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Biomedical subjects

C W Drake

Publications and source records attributed to C W Drake.

14 recordsLinked to original sources

Root caries prevalence in black and white North Carolina adults over age 65.

The baseline root caries prevalence of 809 dentate black and white home-dwelling North Carolinians over age 65 was determined along with the collection of a large number of demographic and behavioral, clinical, and microbiological variables in the longitudinal Piedmont over-age-65 Dental Study. In comparison to other studies of older adults, the prevalence of decayed-filled root surfaces (DFRS) was low, fewer than 2.0 DFRS in whites, and significantly fewer than that in blacks (1.3 DFRS). Although tooth loss was a substantial problem, nearly half of the white population and almost two-thirds of the black participants exhibited no evidence of root caries history. Even though DFRS prevalence was much lower in blacks, their treatment need for decayed root surfaces (DRS) was significantly higher than for white participants. Correlates with DRS within both race groups appeared to be those that reflect lack of access to dental services or neglect of oral health--decayed coronal surfaces, higher rates of tooth extraction, high CPITN scores and worst loss of attachment greater than or equal to 7 mm, and more than a year since the last dental visit. Some variables were associated significantly with one racial group, but not the other, while others, particularly root surfaces at risk and age, were not associated significantly with DRS. We concluded that although there was considerable neglect of root caries, particularly among blacks, it was not a serious problem among older North Carolinians.

Aged

Models for coronal caries and root fragments in an elderly population.

A random sample of 809 dentate, home-dwelling people 65 years of age or older participated in a study to determine the prevalence of dental diseases in the elderly. Part of the study investigated the determinants of coronal caries and root fragments in these older adults. Using a wide array of potentially explanatory variables available, logistic regression models were developed to identify relationships between these variables and coronal caries and root fragments. The variables with the most explanatory power in the coronal caries model were the presence of decayed root surfaces, lower salivary flow rate, lack of regular dental care and an interaction variable including race and a perception of financial well-being. When a subsequent model was created that did not include decayed root surfaces or root fragments as potential explanatory variables, an additional variable relating to self-perception of mouth appearance emerged. The strongest variables in the model for root fragments were episodic (vs. regular) dental visits, presence of root caries, lack of replacement for lost teeth, high levels of Streptococcus mutans and number of teeth present in the mouth.

Black or African American

Dental treatment needs in an elderly population.

A random sample of 1,019 adults 65 years of age and older, living in their own homes, consented to a clinical dental examination and an interview. Eight hundred nine subjects were dentate and 210 were edentulous. Each dentate person was examined for caries and periodontal conditions, as well as a separate determination of restorative and extraction treatment needs. Most people in this study lacked restorative treatment needs of any kind. Blacks required restorative treatment and extractions more often than whites. Carious coronal and root surfaces, pocket depths, number of teeth, as well as educational level and time since last visit to the dentist were related to treatment needs. While clinical findings were related to treatment needs, precise determinations of treatment needs of this elderly population generally could not be based solely on clinical findings. Additional behavioral, social, and health factors appear to play a role in dentists' decisions when determining treatment needs of older persons.

Black or African American

Reasons for restoration replacement: differences in practice patterns.

Patients receive varying types and amounts of restorative treatment, depending on the prescribing dentist. The aim of this study was to enhance the understanding of the variation of the restoration replacement practices of dentists. Three dentists in private practice in similar semirural communities with comparable practice demographics were asked to gather data on all restorations they replaced over a period of 1 month. They recorded the tooth number, number of restored surfaces, restorative material being replaced, number of surfaces in the replacement restoration, the replacement restorative material, and the reasons for the replacement restoration. Statistically significant differences were found among the dentists as to the reasons for posterior restoration replacement, replacement materials used, and increase in size of the replacement restorations. Differences were attributed to individual practice philosophies, demonstrating that clinical information was not the sole determining factor as to type of replacement restorations that patients received.

Composite Resins

Dental restoration longevity: survival functions and statistical indices in low and high failure rate groups.

A group of 71 patients was examined to determine the longevity of restorations placed at the University of North Carolina School of Dentistry. Patients with an overall restorations failure rate of equal to or greater than 40 per 1000 restoration-yr were categorized as having a "high failure rate" and those below that were considered "low failure rate". An investigation was made to determine statistical differences between these two groups of patients using survival analysis and various statistical indices. Time of exposure and age of patients for both groups were similar. High rate patients had a greater number of anterior restorations and anterior teeth restored. In addition, the number of restorations per tooth was significantly greater in anterior and posterior teeth of the high failure rate group. No single variable was found to account for the differences in the failure rates in the two groups of patients. A prospective study is needed in order to examine possible causes for restoration failures.

Dental Restoration, Permanent

A comparison of restoration longevity in maxillary and mandibular teeth.

This study determined if the survival time of restorations in maxillary and mandibular teeth differed in a group of 71 patients. The 1,232 restorations were placed by a dental school clinic in a 29-year period. There were no significant systematic differences in the survival time of restorations in maxillary and mandibular molars, premolars, and canines. Maxillary and mandibular incisors show significant differences in survival patterns. Of the mandibular restorations available for follow-up, 71% were still intact after 26 years.

Adult

Longevity of restorations in a dental school clinic.

The longevity of 1,207 restorations placed by students was studied in 70 adult patients. The overall percentage of restorations lasting ten years or more (P10) was 75.4 percent and survival times were longer than in most previous restoration longevity studies. Cast restorations lasted significantly longer than amalgams, which in turn lasted significantly longer than composites. P10 values were 91.1 percent, 72.0 percent, and 55.9 percent, respectively. Analysis by surfaces involved indicated that single-surface lasted longer than multisurface restorations. The survival of restorations placed in patients aged 60 or more was less favorable (P10 = 56.8 percent) than for younger patients (P10 = 78.3 percent). A subset of the population was identified on the basis of a restoration failure rate of greater than 4.0 X 10(-2) failures/restoration year. This group, comprising 18.6 percent of the population, accounted for 56.1 percent of all restoration failures. The P10 value for this high-risk group was 55.8 percent, as compared with 83.9 percent for the remainder of the population.

Adult

The accuracy of oral self-perceptions in a dentate older population.

A random sample of 1,016 subjects aged 65 and older were interviewed and examined in their own homes. The sample was stratified by race and place of residence. As part of the interview, the 821 dentate subjects were asked to rate their mouth appearance, chewing ability, and mouth health. Most subjects responded positively to these questions. The self-perception of mouth health was most related to the presence of anterior teeth. Perception of chewing ability was most related to the number of anterior teeth present, total number of teeth present, and the need for extractions. Subjects also were asked about their perceived dental needs. A small proportion of subjects thought they needed restorations, periodontal treatment, or teeth replacement. Subjects generally were not able to define the extent of their treatment needs, but their self-perceptions of mouth appearance, chewing ability, and mouth health had some relationship to their oral health.

Aged

Streptococcus mutans, lactobacilli, and caries experience in older adults.

This study investigated salivary levels of Streptococcus mutans, lactobacilli, and caries experience in a random sample of 448 black and 362 white older dentate adults living in North Carolina. Significant proportions of the participants had stimulated salivary flow rates less than 1.0 mL/min, salivary buffering capacity less than 4.0, S. mutans levels of 10(5) cfu/mL or more in stimulated whole saliva, or lactobacilli levels of 10(5) cfu/mL or more. Each of these factor levels could be considered, on a clinical basis, to increase caries risk. In general, people with higher levels of S. mutans or lactobacilli had more untreated coronal and root caries, but not greater total caries experience.

Aged