Biomedical subjects

A A Schuller

Publications and source records attributed to A A Schuller.

16 recordsLinked to original sources

PubMed2006

[Direct access to the dental hygienist 2. Opinions of dental hygienists and dentists].

In this paper the opinions from dental hygienists and dentists are described concerning the question whether patients could visit the dental hygienist without being seen by a dentist first (access without referral). Eight of ten dental hygienists have a positive attitude towards the idea of access without referral. Dentists were much more sceptical about this idea. There are different opinions about which treatment, what kind of patients, which age groups etcetera a dental hygienist could treat without referral from the dentist. When access without referral becomes relevant, pilot studies are advised before implementing the concept of access to the dental hygienist without referral from the dentist.

Clinical Competence↗

PubMed2006

[Oral health care in nursing and old people's homes and institutions for the mentally handicapped].

Staff members and residents of nursing homes and old people's homes were interviewed about the facilities and provision of oral health care. Clinical examinations were performed to obtain data about the oral health status of the institutionalised elderly. Results show that in most cases the oral health care facilities were insufficient to give care to persons with natural teeth. Of the edentulous elderly 43% reported that the retention of the lower denture was insufficient.

Aged↗

PubMed2006

[Trends in oral healthcare. Caries prevalence and frequency of visits to the dentist for checkups].

In 2003 the project 'Changes in oral health and preventive behaviour'was carried out for the sixth time in succession in The Netherlands. Children and adolescents were asked to fill out a questionnaire and to participate in an oral health examination. Compared to the 1996/1997 results 9-year-olds had a lower incidence of FS and DMFS, 14-year-olds had a higher incidence of DS, and 20-year-olds had a larger number of DS and a smaller number of FS, DMFS and DMFT in 2003. The care index in 2003 was between 48% and 68%. Compared to the 1996/1997 results more 21-year olds visited the dentist annually instead of twice a year. Considering possible consequences of the change in the Dutch health insurance system as of January 2006, such tendencies need careful monitoring.

Adolescent↗

PubMed2005

[Direct access to the dental hygienist 1. Opinions of relevant national organizations].

The opinions of professional dental organisations, the government (Ministry of Health), patient organizations and the medical assurance companies are collected on the question whether patients could visit the dental hygienist without being seen by a dentist first. The general opinion is that this could be possible for those treatments for which the dental hygienist are fully qualified. However, the professional organizations of the dentists claim that the dentist should always be responsible for the patient register and thereby the first responsible for the dental health of the patients. Pilot projects are advised to study how the various dental workers can most efficiently work together.

Cooperative Behavior↗

PubMed2003

[The effect of fluoride application in adolescents of lower socio-economic status].

Purpose was to study the effect of professionally applied topical fluoride on oral health status on the population level in adolescents with lower socio-economic status. Adolescents attending dental clinics where professional fluoride application is a routine procedure (high-fluoride group) were compared to adolescents from other clinics (low-fluoride group). The study consisted of a questionnaire, a clinical examination with two bitewing radiographs. X-rays showed no statistically significant differences in the number of DS, FS or DFS. Clinically, there were no statistically significant differences in the number of FS or in the number of DFS. The low-fluoride group had a statistically significant higher number of DS than the high-fluoride group. The results suggest that professionally applied fluoride has a limited effect on caries and treatment experience in a population. These results justify a randomised clinical trial to study the effectiveness of professionally applied topical fluorides.

Adolescent↗

PubMed2001

Oral status indicators DMFT and FS-T: reflections on index selection.

Oral status in a population has traditionally been described by the DMFT index (decayed, filled, and missing teeth). There seems to be contradicting and confusing evidence in the literature with regard to the usefulness of different indices. Limitations of the DMFT are recognised, and attempts have been made to develop other indices. Two indices, DMFT and FS-T (filled and sound teeth) have been selected for analysis in the present paper. The purpose of this paper is to examine the relationship between DMFT and FS-T in different populations, and to show consequences of choice of index exemplified in analytical analysis. Data stem from the Trondelag-83 and -94 studies that were follow-up studies of the Norwegian portion of the 1973 International Collaborative Study. Sunflower scatter plots and regression analyses were used to describe the variation in DMFT and FS-T in different populations. DMFT was more suitable for describing variation in populations with low levels of disease than FS-T, while FS-T was more suitable for describing variation in populations with high levels of disease. It may be concluded that both DMFT and FS-T should be presented when describing oral status in a population. However, choice of index depends first of all on the purpose of the investigation. If there are theoretical reasons to prefer one index instead of the other, the superiority of the alternative index in terms of variation must be disregarded.

Adult↗

PubMed2001

Caries in populations--a theoretical, causal approach.

The focus of this paper is caries in populations. Caries is assessed as a phenomenon and as it occurs in populations. It is observed that in recent literature the notion of causation of caries is restricted to the biological process on the tooth surface. This may be sufficient to explain caries as a phenomenon, but it is argued that a biological causation is insufficient in order to understand caries and its variation in populations. The understanding of the determinants of a population's oral health has been seriously impeded by the absence of a theoretical framework. A framework would be useful to the extent that it would bridge relevant categories for portraying complex causal patterns of caries in populations. An approach to a framework has therefore been outlined, and the idea of such a framework has been confronted with three critical comments. The framework is as yet pragmatic, incomplete, uncertain and fragmented. Yet, even such an approach may invite greater precision in epidemiological concepts about causes of caries than presently prevails. The framework directs attention to health effects of collective phenomena that cannot be reduced to individual attributes. The image proposed in this paper is intended to spur discussion about important aspects of the epidemiology of caries in populations.

Attitude to Health↗

PubMed2001

An "S-shaped" relationship between smoking duration and alveolar bone loss: generating a hypothesis.

BACKGROUND: A number of epidemiological studies have shown that smoking is a risk factor for periodontal disease. Little is known about the relationship between smoking duration and alveolar bone loss. The purpose of this research was to describe the prevalence of alveolar bone loss according to smoking status in Norway. A dose-response model for duration of tobacco smoking on alveolar bone loss was then developed and discussed. METHODS: The study population consisted of 812 individuals living in Norway aged 45 to 64 years old (248 current smokers, 245 former smokers and 319 non-smokers). Alveolar bone loss was measured on bite-wing radiographs. Simple descriptive statistics were used to describe the central tendency and variation in alveolar bone loss. Regression analyses were performed to study the relationship between smoking duration and alveolar bone loss. RESULTS: Mean alveolar bone loss varied between 1.51 mm and 2.64 mm depending on smoking status and age. Mean alveolar bone loss was lowest in non-smokers and highest in current smokers. Given identical smoking status, the mean alveolar bone loss increased with increasing age except for the 2 oldest age groups of current smokers. CONCLUSIONS: Our results generate the hypothesis that the relationship between smoking duration and alveolar bone loss was "S-shaped." Assuming that alveolar bone loss is irreversible after smoking cessation, it could be hypothesized that there is a threshold period for tobacco smoking after which the accumulated effect of smoking becomes clinically observable. After a certain number of years of smoking, the effect on alveolar bone loss seems to level out. To test this hypothesis, the relationship between smoking duration and alveolar bone loss should be studied in a prospective study design.

Age Factors↗

PubMed2000

[School injuries among 7 to 15 years old children].

This study had two purposes: first, to describe the incidence and characteristics of school injuries among 7 to 15 year old pupils in Norway; second, to identify effective preventive measures. Data on school injuries were taken from the Norwegian National Injury Register (National Institute of Public Health) for the 1995-97 period, n = 2,975. The incidence of school injuries was 29 per 1,000 children-years. Over the nine-year age span, boys had a higher cumulative incidence (292 injuries per 1,000 boys) than girls (239 injuries per 1,000 girls); 1% of the injuries was categorized as severe. Among pupils aged 7-12, 34% of injuries occurred during sports activities; among the 13-15 age group, 60% were related to sports. A literature review was conducted in order to identify preventive measures shown to be effective in reducing school injuries. The databases used were Cochrane Library (issue 4, 1998), Medline (1966-98) and Embase (1980-98). However, no studies found in the literature had evaluated preventive measures. On the basis of our findings, we suggest that preventive measures should emphasise non-sport injuries among the younger pupils and sport injuries among the older pupils. Preventive measures should be evaluated.

Accident Prevention↗

PubMed2000

Oral health changes in an adult Norwegian population: a cohort analytical approach.

OBJECTIVES: The purpose of this analysis was to study temporal variation in oral health in an adult population. The cohort analysis comprised 1) estimation of longitudinal, cross-sectional, and time-lag differences in caries and treatment experience of the adult population in Trøndelag from 1973 to 1983 and to 1994; 2) assessment of which of the effects of age, period and cohort was the most plausible explanation for the observed differences and 3) discussion of causal and other factors underlying the effects of age, period and cohort. METHODS: Cohort analysis was used to study changes in oral health over time. Study participants were selected by random sampling in 1973, 1983, and 1994 (n = 1959, n = 3195, n = 2341 respectively). The methods of data collection comprised standardised clinical measurements and a self-administered questionnaire. Cohort tables were established to analyse changes in DFT from 1973 to 1983 and DFT and DFS from 1983 to 1994. RESULTS: Four patterns of changes in oral health were identified from adolescence to older adulthood. They point in different directions which indicate that complex processes are present. There were two and three significant changes in the subsets of analysis. Assumptions and conditions that allow identification of separate cohort, period, and age effects appeared not to be present. The pattern of changes was consistent with main effects of both age, period, and cohort. The effects were discussed from the perspective of the chosen frame of explanatory factors. CONCLUSIONS: The changes in oral health between populations in 1973, 1983 and 1994 were the combined consequences of simultaneously occurring factors that account for both age, period and cohort effects.

Adolescent↗

PubMed1999

Adjusting estimates of alveolar bone loss for missing observations: developing and testing a general model.

The occurrence of missing teeth is a vexing and growing problem in epidemiological studies of dental disease. The number of units of measurement (i.e., teeth/tooth sites) varies between persons and may affect summary statistics in descriptive studies as well as in analytical studies. The purpose of the present study was to develop a general model to adjust summary statistics for missing teeth. The proposed method was applied to alveolar bone loss in current smokers, former smokers, and non-smokers, from 45 to 64 years of age (n = 812). Alveolar bone loss was measured on bitewing radiographs. The adjustment method was based on the assumption that the probability of losing a tooth was an increasing function of alveolar bone loss. The main finding of the present study was that mean alveolar bone loss increased after adjustment for the number of missing teeth. This increase was larger for current smokers than for non-smokers, indicating that the effects of smoking were slightly underestimated when missing sites were ignored. Further research is required for the model to be applied to other data, estimating different types of dental disease with various degrees of disease prevalence and various numbers of missing teeth, and for validating the adjustment method by means of longitudinal data.

Age Factors↗

PubMed1999

Better oral health, more inequality--empirical analysis among young adults.

OBJECTIVE: The purpose of the study was to examine the development of the distribution of oral health according to socio-economic status in young adults from 1983 to 1994. PARTICIPANTS: Study material consisted of 23-24 year old adults randomly selected from municipalities in Trøndelag in 1983 and 1994 (n = 796, n = 454). RESULTS: The results showed that while overall oral health had improved (reduction in mean DFS of 54% from 1983 to 1994), inequality in DFS between socio-economic groups had increased from 1983 to 1994. The widening disparity appeared to be mainly due to a greater decrease in DFS among the group of individuals with high education. None of the comparable variables, gender, residence, time since last dental visit nor type of clinic could explain the widening gap in DFS. For 1994, differences in oral health according to socio-economic status seemed not to be associated with the use of dental services but rather with the comprehensiveness of treatment. Smoking was more prevalent in the low socio-economic group and associated with a higher mean DFS. CONCLUSION: The target set by the WHO that by the year 2000 the actual differences in health status between groups should be reduced by at least 25% (WHO, 1988) seems to be unattainable among young adults in Norway.

Adult↗

PubMed1998

Changes in the oral health of adults from Trøndelag, Norway, 1973-1983-1994.

The purpose of this paper is to describe the changes in the oral health of adults from Trøndelag, Norway, over two decades (1973-1983-1994), from both a quasi-longitudinal and a time-lag perspective. Study participants were selected by random sampling in 1973, 1983 and 1994 (n=1759, n=3195, n=2341). Data were collected by epidemiological registrations and questionnaires. Oral health was measured by the additive DMF index. The number of decayed teeth was low in all age groups in 1994. There was a reduction in the number of filled teeth from 1983 to 1994 in the time-lag perspective in the youngest age group and the urban middle-aged group. The rural middle-aged adults and the older adults showed more filled teeth in 1994 than in 1983. In a quasi-longitudinal perspective, no significant changes in the 1960 birth cohort and the 1939-48 urban birth cohort were shown from 1983 to 1994, while the 1930-38 birth cohort and 1939-48 rural birth cohort acquired more filled surfaces during this period. There are now at least two different oral health populations of adults. The younger with the potential to carry oral health benefits into old age, and an elderly population burdened with extensive treatment but keeping their natural teeth.

Adolescent↗

PubMed1998

Increasing number of teeth present in a quasi-longitudinal study in adults: a methodological note.

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 one's 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.

Adult↗

PubMed1996

Testing the consistency of measurements of the distance between the cemento-enamel junction and the alveolar bone crest on bitewing radiographs.

UNLABELLED: The purpose of the research described in this paper is to test the consistency of measurements of the distance between the cemento-enamel junction and the alveolar bone crest (CJ-AC) on bitewing radiographs. The present paper shows how the consistency tests were organized and which statistical analyses were used. Since the actual characteristic (CJ-AC) could not alter, the variations of the results had to be due to one more of the 5 m-factors (man, material, machine, method and manipulation). To test the consistency of the measurements of CJ-AC, a pretest and an en route test were performed. Both the bitewing radiographs for the pretest and the en route test were sampled at random from the principal material. The principal material consisted of 856 sets of bitewing radiographs from persons born 1930-1949. The pretest of 40 sets of bitewing radiographs were read twice by 2 independent readers. The en route test consisted of 85 sets of bitewing radiographs which were read twice by 1 reader. Neither the results of the pretest nor the results of the en route test showed statistical or clinical differences of significance. IN CONCLUSION: the consistency of this method of measuring is satisfactory for the 2 readers.

Aged↗

PubMedDate not supplied

Effect of the routine professional application of topical fluoride on caries and treatment experience in adolescents of low socio-economic status in the Netherlands.

The purpose of this study was to study the effect of professionally applied topical fluoride on oral health status at the population level in adolescents with low socio-economic status. Adolescents attending dental clinics where professional fluoride application was a routine procedure (high-fluoride group) were compared to adolescents from other clinics (low-fluoride group). The study consisted of a questionnaire, a clinical examination and two bitewing radiographs. X-rays showed no statistically significant differences in the number of DS, FS or DFS. Clinically, there were no statistically significant differences in the number of FS or in the number of DFS. The low-fluoride group had a statistically significant higher number of DS than the high-fluoride group. The results indicate that professionally applied fluoride has no effect on caries and treatment experience in a population. These results justify a randomized clinical trial on a population level to study the effectiveness of professionally applied topical fluorides.

Adolescent↗