Applications of self-reported assessments of oral health outcomes.
Explore the source record for details and available documents.
Attitude of Health Personnel↗
Biomedical subjects
D Locker
Publications and source records attributed to D Locker.
Negative dental experiences and their relationship to dental anxiety.
Although negative dental experiences are often cited as the major factor in the development of dental anxiety, very few studies have provided data on their prevalence. The studies that are available used limited samples from which it is not possible to generalise, or confined their enquiries to painful experiences only. In this paper data are provided on negative dental experiences and their relationship to dental anxiety obtained from a large, random sample of the general population. Just over three-quarters reported what are termed as direct negative experiences; 71 per cent had had experiences that were painful, 23 per cent experiences that were frightening and 9 per cent experiences that were embarrassing. Such experiences were not confined to childhood. For 23 per cent, the first experience of this kind happened during adolescence and for 40 per cent in adulthood. The relationship between these experiences and dental anxiety was strong. Subjects reporting all three types of experience were 22.4 times at risk of being dentally anxious than subjects reporting none of them. The data suggested that the nature of these unpleasant experiences was more important than the age at which they occurred in predicting dental anxiety. One third of dentally anxious subjects reported a negative response experience in the form of feeling faint, fainting or having a panic attack while at the dentist. Further research using more appropriate methods is needed to clarify the role of dental experiences in the genesis of dental anxiety.
Adolescent↗
Pain and the quality of life in patients referred to a craniofacial pain unit.
Although there are reasons to believe that temporomandibular disorders and other facial pain conditions would have a major impact on the quality of patients' lives, only a small number of studies have attempted to address this in a systematic way. In this study, data on pain and its consequences were assessed for 121 patients making their first visit to a craniofacial pain research unit. The extent to which musculoskeletal and neurologically based facial pain compromised the quality of life was measured using the Oral Health Impact Profile, a recently developed index of the functional and psychosocial outcomes of oral conditions. The data indicated that facial pain had a substantial impact on daily life and that its most common outcomes were psychologic. When compared with a nonpain population, the extent of this impact was striking. There was a four-fold increase in functional problems such as difficulty chewing foods and a nine-fold increase in reports of depression. As anticipated, scores on the Oral Health Impact Profile were associated with the characteristics of the pain and diagnostic subgroups.
Adult↗
Interaction between cisplatin-modified DNA and the HMG boxes of HMG 1: DNase I footprinting and circular dichroism.
The interactions between the two boxes A and B of HMG 1 and cis-diamminedichloroplatinum(II)-modified DNA containing a single intrastrand cross-link at the d(GpG) site were studied by DNase I footprinting and circular dichroism. The DNAase I cleavage patterns of the HMG box-platinated DNA complexes are identical, the two boxes inhibiting the DNase I cutting over at least 15 and 12 nucleotide residues in the platinated strand and the complementary strand, respectively. As judged by circular dichroism, the two boxes have the same alpha-helical content (56%) and they induce the same conformational changes in the platinated DNA.
Amino Acid Sequence↗
Health outcomes of oral disorders.
While there is a substantial body of data on patterns of dental disease in both adult and child populations, there is relatively little information concerning the consequences of oral disorders for well-being and the quality of life. In addition, dentistry lacks measures of health outcomes for use in dental health surveys and clinical trials. However, interest in this area is growing and a number of oral-condition specific health status measures have been developed over the last 10 years. The most sophisticated is the Oral Health Impact Profile (OHIP) which is being developed and tested by research teams in Australia, Canada and the US. This consists of 49 items organized into seven sub-scales which address the way in which oral conditions compromise functioning and social and psychological well-being. A study of older adults in Canada which used OHIP found that it had good measurement properties. Nevertheless, there was only a weak association between scores on this measure and clinical indicators of oral disease. Further analysis revealed that social factors were as important as clinical factors in explaining the health outcome of oral disorders. This finding is consistent with contemporary concepts of health and provides some evidence to support the view that the social context in which we live is important in shaping responses to disease and the experience of health and illness.
Aged↗
Stability of Dental Anxiety Scale scores: a longitudinal study of older adults.
Explore the source record for details and available documents.
Aging↗
Loss to follow-up in a longitudinal oral health survey of older adults.
Explore the source record for details and available documents.
Aged↗
Xerostomia in older adults: a longitudinal study.
Although xerostomia in older adults has received substantial research attention, there have been few longitudinal studies of non-patient populations. Consequently, little is known about the incidence or course of this condition among this group. This paper reports the results of a longitudinal study designed to address these issues. In 1989, data on xerostomia were collected from 907 randomly-selected community dwelling adults aged 50 years and over. Three years later, 611 (71% of those presumed to be alive) were followed-up and data on xerostomia collected again. At baseline, 15.5% of these 611 subjects reported xerostomia, while at follow-up this had risen to 29.5%. The majority of the latter (115/180) were incident cases, reporting xerostomia only at follow-up, while the remainder were chronic cases, reporting xerostomia at both baseline and follow-up. A crude estimate of the three-year incidence rate was 22.5%. In a logistic regression analysis, three baseline variables were associated with incidence; older subjects, those with one or more chronic medical conditions and those reporting their general health as poor were more likely to develop xerostomia. In a similar analysis, age was the only variable associated with chronicity, with older subjects more likely to be chronic cases. The data also suggest that the onset of xerostomia was associated with an increase in other oral symptoms and problems with eating, communication and social interaction.
Age Factors↗
Deletions induced in the white and vermilion genes of Drosophila melanogaster by the antitumor drug cis-dichlorodiammineplatinum(II).
This paper describes the analysis of cisplatin induced mutations at the white (w) and vermilion (v) loci located on the X chromosome of Drosophila melanogaster. Twenty-eight w and eight v mutants have been found in a male genetic context and 42 w mutants in a female genetic context. In these latter experiments, genetic analysis showed the presence of multi-locus deficiencies in 18 out of 42 w mutants. Eighteen w and three v intragenic mutations were analyzed at the molecular level. Seventeen w and three v mutants carry deletions within the gene, ranging in size from 4 to 109 base pairs. Sequence analysis of the mutants indicates that most of them were produced by non-homologous recombinational events occurring between short (2-5 bp) sequence repeats on both sides of the deletion, one repeat being retained at the new junction. These results differ largely from those obtained in prokaryotic and other eukaryotic cells.
ATP-Binding Cassette Transporters↗
Disproportionate dental anxiety in the over 50s.
Explanations of dental anxiety in terms of either conditioning or personality predispositions alone are not sufficient to account for all individuals presenting with dental anxiety, since they are not a homogenous group. It was hypothesized that individuals, with wide ranging anxiety problems would be more likely to carry dental anxiety into old age. This prediction was supported by a comparison of older dentally anxious individuals with other older individuals who admitted to dental anxiety previously but were no longer dentally anxious. The results were interpreted in terms of Lang's bioinformation model of anxiety.
Aged↗
Social and functional impact of reduced posterior dental units in older adults.
The number of teeth needed to maintain adequate dental function in older adults is unknown. The purpose of this study was to examine the relationship between oral function and the number of opposing pairs of posterior teeth. We identified 338 subjects with complete anterior dentitions from an interview and examination survey of Ontario adults aged 50 and over; 261 had no partial denture and 77 had removable partial dentures (RPD). Oral function was measured using questions assessing chewing ability, mandibular function and socio-psychological impact. Subjects with no partial dentures were further allocated to five groups, based on their dental status: complete dental arch (n = 69); 5-7 functional units-pairs of opposing posterior teeth (n = 109); 3 or 4 functional units (n = 48) and 0-2 functional units (n = 35). Oral function problems increased with decreasing functional units being markedly more prevalent among the groups with 0-2 functional units. 34% of subjects in the 0-2 group reported one or more problems with chewing ability compared to 6-17% in the other groups (chi 2 P = 0.001 d.f. = 3). The 77 subjects who wore removable partial dentures, reported social and dental function at levels comparable to those with no dentures. From these results, there appears to be little socio-functional need to replace lost posterior teeth with a partial denture unit the person has fewer than, 3 posterior functional units. The low number of partial denture wearers limited our ability to detect a lasting benefit from RPD treatment.
Aged↗
Subjectively reported oral health status in an adult population.
This study describes the subjectively reported oral health status of an adult population aged 18 yr and over. The study used measures of the functional, social and psychological impact of oral disorders, originally developed for surveys of older adults, and aimed to determine whether or not they were sensitive to the oral health concerns of younger adults. It compared four age groups (18-29 yr; 30-49 yr; 50-64 yr; 65 yr and over) in terms of the following subjective oral health indicators: ability to chew, problems speaking, oral and facial pain; other oral symptoms; problems eating; problems with communication-social relations; limitations in activities of daily living and worry and concern. The initial hypothesis that few younger subjects would report the kinds of problems documented by these indicators was not supported. On all measures except ability to chew, younger subjects were as likely to be compromised by oral conditions as older subjects.
Activities of Daily Living↗
Evaluation of an area-based measure as an indicator of inequalities in oral health.
The literature on inequalities in health provides convincing evidence that lower socioeconomic groups have poor oral health when compared to higher socioeconomic groups. Since conventional measures of socioeconomic status such as occupation, income and education have a number of weaknesses which may limit their ability to describe and explain health inequalities, alternatives in the form of area-based measures are increasingly being used. In this paper, a conventional measure, household income, and an area-based measure of socioeconomic status are compared in terms of their ability to identify inequalities in oral health. The data used in the analysis were taken from a telephone interview survey of the oral health of older adults in the province of Ontario, Canada. While household income proved to be a marginally better predictor of these inequalities than the area-based measure, the latter had a number of distinct advantages from an epidemiological and planning perspective. Moreover, it identified variations in measures of oral health that were independent of household income, and the region of the province in which subjects lived.
Chi-Square Distribution↗
Association between clinical and subjective indicators of oral health status in an older adult population.
Since the mid-1970s a number of investigators have developed measures of the extent to which oral disorders compromise functional, social and psychological well-being. They have also examined the associations between clinical indicators of oral health status and these subjective indicators. In general, these associations have been inconsistent and weak. One reason for this might be that the subjective indicators employed were rudimentary and insensitive to the health outcomes of oral disorders. The development of the Oral Health Impact Profile, a more sophisticated measure of the health outcomes of oral disorders, provided a method to examine this hypothesis. Using data from an oral health survey of older adults, we examined the associations between OHIP scores and a variety of clinical indicators of tooth loss, caries and periodontal disease. Even with this measure the associations were predominantly weak, the strongest of the correlations being 0.53. We also examined the influence of personal and sociodemographic characteristics on the relationship between tooth loss and its psychosocial outcomes. Five variables reflecting expectations and resources explained as much variance in OHIP scores as did the number of missing teeth. This analysis illustrates the essential distinction between disease and health and the way in which measures of oral health can be used to pursue fundamental issues in behavioural science and health services research.
Aged↗
Evaluation of subjective oral health status indicators.
OBJECTIVES: This paper reports the results of a study to evaluate the performance of a battery of subjective oral health status indicators originally developed for use in large scale surveys of older adults. The aim was to assess their generalizability, efficiency, reliability, and validity when used in a study of adults aged 18 years and over and to compare their performance with respect to younger and older adults. METHODS: Data were collected by means of a mail survey and self-complete questionnaire of a random sample of the population aged 18 years and older. RESULTS: The results suggested that the measures were sensitive to the oral health concerns of adults of all ages and that item nonresponse was within acceptable limits. Test-retest and internal consistency reliability statistics were good and all hypotheses designed to assess concurrent and construct validity were confirmed. CONCLUSIONS: The results confirm an earlier, but more limited, evaluation and suggest that these indicators are useful for descriptive oral health surveys of general populations.
Adolescent↗
Differentiation between musculoligamentous, dentoalveolar, and neurologically based craniofacial pain with a diagnostic questionnaire.
A self-administered questionnaire consisting of 21 questions, diagrams for chief pain location, and a digital pain scale was used prospectively to sort 92 patients with orofacial pain into three categories: (1) musculoligamentous (ie, temporomandibular disorders); (2) neurologically based (ie, migraine, trigeminal neuralgia, tension-type headache, cluster headache, and atypical facial pain); and (3) dentoalveolar pain. Sensitivity, specificity, as well as negative and positive predictive values suggest that this questionnaire may be used reliably to identify patients with orofacial pain that fits the above-described pain categories without prior knowledge of the clinical diagnosis. Digital pain scale findings indicated that on presentation, pain level could not be correlated with any particular pain category, but when using this scale to describe past pain experience, patients with neurologically based pain selected the highest digital pain scale values up to six times more frequently than patients with musculoligamentous or dentoalveolar pain. Patients with musculoligamentous or dentoalveolar pain selected the lowest digital pain scale values up to 15 times more frequently than those with neurologically based pain. Although this questionnaire may be used for initial categorization of pain, there is still no substitute for a thorough history and clinical examination.
Adult↗
Correlates of tooth loss in a Canadian adult population.
Oral health data collected from a mail survey of an Ontario population of adults aged 18 years and over were used to conduct a preliminary investigation of the incidence and correlates of tooth loss and to explore its functional, psychological and social consequences. Of the sample of 500 dentate subjects, 10 per cent reported losing one or more teeth in the previous year. Comparisons between those with and without tooth loss showed significant differences according to age, household income and place of birth. Those subjects wearing partial dentures, possessing fewer teeth at the start of the study period, or who only attended the dentist when having pain or other trouble, were also more likely to have experienced tooth loss in the preceding year. Logistic regression analysis identified only age as a significant independent risk factor. Subjects who lost teeth were significantly more compromised in their oral functions and psychosocial behaviors, as measured by a battery of subjective oral health indicators. Whether or not these problems were pre-existing or the consequences of losing teeth during the past year cannot be determined from this study. This investigation suggests that tooth loss is still a concern for many Canadian adults, and demonstrates the importance of teeth in their overall well-being.
Adolescent↗
Preventive oral health behaviors in a multi-cultural population: the North York Oral Health Promotion Survey.
To examine the preventive oral health behavior levels of randomly-selected dentate and edentulous adults, age 18 and over, a mail survey was conducted in North York, Ontario, a multicultural suburb of Metropolitan Toronto (n = 1,050). High optimal levels of at least daily tooth brushing were reported by the majority of the dentate (96 per cent). Lower rates were evident for yearly preventive visiting (69 per cent), daily flossing (22 per cent), daily use of an interdental device (25 per cent), not snacking between meals (12 per cent) and eating one or no cariogenic foods on the previous day (36 per cent). Logistic regression results indicated higher levels on an additive index of oral preventive behaviors for females, those having a higher education and non-Italian respondents. Edentulous respondents reported high daily denture cleaning rates (87 per cent), but less frequent night removal (51 per cent), checking for oral lesions (68 per cent) and preventive visiting (12 per cent). Oral disease is one of the most common and costly chronic disorders affecting modern populations. However, unlike most other chronic diseases, it is largely preventable. These data indicate a clear need for determined oral health promotion efforts to inform and encourage increased levels of preventive behaviors in addition to tooth and denture brushing, particularly among specific sociodemographic and ethnic groups.
Adolescent↗