Biomedical subjects

Douglas E Morse

Publications and source records attributed to Douglas E Morse.

17 recordsLinked to original sources

PubMed2006

Oral and pharyngeal cancer incidence and mortality among Hispanics, 1996-2002: the need for ethnoregional studies in cancer research.

OBJECTIVES: We investigated whether oral cavity and pharyngeal cancer (OPC) incidence and mortality statistics among Hispanics in New York State differed from those among Hispanics in the United States as a whole. METHODS: OPC incidence and mortality statistics for 1996-2002 were obtained from the New York State Cancer Registry and compared with national statistics released by the Surveillance, Epidemiology, and End Results (SEER) program for the same period. RESULTS: Among Hispanic men, OPC incidence rates were approximately 75% and 89% higher in New York State and New York City, respectively, than national rates reported by the SEER program. No notable differences were identified among Hispanic women. Incidence rates among New York State Hispanic men were 16% higher than those of their non-Hispanic White counterparts. The difference was twice as high (32%) among Hispanic men in New York City. Mortality rates among both men and women exhibited patterns similar to the incidence patterns. CONCLUSIONS: Ethnoregional differences exist in the incidence and mortality rates of OPC in the United States. New York State Hispanic men exhibit much higher incidence and mortality rates than US Hispanics as reported by the SEER program.

Adult↗

PubMed2006

Associations of ethnicity/race and socioeconomic status with early childhood caries patterns.

OBJECTIVES: The purpose of this project was to evaluate ethnicity/race, household income and caregiver education level as predictors of (1) any early childhood caries, and (2) each of four proposed patterns of primary dentition caries. METHODS: Between February 1994 and September 1995, five examiners visually examined Arizona pre-school children ages 5-59 months old. Self-reported demographic information including family income, caregiver education level and ethnicity/race were obtained at the time of examination. Multivariate analyses were conducted to assess the association of income, education and ethnicity/race with a child having any caries and with each of the proposed caries patterns seen in 3850 examinations. RESULTS: Income and education were inversely associated with: (1) any early childhood caries, and (2) the maxillary incisor caries pattern. A positive association between these caries patterns and minority ethnicity/race status was also identified. Three additional caries intraoral patterns demonstrated more varied associations with socioeconomic status (SES), ethnicity/race and income and education. CONCLUSIONS: This study supports the association of both ethnicity/race and social status with any early childhood caries. The patterns of caries were each found to be associated with specific and different socioeconomic-demographic indicators. The practical importance of these findings is that global measurement of ECC, without regard to specific caries pattern, leads to the potential for substantial non-differential misclassification of disease. The consequence of this is the potential for important ECC-SES-ethnicity/race associations to be masked. This, in turn, decreases the ability of surveys and investigations to accurately identify sub-groups of the population at greatest risk of developing ECC.

Arizona↗

PubMed2006

Disparities in oral and pharyngeal cancer incidence, mortality and survival among black and white Americans.

BACKGROUND: The authors present statistics and long-term trends in oral and pharyngeal cancer (OPC) incidence, mortality and survival among U.S. blacks and whites. METHODS: The authors obtained incidence, mortality and five-year relative survival rates via the Surveillance, Epidemiology and End Results (SEER) Program Web site. Current rates and time trends for 1975 through 2002 are presented. RESULTS: From 1975 through 2002, age-adjusted incidence rates (AAIRs) and mortality rates (AAMRs) were higher among males than among females and highest for black males. By the mid-1980s, incidence and mortality rates were declining for black and white males and females; however, disparities persisted. During the period 1998-2002, AAIRs were more than 20 percent higher for black males compared with white males, while the difference in rates for black and white females was small. AAMRs were 82 percent higher for black males compared with white males, but rates were similar for black and white females. Five-year relative survival rates for patients diagnosed during the period 1995-2001 were higher for whites than for blacks and lowest for black males. CONCLUSIONS: Despite recent declines in OPC incidence and mortality rates, disparities persist. Disparities in survival also exist. Black males bear the brunt of these disparities. PRACTICE IMPLICATIONS: Dentists can aid in reducing OPC incidence and mortality by assisting patients in the prevention and cessation of tobacco use and alcohol abuse. Five-year relative survival may be improved through early detection.

Adult↗

PubMed2005

Sociodemographic risk indicators for depressive symptoms among persons with oral cancer or oral epithelial dysplasia.

PURPOSE: We report findings from a study that measured associations between sociodemographic risk indicators and depressive symptoms among individuals diagnosed with either oral cancer or a premalignant lesion. MATERIALS AND METHODS: Incident cases of oral cancer and oral epithelial dysplasia (OED) were identified by reviewing pathology reports generated by 3 oral pathology laboratories serving primarily community-based oral and maxillofacial surgeons. Subjects were interviewed by telephone to collect information on sociodemographic characteristics, depressive symptoms using the Center for Epidemiologic Studies-Depression (CES-D) Scale, and social support using the Berkman Social Network Inventory. RESULTS: The analysis included 167 oral cancer and 234 OED cases. Nineteen percent of the subjects had a CES-D score indicative of clinical depression (CES-D > or =16). Forward and backward stepwise logistic regression identified diagnosis (cancer/OED), age, social support, employment status, and gender as sociodemographic indicators of CES-D scores of 16+. In the final model, which also controlled for smoking and drinking, the odds of having elevated CES-D scores (16+) were 79% higher among oral cancer relative to OED cases. The odds of high CES-D scores were significantly reduced in persons over the age of 50 compared with those aged 50 years and younger as well as in persons with higher, relative to low, levels of social support and in persons employed outside the home compared with those who were not. Although not statistically significant, men were more likely to have CES-D scores indicative of clinical depression. CONCLUSIONS: Knowledge of sociodemographic characteristics may assist the clinician in identifying those individuals with an elevated risk of concomitant depressive symptoms.

Adult↗

PubMed2005

Dental caries, periodontal disease, and cardiac arrhythmias in community-dwelling older persons aged 80 and older: is there a link?

OBJECTIVES: To examine whether caries or periodontitis is associated with cardiac arrhythmias in community-dwelling people aged 80 and older. SETTING: Urban, community-based population in Stockholm, Sweden. DESIGN: Cross-sectional. PARTICIPANTS: Eligible persons were identified through the Kungsholmen Project, which is an ongoing, longitudinal, population-based study of the oldest old. The present study included 125 dentate individuals. MEASUREMENTS: Data from interviews, a medical examination, and an oral examination. The assessment of cardiac arrhythmia was based on a clinical examination by a physician or the Stockholm Inpatient Register. Active root caries, active coronal caries, and periodontitis were assessed using previously defined National Institute of Dental and Craniofacial Research diagnostic criteria. RESULTS: The primary finding of the multivariate logistic regression analysis was that persons with three or more active root caries lesions had more than twice the odds of cardiac arrhythmias than persons without active root caries. The results did not notably change after adjusting for age, medications that reduce saliva, and number of teeth. Persons with one to two active coronal caries lesions had 2.8 times higher odds (95% confidence interval=1.1-7.0) of arrhythmia than persons without active coronal caries, but there was no greater risk for persons with three or more coronal caries lesions. There was no association between periodontal disease and arrhythmia. CONCLUSION: The findings indicate that there may be a link between active root caries and cardiac arrhythmias in the oldest old. Nevertheless, although a biological pathway is not obvious, it is plausible that both are simply markers of declining general health. The results suggest the need for further study of these relationships.

Aged↗

PubMed2005

Dental caries in twelve- and fifteen-year-olds: results from the basic oral health survey in Haiti.

OBJECTIVE: Reports on oral health investigations in Haiti are sparse. There are only three peer-reviewed published articles on oral health in Haiti. In order to construct a national dataset useful for public health planning, a representative dental caries survey of Haitian school attending children was conducted in 1999. METHODS: This survey was conducted using a modified version of the World Health Organization (WHO) Basic Oral Health Survey (BOHS) pathfinder method. Children ages 12 and 15 years old attending public or private schools in both rural and urban regions were targeted in seven of the nine geographic Departments of Haiti: each Department constituted a strata that was further stratified into the major urban center and one or more rural towns. Four trained examiners, calibrated to WHO caries criteria, conducted the survey RESULTS: Of the total 1,218 examined 12- and 15-year-olds, 31% of the 12-year-olds and 46% of the 15-year-olds had a DMFS of 1 or more, i.e., these percentages are the simple prevalence levels of dental caries for those age groups in Haiti. Mean DMFS scores were 1.01 (SE 0.09) and 2.52 (SE 0.02) for the 12- and 15-year-olds, respectively. No difference was observed between gender, while differences were found by geographical classification. Less than 1% of the children had any dental restorations. CONCLUSIONS: The findings from this investigation suggest that at the population level, permanent dentition caries in early adolescence is a minimal health problem, relative to dental caries in other neighboring Caribbean countries, as well as to other health conditions in Haiti. However, at the individual level, those children afflicted with decay are without dental services for all practical purposes.

Adolescent↗

PubMed2005

The strength of two indicators of social position on oral health among persons over the age of 80 years.

OBJECTIVE: The objective of the present study is to analyze how two dimensions of social position, education and social class, are associated with oral health among generally healthy, community-dwelling persons over the age of 80 years. METHODS: The present investigation is based on a sample of 157 community-dwelling individuals from The Kungsholmen Elders Oral Health Study (KEOHS) and included data from interviews and oral examinations. Social position was measured by education and social class. Oral health was measured by active coronal caries, active root caries, edentulism and use of dental services. RESULTS: The primary findings of the adjusted multivariate logistic regression analysis were that, compared to persons who had been in higher positions, persons who had been blue-collar/ white-collar workers had significantly greater odds of having coronal caries and high, but nonsignificant odds of being edentulous. Further, persons with elementary/ medium education tended to forego regular dental services more than persons with high education. CONCLUSION: The study identified social inequalities in oral health even in a population of independently living, generally healthy very old Swedes and in a country where the public health policies have tried to minimize these inequalities.

Age Factors↗

PubMed2004

Tooth loss and caries prevalence in very old Swedish people: the relationship to cognitive function and functional ability.

OBJECTIVE: To analyse whether cognitive function and functional ability are related to oral health among community-dwelling older people over the age of 80 years. BACKGROUND: This cross-sectional study is based on the Kungsholmen Elders Oral Health Survey (KEOHS). The study included oral examinations carried out in two local clinics by standardised examiners and interviews using structured questionnaires. MATERIALS AND METHODS: Altogether 159 individuals were included in this study. Coronal caries and root caries were assessed using the National Institute of Dental and Craniofacial Research (NIDCR) diagnostic criteria. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) index and functional ability was assessed by a global measure of self-reported changes. RESULTS: Older adults with a low MMSE score (< or = 23) tended to have a higher risk of coronal caries than those with higher scores. Participants with mild cognitive decline (MMSE = 24-26) and with a decrease in functional ability had a significantly higher risk of root caries. These associations changed little when adjusted by the covariates. In addition, people with a low MMSE (0-23) had a four times higher risk of not using dental services regularly. This result was unchanged after adjusting for the variables studied. CONCLUSIONS: This study revealed associations between the cognitive and functional status of the individual and aspects of oral health, that may contribute to a deeper understanding of the background of oral health status in older adults.

Activities of Daily Living↗

PubMed2003

Classification of dental caries patterns in the primary dentition: a multidimensional scaling analysis.

OBJECTIVE: Clinical patterns of early childhood caries (ECC) encompassing specific teeth or surfaces have been previously proposed on an a priori basis and have been used as case definitions. The underlying assumption is that the patterns result from different host response and environmental conditions. Identifying caries patterns has utility in refining case definitions of ECC. Well-defined caries patterns should enhance the ability of an analysis to identify meaningful associations between suspected risk factors and ECC. The purpose of this project was to identify patterns of caries in the dentition of preschool children using multidimensional scaling without a priori pattern delineation. METHODS: Between February 1994 and September 1995, five examiners visually examined 5171 Arizona preschool children aged 5-59 months old. Multidimensional scaling (MDS) was used as a classification/taxonomy technique to identify any underlying structure of the caries data. MDS provided a classification scheme for individual tooth surfaces based on the dissimilarity measures of squared Euclidean distance and of variance using an alscal analysis. Both two- and three-dimensional solutions were pursued; s-stress, stress, R-square and residual patterns were assessed in determining the best dimensional model, with the resulting quadrant positions of the tooth surfaces suggesting potential caries patterns. RESULTS: All models demonstrated excellent fit. Two- and three-dimensional solutions suggested four caries patterns: (i) any maxillary incisor surfaces, (ii) first molar occlusal surfaces, (iii) second molar pit and fissure surfaces, and (iv) any smooth surfaces, excluding the maxillary incisor surfaces. CONCLUSIONS: This is the first delineation of primary dentition caries patterns produced by a classification analysis without a priori pattern definitions. The identified caries patterns may arise from specific risk factors and/or be a function of the timing of various risk factor exposures. Use of these patterns as case definitions should enhance the ability to identify associations between suspected risk factors and ECC.

Child, Preschool↗

PubMed2003

Social relations as determinants of oral health among persons over the age of 80 years.

OBJECTIVE: To analyze whether social relations during a 7-year follow-up influence oral health among generally healthy, community-dwelling persons over the age of 80 years. METHOD: The present investigation is based on a subsample of 129 dentate community-dwelling individuals from The Kungsholmen Elders Oral Health Study (KEOHS), which included data from interviews and oral examinations. Social relations were measured in terms of marital status, living alone, frequency of contacts, number of confidants, and satisfaction with social contacts and with the frequency of contacts. Oral health was measured in terms of coronal caries and root caries. RESULTS: The primary findings of the adjusted multivariate logistic regression analysis were that persons who lived alone or who became alone during the 7 years prior to the dental examination had greater odds of having coronal caries (odds ratio (OR): 2.4, 95% CI: 1.0-5.7) than those who continually lived with others, and that persons who were continuously dissatisfied with the frequency of their social contacts were more likely to have root caries than those who reported a sustained satisfaction with the frequency of their social contacts (OR: 2.9, 95% CI: 1.2-7.2). CONCLUSION: This study suggests that social relations are related to the oral health status of old-old individuals. From a psychosocial perspective, our findings contribute to a deeper understanding of the background of oral health status in older adults.

Activities of Daily Living↗

PubMed2003

Enhancing medical and public health capabilities during times of crisis.

Terrorist attacks and other catastrophic events will create demands that severely challenge the capacity of the medical/public health system. To meet the surge, a cadre of professionals should be trained to operate around the nucleus of medical/public health officials. At New York University, an inter-institutional team is considering specific roles for and an approach to training dentists to enable these health care professionals to supplement medical/public surge needs based upon informatics systems that provide critical information.

Delivery of Health Care↗

PubMed2002

Maternal risk indicators for childhood caries in an inner city population.

OBJECTIVES: This study evaluated whether characteristics of mothers, such as high mutans streptococci (MS) level, caries experience, reported sugar consumption and demographic variables, could be important risk indicators of caries for their children. METHODS: Mothers selected on the basis of the caries status of their 3-5-year-old-children were tested for MS, caries, reported sugar consumption and demographic variables. RESULTS: We found strong associations between children's caries and their mothers' MS levels (high/low adj. OR = 11.3), maternal active caries (yes/no adj. OR = 4.0) and maternal sugar consumption (high/low adj. OR = 4.2). In this small study, mothers' demographic variables were not associated with the status of caries in their children. CONCLUSIONS: Our findings suggest that maternal high MS levels, maternal active decay and maternal sugar consumption are strong risk indicators for children's caries. Although further study is needed, these three maternal risk indicators, taken together, may prove useful in predicting children's caries risk.

Analysis of Variance↗

PubMed2002

Prosthetic crowns and other clinical risk indicators of caries among old-old Swedish adults: findings from the KEOHS Project. Kungsholmen Elders Oral Health Study.

OBJECTIVES: The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, community-dwelling persons over the age of 80 living in Kungsholmen, Sweden. This paper explored possible clinical risk indicators of coronal and root caries among the KEOHS subjects. DESIGN: In this cross-sectional study, dentate KEOHS subjects received a caries assessment using defined visual, tactile criteria. SETTING: Examinations were carried out in two local clinics by standardized examiners. SUBJECTS: One hundred twenty-nine dentate persons were examined. MAIN OUTCOME MEASURES: The examination identified decayed and filled surfaces, prosthetic crowns, and missing teeth. RESULTS: More root than coronal surfaces had untreated decay, and secondary root caries contributed the greatest number of decayed surfaces. Ninety percent of the examined dentate subjects had at least one prosthetic crown. Root surfaces exposed to crown margins were more likely to have caries than root surfaces not so exposed, particularly among women. The presence of untreated coronal caries (yes/no) was positively associated with having untreated root caries and an intermediate number (14-20) of teeth, but inversely associated with having 4+ prosthetic crowns. Active root caries (yes/no) was positively associated with having untreated coronal caries, 14-20 teeth, and 4+ prosthetic crowns. Nearly 20% of identified root lesions were present at or below the gingival margin, and most (88%) were secondary caries associated with crown margins (65%) or other restorations (23%). CONCLUSIONS: Our findings suggest that some dental characteristics, including the presence of prosthetic crowns, are risk indicators for the presence of untreated coronal and root caries.

Age Distribution↗

PubMed2002

Dental caries experience of female inmates.

OBJECTIVES: The purpose of this study was to determine the extent of dental caries and level of unmet dental need among female offenders in a federal prison in Connecticut. METHODS: All inmates admitted into the Federal Correctional Institution at Danbury, Connecticut, from May 31, 1997, to May 21, 1998, were given oral screening examinations (n=500; age range=20-65 years). The data were analyzed in terms of race/ethnicity and age groupings. DMF and D/DF scores were determined. RESULTS: The mean DMFT and DMFS scores were 16.8 and 57.0, respectively; the scores were higher for non-Hispanic whites and Hispanics than non-Hispanic blacks, and increased with age. The mean DT/DFT and DS/DFS scores were 36.8 percent and 36.0 percent, respectively. These scores were higher for non-Hispanic blacks than non-Hispanic whites and Hispanics, and decreased with age. CONCLUSIONS: Female prisoners had high levels of dental caries and racial disparities persisted in the prison.

Adult↗

PubMed2002

Dental caries in persons over the age of 80 living in Kungsholmen, Sweden: findings from the KEOHS project.

OBJECTIVES: The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, community-dwelling persons over the age of 80 living in Kungsholmen, an area in central Stockholm. This paper reports findings regarding the prevalence and severity of dental caries among the dentate participants. BASIC RESEARCH DESIGN: Caries examinations were conducted on eligible persons participating in the Kungsholmen Project, an ongoing, longitudinal study of older adults. SETTING: Caries examinations were carried out between 1994 and 1996 at two local clinics by three standardised examiners using defined visual, tactile criteria. PARTICIPANTS: Among 296 potentially eligible participants, 159 were examined, and a total of 129 had at least one tooth. MAIN OUTCOME MEASURES: The caries examination identified decayed and filled surfaces and missing teeth. RESULTS: Of the dentate subjects examined, 80% had teeth in both arches; 98% had at least one coronal filling; 81% had one or more restored root surfaces. Depending upon age and gender, between 36% and 56% of those examined had untreated coronal caries, and between 54% and 75% had untreated root caries. CONCLUSIONS: These findings document the substantial and ongoing impact of dental caries in a sample of generally healthy, community-dwelling older adults and underscore the importance of continued caries prevention and treatment in the aged.

Age Factors↗

PubMedDate not supplied

Median ages of eruption of the primary teeth in white and Hispanic children from Arizona.

PURPOSE: The purpose of this project was to establish median eruption ages of primary teeth and evaluate eruption differences between contralateral teeth by gender, ethnicity, and household income. Data was derived from a caries study of preschool children. METHODS: A total of 4,277 white (non-Hispanic) and Hispanic preschool children from Arizona were visually examined for caries and tooth eruption status by 5 examiners between February 1994 and September 1995. Analyses of eruption status were conducted using logistic regression to produce an eruption probability distribution from which median eruption ages for the primary teeth were determined. Possible differences in eruption timing between contralateral teeth by gender, ethnicity, and household income were examined. RESULTS: Eruption status of 1 tooth was significantly predictive of the pair-matched tooth for all pairs. Differences were found for the maxillary central incisor (gender) and the mandibular second molar (ethnicity). Eruption ages did not vary by household income. Median eruption ages for each of the 10 primary teeth are presented. CONCLUSIONS: This study provides contemporary median eruption ages for primary teeth.

Age Factors↗

PubMedDate not supplied

Historical evolution of primary dentition caries pattern definitions.

A variety of dental caries patterns encompassing differing teeth have been proposed, and their use may have utility in Early Childhood Caries (ECC) investigations by minimizing case misclassification. Recent reports have proposed multiple pattern schemes. The purpose of this paper was to review the historical evolution of ECC patterns to assist the clinician and researcher in understanding the strengths and limitations of contemporary caries pattern definition(s).

Dental Caries↗