bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does dental service utilization drop during economic recession? The example of Finland, 1991–94
Authors: Suominen‐Taipale Liisa , Widström Eeva 
Published: February 2007

Abstract –After enjoying rapid economic growth in the 1980s, Finland suffered a deep economic recession that began in 1990. It has been claimed that recession and uneven subsidies influence the use of dental services negatively. Finnish adults born after 1956 and world war veterans are entitled to subsidized dental care either in the Public Dental Service (PDS) or in the private sector. Other adults pay their treatment costs. Objectives: The purpose of this paper is to determine whether the economic recession in Finland during the early 1990s affected the use of dental services. Methods: The data were collected by the National Research and Development Centre for Welfare and Health using a method called CATI (Computer Assisted Telephone Interview). The target population was non‐institutionalized persons aged 25–79 years. Results: About one‐third of those interviewed had visited a dentist during the previous 6 months and this proportion was stable during the years studied. Number of teeth, length of education, income and sex had the highest predictive values for use of dental services as analyzed by multiple logistic regression. Two‐thirds had visited a private practitioner, one‐third a PDS clinic and a small percentage some other dentist or denturist. Conclusions: The results showed that the dental service utilization by Finns was stable during this period of economic downturn and only minor changes occurred in the mean number of visits. The most prominent change was seen in the youngest age group, among whom dental utilization decreased by almost 10%. The study indicated that subsidies do not strongly affect dental utilization today.
Approximal caries and sugar consumption in Icelandic teenagers
Authors: Árnadottir I. B. , Rozier R. G. , Sæmundsson S. R. , Sigurjóns H. , Holbrook W. P. 
Published: February 2007

Abstract –The aim of this study, conducted in 1994, was to examine the association between approximal caries and sugar consumption in teenagers residing in three fluoride‐deficient areas in Iceland while controlling for a number of behavioral, residential and microbiological factors. One hundred and fifty subjects (mean age 14 years) selected from the Icelandic Nutritional Survey (INS) were examined radiographically and they completed questionnaires about sugar consumption frequency. Total grams of sugar intake were obtained from the INS for each subject. Caries experience on approximal surfaces, diagnosed from radiographs, was used as the dependent variable in the analyses. Altogether 45.2% of subjects were caries free on approximal surfaces. The overall sample was found to have a mean DFS on approximal surfaces of 2.73 (s= 4.36) per subject. Average daily total sugar intake was 170 g per subject and the mean number of sugar‐eating occasions between meals was 5.32 (s= 6.29) per subject. The regression model indicated that the frequency of between‐meal sugar consumption was associated with approximal caries, with frequency of candy consumption being the most important of the sugar variables. In multivariate analysis, no relationship was found between dental caries and total daily intake of sugar, although a significant relationship between total sugar consumption and presence of caries was seen in bivariate analysis. Between‐meal consumption of sugar remains a risk factor for the occurrence of dental caries, especially in populations with moderate‐to‐high levels of dental caries experience.
Stability of dental health behavior: a 3‐year prospective cohort study of 15‐, 16‐ and 18‐year‐old Norwegian adolescents
Authors: Åstrøm Anne Nordrehaug , Jakobsen Reidar 
Published: February 2007

Abstract –There is a need for a descriptive epidemiology of patterns of dental health behavior through adolescence. Objectives: The purpose of this study was to assess the tracking (degree of stability) of several categories of self‐reported dental health behavior in adolescence over a 3‐year period. Methods: In 1992, a representative sample of 970 15‐year‐old adolescents of Hordaland county, Norway, completed questionnaires under supervision at school. Postal follow‐up studies 1 and 3 years later provided 709 and 781 answers, respectively. The present analyses included 581 adolescents who participated on all three occasions and 670 adolescents who replied in 1992 and 1995. Paired sample t‐tests, cross‐tabulations and Pearson's correlation coefficients were used to assess stability. For use in the cross‐tabulations all variables were transformed into binary categories (active and inactive). Results: A substantial proportion of adolescents remained consistently in the same behavioral category for all 3 survey years. Toothbrushing (80%) and use of dental floss (64%) were the most stable activities, while consumption of sugared mineral water (53%), intake of chocolate/sweets (52%) and use of F‐rinse (54%) were less stable. However, Pearson's correlations between corresponding behaviors assessed in 1992 and 1995 were moderate and varied from 0.59 (toothbrushing) to 0.22 (F‐rinse) (P < 0.001). Conclusion: The results do not conclusively indicate a pattern of tracking. The tendency is, however, clear enough to support the assumption that dental health behavior continues during adolescence into adulthood.
Changes in the oral health of adolescents treated by the Finnish public dental services between the ages of 13 and 15 years
Authors: Utriainen Pekka , Pahkala Kimmo , Kentala Jukka , Laippala Pekka , Mattila Kari 
Published: February 2007

Abstract –Oral cavity health was monitored in 2422 young people aged 13–15 years attending four health centres in Finland between 1992 and 1995. Assessments were made in terms of DMF, D and CPITN indices at clinical examinations. Of those who had no carious teeth at the initial examination, 60% did not develop cavities during the whole period, whereas half of those who had at least two carious teeth at the initial examination developed at least three new carious teeth The treatment time needed by the latter accounted for half of the total time expended by the researchers until the end of the period. Costs can be saved or new patients brought into the dental care system by reorganizing the treatment of the patients who suffer from abundant caries and by reducing the resources devoted to the treatment of healthy patients.
The relationship between socio‐dental indices of handicap, felt need for dental treatment and dental state in a group of frail and functionally dependent older adults
Authors: Lester Vivienne , Ashley Frank P. , Gibbons David E. 
Published: February 2007

Abstract –The present study was designed to investigate the relationship between self‐reported oral handicap as measured by socio‐dental indicators and both dental state and felt need for dental treatment in a group of frail and functionally dependent older adults. A total of 263 housebound adults over the age of 60 years were investigated with regard to their self‐reported dental handicap using the socio‐dental indices derived by Locker (Community Dent Health 1992;9:109–24) Of these, 117 were in long‐stay residential facilities, 67 in sheltered housing and 79 in private housing. The majority were female (76%) and the largest age group comprised 81–90‐year‐olds (44%), while only 8% were in the youngest group of 60–70‐year‐olds. A high level of handicap was recorded. In the previous 4 weeks, 74% of the group experienced difficulty in chewing, 54% some other functional handicap, 22% oral pain, 72% some incident of discomfort and 30% some social problem related to their oral condition. The socio‐dental indices related more to the number of teeth than to age or gender. Ability to chew five index foods was related directly to the number of teeth present (P < 0.001) but unless there were more than 20 teeth present, subjects with natural teeth were more dissatisfied with their appearance than those with complete dentures (P=0.002). The 57 subjects (29%) who expressed a desire for treatment had significantly higher handicap scores (P < 0.001). Thus the results indicate that there are high levels of oral handicap in frail and functionally dependent older adults that are related to both the number of natural teeth retained and desire for treatment
Factors associated with caries incidence in an elderly population
Authors: Powell L. Virginia , Leroux Brian G. , Persson Rigmor E. , Kiyak H. Asuman 
Published: February 2007

Abstract –The purpose of this paper was to identify baseline factors associated with future caries development in older adults (age 60) during a 3‐year study period. Poisson regression analysis was used to determine the association between potential risk factors and disease incidence. The significant factors associated with high coronal caries incidence rates were high baseline root DMFS (P < 0.001), high counts of mutans streptococci and lactobacilli (P=0.036), male geder (P=0.007), and Asian ethnicity (P < 0.002). These factors had small to moderate effects on incidence rates, with relative risk values of approximately 1.2 to 2 The significant factors associated with higher disease incidence on root surfaces were baseline coronal DMFS (marginally significant, P=0.078), high bacterial counts (P=0.002), and Asian ethnicity (P=0.009). The predictive value of the models was low for both coronal and root caries. This result may be because this population had a higher than usual caries incidence rate, making discrimination among these caries‐active individuals difficult. The current study affirmed the value of baseline DMFS and salivary variables to modeling caries incidence and introduced ethnicity as a variable useful for the study of dental caries in older adults.
Oral health status of Canadian‐born and immigrant adolescents in North York, Ontario
Authors: Locker D. , Clarke M. , Murray H. 
Published: February 2007

Abstract –Studies from a number of countries, including Canada, have demonstrated that the oral health status of immigrants is worse than that of their native‐born counterparts and that they make less use of dental services. To date, however, little information is available which documents changes in immigrant oral health following immigration. This paper reports the results of a study conducted in the City of North York, Ontario, that examined the oral health status of Canadian‐born and immigrant adolescents aged 13 and 14 years. The former had better oral health than the latter on all parameters assessed and made more use of dental services. Within the immigrant population, there was a signicant association between oral health and time since immigration. Those who had been in Canada 6 or more years were signicantly healthier than those who had arrived within the preceding 2 years. While changing patterns of immigration may account for part of these differences, the data suggest that access to dental public health programs, delivered to students between the ages of 4 and 14 years, have been effective in improving the oral health of those born outside Canada. Since these programs cease at age 13 or 14 years, barriers to accessing the private dental care sector may mean that the residual inequities and inequalities evident in the data widen as these individuals age.
Cross‐cultural comparison of attitudes and opinions onuorides anduoridation between Australia and Japan
Authors: Tsurumoto A. , Wright F. A. C. , Kitamura T. , Fukushima M. , Campain A. C. , Morgan M. V. 
Published: February 2007

Abstract –This paper reports on two studies exploring similarities and contrasts in knowledge, attitudes and opinions onuorides anduoridation of two culturally different population groups. Therst study compares the attitudes and opinions of parents of primary (elementary) schoolchildren in Melbourne, Australia, and Yokohama, Japan, and the second study compares the attitudes and opinions of dentists drawn from the same geographic areas. A self‐administered questionnaire collected data on 517 parents and 629 dentists. The questionnaires were of similar design and content for both parents and dentists. They included a series of knowledge and attitudinal statements on preventive dentistry and use ofuorides. Attitudinal responses were measured on a 5‐point agree‐disagree Likert scale. Data were analyzed using both bivariate and multivariate techniques. Australian parents appeared better informed on the benets of wateruoridation and held more favorable opinions onuorides anduoridation than their Japanese counterparts. Similarly, Australian dentists held more positive attitudes toward the use of fluorides and fluoridation than their Japanese peers. Cultural norms and experiences appear to shape parental attitudes, whereas the focus of dental education and dental practice on restorative treatments in Japan appears to be a substantial inuence on the attitudes and opinions held by Japanese dentists.
The use of clinical dental auxiliaries as examiners in caries prevalence surveys in the United Kingdom: a feasibility study
Authors: Kwan Stella Y. L. , Prendergast Michael J. 
Published: February 2007

Abstract – Objectives: This study investigated the use of clinical dental auxiliaries as examiners in caries prevalence surveys of 5‐ and 12‐year‐old children in the United Kingdom. Methods: A random sample of four therapists and four hygienists was drawn from 23 clinical dental auxiliaries employed in the Community Dental Service in Yorkshire, United Kingdom. Training and calibration were carried out according to national guidelines for caries prevalence surveys. Sixteen 5‐year‐old and sixteen 12‐year‐old children were examined in the calibration exercise. Agreement was assessed using 95% condence intervals of mean dmft/DMFT of the group, sensitivity and specicity values, and kappa statistics on dft/DFT. Results: For 5‐year‐old children, a good level of agreement with the standard examiner was achieved with sensitivity scores ranging from 0.84–0.98, specicity scores from 0.93–0.97, and kappa scores from 0.80–0.89. For 12‐year‐old children, sensitivity scores ranged from 0.56–0.95; specicity scores from 0.93–0.99; and kappa scores from 0.66–0.83. Four examiners failed to achieve the minimum scores on all measurements. Conclusion: It was concluded that clinical dental auxiliaries could be used as examiners in caries prevalence surveys of 5‐year‐old children. However, in order to attempt to meet the national standard for agreement in surveys of 12‐year‐old children, four of the eight examiners in the present study would require further training. Possible reasons for this difference are discussed.
Increasing number of teeth present in a quasi‐longitudinal study in adults: a methodological note
Authors: Schuller Annemarie A. , Holst Dorthe 
Published: February 2007

Abstract –This paper discusses the impossible result of an increase in the number of teeth present in a quasi‐longitudinal study of an adult population. In 1983 and 1994, random samples were drawn from birth cohorts 1939–48 and 1930–38. The paradoxical result that adults acquired new teeth in the quasi‐longitudinal study gave rise to questions about the comparability of the two samples. Four main sources of failure in comparability are described and discussed: instrumental stability, criteria consistency, response bias, and compositional change in aging cohorts. The lower response rate among persons with two edentulous jaws, and possibly among persons with one dentate jaw, was concluded to be the main reason for the increase in the overall group median and mean number of teeth present. In general, in studies with a similar study design, problems of comparability between the samples demand ones attention and should therefore be carefully evaluated. Compositional change of the population as a source of failure in sample comparability cannot be avoided, while the other three sources (instrumental stability, criteria consistency, response bias) can largely be avoided by careful planning and efficient use of resources.
Patient satisfaction with emergency oral health care in rural Tanzania
Authors: Ntabaye M. K. , Scheutz F. , Poulsen S. 
Published: February 2007

Abstract –Emergency oral health care, as conceived in Tanzania, is an on‐demand service provided at a rural health center or dispensary by a Rural Medical Aide. The service includes: simple tooth extraction under local anesthesia, draining of abscesses, control of acute oral infection with appropriate drug therapy, first aid for maxillo‐facial trauma, and recognition of oral conditions requiring patient referral for further care at the district or regional hospital dental clinic. The objective of the present study was to describe patient satisfaction with emergency oral health care services in rural Tanzania and determine the relative importance of factors influencing patient satisfaction. The study was carried out as a cross‐sectional interview survey between April 1993 and May 1994 using a patient satisfaction questionnaire in rural villages in the Rungwe district of Tanzania. It included 206 patients aged 18 years or more who had received emergency oral health care between April 1993 and March 1994. Overall, 92.7% of the respondents re‐ported that they were satisfied with the service. Patients who were married, had no formal education and lived more than 3 km from the dispensary were more likely to be satisfied with treatment. In a logistic regression model, a good working atmosphere at the dispensary, a good relationship between care provider and patients (art of care) and absence of post‐treatment complications significantly influenced patient satisfaction with odds ratios of 10.3, 17.4 and 6.2, respectively.
Korean dental hygienists' knowledge and opinions about etiology and prevention of dental caries
Authors: Moon Hyock‐Soo , Jung Jae‐Yeon , Horowitz Alice M. , Ma Deuk‐Sang , Paik Dai‐Il 
Published: February 2007

Abstract – Objectives: Because of their formal education Korean dental hygienists have the potential to be the primary source of information on caries prevention for patients and the general public, and inuence the use and adoption of caries preventive procedures. The purposes of this study were to determine the knowledge and opinions about caries etiology and prevention among Korean dental hygienists, and to describe associated factors. Methods: A pre‐tested, 20‐item questionnaire was mailed to 1120 dental hygienists selected by stratied d random sampling and allocated proportionately. A postcard reminder was sent to all dental hygienists after 1 week. Non‐respondents were sent additional complete mailings after 3 and 7 weeks. The response rate was 77% (n=863). Results: Analysis of six factors thought to be related to knowledge about caries etiology and prevention showed that dental hygienists who were taught to provide oral health education and believe that it is desirable to practice oral health education during dental hygiene school and those employed in health centers were likely to be more knowledgeable about caries etiology and prevention than other hygienists (P < 0.05). In regression analysis of the perceived effectiveness of caries preventive procedures, hygienists who provided oral health education during their formal training tended to rate caries preventive procedures as being more effective than other dental hygienists (P < 0.05). Conclusions: Overall, the results of this study suggest that most dental hygienists do not have up‐to‐date information on the etiology and prevention of dental caries, mechanisms of action ofuoride e and effectiveness of preventive procedures. Efforts to increase the level of knowledge of Korean dental hygienists about caries prevention should focus on strategies to educate dental hygienists who have not been taught to provide oral health education, who do not have favorable opinions about the desirability of oral health education, and who had no experience with providing oral health education as part of their work, especially hygienists working in private clinics. Further, these efforts should include the revision of dental hygiene curricula and continuing education courses.
Comparison between the DMF indices and two alternative composite indicators of dental health
Authors: Benigeri Mike , Payette Martin , Brodeur Jean‐Marc 
Published: February 2007

Abstract –The DMFT and DMFS indices employed in the majority of oral epidemiological studies have several limitations. In response to this problem, Sheiham et al. (Community Dent Health 1987;4:407–14) proposed two alternative dental health indicators: the number of functioning teeth (hereafter referred to as FS‐T) and tissue health (T‐Health). Using data from an epidemiological study on the dental health status of adults aged 35–44 from Quebec (N=2110), this article compares the alternative indices with the conventional DMFT and DMFS indices. By comparing Pearsons correlation coefcient for the four indices in this study with the number of decayed, missing andlled surfaces, it is noted that the FS‐T index bears the strongest correlation to the three variables. It is also the only index whose correlation coefcient is greater than 0.3 for each of the three DMFS components. A risk group was created for each index, composed of the 18% of people demonstrating the poorest index. The risk groups's FS‐T index results in an average of 4.3 decayed surfaces (compared with 2.6 for the DMFT), 92.7 missing surfaces (74.4 for the DMFT) and 9.0 filled surfaces (compared with 26.9 for the DMFT). Using linear regression analysis with each index as a dependent variable, and peoples socio‐demographic characteristics, regular use of dental services and perception of dental health as independent variables, it appears that the percentage of the explained variance (R2) is 21.2% for the FS‐T index, 13.8% for the T‐Health index, 12.3% for the DMFS index and only 7.6% for the DMFT index.
Dental fluorosis in Chilean children: evaluation of risk factors
Authors: Villa Alberto E. , Guerrero Sonia , Icaza Gloria , Villalobos Jaime , Anabalón Mireya 
Published: February 2007

Abstract –The purpose of this case‐control study was to determine the association between very‐mild‐to‐moderate enamel fluorosis and exposure during early childhood to fluoridated water, mainly through ingestion of powdered milk. Analysis was performed on 136 residents of the optimally fluoridated community of San Felipe in the Chilean Fifth Region, who were categorised into one of three groups according to their age when water fluoridation was introduced in 1986: Group I was born after 1986; Group II was 16–24 months old in 1986; and Group III was >24 months of age. The case and control subjects were selected on the basis of a clinical examination given in July 1996. Dean's scoring system was used to determine fluorosis status. Risk factor exposure was ascertained by a questionnaire used in interviews with mothers of participating children. Logistic regression analysis, after adjustment for confounding variables, revealed that very‐mild‐tomoderate enamel fluorosis of permanent central maxillary incisors (CMI) was strongly associated both with the age of the subjects when water fluoridation began and with breast‐feeding duration for children belonging to Group I. Subjects in Group I were 20.44 times more likely (95% CI: 5.00–93.48) to develop CMI fluorosis than children who were older than 24 months (Group III) when fluoridation began. Subjects who were between 16 and 24 months old when water fluoridation began were 4.15 times more likely (95% CI: 1.05–16.43) to have CMI fluorosis than children older than 24 months. An inverse association was found with breast‐feeding duration (OR=0.86, 95% CI: 0.75–0.98) among Group I subjects but not in Groups II and III. Results obtained suggest that the current fluoride concentration in drinking water may be contributing to fluorosis. Further studies will be necessary to determine the relative competing risks of dental fluorosis and dental caries in Chilean children in order to establish the most appropriate water fluoridation level in Chile.