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Biomedical subjects

D E Barmes

Publications and source records attributed to D E Barmes.

At least 73 records · Page 4Linked to original sources
PubMed1977

WHO's accent on prevention.

It is widely recognized that oral health has its major obstacles in the form of dental caries and periodontal diseases and that in many populations each of these disease areas attacks nearly 100% of the population during the normal life span. Furthermore, there are clear signs of sharp increases in the dental caries problem in populations which previously benefited by a near absence or low prevalence of the disease. For highly developed countries dental caries and periodontal disease are responsible for an ever increasing economic burden which could easily become intolerable for even the richest of economies. In developing countries where dental caries prevalence is increasing the extreme lack of manpower resources is the first barrier, any response to which will encounter the second and associated economic constraint. It is essential for both situations that greater emphasis be given to prevention of oral diseases both by methods already proven, such as fluoridation of water supplies and other uses of fluorides, by oral hygiene programs, and by coordinated research to develop complementary or other methods. The WHO program in oral health has now developed a priority activity to promote and guide such endeavors.

Dental Caries↗
PubMed1977

The world wide distribution and significance of oral diseases.

Data available to WHO shows that the profile of oral diseases differs dramatically between the technically advanced and the developing countries. In technically advanced countries the high tooth mortality due to caries is decreasing as a result of widespread dental care, though the incidence of the disease is little affected. Unless preventive measures can be applied the cost of maintaining curative services will outstrip the financial resources of even the most prosperous countries. In the developing countries where manpower is scarce the traditionally low prevalence of caries is tending to increase with progressive urbanization. Preventive measures are therefore vitally important and there is urgent need for field testing in these conditions. In both cases the development of preventive measures against periodontal disease is essential if teeth saved from loss by caries are not to be lost in later decades from the ravages of periodontal breakdown.

Dental Caries↗
PubMed1976

Associations between the total fluoride content of dental plaque and individual caries experience in Australian children.

Individual caries experience (DMFT) and the total fluoride content of dental plaque were determined for 72 schoolchildren, aged 9.7-13.0 years, lifelong residents in one of three New South Wales towns, where the fluoride levels of the reticulated water supplies were: Katoomba, less than 0.1 parts/10(6); Sydney, 1.0 parts/10(6) for 4 years; and Yass, 1.0 parts/10(6) for 16 years, prior to sampling. The mean fluoride content of plaque in Sydney (22.6, s.d. = +/- 16.8 parts/10(6)) and Yass (25.6, s.d. = +/- 16.4 parts/10(6)) differed significantly (t = 2.27, P less than 0.05 and t = 3.30, P less than 0.02, respectively) from that in Katoomba (13.5, s.d. = +/- 8.3 parts/10(6)). Significant inverse associations were demonstrated between total plaque fluoride and individual caries experience (DMFT) in Sydney (r = -0.45, P less than 0.025) and overall (r = -0.28, P less than 0.010). Inverse trends were established between plaque quantity (dry weight of plaque collected) and fluoride levels. No associations could be demonstrated between fluoride treatment (dentifrice, tablets or topical application) and plaque fluoride, DMFT or plaque quantity.

Adolescent↗
PubMed1976

An evaluation of proposed revisions to the W.H.O. manual "Oral Health Surveys-Basic Methods".

The authors describe the organization and results of an epidemiologic training program which formed part of a W.H.O. sponsored course in public health dentistry held in Malaysia in May-June 1975. Twenty-two participants from 16 countries took part. They had a wide variety of qualifications and training; only four had had previous experience in the conduct of an oral health survey. The method and criteria that were proposed for inclusion in the second edition of Oral Health Surveys - Basic Methods were tested in two calibration exercises and one field trial. The usefulness of most of the recommendations was confirmed. The main problem areas concern dentofacial anomalies, intense gingivitis and advanced periodontal involvement. A successful feature of the study was the practicability for public health planning of assessing requirements for treatment.

Child↗
PubMed1976

Features of oral health care across cultures.

This paper sets out to draw together the findings from the five individual studies and to draw tentative conclusions from them. It is pointed out that the comparisons made are between system factors and not between whole systems of oral health care. An attempt is made to evaluate the effectiveness of individual system features in the hope of being able to suggest ways in which those shown to be most beneficial might be incorporated into complete systems. In relation to caries experience, measured as DMF teeth, there is a wide variation, not only by each of the separate components to that total. In those studies where extensive school dental services exist, the F component accounts for almost all the score while in the other study groups it forms only about half the total, the proportion tending to be greater in the non-metropolitan than in metropolitan populations. In the same way treatment/need ratios and amounts of retreatment required show the benefits of the existence of the school dental service. The treatment/need ratio is then examined in relation to selected variables such as method of payment, utilization of auxiliaries, the existence of specified target groups etc. When the method of stepwise regression analysis is applied to the pooled samples utilization of services remains the most important predictor of treatment/need ratio. Others in order of importance are whether dental personnel decide on frequency of visits, whether the last visit was made for symptomatic reasons alone and whether lack of severity of symptoms had been a reason for avoiding oral health care. In relation to periodontal conditions no clear picture has emerged and this may demonstrate how systems of all types have failed to deal with this problem. Although much remains to be elaborated three main findings have already emerged from this study: (i) The need for reinforcement of preventive behaviour and services. (ii) The effectiveness of regulated contact between consumer and provider in meeting treatment needs. (iii) The need to concentrate on quality as well as volume of care in providing adequately for the needs of child and adolescent populations.

Adolescent↗
PubMed1976

What a public health planner wants from a periodontal assessment.

Despite certain shortcomings, the assessment of caries using the DMF system of scoring is relatively simple, reproducible and provides some indication of treatment needs and the success of the treatment measures provided. No such index is yet in existence which will give similar information about the much more complicated disease processes involved in periodontal disease. Early attempts to introduce suitable indices included the PI index PMA and OHI indices with their modifications. These indices have performed best in assessing disease status but gave little or no information about treatment needs, treatment achievement or failure. WHO attempted to simplify the indices so that they could be scored on a present or absent basis, but clinical trials revealed the impossibility of maintaining comparability even on this level. Subsequent refinement of the procedure has produced improvements in the system including the recording of five categories of treatment needs, namely special oral hygiene instruction, prophylaxis and oral hygiene, instruction, periodontal therapy without extraction of teeth and periodontal therapy with extraction of some or all teeth. The system is described in the second edition of the WHO manual on Oral Health Surveys. There is still need for epidemiologists to further refine the criteria of periodontal disease and to identify the significance of the various signs of gingival and periodontal pathology.

Dental Care↗
PubMed1975

Current systems of delivery of oral health services.

It is suggested that in implementing, extending and redirecting systems of delivery of oral health services we should be maximizing preventive care, indirect payment and targeting for need, wheras for manpower employment and type the accent should be on selecting the best blend for the specific services to be provided, with a readiness to use constructive initiative in all areas. In associated operations research, the urgent need is for sound data on the effectiveness and efficiency of different payment systems, and on the optimal blend of private and public, professional and auxiliary manpower. What has been achieved in the delivery of oral health services over the past 50 years has been no mean feat, but what lies ahead to be done both in developed and developing countries is a task of herculean proportions.

Delivery of Health Care↗
PubMed1974

Etiology of caries in Papua New Guinea. The trace element content of urine samples and its relation to individual dental caries experience.

Samples of urine obtained from 10 adult people in each of 10 selected villages in the Sepik district of New Guinea were analysed to determine the levels of 19 elements thought to be of possible relevance to the prevalence of dental caries, judged by the results of previous research. Subjects with dental caries experience could be distinguished from those who are caries-free on the basis of the content of urine samples, as evidenced by the calculation of a statistically significant discriminant function. The elements most likely to be meaningful in relation to such discrimination are molybdenum, magnesium, copper, lead, phosphorus, strontium, and possibly zirconium and potassium. The concentrations of magnesium and phosphorus were significantly correlated with a number of other elements in the samples. Fluorine appears to have a considerable bearing on the output of magnesium, phosphorus, strontium, zinc, and calcium, the first four of which were named above as being major determinants in the discriminant function.

Dental Caries↗