bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Guamanian Dental Caries Preventive Programs after 13 Years
Authors: Sterritt Gene R. , Frew Ralph A. , Rozier R. Gary 
Published: April 2007

Abstract Objectives: To address the high prevalence of dental caries in Guamanian children, a school‐based fluoride mouthrinse program, a clinic‐based pit and fissure sealant program, and community water fluoridation were phased in over a 13‐year period. The purpose of this paper is to evaluate the impact of these programs on the prevalence of dental caries. Methods: Cross‐sectional samples representative of schoolchildren in grades 1 through 8 were selected in 1976, 1979, 1984, 1986, and 1989. These years include the starting years for each of the three interventions and varying follow‐up periods for each. About 1,000 children in each of the survey years were examined to derive DMF surface scores. Results: After eight years of fluoride mouthrinsing, DMFS scores were reduced by 25.4 percent in 6–14‐year‐olds. With two additional years of fluoride mouthrinsing and with pit and fissure sealants, overall DMFS scores declined an additional 44.4 percent. In 1989, three years after community water fluoridation was initiated on the island and continuation of the other two programs, there was a further decline in overall DMFS scores of 34.5 percent. Over the entire study period—during which there were 13 years of fluoride mouthrinsing in the schools, five years of sealant application, and three years of community water fluoridation—DMFS scores declined 72.8 percent overall (5.14 surfaces per child) and 71.9, 71.0, and 78.8 percent for occlusal, buccal‐lingual, and proximal surfaces, respecttively. Conclusions: An intensified preventive dentistry program introduced on an island with high caries prevalence twice that of the US mainland was successful, and contributed to a reduction in the prevalence of caries to a level equivalent to that of the United States at the end of the study period.
Impact of HIV on VA Dental Services: Report of a Survey
Authors: Manz Michael C. , Weyant Robert J. , Adelson Richard , Sverha Susan K. , Durnan J. Richard , Geboy Michael J. 
Published: April 2007

Abstract Objectives: This study assessed knowledge, attitudes, and behaviors related to the treatment of HIV‐infected patients by Department of Veterans Affairs (VA) dental personnel. Methods: A questionnaire was mailed to all VA dentists, hygienists, and EFDA assistants and completed anonymously in May 1991. Descriptive results are reported along with comparisons between the findings from this study and a similar VA survey conducted in 1988, as well as several national surveys of non‐VA dentists. Results: Nearly all VA respondents reported participation in some type of continuing education on HIV and infection control. They also reported high compliance with recommended infection control procedures. Furthermore, the findings suggest that VA dentists and hygienists have a high willingness to treat HIV‐infected patients, far exceeding that expressed by non‐VA dentists. However, a high level of anxiety related to occupational exposure to HIV seems to exist. Most respondents perceived a higher risk of HIV infection from commonly encountered occurrences in the workplace than actually exists based on current knowledge. Conclusions: While efforts to further reduce the risk of infection and improve care should continue, future efforts also should be directed toward reducing the anxiety of VA dental personnel in the treatment of infectious patients.
Understanding Dental Service Use by Older Adults: Sociobehavioral Factors vs Need
Authors: Tennstedt Sharon L. , Brambilla Donald L. , Jette Alan M. , McGuire Sheila M. 
Published: April 2007

Abstract Objectives: This study investigated correlates of dental care use in a representative sample of adults aged 70 and older throughout New England. Methods: Data were collected in in‐home interviews and dental examinations. Following Andersen's behavioral model of health services utilization, varied measures of sociodemographic characteristics, dental health attitudes and practices, perceived need for care, and need objectively determined by clinical examination were included as potential correlates. Results: Recency of last visit was associated with positive attitudes toward dental care, regular dental hygiene, and having a usual source of care. Among dentulous subjects, recency of last visit also was related to sex and living arrangements. Frequency of visits for dentulous subjects was associated with the same variables, as well as with age and social class or education, in addition to need for care. For edentulous subjects, only a usual sourse of care and higher social class were associated with more frequent visits. Conclusions: Perceived need and attitudes toward dental care are important influences on use of care. Older persons must be convinced of the importance of regular dental care.
Differences in Judgments of Persuasive Argument Quality by Three Population Groups in Iowa
Authors: Bolden Aljernon J. , Logan Henrietta L. 
Published: April 2007

Abstract Objectives: This study describes a method for studying the perceived persuasiveness of rationales for adopting preventive health behaviors. Methods: Using the Elaboration Likelihood Model, we surveyed 156 individuals as to the level of persuasiveness that each of several categories of reason presented in adopting target “prevention” behaviors such as eliminating the use of smokeless tobacco or seeking regular dental care. Results: Significant differences between what the public reported as persuasive reasons and those selected by future dental practitioners were found. Patients saw potential cost savings, elimination of future pain, and being told by an authority person to adopt a behavior as highly persuasive reasons to adopt a target behavior. Nonwhite patients gave significantly higher scores than did white patients to arguments centering on social/aesthetic appeal. On the negative side, episodic care seekers felt significantly more strongly than regular care seekers that their practicing dental prevention activities (e.g., regular checkups, brushing, and flossing) benefited someone other than themselves (dental profession and dental manufacturers). Conclusions: Results of this study suggest that one way to improve persuasive public health preventive messages is to consider whether the fundamental arguments on which preventive health campaigns are built have broad patient appeal.
Considerations in Establishing a Dental Program for the Homeless
Authors: Bolden Aljernon J. , Kaste Linda M. 
Published: April 2007

AbstractThe homeless are a diverse group who present the dental profession with a number of difficult challenges in the delivery of oral health services. Utilization of dental services by the homeless is low when provided in traditional settings and access is limited. The purpose of this case study is to review program planning issues focusing on the unique aspects of establishing dental programs for the shelter‐based homeless. This paper is based on experiences in developing a dental program for homeless persons in Boston. The establishment of a portable dental program in 1988 for persons residing in shelters in the greater Boston area involved many administrative and clinical considerations. These factors included determination of needs and barriers to dental care, resource identification and development, program planning and implementation, evaluation, and the development of constituency support. The diversity of the homeless population in combination with the variation of space and medical resources at different shelter sites dictates flexibility in the development of programs to address the oral health needs of the homeless.
Introduction to the Symposium
Authors: Burt Brian A. 
Published: April 2007

AbstractJanuary 25, 1995, is the 50th anniversary of the first controlled addition of fluoride to a public water supply. Those 50 years have seen extraordinary advances in oral health and consequent quality of life, for which fluoride use is generally considered the primary reason. More extensive exposure to fluoride in the modern era, however, has led to both a continuing decline in caries experience and an increased prevalence of dental fluorosis in children. At the other end of life, fluoride's role in bone strength among older people is not well defined. This symposium examines several aspects of fluoride use in the United States today, and has the purpose of helping to define the balance between maximizing the benefits of fluoride while minimizing its undesirable side effects.
Commentary on and Recommendations for the Proper Uses of Fluoride
Authors: Horowitz Herschel S. 
Published: April 2007

AbstractFluorosis has been associated with the fluoride concentration of drinking water, use of dietary fluoride supplements, early use of dentifrices, and prolonged use of infant formula. The literature, however, does not show associations between fluorosis and use of fluoride mouthrinses, professionally applied fluorides, bottled waters, carbonated beverages, and juices. It is unwise to issue laundry lists of items that may be implicated as problem‐causing when, in fact, they may not be. Although usually classified without fluorosis, children in Dean's “questionable” category would be classified with the condition if the TFI or TSIF were used. Accordingly, Dean, in 1942, really reported only 52.8 percent of children without fluorosis in Kewanee, a community with 0.9 ppm fluoride in drinking water. Because the morbidity and sequelae of dental caries have declined, undue emphasis has been placed recently on the risks of using fluoride rather than on its profound beneficial effects. Although of paramount importance, conclusions cannot be drawn on whether fluoride protects against, contributes to, or has no effect on bone fractures or is valuable in treating osteoporosis. Careful thought is required before making recommendations that may reduce health benefits because of unfounded concerns about perceived risks. There should be greater regulation of extraneous fluoride sources, rather than reliance on educational efforts or recommendations to eliminate use of highly effective preventive regimens.
Dental Fluorosis and Caries Prevalence in Children Residing in Communities with Different Levels of Fluoride in the Water
Authors: Jackson Richard D. , Kelly Sue A. , Katz Barry P. , Hull James R. , Stookey George K. 
Published: April 2007

Abstract Objectives: This study investigated the prevalence of dental fluorosis and caries in 7–14‐year‐old children residing in communities with negligible (NF: 0.2 ppm), optimal (OPF: 1.0 ppm), and four‐times optimal (4X OPF: 4.0 ppm) naturally occurring fluoride in their water systems. Methods: Examinations were performed on 344 children who were lifetime residents of their communities. Results: Whether using the tooth surface index of fluorosis or Dean's index, children examined in the 4X OPF community had the highest prevalence of dental fluorosis. While the severity of fluorosis seen in the OPF and NF communities was mild in appearance, the results indicate that fluorosis does occur in optimally and negligibly fluoridated communities. Compared to the NF community, DMFT and DMFS scores in the OPF community were 9.2 percent and 21.2 percent lower, respectively. Conclusions: The ingestion of water containing 1 ppm or less fluoride during the time of tooth development may result in dental fluorosis, albeit in its milder forms. However, in these times of numerous products containing fluoride being available, children ingesting water containing 1 ppm fluoride continue to derive caries protection compared to children ingesting water with negligible amounts of fluoride. Thus, the potential for developing a relatively minor unesthetic condition must be weighed against the potential for reducing dental disease.
Smoking and Oral Health: a Population Survey in Finland
Authors: Telivuo Matti , Kallio Pekka , Berg Mari‐Anna , Korhonen Heikki J. , Murtomaa Heikki 
Published: April 2007

Abstract Objectives: A survey was conducted to study smokers' oral health behaviors and attitudes, and to determine if smokers were advised by their dentists to quit smoking. Methods: A random sample of 1,200 adults 15 to 64 years of age living in the province of North Karelia, Finland, was selected in each of two study years (1990 and 1991) and surveyed using a mail questionnaire. The 102‐item questionnaire solicited information on smoking status, oral health behaviors, missing teeth, perceptions of tobacco's harmful effects on oral health, smoking status and quitting, and advice on smoking cessation provided by dentists. Variations in behaviors and opinions according to smoking status were analyzed. Results: Nonsmokers reported more frequent healthy oral health behaviors than did daily smokers, with the exception that no difference in toothbrushing frequencies existed among women. Daily smoking was associated with increased use of sugar in tea or coffee, and with more frequent alcohol consumption. Daily smoking was correlated with the number of missing teeth in bivariate analyses, but not in multivariate analyses. Fewer daily smokers than nonsmokers considered smoking to have harmful effects on oral health. The majority of daily smokers, however, wanted to quit. Eight percent of daily smokers reported that they had been advised by their dentist to quit. Conclusions: Dentists need to provide patients with counseling on tobacco use because of the desire of many smokers to quit. Counseling of smokers by the oral health team requires special attention and skills, because smokers' health behaviors and attitudes appear to be less favorable to oral health compared to nonsmokers.
Attitudes of College Football Coaches Regarding NCAA Mouthguard Regulations and Player Compliance
Authors: Ranalli Dennis N. , Lancaster Diana M. 
Published: April 2007

Abstract Objectives: The purpose of this study was to assess the attitudes of Division 1‐A college head football coaches regarding the NCAA mouthguard regulations, current patterns of use by players, and responsibility for enforcement; and to compare the coaches' responses with those of officials studied previously. Methods: A 15‐item questionnaire was mailed to all 106 Division 1‐A football coaches to assess their attitudes. Percent frequency distributions of coaches' responses to each item were computed and compared to the officials' responses. Results: Responses were received from 98 coaches (92.45%). While 87 percent of coaches reported having a team dentist, the majority reported that the team trainer was responsible for selecting the type of mouthguard used. Most coaches (53%) reported that all players wore mouthguards, but that quarterbacks were least compliant. Most coaches reported that mouthguard rules were beneficial in determining player compliance and resulted in more frequent use. Seventy‐four percent would warn the player of a violation themselves, yet only 26 percent felt the coach had the greatest influence on players wearing mouthguards. Seventy‐six percent felt the current enforcement of the rules is appropriate. Coaches opinions varied from those of officials. Conclusions: Coaches view themselves, the players, or the trainer as most responsible for players wearing mouthguards, not referees. This finding coincides with the officials' opinion that the coaches should be accountable.
Fluoride Supplement Use by Children in Fluoridated Communities
Authors: Pendrys David G. , Morse Douglas E. 
Published: April 2007

Abstract Objectives: The purpose of this study is to describe patterns of inappropriate fluoride supplementation among a sample of Connecticut schoolchildren living in optimally fluoridated areas. Methods: Fluoride exposure histories were obtained via a written questionnaire with a response rate of 89 percent and an overall reliability of 87 percent agreement. Results: A total of 575 subjects lived the entire first eight years of life in a fluoridated community. Of these, 26.1 percent had a history of inappropriate supplementation sometime during that period, including 31.8 percent of subjects with mild to moderate fluorosis and 22.8 percent of subjects without fluorosis. There were no significant supplement history differences related to current age, sex, or socioeconomic status. Overall, 71 percent of these subjects used only vitamins with fluoride, while only 14 percent were reported to have used fluoride supplements alone. Sixty‐eight percent of the subjects who were supplemented while breast feeding, continued supplementation after cessation of breast feeding. Conclusions: These findings reinforce the need for health professionals to be targeted more aggressively at the school, residency, and private practice levels to better promote a full understanding of the proper utilization of fluoride supplements.
The Prevalence of Dental Fluorosis in a School‐based Program of Fluoride Mouthrinsing, Fluoride Tablets, and Both Procedures Combined
Authors: Nowjack‐Raymer Ruth E. , Selwitz Robert H. , Kingman Albert , Driscoll William S. 
Published: April 2007

Abstract Objectives: The objective of the study was to describe and compare the prevalence and severity of dental fluorosis in children who participated in an eight‐year clinical trial of the effectiveness of school‐based fluoride procedures according to three treatment regimens and age of regimen initiation. Methods: At baseline in 1981, 1,640 kindergarten and first grade children residing in a fluoride‐deficient community (Springfield, OH) were assigned randomly to a group that(1) rinsed once a week with a 0.2 percent neutral NaF solution; (2) chewed, rinsed, and swallowed daily a neutral 2.2 mg NaF tablet; or (3) carried out both procedures. DMFS examinations were conducted at baseline and after two, five, and eight years of treatment. As a follow‐up in 1992, fluorosis examinations using Dean's index were conducted on 448 remaining subjects. Results: Overall, the prevalence of fluorosis was 4.4 percent with 20 children classified as having some definitive level of the condition. No statistically significant differences existed in the prevalence or severity of fluorosis: (1) among the preventive regimens; (2) among children who began the regimens at ages 5, 6, or 7; or (3) by eruptive status of teeth. Conclusion: These results reiterate the safety of school‐based fluoride mouthrinse, fluoride tablet, or combined regimens in communities with fluoride‐deficient water supplies.
Associations Between Exposure to Fluoridated Drinking Water and Dental Caries Experience among Children in Two Australian States
Authors: Slade Gary D. , Davies Michael J. , Spencer A. John , Stewart Judy F. 
Published: April 2007

Abstract
Objectives: This study assessed associations between exposure to fluoride in water and dental caries experience among children in two Australian states. Methods: Cross‐sectional data were obtained from 9, 690 South Australian children aged 5–15 years and 10, 195 Queensland children aged 5–12 years. School dental service practitioners recorded DMFS and dmfs data. A questionnaire to parents gained information about residential history that was used to calculate children's percent of lifetime exposed to fluoridated water. Results: Greater exposure to fluoride in water was associated with lower dmfs and DMFS in both states (P<.01), although in South Australia the effect for DMFS was statistically significant only after controlling for extent of unknown fluoridation exposure and for fluoride supplements. Caries‐fluoridation associations were stronger for dmfs compared with DMFS and for Queensland (5% of population fluoridated) compared with South Australia (70% of population fluoridated). Effects for DMFS persisted after controlling for socioeconomic factors. Conclusions: Fluoridation was associated with lower caries experience. The weaker association with DMFS in South Australia may be due to less caries and more fissure sealants in that state, and is consistent with a “diffusion” effect, whereby a high proportion of the population exposed to fluoridation diminishes differences among exposure groups.
Dental Caries‐reducing Effects of a Milk Fluoridation Project in Bulgaria
Authors: Pakhomov Guennadi N. , Ivanova Katerina , Moller Ingolf J. , Vrabcheva Maria 
Published: April 2007

Abstract Objectives: The aim of the present study was to investigate the effects of a community‐based milk fluoridation project on dental caries. Methods: Fluoridated milk was provided to about one‐half of kindergarten and other schoolchildren in Asenovgrad, a town in the southern part of Bulgaria. The estimated daily milk consumption was 200 ml containing 1 mg of fluoride (∼5 ppm F). Cross‐sectional samples of 61/2‐year‐olds in Asenovgrad and Panaguriche (a nearby town selected as the reference community) were examined at the start of the study in 1988 and after three years. Additional cross‐sectional samples of 7 1/2‐year‐olds in Asenovgrad who were and were not drinking fluoridated milk were examined at baseline and at three years to provided an internal control group. Samples of 6 1/2‐and 8 1/2‐year‐olds from Asenovgrad and Karlovo were examined in 1993 to provide for five‐year follow‐up comparisons. Results: In 6 1/2‐year‐old children who had consumed fluoridated milk for three years, there was a decrease in the mean dmft per child of 40 percent and in the mean DMFT of 89 percent compared to children examined at baseline. Children in Asenovgrad who were 4 1/2 years old at the start of the study and had been drinking fluoridated milk for three years had on average 44 percent fewer dmft and 83 percent fewer DMFT at 7 1/2 years of age than those not drinking fluoridated milk. After five years the dmft index was 40 percent less and the DMFT index 79 percent less in those children who had participated in the full five years of the program compared to the control group. Conclusions: Results seem to confirm the caries‐reducing effects of milk fluoridation found in previous studies. Unexpected large caries reductions obtained in this nonexperimental study, however, probably cannot be attributed to the fluoridation of milk alone. The mere introduction of the project might have led to other changes affecting dental caries, such as improved oral hygiene and better dietary habits.
Refining the Estimate of the Critical Period for Susceptibility to Enamel Fluorosis in Human Maxillary Central Incisors
Authors: Evans R. Wendell , Darvell Brian W. 
Published: April 2007

Abstract Purpose: The purpose of this study was to determine an improved estimate of the critical period for susceptibility to fluorosis in human maxillary central incisors. Methods: The fluorosis score, S, of the incisal (I), middle (M), and cervical (C) third divisions on the labial surface of right maxillary central incisors of subjects (a representative sample of 1,085 Hong Kong Chinese children aged 7 to 12 years surveyed in 1986) was determined according to the Chronological Fluorosis Assessment (CFA) Index. Subject data were grouped by month of birth relative to June 1978, when the designated concentration for waterborne fluoride in the community water supply was reduced from 1.0 to 0.7 mg/L. The analytical task was one of finding the correlation maximum in a system of 12 variates and adjustable parameters including the waterborne fluoride concentration, [F‐], and the fluorosis score. Results: The main findings were: (1) the peak correlation of S vs [F‐] for the male incisal third centered at 17.5 months after birth; (2) and six months later for females; (3) the correlation of S with [F‐] is maximized for S(M) following S(I) by two months, and S(C) following S(M) by a further two months for both males and females; and (4) the critical period for exposure to fluoride is of about four months' duration for each third. Conclusions: The maxillary central incisor, as a whole, appears most at risk to fluorosis from dietary fluoride between age 15 and 24 months for males and between 21 and 30 months for females.