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D V Kleinman

Publications and source records attributed to D V Kleinman.

At least 37 records · Page 2Linked to original sources
PubMed1996

An overview of the oral health component of the 1988-1991 National Health and Nutrition Examination Survey (NHANES III-Phase 1).

As part of a Federal consortium, the National Institute of Dental Research's (NIDR) Division of Epidemiology and Oral Disease Prevention (DEODP) staff and consultants collaborated with the National Center for Health Statistics (NCHS) to conduct a national oral health examination as a component of the 1988-94 National Health and Nutrition Examination Survey (NHANES III). The Phase 1 took place between October 18, 1988, and October 24, 1991, at 44 survey locations; Phase 2, between September 20, 1991, and October 15, 1994, at 45 sites. This article provides general background information on the NHANES III and its oral health examination component which pertains to all six years of the full survey. It also focuses on particular aspects of the first three years of the survey (NHANES III-Phase 1)--the database for the articles in this peer-reviewed Special Issue--and provides the essential context for the substantively oriented analyses of the Phase 1 database which are presented in the articles which follow this overview.

Adolescent↗
PubMed1995

Overview of research needs and opportunities for improving the oral health of aging veterans.

This article summarizes health services research recommendations from and similarities of selected oral health research agendas. Themes of research needs and opportunities emphasize the need for development of more comprehensive measures of oral health and functioning, investigations of the effects of improved access on increased utilization and ultimately on oral health, and studies of the relationship between oral health and general health. In addition, future needs include enhanced technology assessment and studies of science/technology transfer into oral health practice, development of better measures and studies of health outcomes, and investigations of the effects of delivery system variables on costs, productivity, and services. Postconference review and input from The Department of Veterans Affairs providers and patient and policymaker groups is recommended to complete the development of an agenda. Adequate funding, trained research personnel, and a commitment to oral health services research are needed to ensure implementation.

Aged↗
PubMed1995

Loss of periodontal attachment in HIV-seropositive military personnel.

The cross-sectional relationship between severe loss of periodontal attachment (LPA) and worsening immune status due to HIV infection was evaluated in 474 HIV-infected subjects (416 men, 58 women) aged 18 to 49 years who had been classified at stages 1 through 6 of the Walter Reed Army Institute of Research (WR) Staging Classification System. LPA was measured at four sites per tooth using a manual probe; severe LPA was defined as > or = 1 site/subject exhibiting > or = 5 mm LPA. Severe LPA was found in 94 (20%) of the subjects. Modeling with multiple logistic regression analysis revealed that WR stage and peripheral CD4+ lymphocyte cell counts were not significant independent predictors of severe LPA. Severe LPA was more common in subjects at WR stage 5 or 6 who exhibited oral candidiasis (OC), a marker of immune system damage, than in persons at those WR stages without OC (odds ratio = 7.85; 95% confidence interval (CI) = 1.94-31.81). After the analysis controlled for WR stage, younger subjects receiving AZT had greater odds of severe LPA than same-age subjects not taking the drug (e.g., odds ratio for subjects aged 30 years = 2.59; 95% CI = 1.22, 5.49). Other significant predictors in the model included male sex; retired military status; cigarette smoking; and presence of cratered, ulcerated, or necrotic interdental papillae. HIV-associated immune deficiency may be associated with localized severe LPA, but this may be an indirect association due to medication use, opportunistic infection, or other factors not captured by the WR staging system or peripheral CD4+ cell counts.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1994

Epidemiology of oral mucosal lesions in United States schoolchildren: 1986-87.

Oral mucosal lesion findings from a national multistage probability oral health survey of United States schoolchildren in kindergarten through grade 12 are reported. In the 1986-87 school year 39,206 children aged 5-17 yr were examined by 14 dentists trained in standardized clinical diagnostic criteria for dental caries, periodontal conditions and oral mucosal lesions. In addition all children were asked whether or not they ever had "cold sores," "fever blisters," or "canker sores", and adolescents (grades 6-12) were questioned about their history of tobacco use. About 4% of the children had one or more oral mucosal lesions present at the time of the examination, while 33 and 37% reported a history of recurrent herpes labialis and recurrent aphthous ulcers, respectively. The most prevalent lesions clinically observed were recurrent aphthous ulcers (1.23%), recurrent herpes labialis (0.78), smokeless tobacco lesions (0.71), and geographic tongue (0.60). Differences in prevalence were analyzed by age, sex, race, metropolitan area, and geographic region. Almost 10% of 12-17-yr-olds reported current use of some type of tobacco product. In adolescents the current use of tobacco products had a marked effect on the prevalence of oral lesions.

Adolescent↗
PubMed1993

Toward assessing trends in oral mucosal lesions: lessons learned from oral cancer.

Trend data on oral mucosal lesions are limited. The literature is comprised of a large number of studies documenting the prevalence of various lesions in different populations. Trend data on cancers of the oral cavity and pharynx are the exception. An overview of the international epidemiologic studies of these cancers is provided. General conclusions across studies and countries for trend data of these cancers cannot easily be drawn, since variations exist in data collection methods, risk factors, and other characteristics of the study populations. This paper also reviewed the available prevalence data for oral mucosal lesions in general as well as data on leukoplakia, recurrent herpes labialis, and recurrent aphthous ulcers. A few studies of the incidence of leukoplakia are described. In order to explore the potential for future trend data on oral mucosal lesions, this paper discusses issues related to the feasibility and structure of monitoring these lesions. Criteria that could be used to identify which conditions should be monitored in the future were discussed, such as, those that present a public health problem, those that are sentinel events for serious conditions, and infectious lesions. Once lesions are identified, it is clear that international consensus for diagnostic criteria of these lesions is needed in order to permit comparisons to be made among studies. Finally, strategies for monitoring these conditions and factors that may affect future trends are reviewed.

Canada↗
PubMed1991

Epidemiologic studies of oral mucosal conditions--methodologic issues.

The methods used in the international English-language literature of epidemiologic investigations of oral mucosal conditions were reviewed. Methods used to study leukoplakia, lichen planus, recurrent herpes labialis, recurrent aphthous ulcers, geographic tongue and candidiasis are highlighted. In addition, studies of the full range of pathologies documented in a population were reviewed. The methodologic issues raised by the epidemiologic literature as well as those to be considered for future studies of oral mucosal conditions are presented. Emphasis is placed on study population selection, diagnostic criteria development, type and training of examiners, risk factor assessment and issues related to data collection, analysis and reporting.

Candidiasis, Oral↗
PubMed1991

HIV and periodontal health. A study of military personnel with HIV.

In 230 military personnel who were seropositive for the human immunodeficiency virus, the prevalence of viral and fungal infections in the mouth was clearly related to the degree of immune dysfunction as measured by T4-lymphocyte counts. The relation between periodontal health and T4 counts was less clear. Tobacco use was related to the increased occurrence of both mucosal lesions and periodontal diseases.

Adolescent↗
PubMed1988

Impact of an NIDR educational program on the teaching of caries prevention in dental hygiene.

An evaluation is reported of selected educational and promotional activities of the National Institute of Dental Research related to caries prevention. Data were collected from U.S. dental hygiene program directors (n = 183) and faculty (n = 718) by mail questionnaire between November 1984 and May 1985. The impact of NIDR activities on the caries prevention curricula in dental hygiene education programs was investigated. Results show that the educational activities of the NIDR, as well as selected state and program characteristics, are associated with differences in the caries prevention curricula of dental hygiene programs and the caries prevention teaching of the faculty. The more frequent and the more personal the contact with NIDR activities, the greater the emphasis given to caries prevention in the curriculum structure and in the teaching practices of the faculty.

Curriculum↗
PubMed1986

Practice characteristics of women dentists.

The literature on practice characteristics of women dentists is discussed to identify the information available on how women practice dentistry. Few reports have been published that describe or analyze such data. Of the available studies, few are national in scope and even fewer compare male and female age-matched graduation cohorts. With the increase in the number of women dentists, human resource planning and analyses and design of educational curricula will require improved knowledge of the practice characteristics of men and women dentists.

Dentists, Women↗
PubMed1980

Providing preventive dental care in the community using the team approach: a comparison of five training programs.

Five dental schools developed training programs for dental and dental auxiliary students in planning and delivering preventive dental services in a community setting. The schools (1) designed a curriculum that would train dental students to plan, organize, and manage the delivery of community preventive services using a team approach; (2) developed a related curriculum for dental auxiliary students; (3) implemented the program intramurally and extramurally in selected community settings; and (4) planned and conducted an evaluation of the program. Each school individualized the program to the interests of its students, the constraints of its curriculum, and the needs of community groups. A total of 228 dental and 576 dental auxiliary students were trained. A full range of community sites and target populations were provided with preventive dentistry services.

Clinical Competence↗