bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public Health Implications of Recent Research in Periodontal Diseases
Authors: Burt Brian A. 
Published: May 2007

AbstractKnowledge of the epidemiology, natural history, and bacterial etiology of the periodontal diseases has advanced considerably as a result of research conducted through the 1980s. Prevention and control of these conditions, however, remains mechanical, cumbersome, and often impractical, based as it is on bacterially nonspecific plaque removal for an indeterminate period. This research has not yet changed the content of public health programs, but it does affect the way the programs are applied. Because severe, generalized disease seems to be less prevalent than previously thought, the need of regular, routine professional care for everybody is questioned. Professional care in a public health context is likely to be more efficient when targeted toward those with severe disease. Dental health education for personal oral hygiene is still supported by scientific studies, though a targeted approach and careful assessment of educational content is needed. Until predictive screening methods for identifying susceptible individuals are developed, selection of priority groups for education and treatment should be guided by epidemiologic data.
Primary Canine Hypoplasia in Head Start Children
Authors: Silberman Stephen L. , Duncan William K. , Trubman Aaron , Meydrech Edward F. 
Published: May 2007

AbstractPrimary canine hypoplasia is an incomplete or defective development of the enamel matrix. The lesion is located on the labial surface and is seen more frequently on mandibular teeth. The purpose of this preliminary study was to determine the prevalence of this lesion among Head Start children. During a dental needs assessment of Mississippi Head Start children, 371 children from 11 centers were examined for this lesion. Of the centers, four were located in optimally fluoridated communities, and six were located in fluoride‐deficient communities. Ages ranged from three to five years. There were 206 males and 165 females, 334 black and 37 white children. At ten centers all children were black, while all children at one center were white. Results indicated no significant differences in the black population between fluoridated (38.2%) and fluoride‐deficient (36.3%) communities (F = .729) or between males (36.8%) and females (37.6%) (P = .877).When data were collapsed on sex and fluoridation status, the racial differences were highly significant (P =.001). The prevalence rate of dental caries associated with primary canine hypoplasia was 26.0 percent. These preliminary data indicate that the presence of primary canine hypoplasia may result in an increased potential for the tooth becoming carious.
Oral Health Knowledge and Attitudes of Elementary Schoolteachers in Michigan
Authors: Lang Paul , Woolfolk Marilyn W. , Faja Barbara Wirth 
Published: May 2007

AbstractTeachers at elementary schools in two areas (urban and rural) of Michigan were surveyed to determine their sources of information about oral health and their knowledge and attitudes about dental diseases and disease prevention. Questionnaires were completed by 404 teachers (62% response rate). More than 80 percent of respondents from both areas were female. Demographic characteristics that were significantly different between groups included: median ages of urban and rural respondents (P<.01), median numbers of years in teaching (P<.01), and median years in residence (P<.03). Despite these differences, responses to the questionnaire varied little. For both groups, the most frequently cited sources of information about dental health were dentist's office (82%), followed by magazines and books (74%). The teachers considered preventing tooth decay as the most important reason for good oral hygiene. When asked to rank the effectiveness of ten methods of preventing caries in children, teachers ranked efficacious methods such as fluoridated water and pit and fissure sealants lower than making regular dental visits and reducing intake of sugared foods. Asked to rank the most effective method for children to receive fluoride, urban respondents ranked fluoridated water first, while rural respondents ranked this measure third. Findings suggest that teachers' knowledge about oral health and current methods of prevention is incomplete, is inaccurate in some instances, and varies little by geographic area.
Preventive Control of AIDS by the Dental Profession: A Survey of Practices in a Large Urban Area
Authors: Rydman Robert J. , Yale Seymor H. , Mullner Ross M. , Whitels David , Vaux Keith 
Published: May 2007

AbstractThe purpose of this study was threefold: (1) to report the proportion of dental practitioners adhering to the 1987 Centers for Disease Control (CDC) procedures for using infection control techniques (ICTs); (2) to identify attitudes toward infection control and disease; and (3) to establish whether certain practitioner characteristics or use of certain ICTs were related to willingness to treat HIV‐positive patients, willingness to volunteer for an HIV specialty clinic outside of regular practice, vaccination against hepatitis B, and a felt need for a specialty clinic within the practice to treat HIV patients effectively. A survey of approximately 3,800 members of a major metropolitan dental society found that 89 percent of respondents regularly used at least one CDC ICTbeyond routine medical histories. Ninety‐one percent indicated a moderate to extreme change in attitude toward the risks of infectious diseases and the regular use of ICTs (80.2% identified AIDS as the major factor in this change). Twenty‐seven percent indicated that they would knowingly treat HIV‐positive patients. No differences were found among practitioners willing to treat HIV‐infected patients and those unwilling to treat these patients in terms of adherence to the CDC ICT recommendations for dentists. Statistical association between ICT use and other practitioner response variables are discussed.
Evaluation of the Comparative Effectiveness of Fluoride Mouthrinsing, Fluoride Tablets, and Both Procedures in Combination: Interim Findings after Five Years
Authors: Driscoll William S. , Nowjack‐Raymer Ruth , Heifetz Stanley B. , LI Shou‐Hua , Selwitz Robert H. 
Published: May 2007

AbstractThis article presents five‐year interim findings of an eight‐year clinical trial designed to compare the relative caries‐preventive benefits of weekly fluoride mouthrinsing, daily fluoride tablet administration, and both procedures combined. Children in kindergarten and first grade residing in Springfield, Ohio, a non fluoridated community, were assigned randomly in school to one of three groups that (1) rinses once a week in school with a 0.2 percent neutral NaF solution; (2) chews, rinses with, and then swallows daily in school a neutral 2.2 mg NaF tablet; or (3) carries out both procedures. At baseline (1981), 1,640 participants were examined clinically using the DMF surface index. After five years, 789 children were available for reexamination. Findings show that subjects in the combination group experienced a mean caries increment of 1.47 DMFS, 16.5 percent lower than the mean score of 1.76 DMFS for children in the tablet group and 31.3 percent lower than the 2.14 DMFS for those in the rinse group. Only the difference in incremental caries scores between the combined fluoride procedure and the fluoride rinse was statistically significant (P<.05). Despite the finding of an additive caries‐preventive benefit among children who followed the combined regimen, it would be premature to judge which procedure is best before results of the final examinations become known.
Oral Health Status of Mexican‐Americans with Low and High Acculturation Status: Findings from Southwestern HHANES, 1982–84
Authors: Ismail Amid I. , Szpunar Susan M. 
Published: May 2007

AbstractThis article presents the results of a cross‐sectional analysis of the prevalence of dental caries and periodontal disease, as well as the use of dental services, among 395 low acculturated dentate Mexican‐Americans, 12–74 years of age, examined during the southwestern portion of the Hispanic Health and Nutrition Examination Survey (HHANES). Comparisons were carried out with 1,894 dentate Mexican‐Americans who had high acculturation status. Mexican‐American adolescents and adults with low acculturation status had 73 and 116 percent higher mean number of decayed and missing teeth, respectively, compared with those with high acculturation status. The differences between the two groups, however, did not remain statistically significant when the confounding effects of age, sex, education, and income status were taken into account. Gingivitis and periodontal pocketing were highly prevalent in both groups, but those with low acculturation status had significantly higher disease levels than those with high acculturation status. Despite the unmet dental needs and the higher prevalence of dental caries and periodontal disease, Mexican‐Americans with low acculturation status were significantly less likely than those with high acculturation status to have dental insurance and to have visited the dentist as frequently.
The Missouri Elks Mobile Dental Program–Dental Care for Developmentally Disabled Persons
Authors: Dane John N. 
Published: May 2007

AbstractThis article describes the origins, funding, organization, operation, utilization, and outreach program of a statewide mobile dental program for the disabled in Missouri. The article includes information based on analysis of productivity reports and patient records. Comparisons are made between the utilization by mentally retarded (MR) and other disabled patients (MCCS), their county of residence, and the location where service was provided (rural vs urban). The mean number of dental procedures provided per client was 7.3. More procedures (8.35) were provided to urban clients than rural clients (5.81). The utilization rate of urban MR clients was 63.9 percent, compared to 60 percent for rural MR clients. Other findings show 10.7percent urban MCCS clients utilized the mobile dental program, versus 13.5 percent of the rural MCCS clients. The budgeted expenditures for providing care to this underserved group were $46,000 less than the estimated value of dental care provided in a private practice setting.
Evaluating the Impact of P.L. 99‐252 on Decreasing Smokeless Tobacco Use
Authors: Chen Moon S. 
Published: May 2007

AbstractLiterally, Public Law 99‐252 (otherwise known as the Comprehensive Smokeless Tobacco Health Education Act of 1986) includes provisions that are informational in nature. Implicitly, however, this law is considered part of the federal effort in disease prevention and health promotion. This paper reviews the societal and legislative context of that act and presents a plan to evaluate the impact of this law on decreasing smokeless tobacco use. The uniqueness of this plan is its incorporation of nine disciplinary perspectives in the derivation of indicators to measure process, impact, and outcome measures for decreasing smokeless tobacco use. A basic prevention strategy is suggested by this interdisciplinary approach. In addition, specific lessons could be applied from the history of successes in public health to decreasing smokeless tobacco use.
P.L. 99‐252 and the Roles of State and Local Governments in Decreasing Smokeless Tobacco Use
Authors: Capwell Ellen M 
Published: May 2007

AbstractEvaluation of the impact of the Comprehensive Smokeless Tobacco Health Education Act of 1986 (P.L. 99‐252) will help determine the level of progress being made to reduce smokeless tobacco use and will help determine changes or new strategies needed to prevent or reduce smokeless tobacco use. Indicators of progress made toward implicit goals and explicit provisions of P.L. 99‐252 are proposed as appropriate for local, state, and federal government health agencies to address. Examples of roles that can be played by health agencies relative to implicit goals of the law are drawn from experiences of public health professionals in Ohio and other states. These roles relate to work with the media, research and evaluation, surveillance activity, support for development of materials and implementation of programs, and funding for community educational programs. Indicators to measure impact of explicit provisions of the law focus on provisions specified in the ' public education section of the law. Proposed indicators involve monitoring the development and availability of programs, materials and media, monitoring research and dissemination of findings, and monitoring technical assistance and grants available. Possible measurement and evaluation strategies are discussed. Survey methodology seems most suitable for monitoring level and type of anti‐smokeless tobacco activity in which health agencies engage and for determining awareness of resources available through the law.
Periodontal Health of 14‐17‐year‐old US Schoolchildren
Authors: Bhat Mohandas 
Published: May 2007

AbstractThis paper describes the findings related to periodontal health in 14‐17‐year‐old children who participated in the National Survey of Oral Health in US Schoolchildren, conducted by the National Institute of Dental Research (NIDR) during 1986‐87. Gingivitis was observed in approximately 60 percent of children in this age group. The proportion of examined sites per child with gingivitis, however, was less than 6 percent. Gingivitis was most common in molar areas in the maxilla and incisor areas in the mandible. Supragingival calculus was observed in nearly 34 percent of the children, and subgingival calculus in approximately 23 percent. The proportion of teeth per child with calculus was approximately 8 percent for supragingival and 4 percent for subgingival calculus. Both types of calculus showed a predilection for molars in the maxilla and incisors and cuspids in the mandible. The mean periodontal attachment loss was 0.33 mm. The teeth most frequently affected by attachment loss of 2 mm or more were maxillary molars and bicuspids, followed by mandibular molars and cuspids.
On‐site Screening for Urinary Hg Concentrations and Correlation with Glomerular and Renal Tubular Function
Authors: Naleway Conrad , Chou Hwai‐Nan , Muller Tommy , Dabney Jacquelyn , Roxe David , Siddiqui Farrida 
Published: May 2007

AbstractAt the American Dental Association 1985 and 1986 Annual Sessions, an on‐site screening for mercury was conducted as part of the Health Screening Program (HSP) to identify dentists having elevated urinary mercury concentrations. The data generated from this study were used to examine the relationship between elevated urinary mercury exposure and kidney dysfunction. Kidney dysfunction was assessed by measurement of serum and urine β2microglobulin concentrations, serum creatinine, and creatinine clearance. The mean values found for urinary mercury were 5.8 μg Hg/L and 7.6 μg Hg/L for 1985 and 1986, respectively. Urinary mercury concentrations for this population were found to fall within the range of not detected to 115 μg Hg/L. Of the total number of participants assayed in 1985 and 1986, roughly 10 percent of the sample exhibited elevated mercury concentrations above 20 μg Hg/L. An analysis of the clinical markers indicated no clear relationship between elevated urinary mercury concentrations and kidney dysfunction. In addition to mercury testing, all dentists who participated in the 1985 and 1986 HSP were issued a questionnaire soliciting information as to their professional exposure. Those participants who were identified as having elevated urinary mercury concentrations in the 1985 HSP were issued a followup questionnaire that addressed psychological and neuropsychological symptoms. From these questionnaires three significant relationships were found. These relationships were associated with mercury/amalgam handling and skin contact, the number of amalgams placed by the dentist, and the number of hours of practice per week. The reported absence of a clear relationship between urinary mercury concentrations and potential kidney dysfunction is in agreement with other findings at the mercury concentrations tested. Based on the data generated from this study, these results support the use of an on‐site screening procedure as a quick and accurate measure of total mercury excretion.
A Critique of Topical Fluoride Methods (Dentifrices, Mouthrinses, Operator‐, and Self‐applied Gels) in an Era of Decreased Caries and Increased Fluorosis Prevalence
Authors: Ripa Louis W. 
Published: May 2007

AbstractWithin the last 20 years there has been a decrease in the caries prevalence of US schoolchildren, a change in the intraoral caries pattern, and a slowing of the progress of lesions. Simultaneously, the prevalence of enamel fluorosis has increased. The increase principally is in the milder, cosmetically acceptable forms and is more noticeable in fluoride‐deficient communities than those with optimal or above‐optimal water fluoride concentrations. Circumstantial evidence indicates that a principal contributor to the caries decline is the extensive use of fluoride dentifrices. Conversely, although use of a fluoride dentifrice can add to the total daily amount of ingested fluoride in preschool children, there is little evidence to suggest that dentifrice ingestion is a principal factor causing the fluorosis increase. The value of fluoride methods may be assessed in relative or absolute terms. The relative, or percentage, caries reduction attributed to fluoride mouthrinses and gels appears to be a property intrinsic to the methods themselves and generally is little affected by the caries activity of the population being treated. Conversely, the absolute, or numerical, caries reduction is dependent upon the level of disease in the population. Thus, the reported caries decline reduces the number of surfaces prevented from developing caries, even though the percentage reduction remains substantially unchanged. Although inadvertent ingestion of fluoride can result from the use of mouthrinses and gels, there is little evidence to suggest that they have contributed to the fluorosis increase. When using topical methods, prudence should prevail to avoid ingestion of fluoride. Fluoride dentifrices should continue to be used routinely, and although lower potency dentifrices may be considered, the literature does not provide strong support for their need. Use of fluoride mouthrinses and gels for individual patients should be predicated upon their caries activity or risk. Use of these methods in public health programs is a matter of cost‐effectiveness, which will be influenced by the caries prevalence of the target population.
Reaction Paper: The Use of Topical and Systemic Fluorides in the Present Era
Authors: DePaola Paul F. 
Published: May 2007

AbstractSystemic fluoride may enhance the resistance of the tooth by way of (1) an alteration in tooth morphology, and (2) a conversion of the hydroxyapatitic mineral to a fluoridated state with an attendant reduction in solubility and an enhancement of the re mineralization phase of the caries process. It has been reported by a number of investigators, although it is not universally accepted, that the posterior teeth from fluoridated areas have a distinct morphology that is less susceptible to caries attack. Fluorapatite and hydroxy apatite do not differ appreciably with respect to the amount of mineral that dissolves at a specified concentration of acid. However, if solubility is considered as a function of pH at equilibrium, i.e., the final pH after the dissolution products have entered the solvent‐a model more akin to the in vivo situation‐hydroxyapatite is the conspicuously more soluble of the two minerals. In this connection, epidemiologic data suggest that children with unusually high levels of surface enamel fluoride have little or no caries. This observation is consistent with the finding that the solubility of solid apatite solutions with varying degrees of fluoride substitution was inversely related to fluoride content, with minimal solubility at 0.5 substitution, a value observed in natural teeth at the very outermost surface of the enamel. Evidence of a preemptive effect of fluoride has also been shown in field studies in which subjects had reduced levels of caries with fluoride exposure in childhood only.
Predicting Concerns for the Mouth among Institutionalized Elders
Authors: MacEntee Michael I. , Hill Patricia M. , Wong Glen , Mojon Philippe , Berkowitz Jonathan , Glick Ned 
Published: May 2007

AbstractThere is a widespread belief that old people do not have healthy mouths, although the reason for this neglect is not clear. A random sample of 41 long‐term care facilities in Vancouver was selected–653 residents were examined and about three‐quarters of them were interviewed–to find associations between variables that might influence a concern for oral health and to assess the effectiveness of multivariate models for predicting this concern. A bivariate analysis of the data, using chi‐square tests, assessed any significant associations between the variables, and three classification techniques–discriminant analysis, logistic regression, and CART (classification and regression trees)–were used to assess the usefulness of the multivariate models. Complaints of oral problems were heard from half (53%) of the sample. Most (85%) of the participants expressed a desire for treatment, while fewer than half (44%) of the participants had used a dental service since entering the facility or in the previous year. The complaints were associated significantly with the subjects who had been to a dentist recently, with those dissatisfied with the cost or quality of previous treatment, and with women. The desire for treatment was associated significantly with the recent use of dental services, and with a lack of concern for the cost of dental treatment, while the use of services was associated significantly with subjects who were younger, dentate, or from the higher socioeconomic groups. The multivariate classification techniques offered a wide range of prediction rates for complaints (62‐74%), desire for treatment (63‐91%), and use of services (56‐97%); however, the complexity of the techniques and the range of the results suggest that they were not particularly useful for predicting the concerns of this population.
The Reorganization of the City of Toronto Dental Services: A Community Development Model
Authors: Lee Jack 
Published: May 2007

AbstractThe dental program of the Department of Public Health, City of Toronto, is over 75 years old. Recently, the department engaged in extensive community‐based planning, which culminated in the closing of forty‐eight school based clinics and the opening of eight community clinics. A geriatric dental program also was established. This paper will describe the data utilized, the analysis of which enabled the department to focus its efforts on those at high risk for dental disease. These groups included immigrants and institutionalized seniors. This analys is also enabled the department to locate its clinics in those areas of the city with greatest need. The community development model, quite unique to major reorganizations, is also described. It was this wide support that resulted in the unanimous approval by the city council of the reorganization and gave impetus to personnel changes resulting in the ability of staff to communicate in the major languages of a city where over 50 percent speak a language other than English or French.