bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reactor Paper The Impact of Recent Changes in the Epidemiology of Dental Caries on Guidelines for the Use of Dental Sealants: Clinical Perspectives
Authors: Söderholm Karl‐Johan M. 
Published: April 2007

SummaryWhen used properly, sealants result in improved dental health. However, their use on all occlusal tooth surfaces for preventive reasons will result in wasted dental care resources. To optimize the preventive effects of sealants, a delivery model should be initiated that uses specially trained dental hygienists or dental assistants who visit schools to explain oral health‐related issues, conduct visual inspections of clinical oral health status, identify patients at risk for dental caries, and generate a central database for program operation. When a high‐risk patient is identified, auxiliary personnel could place sealants and recall the patient for a new visual inspection six months later. If caries is suspected at that time, the patient could be sent to a dentist for additional treatment.To offset the negative effects caused by overutilization of sealants, their usage should be divided into two categories. First, a preventive option should be available, and the fee for use of sealants in this option should be lower compared to the fees used today. By using specially trained auxiliary personnel to place such sealants, the fee could be kept reasonably low. Second, a sealant treatment option that targets treatments of incipient lesions also should be available. The fee for such a treatment should be close to that of the traditional occlusal restoration, and the application should be by a dentist.By using such a fee structure based on market forces, one would expect that sealant usage would increase among patients suffering from early carious lesions, while the usage of preventive sealants would remain the same or decline. This utilization pattern for dental sealants would contribute to improved efficiency of sealant usage in the treatment of dental caries, particularly at a time when caries frequency is declining. The improved efficiency could release dental care resources that should be used to target risk groups with improved education in dental health. By using such a strategy, the long‐term effect would be not only the placement of fewer restorations, but an improvement in dental health among adolescents and adults.
The RCI Revisited after 15 Years: Used, Reinvented, Modified, Debated, and Natural Logged
Authors: Katz Ralph V. 
Published: April 2007

Abstract Objectives: The purpose of this article is to review the status of the Root Caries Index (RCI) 15 years after it was first introduced in the dental literature as a method for the reporting of supragingival root lesions. This review focuses on the extent to which the RCI has been used by epidemiologic researchers, as well as on the issues concerning the RCI as a useful index that have been raised and debated in the literature by those epidemiologic researchers. Methods: The debated points are categorized into six issues, including whether: (1) the RCI underestimates the prevalence of root caries by omitting subgingival root caries lesions; (2) the RCI overestimates the prevalence of root caries by using too rigid a definition of when recession can be visualized; (3) the RCI makes the assumption that there is a linear relationship between root caries lesions and the occurrence of at‐risk surfaces, i.e., surfaces with recession; (4) the RCI, by ignoring missing teeth, distorts the descriptive epidemiologic picture of root caries; (5) recession is a predictor of root caries versus merely being an antecedent state; and (6) the imprecision of diagnosing gingival recession renders the RCI useless. Results: Given both the evidence from recent studies and the professional interest in subgingival root caries, as addressed in the first debated point, it seems reasonable to modify the RCI to include a separate reporting of subgingival root caries. Of the remaining debated points over the past 15 years, three of these (points #2, #4, and #5 above) seemingly serve to clarify specific aspects of the RCI that were intended as inherent elements of the RCI as originally presented. The question as to whether there is an assumption of a linear relationship between root caries lesions and the occurrence of at‐risk surfaces (point #3) is answered in the negative. The final debated point (#6), while addressing a fundamental periodontal tissue measurement issue—namely the reliability of identifying gingival recession—and while theoretically interesting, should not undermine the current use, or utility, of the RCI, but rather suggests the need for improved periodontal diagnostic techniques for the condition of recession. Conclusion: After 15 years, the RCI appears to be one of the two most common methods of reporting root caries in the epidemiologic literature (along with DFS counts). In fact, the best overall descriptive picture of root caries is achieved when these two reporting methods are presented in the same study accompanied by descriptive presentations of missing teeth and at‐risk surfaces. Of all the debated points in the literature, the suggested modification of including subgingival lesions in the RCI leads now to the recommendation to collect subgingival data, but to do so in a manner that allows for separate presentation of supra‐ and subgingival root caries findings.
The Association of Early Dental Caries Patterns with Caries Incidence in Preschool Children
Authors: O'Sullivan David M. , Tinanoff Norman 
Published: April 2007

Abstract Objectives: This study assessed the development of caries in preschool children over two years according to baseline caries pattern. Methods: Connecticut Head Start children (n=142, mean age=3.8 years) were examined for dental caries at baseline (spring 1991) and once annually for two years. Children were categorized at baseline as caries‐free, having pit and fissure (PF) caries, or having maxillary anterior (MA) caries. Results: After two years, children who presented at baseline with MA or PF caries had a mean posterior dmfs of greater than seven and four times, respectively, that of children who were caries‐free at baseline. When dental caries of the primary dentition was categorized by specific posterior patterns (i.e., posterior proximal [PPJ] and buccal/lingual [BL]), change in dmfs for the PP and BL patterns in the group that presented with pit/fissure caries at baseline were nearly four and three times greater, respectively, than for those in the caries‐free group. The group that presented with maxillary anterior caries at baseline had PP and BL caries increments eight times those of children who began caries‐free. Conclusion: Dental caries presentation in 3‐ to 4‐year‐old children can identify those children and tooth surfaces that will be at the greatest risk for future caries development.
Introduction to the Symposium on Minimal Intervention Techniques for Caries
Authors: Horowitz Alice M. 
Published: April 2007

AbstractAlthough dental caries has declined precipitously in many industrialized countries, this disease has escalated in less developed countries. Moreover, dental caries remains a public health problem even in most industrialized countries because the disease frequently is more prevalent among subpopulations without access to preventive regimens and treatment. In some developing countries where dental facilities and providers are rare, alternative measures for managing frank lesions are being used. One example of these minimal intervention techniques is “Atraumatic Restorative Treatment” (ART). This procedure, endorsed and actively promoted by the World Health Organization, requires no anesthetic and its costs are minimal. This symposium addresses several aspects and issues of minimal intervention techniques for caries management.
Glass Ionomer as Fissure Sealant—a Critical Review
Authors: Simonsen Richard J. 
Published: April 2007

AbstractThis paper presents a review of the literature on glass ionomer cements used as fissure sealants. An objective assessment of the presently available scientific literature on the use of glass ionomer materials as pit and fissure sealants is not encouraging in terms of retention, but appears somewhat more positive for caries prevention. At the time of this writing, the published literature indicates that retention for resin‐based sealants is better than for glass ionomer sealants, but differences in caries prevention remain equivocal. Future research should concentrate on assessing the effects of fluoride‐releasing, resin‐modified, glass ionomer materials.
Dentists' Stated Restorative Treatment Thresholds and Their Restorative and Caries Depth Decisions
Authors: Lewis Donald W. , Kay Elizabeth J. , Main Patricia A. , Pharoah Michael G. , Csima Adele 
Published: April 2007

Abstract Objective: This study examines the relationships between stated restorative treatment thresholds of 16 dentists and both their restorative decisions and caries depth determinations for approximal tooth surfaces based on bitewing radiographs. Methods: Sixteen dentists independently examined 15 pairs of experimental bitewing radiographs. They separately recorded restorative and dental caries depth decisions for 4,864 unrestored approximal tooth surfaces, 304 identical surfaces per dentist. In addition to caries depth and restorative decision data, these dentists provided their restorative thresholds using a five‐point scale. Results: Three dentists stated it would be appropriate to restore enamel lesions, nine would wait until caries had reached the dentinoenamel junction, and four would wait until caries extended into the dentine. Although dentists stating an enamel restorative threshold intended definitely or probably to restore relatively more surfaces and recorded relatively more surfaces with dentinal caries, ANOVA analyses revealed that the differences among the restorative and the depth means according to the restorative thresholds were not significant. Considerable variation existed in both the restorative and depth decisions among the dentists in each threshold group. Conclusion: Although interesting trends occurred in the restorative and depth decisions relative to the stated thresholds, this study suggests, like others in Europe, that these thresholds cannot be taken at face value to explain restorative decisions
Factors Influencing the Amount and Type of Dental Services Received by Older Adults in Four Municipalities in Ontario, Canada
Authors: Leake James L. , Hawkins J. Robert , Locker David 
Published: April 2007

Abstract Objectives: The purpose of this study was to investigate the factors influencing the pattern (amount and types) of dental care provided to dental visitors participating in the baseline stage of the Ontario Study of the Oral Health of Older Adults. Methods: We interviewed and examined older adults from four municipalities in Ontario and obtained dental service records for the previous two years for those reporting a dental visit. Individual services and their corresponding time and values were aggregated into categories. We compared the pattern of care for dentate and edentulous subjects, and by age, municipality of residence, and social, demographic and economic characteristics. Results: The 473 subjects received 5,031 services, more than four hours of dental care per subject over the two years. The 29 edentulous subjects received about one‐third the number of services compared with the dentate; however, there were no differences in relative time units (RTUs) or relative value units (RVUs). Among the dentate the amount of care (RVUs) varied by municipality of residence and by visiting behavior, but not by age, income, or other socioeconomic variables. Conclusion: Both dentate and edentulous visitors received over two hours of care per person per year. Dental care patterns were influenced by dental status, area of residence, and visiting behaviors.
Self‐disclosure Experience of People with HIV Infection in Dedicated and Mainstreamed Dental Facilities
Authors: Barnes Donna B. , Gerbert Barbara , McMaster James R. , Greenblatt Ruth M. 
Published: April 2007

Abstract Objectives: People infected with HIV choose dental care in dedicated or mainstreamed facilities. In this study, people with HIV were asked whether they sought care in dedicated or mainstreamed dental facilities, their reasons for choosing this source of care, their HIV disclosure experiences, and what, if any, consequences the disclosure had on access to dental care. Methods: Patients in a dedicated AIDS medical clinic (n=84) responded to questions in a telephone survey. The sample was predominantly gay, white males with symptomatic HIV infection, from randomly chosen clinic appointments. Results: The study found that 67.6 percent of respondents who had seen a dentist since their HIV diagnosis chose mainstreamed dental facilities. The majority of study participants (70%) disclosed their HIV status. Of those subjects who chose disclosure, discrimination was minimal (2.7%). Conclusion: Results suggest support for public policy encouraging people with HIV to go to any dentist with whom they feel most comfortable and with whom they will receive the best possible care, regardless of whether the dentist practices in a dedicated or mainstreamed facility.
Drinking Water Fluoride Levels, Dental Fluorosis, and Caries Experience in Brazil
Authors: Cortes Denise Fonseca , Ellwood Roger Phillip , O'Mullane Dennis M. , de Magalhaes Bastos Jose Roberto 
Published: April 2007

Abstract Objectives: The main aim of this study was to consider the association between water fluoride levels and caries prevalence in three Brazilian populations. Methods: A total of 457 6–12‐year‐old lifetime residents from three economically deprived groups with 2–3, 0.7, and less than 0.01 ppm F in their water supplies were examined. Dental caries was recorded on permanent upper central incisors and first molars and all primary teeth (dmft). Results: There was a significant trend (P<.01) for the mean dmft to decrease with increasing levels of fluoride in the drinking water. Caries experience in the six permanent teeth was significantly lower (P<.01) in the area with 0.7 ppm F than in the other two groups. For the 2–3 ppm F group significantly more caries was found in subjects with higher TF scores (P<.05). Conclusion: Optimization of fluoride levels in the drinking water remains a valuable dental public health measure in Brazil.
The Dawn of a New Era
Authors: Scott David B. 
Published: April 2007

AbstractThis paper reviews the scientific events culminating in the fluoridation of communal water supplies. Dental and medical studies completed by 1942 had established the safety and benefits of exposure to drinking water naturally containing fluoride. Researchers and public health workers concluded that it was possible to test the hypothesis that the dental benefits attained where fluoride levels around 1 ppm occurred naturally in drinking water could be safely replicated in low‐fluoride areas by raising the level to this optimal concentration. Grand Rapids became the first test site and by the time the demonstration ended in 1959, around 40 million people in about 2,000 communities already were drinking water with fluoride levels that had been adjusted to optimal. The success of fluoridation brought the dawn of the era of caries control and created great opportunities for research and public health.
Fluoridation and the Private Practice of Dentistry
Authors: Stevens Ray E. 
Published: April 2007

AbstractWater fluoridation holds an important place in the history of Grand Rapids. This paper recounts the firsthand professional experiences of a dentist before and after he joined his father's established dental practice in Grand Rapids, only two years after fluoridation of the city's water supply began. The benefits of water fluoridation are documented through a review of office records. The prevalence of dental caries in patients who were born in Grand Rapids after water fluoridation began is low, and no case of a missing first permanent molar was found. Quadrant dentistry is no longer practiced. Children of parents born in Grand Rapids after the start of water fluoridation experience less decay than their parents, suggesting that factors in addition to water fluoridation have played a role in the downward trends in caries. The complete destruction of mouths of patients seen in this practice 50 years ago no longer happens, providing evidence of the benefits of water fluoridation, the most important advance ever in dentistry.
The Results of Water Fluoridation in Ireland
Authors: O'Mullane Denis , Whelton Helen P. , Costelloe Pat , McDermott Stephen , McLoughlin Jacinta 
Published: April 2007

AbstractThe visit of Dr. Trendley Dean to Dublin in the mid‐1950s helped accelerate the decision to introduce water fluoridation as a public health measure in the prevention of caries in the Republic of Ireland. A challenge to the constitutional validity of the Health (Fluoridation of Water Supplies) Act 1960 failed and in 1964 the water supplies of Dublin city were fluoridated. Over the next seven to eight years all the major urban communities in the Republic of Ireland were fluoridated. Currently, 67 percent of the 3.5 million people in the country reside in fluoridated communities. Studies conducted over the last 20 years show that residents of fluoridated communities have better dental health than those in nonfluoridated communities—the mean dmft is lower in children and the number of natural teeth present in adults is higher.
Water Fluoridation Results in Basel since 1962: Health and Political Implications
Authors: Marthaler Thomas M. 
Published: April 2007

AbstractThe population of the canton Basel‐City has been provided with fluoridated water since May 1962. This paper presents a summary of basic findings from evaluations of this public health intervention. Standard methods were used for assessing dental caries, enamel fluorosis, urinary fluoride, and other data. Caries prevalence of schoolchildren declined until 1977 because of water fluoridation, after which it continued to decline until the late 1980s due to reasons other than water fluoridation. Caries prevalence in Basel was at least as low as in those other parts of Switzerland where either school‐based dental health education programs or comprehensive salt fluoridation programs had been implemented for many years. Enamel fluorosis was seen in 38 percent of the children, similar to regions with comprehensive salt fluoridation, but higher than in low‐fluoride regions. Overlap of salt and water fluoridation in families consuming both fluoridated water and fluoridated salt has occurred, but has not resulted in problems. Fluoride concentrations (close to, but mostly below 1.0 ppm) and excretions (0.45–0.80 mg Fper day in children, around 1 mg in adults) corresponded to expected levels. Statistics from both the School Dental Service and the Public Dental Clinic indicate a dramatic reduction in the amount of conservation dentistry being done and, in adults, prosthetic services. Political steps to remove water fluoridation were taken in 1976, 1982, 1989, and 1993, but have not been successful. Water fluoridation has resulted in the expected benefit and continues to exist beside salt fluoridation used in the other cantons of Switzerland.
And the Next 50 Years? The Future of Recombinant DNA Technology in Oral Medicine
Authors: Slavkin Harold C. 
Published: April 2007

AbstractAs we celebrate this spectacular 50th anniversary, fluoridation continues to be the most effective public health strategy to reduce the disease burden of dental caries. Curiously, while H. Trendley Dean and his colleagues at the National Institutes of Health were investigating the effects of fluoride on tooth enamel in the mid‐1930s, two young boys, one in London and the other in Chicago, were growing up to become the catalysts for another “biological revolution.” These two very talented individuals, James Watson and Francis Crick, would later meet by accident at Cambridge and produce their seminal discovery published in April 1953 as a letter in Nature, a one‐page article provoking an international scientific adventure to understand living organisms in terms of the structure and function of deoxyribonucleic acid (DNA), a universal genetic code and a rationale for the applications of recombinant DNA technology (rDNA) in fields as diverse as agriculture, energy, industry, and health. As we now reflect upon the triumphs from fluoridation and ponder the next 50 years and the complexities of craniofacial, oral, and dental diseases, it becomes increasingly evident that recombinant DNA technology coupled with health promotion, disease prevention, and public education offers the promise for remarkable advances in prevention, diagnosis, and therapeutics in oral medicine.
A Pragmatic Primer… Lessons from Natural Science for the Profession of Dentistry
Authors: Nash David A. 
Published: April 2007

AbstractArtificially supplementing our community water supplies with optimal amounts of fluoride to gain the benefits of a significant reduction in dental caries is a lesson we have learned from natural science, a lesson from nature we have appropriated for culture—and a very pragmatic lesson. Today, we have discovered through science additional principles of nature that can be instructive and that can be appropriated for the profession of dentistry's benefit. This paper reviews five principles of natural science and derives lessons for the profession from these principles. The principles include natural selection, environmental change, form follows function, symbiosis, and entropy. Lessons derived from these principles of natural science are, respectively: survival and thriving of the profession are dependent upon the environment; the status quo will not be maintained—the profession must acknowledge, encourage, and celebrate change; the form the profession assumes must be consistent with its function of serving society; the profession must acknowledge the interdependence and reciprocity existing in its relationship with society; and the profession must continuously, energetically, and creatively reconstruct and renew itself. The challenge before us is to transform dentistry into a profession that continuously anticipates environmental changes by energetically creating new forms or structures that will result in more effective fulfillment of our function: gaining the benefits of oral health for society.
Cancers of the Oral Cavity and Pharynx in the United States: An Epidemiologic Overview
Authors: Swango Philip A. 
Published: April 2007

Abstract Objectives: This paper reviews and summarizes recent epidemiologic data on the incidence, mortality, and survival of cancers of the oral cavity and pharynx. It identifies gaps in the science base, discusses emerging trends, and points out opportunities through which the epidemiology of these cancers can be understood better. Methods: Primary data sources were SEER incidence and survival data from 1973–92 and NCHS mortality data from the same period. Results: In general, the incidence, mortality, and survival rates for oral and pharyngeal cancers are well documented by existing national data; however, gaps in coverage still exist with respect to geographic, racial, and ethnic information. Overall, trends in the occurrence of these cancer types since 1973 have revealed modest improvements in incidence, more substantial improvements in mortality, and little change in survival. However, these trends varied by race, sex, and anatomic subsites. Conclusion: Demographic changes will greatly influence the epidemiology of oral and pharyngeal cancer in coming decades. For older Americans, these cancer types are likely to remain a serious and perhaps increasing problem. Understanding of these cancers can be furthered by continued analysis of existing databases and the creation of new data sources for the future.