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Biomedical subjects

A I Ismail

Publications and source records attributed to A I Ismail.

At least 19 recordsLinked to original sources
PubMed1995

Periodic health examination, 1995 update: 2. Prevention of dental caries. The Canadian Task Force on the Periodic Health Examination.

OBJECTIVE: To make recommendations, based on current evidence, for practising physicians and dentists on interventions for the prevention of dental caries in their patients. OPTIONS: Systemic fluoride administration, professionally administered fluoride, use of fluoride mouth rinses, fissure sealants, oral-hygiene practices, dietary practices, identification of groups at a high risk of dental caries, and early diagnosis and treatment. OUTCOMES: Reduced prevalence of dental caries and fluorosis, longer retention of teeth and lower treatment costs. EVIDENCE: Several MEDLINE searches were conducted for articles published from January 1980 to December 1992, including relevant review articles. VALUES: Relevant clinical findings were evaluated and categorized with the use of the evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination. Recommendations were developed for each method of caries prevention, with reduced incidence of dental caries and improved prevalence of caries-free teeth given high values. BENEFITS, HARMS AND COSTS: The potential benefits of these measures in the long-term are a lower incidence of tooth decay, longer retention of teeth and prevention of fluorosis. The cost saving can be considerable for patients and insurers; however, implementation of some recommendations will be difficult, since the traditional preventive practices of dentists and dental hygienists are not easily changed. RECOMMENDATIONS: There is good evidence that the following manoeuvres are effective in preventing dental caries: use of dentifrices containing fluoride, fluoridation of drinking water, fluoride supplements for patients in areas where there is a low level (0.3 ppm or less) of fluoride in the drinking water, professionally applied topical fluoride and the use of fluoride mouth rinses for patients with very active decay or at a high risk of dental caries and selective use of professionally applied fissure sealants on permanent molar teeth. There is poor evidence that the following manoeuvres are effective in preventing dental caries: professionally applied topical fluoride and the use of fluoride mouth rinses for patients with a low risk of caries, toothbrushing (without a dentifrice containing fluoride) and flossing, cleaning of teeth by a dentist or dental hygienist before topical application of fluoride or at a dental visit and dietary counselling for the general population. There is good evidence to recommend against the use of over-the-counter fluoride mouth rinses by the general population. VALIDATION: These guidelines are compatible with those of the US Preventive Services Task Force. SPONSOR: These guidelines were developed and endorsed by the task force, which is funded by Health Canada. Major funding was provided by the Faculty of Dentistry of the University of Toronto, Toronto and the Faculty of Dentistry of Dalhousie University, Halifax.

Canada↗
PubMed1995

A longitudinal evaluation of fissure sealants applied in dental practices.

Sealants are highly effective in preventing dental caries in the pits and fissures of teeth when applied by trained operators in clinical trials and public health programs. The effectiveness of fissure sealants when applied in dental practices is still not known. The purpose of this longitudinal study was to evaluate the effectiveness of fissure sealants applied in dental practices in preventing dental caries on occlusal surfaces of first permanent molars. In 1990, on the Island of Montréal, 911 randomly selected children, from 6 to 9 years of age, were examined; out of those, 816 and 733 were re-examined in 1991 and 1992, respectively. Only the 733 children with complete examination records were included in this evaluation. Sealant applications were either personally paid for or were paid for by private dental insurers. All children were covered for diagnosis and restorative care by a publicly financed and universal insurance program. Dental treatment records were provided by Quebec's health insurance board. In the epidemiological examination, the occlusal surfaces of first permanent molars, which are the only surfaces included in this analysis, were classified into: sound, non-cavitated and cavitated status, restored, and sealed. Sealants were evaluated for full or partial coverage of the occlusal surface and presence of dental caries. During the first and second years, 11.6% and 17.5% of the students had new sealants. The number of new sealants placed during the two years was 507. Children with caries-free status and whose parents had high school education or higher were significantly more likely to receive sealants during the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Binomial Distribution↗
PubMed1994

Evaluation of orthodontic treatment using the Dental Aesthetic Index.

This investigation evaluates dental esthetic differences of orthodontic patients before and after treatment. The orthodontic treatment provided for patients in this investigation involved the use of removable appliances in 85% of the cases, use of fixed appliances in 2% of the cases, and a combination of fixed and removable appliances in 13% of the cases. Records of patients treated at a dental school clinic between 1959 and 1984 were reviewed. Inclusion criteria for this study included complete patient records, and the presence of dental casts for estimation of the Dental Aesthetic Index (DAI). Of the 932 patients, 116 patient records were included. Fifty patients began treatment during the mixed dentition (age < or = 144 months), and 66 were treated during the permanent dentition (age > 144 months). Pretreatment DAI values and component factors were measured and compared with posttreatment values. The DAI scores improved significantly (p < or = 0.0001) in both age groups (paired t test; Bonferroni correction). However, 20% of the patients showed a worsening or no change in the DAI with treatment. In the mixed dentition group, maxillary anterior irregularities, diastema, and overjet showed statistically significant improvement after treatment (p < or = 0.0001). Patients in the permanent dentition showed statistically significant improvement in the crowding of lower incisors, maxillary anterior alignment, and overjet (p < or = 0.0001). Logistic regression analysis defined five statistically significant factors (p < or = 0.05) that could differentiate patients with successful and unsuccessful treatment outcomes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Fluoride supplements: current effectiveness, side effects, and recommendations.

A critical review of the literature was conducted to determine the current effectiveness of fluoride supplements in caries prevention and their role as risk factors for dental fluorosis. Use of fluoride supplements by young children is idiosyncratic and all of the studies which investigated the effectiveness of this regimen suffered from a significant drop in the number of participants receiving daily supplements. The scientific evidence supports the efficacy of fluoride supplements in caries prevention but there is weaker support for their effectiveness. Fluoride supplements are a risk factor for dental fluorosis, though their contribution to the increase in fluorosis prevalence is less than that of water fluoridation and fluoridated dentifrices because of their more limited and shorter use. There is also evidence that fluoride supplements are used inappropriately in fluoridated areas. The availability of optimal levels of fluorides in beverages in non-fluoridated communities raises the question of whether fluoride supplements are needed in the 1990s, and whether it is time to consider the total fluoride intake not only from water but also from foods, beverages, and dentifrices, when recommending supplements. A re-evaluation of the need for and dosage schedules of fluoride supplements is warranted.

Adolescent↗
PubMed1993

Periodic health examination, 1993 update: 3. Periodontal diseases: classification, diagnosis, risk factors and prevention. Canadian Task Force on the Periodic Health Examination.

OBJECTIVE: To review the 1979 Canadian Task Force on the Periodic Health Examination recommendations on the diagnosis and prevention of periodontal disease. OPTIONS: Self-care at home, professional care, treatment with antimicrobial agents and management of patients at high risk. OUTCOMES: Maintaining the gingiva, alveolar bone and periodontal ligament in a healthy state (absence of gingival bleeding and no loss of epithelial attachment). EVIDENCE: A literature search for articles published from 1980 to 1993 was conducted. Selected studies published before 1980 were also reviewed if there were no recent updates. Evidence was evaluated and classified as good, fair or poor according to the criteria of the task force. VALUES: The task force's evidence-based rules for recommendations were used. In addition, whenever feasible, and on the basis of advice from the reviewers and experts, recommendations were modified in the interest of maintaining oral health (e.g., dental flossing in children). BENEFITS, HARMS AND COSTS: The recommendations are not expected to increase the costs of preventing periodontal diseases for the general population. They could benefit dental patients and reduce costs because they are based on the periodontal needs of patients rather than on the current universal application approach.

Adult↗
PubMed1993

Should the drinking water of Truro, Nova Scotia, be fluoridated? Water fluoridation in the 1990s.

An epidemiological assessment of differences in caries and fluorosis prevalences between children in Truro (< 0.1 ppm) and Kentville (fluoridated at 1.1 ppm in 1991), Nova Scotia, Canada, was completed in 1991. Out of a total of 429 children, in grades 5 and 6, in the two towns in 1991, 219 (51%) were examined. Parents answered a self-administered questionnaire investigating the sources of drinking water used by the children since birth, residence history, use of fluoride supplements, dentifrices, and other fluoride products during the first 6 yr of the life. The examination criteria differentiated between non-cavitated and cavitated carious lesions. Dental fluorosis was measured using the TSIF index. Examiner agreement was excellent. Of the children examined, 80 (36.5%) drank water (fluoridated or non-fluoridated) from municipal water systems during the first 6 yr of life. The children were assigned into five groups based upon residence history and exposure to fluoridated water during the first 6 yr of life. The percentage difference in mean DMFS scores between children in the fluoridated and non-fluoridated groups is 17% (delta DMFS1 = 0.7) when non-cavitated carious lesions are included and 39% (delta DMFS2 = 1.1) when they are excluded. The differences are not statistically significant. The significant risk factors associated with the DMFS1 and DMFS2 scores identified by a stepwise multiple regression analysis are: education level of the father, gender, and number of years of reported use of toothpaste during the first 6 yr of life. Dental fluorosis (mainly TSIF score of 1) was present in 41.5% and 69.2% of the children in the non-fluoridated and fluoridated groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1992

Prevalence of non-cavitated and cavitated carious lesions in a random sample of 7-9-year-old schoolchildren in Montreal, Quebec.

This report describes the prevalence of non-cavitated and cavitated carious lesions in 911 randomly selected children in grades one through three on the Island of Montreal, Quebec, Canada. The criteria for diagnosis were developed for a longitudinal epidemiological study of restorative treatment decisions by dentists practising under a provincial dental insurance program for children. The intra- and inter-examiner reliability correlation coefficients of the two examiners were excellent (Kappa > or = 0.80). The most frequent carious lesion found in the examined children were non-cavitated carious lesions (incipient) within 1.5 of the gingival line on smooth tooth surfaces, and stained or non-cavitated carious lesions on pits and fissures. Out of 911 children in the study, 19.6% had sealants. Children whose parents completed a university education had a significantly lower prevalence of non-cavitated and cavitated carious lesions and fillings, and a significantly higher mean number of sealants than children whose parents had only primary school education. Education status of the parents was a significant risk marker of children with high caries experience and these children had a significantly higher mean number of non-cavitated carious lesions. This study has found that non-cavitated carious lesions are significantly more prevalent than cavitated carious lesions in children.

Chi-Square Distribution↗
PubMed1992

Evaluation of eosinophiluria in the diagnosis of schistosomiasis hematobium: a field-based study.

Using Hansel's stain, eosinophiluria greater than 5% of total urinary white blood cells was found in 59% of a randomly selected population sample in an area endemic for schistosomiasis hematobium. The prevalence and mean level of eosinophiluria were significantly higher in infected subjects than in noninfected subjects (P less than 0.05). The sensitivity (80%), specificity (86%), and positive predictive value (82%) of eosinophiluria as a diagnostic index for schistosomiasis hematobium were significantly higher (Youdin index 0.66; P less than 0.05) than those of proteinuria, hematuria, and leukocyturia taken singly or in combination. However, unlike the latter three measurements, this method involves microscopy. There is a great need for a chemical method for measuring eosinophiluria.

Adolescent↗
PubMed1990

Oral health status of Mexican-Americans with low and high acculturation status: findings from southwestern HHANES, 1982-84.

This 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.

Acculturation↗
PubMed1990

Prevalence of dental caries and dental fluorosis in students, 11-17 years of age, in fluoridated and non-fluoridated cities in Quebec.

The purpose of this study was to evaluate the difference in dental caries and fluorosis prevalence in 936 randomly selected life-long residents selected from public and private schools in Trois-Rivières (1.0 ppm F in 1987) and Sherbrooke (less than 0.1 ppm F), Que., Canada. Students, 11-17 years of age, were examined for dental caries using the National Institute for Dental Research criteria and for dental fluorosis using the Tooth Surface Index of Fluorosis. Because of an inconsistent fluoridation history in Trois-Rivières, comparisons were carried out between two age strata: students 11-14 years of age who consumed for a longer duration suboptimally fluoridated water than those in the second stratum: students 15-17 years of age. Only public school students, 15-17 years of age, from Trois-Rivières had significantly lower mean filled surface and decayed, missing, and filled tooth surface (DMFS) scores (28 and 24%, respectively) than similar students in Sherbrooke. Among private school students, differences were not found, except in the youngest age group in Sherbrooke who had significantly lower mean DMFS than similar students from Trois-Rivières. The prevalence of fluorosis was 45.6% and 58.0% in Trois-Rivières public and private schools, respectively, and 31.1% and 30.1% in Sherbrooke public and private schools, respectively. The use of fluoride tablets was significantly associated with fluorosis. This study showed that water fluoridation benefitted students from public schools and that the risk factors for dental fluorosis were the use of fluoridated water and fluoride tablets.

Adolescent↗
PubMed1990

Natural history of periodontal disease in adults: findings from the Tecumseh Periodontal Disease Study, 1959-87.

The purpose of this epidemiological study was to estimate the degree of change in periodontal attachment level in a sample of adults examined in 1959 and 1987 in Tecumseh, Michigan. Out of 526 individuals between the ages of five and 60 years in 1959, a sample of 325 resided within an 80-km-radius area in 1987. Of those, 167 were re-examined. Loss of periodontal attachment (LPA) was determined with a Michigan #0 probe on four tooth sites (disto-buccal, mid-buccal, mesio-buccal, mid-lingual) for all teeth present. Of the individuals contacted, 28 had lost all their teeth during the 28 years. Of the 167 adults examined, two refused periodontal probing. Out of the 165 adults with LPA measurements in 1987, only 22 (13.3%) had an average increased loss of 2 mm or more per person between 1959 and 1987; five adults (3.0%) had an average LPA increase of 3 mm or more, and only two adults (1.2%) had an average LPA increase of 4 mm or more. The attachment level in 59.3% of all the tooth sites examined in 1959 in the 165 individuals either did not change or changed within +/- 1.0 mm. On the basis of bivariate analyses, the individuals with high LPA increase (greater than or equal to 2 mm) had the following characteristics significantly different from those with low LPA increase: They were older, smoked, had tooth mobility at baseline, higher gingivitis, plaque, calculus, and tooth mobility scores at follow-up, lower education level, and irregular dental attendance.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1990

Risk factors for tooth loss over a 28-year period.

Over 500 residents of Tecumseh, Michigan, were dentially examined in 1959 as part of a community-wide health study. In 1987, the dental examinations were repeated, with use of the same criteria as in 1959, for 167 dentate persons from the original group. Another 28 reported by telephone that they had become edentulous since 1959. This report uses a historical cohort analysis for exploration of the risk factors for tooth loss, both total and partial, over the 28-year period. Over that time, the edentulous lost an average of 18.0 teeth (95% confidence interval 15.5, 20.7), whereas the age-matched 90 dentate persons lost only 3.2 (2.2, 4.2) teeth each. Descriptive data showed the edentulous to have higher baseline scores for plaque, calculus, and gingivitis, and a higher proportion of them smoked, though only loss of periodontal attachment (LPA) of 4 mm or more, early loss of first molars, and educational attainment were significant risk factors in regression analysis. Odds ratios for these three variables were 4.0 (1.2, 12.8), 2.0 (1.3, 3.1), and 0.6 (0.4, 0.9), respectively. The strongest risk factors for partial tooth loss among 116 dentate persons were baseline gingivitis (which was correlated with LPA of 4 mm or more) and the baseline number of teeth present, with odds ratios of 2.4 (1.2, 5.2) and 0.8 (0.7, 1.0), respectively. While the analysis had to be carried out without caries data, it was concluded that total tooth loss is a social-behavioral issue as much as it is disease-related. Social-behavioral factors were less clearly related to partial tooth loss in dentate persons; oral disease characteristics were the most prominent risk factors for partial tooth loss.

Cohort Studies↗
PubMed1989

An evaluation of the Saskatchewan pit and fissure sealant program: a longitudinal followup.

The Saskatchewan Health Dental Plan (SHDP) is a publicly funded dental insurance program for children between the ages of five and 16 years residing in the province. In 1981, fissure sealants were added as a covered expense. Until September 1, 1987, sealants and other dental treatments covered under the SHDP were provided to schoolchildren by dental therapists in dental clinics established in elementary schools throughout the province. After September 1, 1987, the provision of dental services was transferred to private practitioners in the province. The objectives of this study were to (1) estimate the retention rates of sealants after one, two, and three years of placement; and (2) conduct a longitudinal followup of sealed and unsealed sound teeth to measure the effectiveness of sealants in reducing dental caries incidence. Relative to the first objective, a cohort of children was identified and comparisons were carried out for the periods of 1982-83, 1982-84, and 1982-85. For the last objective, a longitudinal evaluation of effectiveness was carried out only for children five to seven years of age in 1981. Saskatchewan children, who experienced higher caries prevalence than children in the United States, had the highest caries increments on occlusal surfaces of posterior teeth. About 79 percent of the sealants applied by dental therapists were retained three years after application. Sealed teeth experienced 46 percent less caries than unsealed teeth four years after the application of sealants.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Dental caries and periodontal disease among Mexican-American children from five southwestern states, 1982-1983.

Analysis of Southwestern HHANES data showed that the prevalence of dental caries among Mexican-American children is similar to that of children of the same age examined during the NIDR survey (1979-1980), despite a lower level of restorative treatment. Approximately 50% of Mexican-American children 17 years of age, however, had five or more teeth that were either decayed or filled. Occlusal surfaces of molars were the most susceptible teeth to decay; few anterior teeth were affected. This distribution of dental caries strongly supports the use of fissure sealants on molar teeth. Children from low-income families had two times more decayed teeth than children from high-income families. Mild gingivitis and poor oral hygiene were more prevalent in the Mexican-American children than in the child population for the region examined during NHANES I in 1971-1974. Children from high-income families had better periodontal health than those from low-income families.

Adolescent↗
PubMed1987

Prevalence of total tooth loss, dental caries, and periodontal disease in Mexican-American adults: results from the southwestern HHANES.

The Southwestern portion of the Hispanic Health and Nutrition Examination Survey (HHANES) was conducted by the National Center for Health Statistics (NCHS) in 1982 and 1983. The survey population was Mexican-Americans residing in five Southwestern states. This report presents data on the prevalence of total tooth loss, dental caries, and periodontal diseases in 3860 Mexican-American adults aged from 18 to 74. Results show that 4.3% of this group was edentulous. Among the dentate, Mexican-Americans had lower overall DMF scores but higher numbers of untreated decayed teeth than did residents of the same region seen in the NHANES I survey in 1971-1974. Caries of the smooth surfaces in both posterior and anterior teeth was more pronounced in the older than in the younger age groups. Mexican-Americans had more gingivitis but fewer periodontal pockets than did the general population in the Western states during NHANES I. The caries pattern in the Mexican-Americans suggests that caries among adults may remain a problem in the future, with the possibility of increased involvement with the aging, although modest, of smooth tooth surfaces.

Adolescent↗
PubMed1987

High-fluoride drinking water, fluorosis, and dental caries in adults.

This study measures the prevalence and distribution of dental fluorosis and coronal caries in lifelong adult residents of two New Mexico communities. One community has a natural fluoride concentration of approximately 0.7 mg/L in its drinking water, optimum for the climate, and the water of the other community is naturally fluoridated at approximately 3.5 mg/L, five times optimum. The differences between the communities in amounts of dental fluorosis and any reduced susceptibility to dental caries associated with higher levels of fluorosis, particularly in molars, the teeth most susceptible to decay, are discussed.

Adult↗