bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indexes for Measuring Dental Fluorosis
Authors: Horowitz Herschel S. 
Published: April 2007

AbstractDental fluorosis, a hypoplasia or hypomineralization of tooth enamel or dentin, ranges in intensity from barely noticeable whitish striations to confluent pitting and staining. Various indexes or classification systems have been used in surveys to measure the presence and severity of enamel fluorosis. Other systems and indexes record all defects in enamel, based on a premise that an etiology for the condition should not be presumed. If all defects are recorded, a retrospective attempt to reconstruct which of them are fluorosis is inappropriate. Dean's classification system has been used most frequently over the years for assessing fluorosis. Therefore, its continued use is sometimes important for historical comparisons. Dean's system, however, has several shortcomings, principally its inability to measure fluorosis in different tooth surfaces. As it has been traditionally used, it also does not permit specifying the cosmetic importance of the most severe fluorosis detected in a dentition. The Tooth Surface Index of Fluorosis (TSIF) eliminates or reduces some of the shortcomings of Dean's method. Use of the TSIF in a survey in Illinois was able to discriminate between the prevalence and severity of fluorosis in four groups of communities with different concentrations of fluoride in their drinking water.
Antifluoridationists Persist: the Constitutional Basis for Fluoridation
Authors: Block Lester E. 
Published: April 2007

AbstractThe controversy surrounding fluoridation persists. In recent years opponents of fluoridation have resorted to the courts with increasing frequency and have achieved a few victories in the trial courts. To date, however, no appellate court has ruled against fluoridation. This article discusses the constitutional basis for the court decisions upholding fluoridation and the main arguments put forth by the antifluoridationists. Five of the more recent cases are summarized, as is the first fluoridation case to be appealed to the US Supreme Court. The article concludes that the legal validity of fluoridation in the United States has been thoroughly tested in the courts and confirmed. It appears that the antifluoridationists will concentrate their future legal attacks on the “harmful effects” of fluoridation on health and the environment. If they can convince the courts that even a few people were truly harmed, the delicate balance between the rights of the state to fluoridate in order to protect the public's health and the rights of the individual not to be harmed could well shift In closing, the question is raised whether the US Congress has the power to pass legislation either to mandate or forbid fluoridation.
Comparison of Medicaid and Non‐Medicaid Dental Providers
Authors: Lang W. Paul , Weintraub Jane A. 
Published: April 2007

AbstractA statewide mail survey of a stratified sample of 640 Michigan general dentists was conducted in 1983, with a response rate of 41 percent, n = 261. An analysis was performed to compare Medicaid and non‐Medicaid providers. About half of all respondents reported that they were not seeing any Medicaid patients (Group 1); 29 percent reported that less than 10 percent of their patients were Medicaid‐eligible (Group 2), and 22 percent reported that 10 percent or more of their patients were Medicaid‐eligible (Group 3). Significant differences existed among the three groups for age of respondent, length of time in practice, and number of new patients seen each month. Respondents with greater percentages of Medicaid patients in their practices were more likely to be in group practice. Stratification of respondents by location suggested that rural providers were more likely than urban respondents to have some Medicaid patients in their practices. Over 40 percent of respondents from all groups reported themselves as being not busy enough. In 1984, more than one million persons in Michigan were eligible for Medicaid dental benefits, but only one‐fourth of these individuals were recipients of dental care. Factors that may limit dentists' participation in the Medicaid program, despite the presence of a large eligible population and self‐reported lack of busyness, are discussed.
Dentists' Response to Financial Incentives in a Mail Survey of Malpractice Liability Experience
Authors: Fiset Louis , Milgrom Peter , Tarnai John 
Published: April 2007

Abstract This two‐part methodologic research was designed to evaluate the effects of a financial incentive on questionnaire response rate and response bias for general dentists surveyed by mail. Subjects were 517 clinicians randomly selected from a two‐state population of practitioners insured by a single malpractice liability carrier. Subjects received a check for either $5 or $10 in the original mailing. In Study 1, a single mailing and postcard follow‐up resulted in a 57.8 percent (111/192) response rate. In Study 2, employing Dillman's Total Design Method, a 69.6 percent (208/299) response was obtained after a third mailing. Analysis of response rate by incentive level in each study revealed no significant differences. In contrast, early responders (first mailing and follow‐up postcard) differed from late responders (second and third mailings) on age (41.4 vs 37.0 years; T=‐2.17; P=.032), non‐Caucasians (27.7% vs 63.9%; χ2=17.3; df=4; P<.002), females (13.9% vs 27.8%; χ2=3.9; df=1; P<. 05), foreign‐trained (7.0% vs 19.4%; χ2=16.5; df=2; P<.001), and dissatisfaction with practice (31% vs 51%; χ2=7.8; df=4; P =. 10). Thus, the magnitude of the financial incentive in this experiment had no differential effect on response rate. But differences in responses from late responders (proxies for nonresponders) on demographic characteristics and key study variables suggest the persistence of response bias despite an acceptable response rate. Future dental health survey research should employ tests for response bias on both sets of variables.
Evaluation of a Dental Public Health Program for Old‐age Pensioners in Denmark
Authors: Petersen Poul Erik , Nörtov Bjarne 
Published: April 2007

AbstractA high priority is given to improvements in the oral health of the elderly in Scandinavia. In 1987 a Danish municipality established a dental public health care program for old‐age pensioners. All 67‐year‐old citizens were offered school‐based preventive and curative care using guidelines and principles established by the Danish Municipal Dental Service for children. Care was provided free of charge. Citizens not wishing to obtain care through the public system could do so from private dental practitioners. Reimbursement for care obtained from the private system was provided by the National Health Insurance and the municipality. The purpose of this study was to evaluate the outcome of the program after three years of operation. A follow‐up design was used and data were collected by interviews and clinical registrations. At baseline and follow‐up 216 (71%) and 235 (77%) pensioners, respectively, were interviewed about their self‐assessments of dental health, dental knowledge, attitudes, and behavior. Clinical data were collected only for the elderly who participated in the public program, and included 194 persons at baseline and 187 at follow‐up. These data included information on tooth loss, dental caries, periodontal health, and presence and function of removable dentures. At the follow‐up, 86 percent of all respondents had regular dental visits of at least once a year compared to 46 percent at baseline; 75 percent participated in the public program and 11 percent obtained care from private practitioners. At the end of the intervention period, fewer elderly reported symptoms of poor oral health or impaired function of dentures. Moreover, improvements in self‐care, knowledge, and attitudes in oral health were found. The clinical data showed a reduction in unmet need for dental treatment. More preventive care services were given to attenders of the public program than the private one. The present evaluation of systematic public dental care demonstrates positive results in improvment of the oral health and life‐quality among the elderly.
Evaluation of Subjective Oral Health Status Indicators
Authors: Locker David , Miller Yasmin 
Published: April 2007

Abstract Objectives: This paper reports the results of a study to evaluate the performance of a battery of subjective oral health status indicators originally developed for use in large scale surveys of older adults. The aim was to assess their generalizability, efficiency, reliability, and validity when used in a study of adults aged 18 years and over and to compare their performance with respect to younger and older adults. Methods: Data were collected by means of a mail survey and self‐complete questionnaire of a random sample of the population aged 18 years and older. Results: The results suggested that the measures were sensitive to the oral health concerns of adults of all ages and that item nonresponse was within acceptable limits. Test‐retest and internal consistency reliability statistics were good and all hypotheses designed to assess concurrent and construct validity were confirmed. Conclusions: The results confirm an earlier, but more limited, evaluation and suggest that these indicators are useful for descriptive oral health surveys of general populations.
The Use of Milk as a Saliva Substitute
Authors: Herod Edward L. 
Published: April 2007

AbstractXerostomia, a clinical manifestation of salivary gland dysfunction, affects many people. These individuals frequently sip liquids to alleviate the discomforts associated with hyposalivation. Milk appears to have many of the chemical and physical properties of a good saliva substitute. Besides the obvious benefit of providing moisture and lubrication for the dehydrated mucosa, milk buffers oral acids, reduces enamel solubility, and contributes to enamel remineralization. These anticariogenic factors are generally attributed to the high calcium and phosphate content along with the milk phosphoproteins that strongly adsorb to enamel. Patients with xerostomia frequently have difficulty in obtaining proper nutrition due to problems associated with lubricating, masticating, tasting, and swallowing food. Milk is a food with high nutritional quality that would certainly benefit most patients with xerostomia. Because of the nutritional, anticariogenic, and moisturizing properties of milk, patients with xerostomia may find milk of value as a saliva substitute to help reduce the oral health problems associated with hyposalivation.SummaryXerostomia is a serious condition frequently affecting the elderly, those undergoing radiation therapy, and individuals with Sjogren's syndrome. The dry mucosa and rampant dental caries associated with the loss of salivary flow presents a frustrating situation for both the patient and the dental practitioner. Xerostomia patients frequently use saliva substitutes to relieve some of the discomforts associated with this condition.Milk appears to be a good saliva substitute. It provides moisture and lubrication for the dehydrated mucosa. Milk aids the patient in masticating, swallowing, and cleansing the mouth of oral debris. Experiments in vivo and in vitro support the hypothesis that, under normal circumstances, milk is not generally cariogenic and may have anticariogenic potential. These anticariogenic factors are attributed to milk's ability to buffer acids produced from sugars, inhibit demineralization of enamel, and facilitate the remineralization phenomenon that occurs with early enamel lesions. The calcium and phosphorus content seems to be a factor in the cariostatic mechanism of milk. Casein also seems to be involved in the reduction of enamel demineralization. Casein phosphopeptides may be responsible for some anticariogenicity by concentrating calcium and phosphate in plaque.
Knowledge of and Practices Related to Caries Prevention among Koreans
Authors: Paik Dai‐ll , Moon Hyock‐soo , Horowitz Alice M. , Gift Helen C. , Jeong Kwang‐lai , Suh Sung‐soo 
Published: April 2007

Abstract Objectives: This study assessed the knowledge and opinions of caries prevention and source of oral health information among Koreans. Methods: A questionnaire consisting of 36 items was used to interview 2,000 Koreans 10 through 69 years of age. Results for only selected questions are reported. A multistage, stratified, random sampling method was used. Results: Sixty‐nine percent of the respondents had heard about fluoride. Only 16 percent knew that some community water supplies in Korea are fluoridated. Fifty‐five percent of respondents who knew about community water fluoridation learned the information from television, whereas 28 percent read about it in a newspaper. Among those respondents who reported hearing about community water fluoridation, only 30 percent had precise information about its purpose. Fifty‐five percent of the respondents reported that toothbrushing is the best way to maintain good oral health. Almost all respondents (97 percent) reported brushing their teeth one or more times a day. Conclusions: These data indicate that there is a relatively low level of accurate knowledge about dental caries prevention among Koreans 10 through 69 years of age. The majority of respondents report learning information about oral health from the mass media.
Dental Caries in Homeless Adults in Boston
Authors: Kaste Linda M. , Bolden Aljemon J. 
Published: April 2007

Abstract
Objectives: Information about the oral health status of the homeless is limited. The purpose of this study is to characterize the dental caries status among users of a dental treatment and referral program at homeless shelters in Boston, MA. Methods: Persons attending the program during a one‐year period were assessed for evidence of dental caries experience by a single examiner. DMFT counts were abstracted from patient records. Results: The population examined (n=73) was 66 percent male with a mean age of 36 years. The racial composition was 51 percent African‐American, 34 percent Caucasian, and 14 percent Hispanic. The 70 dentate people examined had a mean DFT of 11.1 (SD=6.1). The mean percent of DFT that was DT per person was 55.7 percent. Untreated caries was detected in 91.4 percent of those examined. Conclusions: These findings show evidence of previous dental services utilization by these homeless individuals, but demonstrate a high need for preventive and restorative dental therapy.
Prevalence of Dental Caries and Dental Fluorosis in Areas with Optimal and Above‐optimal Water Fluoride Concentrations: a 10‐Year Follow‐up Survey
Authors: Selwitz Robert H. , Nowjack‐Raymer Ruth E. , Kingman Albert , Driscoll William S. 
Published: April 2007

Abstract Objectives: This paper presents findings for dental caries and fluorosis from an October 1990 follow‐up survey in Illinois and compares results with those obtained from two similar school‐based examinations conducted in 1980 and 1985 within the same communities. Methods: The seven study sites were grouped into four categories according to the approximate relation of their water fluoride concentration to the recommended optimal fluoride level for the area. Tests for differences in dental caries and dental fluorosis across the four water fluoride groupings and three examinations were conducted. Results: DMFS scores for children who resided in communities with above‐optimal water fluoride levels did not change significantly from 1980 through 1990. At the optimal water fluoride concentration, caries scores did not change substantially from 1980 to 1985; however, the mean DMFS score in 1990, 1.9, was significantly lower than caries levels observed during the two previous exams. In the optimally fluoridated area, the proportion of fluorosed tooth surfaces increased significantly from 1980 to 1985, but then declined by 1990 to the level observed in 1980 for both age groups. Conclusions: The results suggest that: (1) in the optimally fluoridated community, the apparent increase in the prevalence of dental fluorosis observed from 1980 to 1985 did not continue from 1985 to 1990; and (2) at above‐optimal water fluoride concentrations, dental fluorosis either remained stable or demonstrated no sustained increase over the decade.
Predetermination as a Cost‐containment Mechanism in a Social Allowances Dental Program in Manitoba
Authors: Cooney Peter V. , Hassard T. H. , Spangen Ulla A. 
Published: April 2007

Abstract Objectives: A review of dental consultant actions during predetermination of benefits in the publicly insured indemnity program in Manitoba under which Social Allowances Health Services certificate holders receive dental care was under‐taken to determine the value of this process as a cost‐containment mechanism. Methods: Dollar amounts of services denied by a dental consultant during eight predetermination sessions selected to represent the 96 sessions during the 1990–91 fiscal year were determined and grouped according to category of service. Results: Approximately one‐third of average total expenditures each month were reviewed by the dental consultant through the predetermination process. Of the requested dollar amount reviewed, 26 percent was denied, a savings of 8.5 percent of average total monthly expenditures. The categories of services that made up the denied requests were: prosthodontics (30%); endodontics (32%); restorative (5%); periodontics (12%); and miscellaneous (21%), including diagnostic, surgical, preventive, orthodontic, and adjunctive. Conclusions: A properly administered predetermination process can save a third party 8.5 percent of total plan expenditures; dollar changes to altered treatment plans amount to a 26 percent reduction of expenditures relating to these requests. A predetermination process with an unbiased appeal mechanism provides a system to advise and protect providers regarding what treatment is covered.
Factors Affecting Self‐ratings of Oral Health
Authors: Matthias Ruth E. , Atchison Kathryn A. , Lubben James E. , De Jong Fred , Schweitzer Stuart O. 
Published: April 2007

Abstract Objectives: The purpose of this study is to determine the relationship of self‐rated oral health to a comprehensive battery of clinical, sociodemographic, physical health, and mental health measures in a well‐elderly urban population. Methods: Results are based on telephone interviews and clinical assessments of 550 subjects over 65 years of age participating in a Los Angeles‐based Medicare project during 1990. Subjects were mostly female, white (89%), with above‐average income. Results: Findings show that: (1) the DMF measure is not as strongly related to self‐rated oral health as was a single measure of missing teeth; (2) the major predictors of self‐rated oral health were “worry about teeth” and “appearance of teeth” followed by total missing teeth, race, education, and depression scores; and (3) self‐rated general health is related to self‐rated oral health. Conclusion: Self‐rated oral health may be, for older adults, a better measure of “health” than of “morbidity.”
Differences between Racial Groups in the Impact of Oral Disorders among Older Adults in North Carolina
Authors: Hunt Ronald J. , Slade Gary D. , Strauss Ronald P. 
Published: April 2007

Abstract
Objectives: This study investigated variations in impact of oral disorders between older black adults and older white adults living in North Carolina. Methods: Using the Oral Health Impact Profile (OHIP) questionnaire, 440 participants aged 70 and older provided data on their perceptions of the impact of oral disease on aspects of their lives during the previous 12 months. Results: For 22 of the 49 items queried in the OHIP questionnaire, older blacks reported more frequent impact than older whites (P<.05). For none of the OHIP items did whites report more frequent impact. The impacts reported were diverse and included items reflecting pain, physical disability, psychological disability, and social disability. When the number of items occurring fairly often or very often were summed for dentate participants, blacks reported more items than did whites (3.7 vs 1.1, P<.0001). This difference decreased to 2.7 vs 2.0 (P<.346) after controlling statistically for greater mean periodontal pocket depth, more unreplaced missing teeth, and more episodic dental visits among blacks. Conclusions: Older dentate blacks reported more impact from oral problems than older dentate whites. The differences in reported impact likely are linked to differences in oral status and dental visit history between these two racial groups in North Carolina.
Treatment and Posttreatment Effects of Fluoride Mouthrinsing after 17 Years
Authors: Kobayashi Seigo , Kishi Hiroshi , Yoshihara Akihiro , Horii Kin‐ichi , Tsutsui Akihito , Himeno Tatsuo , Horowitz Alice M. 
Published: April 2007

Abstract Objectives: This study assessed the treatment and posttreatment effects of a school‐based, fluoride mouthrinse regimen. Methods: Children in a nonfluoridated community in Japan participated in a daily rinse program using a 0.05 percent NaF solution in nursery and primary schools, and a weekly rinse with 0.2 percent NaF in junior high school. Students were examined at least annually for dental caries and dental treatment was provided in a public dental clinic through the ninth grade. Incipient carious lesions with no cavitation were not restored. Results: The percent of children in grades one through nine (6–14 years of age) with caries‐free permanent teeth increased from 13.4 percent in 1974 to 73.0 percent in 1991, while the mean DMFT decreased by 86 percent during this period. For 12‐year‐olds, mean DMFT scores declined to about one tooth per child after 1982. For adults 20 years of age, there was a 64 percent difference in DMFS between the treatment group who started the rinse regimen at 4 years of age and continued for 11 years, and the controls who lived in different districts and did not participate in a fluoride rinse regimen. Conclusions: Children who began rinsing at 4 or 5 years of age benefited the most from the program. The program was inexpensive, simple to implement and well accepted by families and teachers. The conservative treatment policy in the public clinic likely contributed to the benefits derived by participants.
The Impact of Recent Changes in the Epidemiology of Dental Caries on Guidelines for the Use of Dental Sealants
Authors: Brown L. Jackson , Selwitz Robert H. 
Published: April 2007

AbstractThis paper reviews recent changes in the epidemiology of dental caries and assesses their potential impact on the diagnosis and management of the disease and the planning and operation of sealant programs. These changes, such as the decline in caries and slowing of the rate of progression of the disease, have important implications for diagnosing and treating incipient lesions, predicting caries risk, and conducting effective disease preventive programs. Traditional paradigms for restoring carious lesions are being replaced by newer strategies that emphasize disease prevention and conservation of tooth structure. The search continues for the identification of practical models for predicting caries risk at the individual level. This paper describes a method useful for targeting resources in sealant placement programs by enabling one to determine the relative effectiveness of sealing alternative tooth surfaces in the oral cavity. One guide serves as a widely adopted manual for those who use or intend to use dental sealants in caries prevention programs. This paper provides a brief review of that document, “Preventing Pit and Fissure Caries: A Guide to Sealant Use,” as well as guidelines for sealant utilization provided by the American Dental Association, and information regarding dental sealant programs under Medicaid. The final portion of the paper provides a synthesis of the epidemiology reviewed and summarizes the implications of findings for sealant programs.