with glare (disability glare) was similar in the two groups, except for the 2.5‐degree size target.
Repeatability (test‐retest variability) of refractive error measurement in clinical settings
Authors: Leinonen Jaakko , Laakkonen Eero , Laatikainen Leila
Published: May 2006

Purpose:  To estimate the repeatability of refractive error measurement (REM) in a clinical environment in cataractous, pseudophakic and healthy eyes.

Methods:  The refractive error of patients referred for cataract surgery or consultation measured by ophthalmic professionals was re‐examined and the measurement results were compared. A total of 99 eyes from 99 persons (41 cataractous, 36 pseudophakic and 22 healthy eyes) with visual acuity (VA) of 0.3–1.3 (logMAR 0.52 to − 0.11) were included. The differences between measurements 1 and 2 were calculated as 3‐dimensional vector values and spherical equivalents (SEs) and expressed as the coefficient of repeatability (CR). The mean time interval between the first and second examinations was 45 days.

Results:  The CRs for all eyes for vertical (V), torsional (T) and horizontal (H) vectors were 0.74 D, 0.34 D and 0.93 D, respectively. The CR of SE for all eyes was 0.74 D. Eyes with lower VA (0.3–0.45) had larger variability in vector and SE values but the differences between VA groups were not statistically significant. The difference in the mean defocus equivalent (DE) between measurements 1 and 2 was, however, significantly greater in the group with lower VA. In all VA groups the mean difference vector was very close to the zero vector, which means that there was no systematic difference.

Conclusions:  Repeatability of refractive error measurements in clinical settings has a certain degree of variability. In this series, the variability in eyes with better VA was not great and was in accordance with earlier findings in healthy eyes. Eyes with lower VA had greater variability due to greater tolerance to defocus. Thus, conclusions concerning changes in the refractive state and the need to make changes in the refractive correction of eyes with poorer vision should be made with caution.
Optic nerve pH and PO2: the effects of carbonic anhydrase inhibition, and metabolic and respiratory acidosis
Authors: Pedersen Daniella B. , Stefánsson Einar , Kiilgaard Jens F. , Jensen Peter K. , Eysteinsson Thor , Bang Kurt , La Cour Morten
Published: May 2006

Purpose:  Earlier studies have demonstrated that carbonic anhydrase inhibitors (CAIs) increase optic nerve oxygen tension (ONPO2) in pigs. We hypothesized that the mechanism of this effect was either a CO2 increase or a pH decrease in tissue and blood. To test this hypothesis we investigated and compared how optic nerve pH (ONpH) and ONPO2 are affected by: (1) carbonic anhydrase inhibition; (2) respiratory acidosis, and (3) metabolic acidosis.

Methods:  We measured ONpH with a glass pH electrode and ONPO2 with a polarographic oxygen electrode. One of the electrodes was placed in the vitreous cavity 0.5 mm over the optic nerve in the eyes of domestic pigs. We measured ONpH during carbonic anhydrase inhibition and ONpH or ONPO2 during NH4Cl‐induced metabolic acidosis and during CO2 breathing (respiratory acidosis).

Results:  Baseline ONpH was 0.12 ± 0.06 lower than arterial pH (mean ± SD, n = 10, p < 0.001). Optic nerve pH decreased with arterial pH during carbonic anhydrase inhibition, metabolic and respiratory acidosis. Optic nerve oxygen tension was not affected by metabolic acidosis but increased during CO2 breathing, as it has been shown to do during carbonic anhydrase inhibition.

Conclusions:  There is a close correlation between arterial blood pH and intraocular pH. Isolated ONpH changes do not affect ONPO2, thus the ONPO2 increase seen with carbonic anhydrase inhibition is probably not only due to pH changes in the blood and optic nerve. Accumulation of CO2, either alone or in combination with a pH change, is likely to cause the ONPO2 increase, but a direct vascular effect should also be considered.
Comparison of two indices of dental fluorosis in low, moderate and high fluorosis Tanzanian populations
Authors: Mabelya L. , van't Hof M. A. , König K. G. , van Palenstein Helderman W. H.
Published: May 2006

Abstract This study aimed at comparing the Thylstrup‐Fejerskov index (TFI) and the Dean's Index (DI) which were applied on three communities with different seventy of dental fluorosis. A total of 1565 children aged between 11 and 18 yr with a mean age of 14.7 were examined for dental fluorosis with the TFI and 1155 of these children were also examined with the Dl. The measurement error for the TFI was 0.50 (10 scale point) compared to 0.53 for DI (6 scale point). The Kappa values and the measurement–remeasurement correlation appeared to be better for the TFI. No difficulties were encountered in applying the TFI in contrast to the Dl, which caused uncertainties in assessing the “questionable” and “very mild” scores. and this may explain the relatively belter reproducibility of the TFI. The correspondence between both indices was determined. TFI 0 corresponded well with DI 0. The conversion values for TFI 1, 2, 3 and 4 into DI scores were 0.3. 0.8, 1.4 and 2.4 respectively. The TFI 5–9 corresponded with DI score 4. TFI could discriminate the severe forms of dental fluorosis which were categorized in Dean's highest score 4. TFI was able to reveal more dental fluorosis than DI in communities with minor and moderate dental Chlorosis. In the community with severe dental fluorosis where more than 85% of all teeth exhibited a DI 1, both indices revealed a comparable prevalence of dental fluorosis. The TFI is considered a near ideal instrument.
Evaluation of a continuing education intervention “Periodontics in General Practice”
Authors: Brown Louise Frances , Keily Pamela Anne , Spencer Andrew John
Published: May 2006

Abstract Evidence exists that some dentists may be failing to perform adequate periodontal diagnostic and preventive care for their patients. Continuing education (CE) is an avenue that is frequently employed as a strategy to alter the style of practice. This paper presents an evaluation of a year‐long continuing education intervention “Periodontics in General Practice”, conducted among randomly selected private general dental practices in Adelaide. South Australia. The CE intervention featured a 1‐day seminar, bi‐monthly newsletters, individualised 3‐monthly comparative feedback, and technical assistance. The study employed a longitudinal quasi‐experimental design, which allowed for evaluation of the effectiveness of the intervention among practices employing hygienists (n: = 12) and not employing dental hygienists (n: = 12), taking into account the covariates of baseline level of provision of periodontal services, the practice's level of participation in the intervention and attendance at other CE courses in periodontics over the year. A comparison group of practice (n: = 12) did not participate in the intervention over the year. Patient record audits, conducted at baseline and at 12 months, provided data for the evaluation of the effect of the intervention on the recording of periodontal diagnostic, preventive and treatment items. Practices participating in the intervention showed increases in the percentage of records containing at least one periodontal diagnostic notation, and those practices employing hygienists showed an increase in the percentage of records with at least one preventive notation and one treatment item. Using ANCOVA to account for covariation, the main effect of the study group was significant in explaining changes in the provision of preventive periodontal services. The results indicate that an extended continuing education intervention can have significant effect on the provision of periodontal services, and that the magnitude of the effect differs between practices employing and not employing hygienists.
Dental health knowledge and attitudes among the middle‐aged and the elderly in Hong Kong
Authors: Schwarz Eli , Lo Edward C.M.
Published: May 2006

Abstract Previous studies on adult Hong Kong Chinese have indicated that their level of knowledge of and attitudes toward dental health might be a potential barrier to effective oral preventive efforts. The knowledge and attitudes of elderly Chinese have not previously been studied. The objectives of this study were to describe Hong Kong adults' knowledge of the causes of the two main oral diseases, caries and periodontal disease, and possible preventive measures, and to analyse possible relationships between knowledge and attitudes and selected sociodemographic and utilization variables. Two populations aged 35–44 yr (n= 398) and 65–74 yr (n= 559) were selected for the study, which was conducted as structured interviews. A knowledge score was constructed from questions on caries and periodontal disease development and prevention. Attitudes were measured in the younger group by beliefs and evaluations of those beliefs according to the theory of reasoned action (the higher the score, the more positive the attitude). Knowledge scores were almost normally distributed in the younger respondents, but were heavily skewed toward 0 in the older group. In both age groups, increased level of education and regularity or recency of dental visits were strongly associated with dental knowledge. Women, regular dental care users, and prevention‐oriented respondents had higher attitude scores. There was no correlation between knowledge and attitudes. Some improvement in knowledge seems to have taken place, especially on the cause of caries, with fewer 35–44‐yr‐old respondents claiming lack of knowledge of the causes of caries and gum disease than in a previous study. In the older group, around half of the respondents were unaware of the causes of dental caries and gum disease.
Attitudes toward dentists and the dental care system among the middle‐aged and the elderly in Hong Kong
Authors: Lo Edward C. M. , Schwarz Eli
Published: May 2006

Abstract A sample of 398 35–44‐yr‐old and 559 65–74‐yr‐old Hong Kong Chinese were interviewed by trained interviewers using a structured questionnaire in an oral health survey conducted in 1991. The present analysis aimed to describe the dental‐care‐seeking behaviour and attitudes of these subjects. It was found that 43% of the younger and 23% of the older age group had visited a dentist within the past year. More than half of the elderly and a quarter of the adults had not been to a dentist for 3 yr or more, and the main reason given by these subjects was that they felt that nothing was wrong. The vast majority of the subjects consulted a dentist only when they had toothache or other dental problems. Less than 20% of the 35–44‐yr‐olds visited a dentist for a check‐up or teeth cleaning, and these subjects were described as having a prevention‐oriented attitude toward oral care. The result of a logistic regression analysis showed that there was a higher chance for subjects to have this attitude if they had dental programme coverage, perceived their teeth to be good, had better dental health knowledge, had a more positive dental attitude, and were less anxious about dental care. However, the influence of these factors was quite weak, because the overall percentage of correct classification of the model was 83.7% and the sensitivity was only 23.3%.
Community risk indicators for dental caries in schoolchildren: an ecologic study
Authors: Amstutz Richard D. , Rozier R. Gary
Published: May 2006

Abstract A statewide survey of NC schoolchildren found wide variation in dental caries prevalence among sampled classrooms. This study examined factors associated with this variation using classrooms as a surrogate for the larger community, in order to identify community risk indicators (CRI). In all, 172 classrooms (3400 students) in Grades K‐6 were available for analysis. Initially, 56 sociodemographic, environmental, health system, and clinical factors were evaluated for their association with caries prevalence (K‐3: average dfs‐f DMF'S; 4–6: average DMFS) using univariate and bivariate analyses. Of these, 21 factors met our criteria for evaluation using WLS multivariate regression. For Grades K‐3 (w=108), population density, parental education, and coastal residence were negatively associated with caries scores, while age, and medical and dental Medicaid expenditures were positive. For Grades 4–6 (n=64), age and fs:dfs ratio were positively associated with caries scores, while population density, population: dentist ratio, and years of natural fluoride exposure were negative. CRIs for both models, when compared to individual models, explained a substantial portion of the variation in caries prevalence, 31% for Grades K‐3 and 51% for Grades 4–6. Results suggest that a risk assessment model based on community rather than individual variables is feasible and further refinement may reveal factors useful in identifying high risk communities.
Association of lifestyle with periodontal health
Authors: Sakki Tero K. , Knuuttila Matti L.E. , Vimpari Sirpa S. , Hartikainen Maija S.L.
Published: May 2006

Abstract All the 1012, 55‐yr‐old citizens of Oulu (a medium‐sized Finnish town) were invited to a clinical examination, and 780 of them participated. The associations of lifestyle with periodontal health were analyzed in the 527 dentate subjects. Periodontal pockets deeper than 3 mm were recorded as a percentage of the surfaces at risk. Lifestyle was measured by questions about dietary habits, smoking habits, alcohol consumption and physical activity. Lifestyle had an independent association with periodontal health. Periodontal pocketing increased with an unheallhier lifestyle. Lifestyle could explain some of the social and sex differences in periodontal health.
Costs of periodontal and prosthodontic treatment and evaluation of oral health in patients after treatment of advanced periodontal disease
Authors: Karlsson Göran , Teiwik Anders , Lundström Asa , Ravald Nils
Published: May 2006

Abstract Retrospective estimations of dental care costs of periodontal and prosthodontic treatment and evaluation of oral health in 37 patients with advanced periodontal disease were carried out. Measures of their subjective evaluation of oral health 7–10 yr after the treatment are presented as a health profile and as indices in single numbers. The relations between oral health as an index and the dimensions in the health profile are analyzed. Dental care costs for treatment in the mandible was SEK 35 550. for the maxilla SEK 45 380 and for both jaws SEK 74 230. After the treatment oral health as well as general health were in excess of 75 on a 0 to 100 scale. Chewing ability, comfort and aesthetics were the variables found to significantly affect the subjective oral health. Oral health in terms of periodontal and prosthodontic conditions was maintained over the observation period.
Patients' perceptions of the decision‐making process leading to extraction of permanent teeth in Norway
Authors: Klock Kristin Solveig
Published: May 2006

Abstract Extraction is the final step in a continuous process in which oral health‐related factors and psycho‐social processes play a role. The purpose of the present study was to investigate the patient's perception of the decision‐making process leading to the extraction of permanent teeth and to determine whether and how patient‐associated characteristics might influence who made the decision to extract and if the patients felt they had any influence on the dentist's decision. A national random sample of Norwegian dentists (n=500) recorded reasons for tooth extraction during a period of 2 weeks in 1988. A total of 437 patients responded (73%), of whom 54% were women. Nearly 33% of the respondents slated that it was their own decision to extract, while about two thirds said that the dentist had suggested extraction. Whether the dentist or the patient made the decision to extract teeth was significantly influenced by the patient's dental attendance pattern, place of residence, number of teeth and belief in retention of his/her own teeth for life (P < 0.05). There was no significant bivariate effect of patients' age, sex. educational level, or score on Corah's Dental Anxiety Scale on who made the decision to extract. Only 0.4% of patients said that family, friends or colleagues had influenced the decision to have teeth extracted. A logistic regression analysis with: “Was it the dentist or the patient who made the suggestion to extract teeth?” as the dependent variable, and the four bivariately significant independent variables showed for all patients that none had a significant effect. For the group of patients with no extractions of third molars and because of orthodontic reasons, only the variable education was found to be significant. It is concluded that even when the decision to extract was the dentist's, most patients felt that they had an influence on it. Family, friends and colleagues had almost no influence on the decision. The only patient characteristic having a significant effect on who made the decision to extract was educational level.
Subjective and objective orthodontic treatment need among orthodontically treated and untreated Finnish adolescents
Authors: Tuominen Maija Leena , Nyström Marjatta , Tuominen Risto Juhani
Published: May 2006

Abstract Subjective orthodontic treatment need was studied in a sample of 340 Finnish adolescents with and without previous orthodontic treatment. The subjects, who were attending two schools preparing students for college, first filled in a questionnaire. Of the 340 subjects, 24.4% of the treated and 24.0% of the untreated expressed subjective orthodontic treatment need (NS). For the clinical examination, 110 subjects were systematically sampled from four groups; subjects who had received orthodontic treatment in the past and a) felt, b) did not feel subjective orthodontic treatment need and subjects who had not received orthodontic treatment in the past and c) felt, d) did not feel subjective orthodontic treatment need. A total of 106 subjects were examined by an orthodontist. Objective treatment need was assessed by using the Treatment Priority Index. Of those clinically examined, 29.4% of the treated subjects were still found to be in objective need of orthodontic treatment; among the untreated subjects, the corresponding figure was 54.5% (P < 0.05). The sensitivity of the orthodontist to detect treatment need felt by the adolescents was, among the treated, 40.0% and the specificity 75.0%. Among the untreated subjects the corresponding figures were 75.9% and 69.2%. Of those treated who had objective treatment need, 40.0% expressed the need themselves (NS). However, of the untreated who had objective treatment need, 73.3% expressed such a need (P < 0.001). Subjects judged to have a very attractive denial appearance (IOTN, Aesthetic Component) were more often detected among those treated than among the untreated. As a clear discrepancy can be observed between objective and subjective treatment need estimates, in orthodontic counseling an understanding of how the patient perceives his/her dentition is essential.
Loss to follow‐up in a longitudinal oral health survey of older adults
Authors: Payne Barbara J. , Ford John C. , Locker David
Published: May 2006

Abstract Longitudinal studies of the oral health of older adults are necessary for the measurement of disease incidence and identification of risk factors for oral disease. Loss of respondents to follow‐up may, however, seriously bias longitudinal results. Using data from the 1989 and 1992 waves of the Ontario Study of the Oral Health of Older Adults, this paper examines loss to follow‐up by comparing the characteristics of lost and retained respondents in terms of clinically‐defined and self‐rated oral health, sociodemographic characteristics, general health status, and health behaviours. Of the original 907 respondents who completed an interview and clinical examination, 611 participated in the 3‐yr follow‐up study. Study attrition rates were higher in the edentulous group. Although some statistically significant differences were found between those retained and lost, the magnitude of the differences was small and unlikely to seriously bias estimates of incidence or risk. These results illustrate the need to consider study attrition, response rates and comparisons of retained and lost to follow‐up respondents in reporting the results of longitudinal studies. Without such information, confidence in the population estimates derived from those studies is undermined.
Caries prevalence and patterns in 3–6‐year‐old Beijing children
Authors: Douglass Joanna M. , Wei Yi , Zhang Bo Xue , Tinanoff Norman
Published: May 2006

Abstract A total of 400 Beijing children. 3–6‐yr‐old. equally distributed by age and sex, were examined for dental cares. Results were analyzed with the traditional dmfs/t index and with the Caries Analysis System. The 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). Over 67% of the children experienced caries, a level comparable to other reports from China and other developing countries, but 50% greater than those seen in United Stales preschool children. Nearly all children with caries experienced fissure caries. In 3‐yr‐olds maxillary anterior caries was the next most prevalent pattern with 43% affected, whilst in the 6‐yr‐olds, posterior proximal caries was the second most prevalent pattern with 68% affected. Since maxillary anterior caries was so prevalent, and because the presence of this pattern has been shown to be a risk factor for future caries, preventing the maxillary anterior pattern may markedly reduce caries in this population.
Cross‐sectional comparisons of caries time trends in nursery school children in Sendai, Japan
Authors: Mayanagi Hideaki , Saito Toru , Kamiyama Kikuo
Published: May 2006

Abstract The aim of this study was to clarify the trends in caries experience in the primary dentition of nursery school children in Sendai, Japan, over a period of 20 yr. An annual clinical dental examination of children aged 2–5 yr at 13 nursery schools in Sendai City was carried out in 1972, 1977, 1982, 1987 and 1992. Data obtained from all five surveys were compared in each age group respectively. The percentages of 2‐, 3‐ and 4‐yr‐olds free from caries increased remarkably until 1977, while that in 5‐yr‐olds started increasing several years later. After such increments, percentages in all age groups except 3‐yr‐olds remained almost at the same level with slight fluctuations. The mean deft and deft values per child in 2‐, 3‐ and 4‐yr‐olds decreased remarkably until 1977, but then remained almost at the same level thereafter. That in 5‐yr‐olds continued decreasing slightly during the 20‐yr period. The marked reduction of caries experience in nursery school children shown during the 1970's did not continue through the 1980's or the beginning of the 1990's.
Dentist's ratings of child dental‐patients' anxiety
Authors: Veerkamp J. S. J. , Gruythuysen R. J. M. , van Amerongen W. E. , Hoogstraten J. , Weerheijm K. L.
Published: May 2006

Abstract This study investigates the extent to which dentists giving treatment are able to evaluate the (changes in) child patients' levels of fear, based on a comparison between direct behavior observations of a group of highly anxious children during sequential dental visits and video observations of the same group made by two independent evaluators using the measuring instrument described by Venhamet al. (9). A significant difference was found between the fear scores given by the two dentists giving treatment and also between their fear scores and those by the independent observers. Both the fear and behavior scores of the two dentists giving treatment, however, clearly correlated with the fear scores of the observers. It is concluded that in this study the two dentists giving treatment were unable to award an unbiased fear score for each treatment given to a child but it was not possible to show that the bias was caused by experiences from previous sessions with the same child. After video training dentists giving treatment are capable of giving a picture of changes in children's fear levels during sequential dental visits.
DMFT and treatment needs in adult population of Oviedo, Spain
Authors: AIvarez‐Arenal A. , Alvarez‐Riesgo J. A. , Lopez J.M.Peña , Vazquez J.P.Fernandez , Vigil M. A. Villa
Published: May 2006

Abstact An epidemiological survey was carried out in 1992 researching dental caries and treatment needs in an adult population in Oviedo, Spain. A representative sample of 261 subjects, randomly obtained and stratified by age, was examined. Results show a dental decay prevalence of 99.6%; 12.5 DMFT index with 2.9. 7.5 and 2.1 mean values for D, M and F components. Women and the lower social class showed the highest DMFT index. Treatment needs reach a mean value of 12.1 teeth per person. Politics are the most needed treatment, the mean value increases with age while the differences among age groups and social classes are statistically significant. The next most needed dental treatment is filling of one surface which decreases with age, is the same for men and women and higher among the middle social class; the differences arc statistically significant among the social classes.
Use of Dental Coping Beliefs Scale to measure cognitive changes following oral hygiene interventions
Authors: Wolfe Gary Robert , Stewart James Edmund , Maeder Linda Ann , Hartz Gary William
Published: May 2006

Abstract This study employed a recently developed questionnaire, the Dental Coping Beliefs Scale (DCBS), to evaluate the effect of oral hygiene interventions on denial beliefs. The DCBS was administered to 100 subjects. Compared to an untreated control group, there was an increase in the ability to improve oral health through self‐effort for the three experimental interventions: Attention (Al), Education (El) and Cognitive Behavioral (CBI). When the Dental Coping Beliefs Scale was divided into scales of Internal Locus of Control, External Locus of Control. Self‐Efficacy, and Oral Health Beliefs, additional changes were evident. For the CBI Group, all four scales changed significantly between baseline measurement and post‐intervention toward beliefs favoring control and prevention of dental disease using brushing and flossing. For the A and E groups, three scales paralleled the results of the CBI: Internal Locus of Control and Self‐Efficacy increased and External Locus of Control decreased after the intervention. However, unlike the CBI, Oral Health Beliefs did not significantly change. Overall, for all experimental groups, there was a shift from external locus of control beliefs to internal beliefs. The untreated Control Group showed no changes across the five weeks. This study was supported by a VA Medical Research Service Merit Review Award.
Psychological characteristics of dissatisfied denture patients
Authors: Moltzer Gerold , Van der Meulen Mary J. , Verheij Hans
Published: May 2006

Abstract A field study was conducted to investigate the psychological characteristics of dissatisfied denture patients using validated personality inventories. In the present study dissatisfied denture patients are patients that keep complaining about their dentures and are referred to a psychologist because it was suspected that their complaints may also be due to psychological factors. The results show that these patients feel more inhibited in their social contacts and more often have the opinion that wearing dentures is unacceptable. Also these patients are high on neuroticism, less social adequate, more rigid, have less self‐esteem and are more externally oriented.
Clinical assessment of periodontitis in young adults – evaluation of probing depth and partial recording methods
Authors: Agerholm Daphne M. , Ashley Frank P.
Published: May 2006

Abstract The present study was carried out to compare the ability of different methods of periodontal assessment to identify those subjects in a population who had suffered the worst periodontal breakdown. Comparisons were made between full mouth approximate attachment loss (CAL) assessment and methods relying on pocket probing depth (PPD) evaluation or on partial recording of CAL or PPD. Both of the latter types of assessment are commonly used in epidemiological surveys. 202 workers at an electronics factory aged between 20 and 40 yr were examined for approximate PPD and CAL, excluding third molars. The data were used to determine which individuals had the worst periodontitis based on CAL at several thresholds. Further analysis was carried out to determine which of these subjects would have been identified on the basis of the presence of deep (6 mm) pocketing, or by using one of a battery of partial recording subsets. CAL was frequently present in the absence of deep pocketing. A subset made up of four approximate sites around each of the 10 index teeth recommended by the WHO for partial recording (two molars in each quadrant and maxillary right and mandibular left central incisors) and a subset comprising maxillary buccal and mandibular lingual sites (“Pritch‐ard” sites) performed best of the subsets considered in identifying the subjects who had been found by full mouth assessment to have at least one or at least two approximate sites with CAL at thresholds of 2, 3 or 4 mm. It was concluded that measurements of CAL using either of these subsets should reduce problems of under‐recording of the prevalence of periodontitis associated with the use of PPDs alone or on CAL assessment at other partial recording subsets.
A survey of reasons for extraction of permanent teeth in Singapore
Authors: Ong Grace , Yeo Jinn‐Fei , Bhole Sameer
Published: May 2006

Abstract A survey was carried out to determine the reasons for tooth extractions of permanent teeth in Singapore. Data were obtained from 52 dentists practising general dentistry over a period of 12 months. At the end of the 12‐month period, data were collected from 1276 patients, from whom a total 272 teeth were extracted. In this population group, the results showed that the percentage of teeth extracted due to periodontal reasons and caries were about the same, that is, 35.8% and 35.4%, respectively. There was an increase in teeth extracted due to periodontal reasons with age. In patients above 40 yr, an average of 76% of teeth were lost due to periodontal reasons. An average of 26.7% of teeth were lost due to periodontal reasons in patients under 40 yr old. However, the trend for loss of teeth due to caries is reversed. Posterior teeth were more frequently extracted compared to anterior teeth. Third molars accounted for 24.7% of all extractions carried out. whilst central incisors were 8.0% of all extractions. Molars were often lost due to caries and lower anterior teeth were most frequently lost due to periodontal reasons. The results of this study did not demonstrate one predominant reason for extraction. Both caries and periodontal reasons were equally common causes of tooth extraction.
Work stress, job satisfaction and emotional well‐being among Canadian dental assistants
Authors: Locker David
Published: May 2006

Abstract Although dentistry is considered to be a stressful occupation, few data exist on work stress among dental assistants. In a previous paper, the extent and nature of work stress among this group was described and linked to a behavioural outcome: namely, intentions to change jobs or seek work outside of dentistry. In this paper the psychological outcomes of work stress, in the form of job satisfaction and emotional well‐being, are examined. Using data collected by a mail survey, it was revealed that the main sources of dissatisfaction for dental assistants were low incomes, lack of opportunity to develop professionally and a lack of recognition. Almost one‐in‐live had scores on a standard measure of emotional distress, which indicated a cause for concern. Work stress proved to be a significant predictor of job satisfaction, and work stress and job satisfaction emerged as significant predictors of emotional well‐being. Social support while at work showed direct and interactive effects on job satisfaction hut not emotional well‐being. Role ambiguity, under‐utilization of skills and low self‐esteem emerged as important issues. These results are of interest theoretically and have important implications for the way denial practice and dentistry are organized.
Dental health of aboriginal pre‐school children in Brisbane, Australia
Authors: Seow W. Kim , Amaratunge Ari , Bennett Robyn , Bronsch Dulcie , Lai P. Y.
Published: May 2006

Seow WK, Amaratunge A, Bennett R, Bronsch D, Lai PY: Dental health of Aboriginal pre‐schools children in Brisbane, Australia.

Abstract This investigation studied the dental health status of a group of 184 Australian Aboriginal children with a mean age of 4.4±0.8 years, who were attending pre‐schools in metropolitan Brisbane, a non‐fluoridated stale capital city. The DDE (Developmental Detects of Enamel) Index was used to chart enamel hypoplasia and enamel opacities. WHO criteria was used to diagnose dental caries. The results showed that 98% of children had at least one tooth showing developmental enamel defects. Each child had a mean of 3.8 ± 1.7 teeth affected by enamel hypoplasia and another 1.1 ± 0.8 teeth affected by enamel opacity. Seventy‐eight percent of the children had dental caries. The mean number of decayed, missing, filled teeth (dmft) per child was 3.8±3.7. The decayed component consituted 3.5 (95%) of the mean dmft, indicating a high unmet restorative need in this group. The mean dmft (decayed, missing, filled, surfaces) was 5.9 ± 7.3. Maxillary anterior labial decay of al least one tooth affected 43(23%) of the children. In this sub‐group, the dmft and dmfs was 9.1 ± 2.8 and 15.4 ± 7.7 respectively. Oral debris was found in 98% of the children. It is hypothesized that the high levels of underlying developmental enamel defects, compounded by low fluoride exposure, poor oral hygiene and a diet high in refined sugars pose an important caries risk factor in this group of children.
Physical and mental health related to dental amalgam fillings in Swedish twins
Authors: Björkman Lars , Pedersen Nancy L. , Lichtenstein Paul
Published: May 2006

Björkman L, Pedersen NL, Lichtenstein P: Physical and mental health related to dental amalgam fillings in Swedish twins.

Abstract In the past years increasing attention has been paid to possible adverse health effects of mercury exposure from dental amalgam fillings. To evaluate possible health effects from amalgam fillings, dental status registered by specially trained nurses was obtained from 587 subjects included in the ongoing Swedish Adoption/ Twin Study of Aging (SATSA). Data on physical and mental health were collected and memory function tested. Mean age was 66 years (SD 9, range 46–89). In the entire material, 25% of the individuals had no own teeth and in the group with own teeth the median number of teeth surfaces filled with dental amalgam was 15 (range 0–65). Analyses of associations between number of surfaces filled with dental amalgam and a number of scales estimating somatic and mental health and memory functions were performed both for the entire group and for individuals having at least 12 teeth. Regardless of the sample, no negative effects on physical or mental health were found from amount of dental amalgam, even after controlling for age, gender, education and number of remaining teeth. When using a co‐twin control design with twin pairs discordant for amalgam exposure, no negative health effects associated with dental amalgam were detected. This study does not indicate any negative effects from dental amalgam on physical or mental health or memory functions in the general population over 50 years of age.
Case‐control study of non‐carious cervical lesions
Authors: Bader J. D. , McClure F. , Scurria M. S. , Shugars D. A. , Heymann H. O.
Published: May 2006

Abstract An exploratory case‐control study of non‐carious cervical lesions was undertaken to examine the effects of a variety of risk factors. Candidate exposure variables were related to erosion, abrasion, and tooth flexure, the three principal putative causal mechanisms for cervical lesions. Because previous studies have tended to focus on specific causal mechanisms, evidence for a multifactorial etiology is inconclusive. Data describing exposure factors were obtained through clinical examination, dietary and behavioral questionnaires, and analysis of study casts from 264 subjects (137 cases, 127 control). Salivary data were also obtained for a subset of these subjects. Patient and tooth‐level logistic regression models were constructed for the full subject group, and the subset with salivary data. For the two patient‐level models, only exposures related to brushing entered. For tooth‐level models, multiple exposures representing all three causal mechanisms were included in both models. The results suggest that non‐carious cervical lesions do have a multifactorial etiology, and that multiple causal mechanisms may operate in the initiation and progression of individual lesions.
Fear of injections and report of negative dentist behavior among Caucasian American and Taiwanese adults from dental school clinics
Authors: Moore Rod , Brødsgaard Inger , Mao Tai‐Kum , Kwan Hsueh‐Wan , Shiau Yuh‐Yuan , Knudsen Robert
Published: May 2006

Abstract Fear of injections and reports of negative dentist behavior and associations with dental anxiety and avoidance of treatment were explored among 951 adults from denial school clinics in Iowa City, Iowa and Taipei. Taiwan. Use and fear of anesthetic injections and negative dentist behavior were assessed by written questionnaire to test associations with demographics, overall dental anxiety (Dental Anxiety Scale or “DAS”) and utilization behaviors. Frequency and logistic regression analyses showed that use of dental anesthetics for routine treatment was much greater overall among Caucasian Americans than Taiwanese, as was fear of injections. Taiwanese and Americans with high dental anxiety (DAS 12) had similar high fear of injections, but inspite of similar fears about dental drilling, high anxiety Taiwanese reported using much less local anesthesia for routine treatments than did high anxiety Americans. Report of condescending remarks to patients (“put downs”) by dentists was mainly an American phenomenon associated with high dental anxiety. Avoidance of appointment making was high for persons afraid of injections and for Americans reporting negative dentist behavior. Avoidance was highest in subjects with high dental anxiety. That predominant characteristics or etiologies of dental anxiety can differ by cultural differences in dental health care systems, dentist beliefs and/or expectations of patients within those systems was discussed in relation to the literature.
Dental caries prevalence in relation to socioeconomic status of nursery school children in Goiâania‐GO, Brazil
Authors: do Carmo Matias Freire Maria , de Melo Rosana Barbosa , Silva Simonne Almeidae
Published: May 2006

Abstract The study was carried out to assess dental caries in the primary dentition of pre‐school children in Goiânia‐GO, Brazil, and to assess the influence of socio‐economic status. The study population comprised 0–6‐yr‐old pre‐school children (n=2267) attending public (low SES children) and private (higher SES children) nursery schools. Mean dmft and percent caries‐free were 0.09 (96.4%) at 1 year and younger, 0.40 (87.3%) at 2, 1.14 (69.9%) at 3, 2.18 (49.5%) at 4. 3.18 (36.1%) at 5, and 3.94 (29.4%) at age 6 years respectively. Caries prevalence was higher in those attending public nursery school than in those attending private schools (P<0.05). Amongst children from public nursery schools the highest dmf component was untreated decay while in private nurseries it was filled teeth. The results indicate that social inequalities exist, which influence denial caries experience. It was concluded that oral health programmes for pre‐school children emphasizing preventive measures and dental health education should be developed mainly in areas of social deprivation.
Variations in restorative treatment decisions: an international comparison
Authors: Kay E. J. , Locker D.
Published: May 2006

Abstract Variations between dentists in treatment thresholds and diagnostic decisions based on radiographs have not been fully explained. Since variations have been shown to exist between as well as within countries, it is possible that the structure of incentives inherent in different health care systems, and cultural influences on health and health care may play a part. This paper compares the results of a study undertaken in Scotland with a replication study undertaken in Canada concerning dentists' restorative thresholds and treatment decisions based on radiographic evidence. The Canadian dentists operated with greater sensitivity but lower specificity than their Scottish counterparts, although ROC analysis indicated similar overall abilities to detect carious lesions. The dentists' action thresholds also differed. However, methodological issues mean that the data from the study need to be interpreted with caution.
Oral impacts affecting daily performance in a low dental disease Thai population
Authors: Adulyanon Supreda , Vourapukjaru Jinda , Sheiham Aubrey
Published: May 2006

Abstract The aim of the study was to measure incidence of oral impacts on daily performances and their related features in a low dental disease population. 501 people aged 35–44 years in 16 rural villages in Ban Phang district, Khon Kaen, Thailand, were interviewed about oral impacts on nine physical, psychological and social aspects of performance during the past 6 months, and then had an oral examination. The clinical and behavioural data showed that the sample had low caries (DMFT=2.7) and a low utilization of dental services. 73.6% of all subjects had at least one daily performance affected by an oral impact. The highest incidence of performances affected were Eating (49.7%), Emotional stability (46.5%) and Smiling (26.1%). Eating, Emotional stability and Cleaning teeth performances had a high frequency or long duration of impacts, but a low severity. The low frequency performances; Physical activities. Major role activity and Sleeping were rated as high severity. Pain and discomfort were mainly perceived as the causes of impacts (40.1%) for almost every performance except Smiling. Toothache was the major causal oral condition (32.7%) of almost all aspects of performance. It was concluded that this low caries people have as high an incidence of oral impacts as industrialized, high dental disease populations. Frequency and severity presented the paradoxical effect on different performances and should both be taken into account for overall estimation of impacts.