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Biomedical subjects

E C Lo

Publications and source records attributed to E C Lo.

At least 19 recordsLinked to original sources

Monitoring patient satisfaction with university dental services under two fee-paying systems.

AIMS: The aim of this survey was to study patients' satisfaction with the dental service of a university in Hong Kong under a recently introduced item-based fee-paying system and reasons for non-attendance at the clinic; and to compare results of the present survey with that of a similar survey of the same dental service under a time-based fee-paying system in 1996. METHOD: A modified Dental Satisfaction Questionnaire was distributed to a random sample of students (n=194) in their lecture rooms and they were asked to complete the questionnaire on the spot. The same questionnaire was sent to a random sample of staff and their spouses (n=207) by mail. RESULTS: Dental Satisfaction Index (DSI) scores calculated from the returned questionnaires were 66 for students and 70 for staff and their spouses. Compared to the scores in 1996, there was no significant difference for that of the students (DSI=65 in 1996) but there was a significant improvement in that of the staff and their spouses (DSI=66 in 1996). Moreover, in the present survey, "busy/no time" and "no perceived dental problem" were the major reasons for non-attendance, in contrast to "long waiting time for an appointment" in the 1996 survey, were the major reasons for non-attendance. CONCLUSION: The recent attempts by the University Dental Clinic to shorten patient waiting time and the change in fee-paying system might have improved the patients' satisfaction with the service.

Chi-Square Distribution↗

Provision of Atraumatic Restorative Treatment (ART) restorations to Chinese pre-school children--a 30-month evaluation.

OBJECTIVES: The objectives of this study were: to provide restorations using the ART approach to pre-school children in Southern China in a kindergarten environment, using a high-strength glass-ionomer restorative material; to assess the acceptability of this approach and to evaluate on a longitudinal basis the restorations placed. SAMPLE AND METHODS: A total of 170 ART restorations were placed in 95 children, aged 5.1 +/- 0.7 years, by seven final-year dental students using standard ART procedures and hand instruments. The restorations were evaluated every six months thereafter by two calibrated independent examiners using explorers and mouth-mirrors. RESULTS: 93% of the children reported that they did not feel pain during treatment and 86% were willing to receive ART restorations again. The cumulative 12- and 30-month survival rates of Class I restorations were 91% and 79%, respectively. The corresponding figures for Class V restorations were 79% and 70%, while those for Class II restorations were 75% and 51%. The failure rates of Class III and IV restorations were high with more than half of them scored as missing within the first year. CONCLUSIONS: The ART approach was shown to be acceptable to Chinese pre-school children for providing restorative dental care outside the traditional clinical setting. The success rates were high for Class I and V restorations in primary teeth, modest for Class II, and low for Class III and IV restorations.

Analysis of Variance↗

Life-extending therapies among patients with advanced cancer: patients' levels of pain and family caregivers' concerns about pain relief.

The purposes of this article are to explore the extent to which oncology unit patients with advanced cancer in Taiwan receive life-extending therapies and to examine the relationship of care goals (curative vs palliative) to levels of pain and family caregivers' concerns about pain reporting and analgesic administration. Forty pairs of patients with advanced cancer and their family caregivers (N = 80) were recruited from inpatient oncology units in Taiwan. Of these patients, 53% were receiving chemotherapy or radiotherapy for life-extending or curative reasons as opposed to palliative goals. Patients with advanced cancer who were receiving life-extending therapies experienced lower levels of pain intensity than did those who were not receiving life-extending therapies. Moreover, Taiwanese family caregivers of patients with advanced cancer had concerns about reporting pain and administering analgesics regardless of whether the patient was receiving life-extending therapies. However, the family caregivers whose patients were receiving life-extending therapies were less concerned about using analgesics than were those caregivers whose patients were not receiving life-extending therapies. Finally, family caregivers' concerns about pain management as measured by the Barriers Questionnaire-Taiwan (BQT) form were related to family caregivers' reluctance to report their patients' pain. Implications of this study are discussed in terms of palliative care and pain educational programs.

Adult↗

An Oral Health Survey in Southern China, 1997: background and methodology.

Relatively limited information is available about the oral health in the Guangdong Province of Southern China, the closest neighbor to Hong Kong. The study intended to explore the oral health status, knowledge, attitudes, and dental care utilization in the Guangdong population as a basis for formulating strategies for oral health prevention and treatment. Through multi-stage stratified and quota-sampling, individuals from urban as well as rural communities were selected (5- to 6-; 12-; 35- to 44-; and 65- to 74-year-olds; total N = 6251). Structured interviews and clinical examinations were performed. Inter-examiner reliability was high (kappa = 0.60-0.96). Samples of community water were taken for fluoride assessment. Overall, the sample surveyed was acceptably representative of the population, with some under-representation of rural residents and agricultural workers. Re-weighting was performed in appropriate analyses. The data analysis model used in the Second International Collaborative Study was used as a guide for the present data analysis. This approach has not previously been used on a Mainland Chinese population.

Adolescent↗

Oral health status and oral health behaviors in Chinese Children.

The objectives of the study were to describe the oral health status and treatment needs of the 5- to 6-year-old and 12-year-old children in Southern China; to describe the patterns of oral health behaviors, knowledge, and attitudes among the 12-year-olds; and to assess the effects of socio-behavioral factors on the 12-year-old children's dental caries experiences. The study sample was comprised of 1,587 5- to 6-year-old and 1,576 12-year-old urban and rural schoolchildren living in Guangdong Province. Three calibrated dentists clinically examined the children, and trained interviewers interviewed the 12-year-olds. Caries prevalence of the 5- to 6-year-old children was high (urban 78% vs. rural 86%); the mean dmft of the urban and rural children was 4.8 and 7.0, respectively. The caries prevalence and mean DMFT score of the 12-year-olds were 41% and 0.9 (urban) and 42% and 0.9 (rural). Only 2% of the 12-year-olds exhibited no calculus or gingival bleeding, while more than 70% had calculus. In conclusion, there is an urgent need for establishing caries-preventive activities for preschool children. The prevalence of caries among the 12-year-olds was not high, but their periodontal condition was unsatisfactory. Knowledge about gum bleeding and the use of fluoride was low. More oral health education activities should be organized, especially for the rural children.

Analysis of Variance↗

Oral health knowledge, attitudes, and practices of Chinese adults.

Only recently have behavioral aspects been taken into consideration in oral health studies in China; thus, relevant information on perceptions in adult Chinese about oral health care is inadequate. In 1996-97, a large-scale oral epidemiological study was conducted in Southern China. Among its objectives were to describe the oral health knowledge, attitudes, and practices of the urban and rural adults living in Southern China and to analyze the influence of selected demographic and socio-economic factors. From 8 urban and 8 rural communities in Guangdong Province, 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds were sampled. Specially trained interviewers from the staff of local government or hospitals conducted face-to-face structured interviews. Almost all of the middle-aged and more than 90% of the dentate elderly surveyed claimed that they brushed their teeth every day and used toothpaste during toothbrushing, but awareness about fluoride content was lacking. The respondents had poor oral health knowledge but positive attitudes toward oral health, providing a basis for more community-based oral health education programs, especially targeting adults who are less-well-educated and have fewer socio-economic advantages.

Adult↗

Utilization of dental services in Southern China.

A population's utilization of dental services is an important parameter in oral health care planning, which has rarely been studied in China. The objectives of this report were to describe the dental service utilization pattern of middle-aged and elderly Chinese and to analyze the influence of selected variables on the use of dental services. A Guangdong Province population of 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds recruited from urban and rural communities was interviewed in their local dialect. It was found that 23% of the middle-aged and 24% of the elderly subjects had visited a dentist within the preceding year. The two most commonly cited reasons for not having seen a dentist for at least 3 years were: no perceived need, and no serious dental problems. Among subjects who had visited a dentist within 3 years, the 3 most commonly received treatments were: fillings, extractions, and dental prostheses. Furthermore, a logistic regression analysis showed that women, subjects who lived in urban areas, were better educated, were wealthier, and had better oral health knowledge were more likely to be a recent dental service user. In conclusion, dental service utilization among the adult Southern Chinese was found to be low, problem-driven, and influenced by some socio-economic factors.

Adult↗

Coronal and root caries in Southern Chinese adults.

Southern China is the most prosperous part of China, but information useful for oral care planning is very limited. A large-scale epidemiological survey was conducted in 1996-97. The objectives of this report were to describe the coronal and root caries of the adult Southern Chinese and to analyze the influence of selected demographic and socio-economic factors on the disease pattern. A total sample of 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds from 8 urban and 8 rural survey sites in Guangdong Province participated in an oral health interview and underwent clinical examination. World Health Organization examination procedures and diagnostic criteria were used. The weighted mean DMFT scores of the middle-aged and the elderly subjects were 4.8 and 16.1, respectively. People living in rural areas had a higher DMFT score than those living in urban areas (4.9 vs. 4.3 in the 35- to 44-year-olds and 16.5 vs. 14.7 in the 65- to 74-year-olds). In both age groups, MT was the major component of the DMFT score. Analysis of covariance showed that women and those who were economically less well off had higher DMFT scores in both age groups. The weighted prevalence rates of decayed/filled roots were 12% and 37%, with a mean of 0.2 and 0.7 teeth affected, in the middle-aged and the elderly, respectively. In conclusion, socio-economic factors had a considerable effect on the dental caries status of adults in Southern China.

Adult↗

Oral mucosal lesions in adult Chinese.

The objectives of this analysis were to determine the prevalence of oral mucosal lesions (OML) among adults in Southern China and to determine possible associations between OML and reported tobacco-smoking and alcohol-drinking habits. The sample consisted of 1,573 35- to 44-year-old and 1,515 65- to 74-year-old Chinese from both urban and rural areas of Guangdong Province. The subjects were interviewed by trained interviewers and underwent a clinical examination of the oral mucosa performed according to WHO guidelines. A specially prepared color atlas of OML was used for lesion recognition and confirmation during the survey. Among the 35- to 44-year-old subjects, the overall prevalence of OML was found to be 13% in urban men, 6% in urban women, 15% in rural men, and 4% in rural women. The corresponding figures for the 65- to 74-year-olds were 22%, 12%, 26%, and 19%. Tongue lesions and white lesions were relatively common, but denture-related lesions were not. No malignancies or erythroplakia was observed. Age and gender were found to relate to the occurrence of OML. In elderly men, smoking was significantly (p < 0.05) associated with some white lesions and tongue lesions, and alcohol drinking was also associated with some white lesions. In conclusion, tongue lesions and white lesions were relatively common in men, but pre-cancerous lesions were not prevalent.

Adult↗

Tooth loss, occluding pairs, and prosthetic status of Chinese adults.

The objectives of this analysis were to describe the numbers of teeth lost and those indicated for extraction, dental prosthetic status, and occluding tooth pairs among adults in Southern China and to investigate factors affecting tooth mortality. A sample consisting of 1,573 35- to 44-year-old and 1,515 65- to 74-year-old urban and rural Chinese was examined clinically by calibrated examiners. Teeth not present for any reason were defined as missing (MT). The sum of MT and teeth indicated for extraction (IMT) was defined as adjusted missing teeth (AMT). Only 4.4% of the urban and 3.4% of the rural 65- to 74-year-olds were edentulous. MT were not significantly different between urban and rural residents, but more IMT were found in rural residents. Women, those who had a lower education level, and those who were less wealthy had more AMT in both age groups. Smoking was found to be associated with AMT in the 35- to 44-year-olds. Eighteen percent of the urban and 27% of the rural elderly had no occluding tooth pairs after IMT were accounted for, and only 38% and 30%, respectively, had 10 or more occluding pairs. Fifty-one percent of the urban and 43% of the rural elderly were found to have some form of dental prostheses in either jaw. A partial denture was more common in urban residents in both age groups.

Adult↗

A community-based caries control program for pre-school children using topical fluorides: 18-month results.

Dental caries in Chinese pre-school children is common, and restorative treatment is not readily available. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. We divided 375 children (aged 3-5 yrs) with carious upper anterior teeth into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). NaF varnish (22,600 ppm F) was applied every three months onto the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. We followed 341 children for 18 months. The mean numbers of new caries surfaces in the five groups were 0.4, 0.4, 0.8, 0.6, and 1.2, respectively (p = 0.001). The respective mean numbers of arrested carious tooth surfaces were 2.8, 3.0, 1.7, 1.5, and 1.0 (p < 0.001).

Analysis of Variance↗

Marginal adaptation of a new compomer under different conditioning methods.

OBJECTIVES: This in vitro study evaluated the marginal adaptation of compomer restorations placed using three different conditioning protocols. MATERIALS AND METHODS: Thirty extracted caries-free molars with 3mm diameter cylindrical cavity preparations were divided randomly into three groups based upon the conditioning treatment used: (I) 36% phosphoric acid; (II) non-rinse conditioner (NRC, Dentsply DeTrey); and (III) no conditioning. Cavities were restored with Dyract AP using Prime&Bond NT (Dentsply DeTrey) as an adhesive. Silicone impressions of the briefly etched enamel surfaces were taken after finishing the restorations. Each sample was then longitudinally sectioned and impressions were taken. Epoxy resin replicas were prepared for SEM analysis. Qualitative and quantitative assessment were performed separately for the enamel- and dentine-restorative interface. RESULTS: Enamel fractures and open margins along the enamel-restorative margin were observed in some specimens in each group. No statistically significant difference was found in the percentage of gaps/cohesive failures between specimens prepared using different conditioning methods. For the dentine-restorative interface, uniform hybrid layers and long resin tags were often observed in Groups I and II. The hybrid layer in Group III was irregular and discontinuous along the interface. A significant difference (p<0.01) in the proportion of marginal gap was found between Group I (2%) and Group III (30%). CONCLUSIONS: Pre-treating the cavity with 36% phosphoric acid significantly improved the adaptation of the compomer and adhesive to dentine compared with no etching. The marginal quality at the enamel-compomer interface was not affected by the conditioning method used.

Acid Etching, Dental↗

ART restorations and sealants placed in Chinese school children--results after three years.

OBJECTIVES: These were to assess whether ART restorations and sealants could be provided to children in a school environment in China, to assess patient acceptability of the ART approach, and to evaluate on a longitudinal basis the treatments performed. METHODS: This study was conducted in Deyang, Sichuan Province, in western China. A total of 294 ART restorations were placed in 197 children and 191 fissure sealants were placed in 140 children by five middle-level dentists in four secondary schools. Standard instruments and procedures for ART were used. The restorative material used was a high-strength glass-ionomer (Ketac-Molar, ESPE). The treatments were evaluated annually after placement by the same examiner who had not been involved in the placement of the restorations nor sealants using explorers and mouth-mirrors. At the 3-year examination an independent external examiner evaluated the restorations using USPHS criteria. RESULTS: Most of the children did not report discomfort during treatment and 92% were willing to receive ART restorations again. The cumulative 1-year and 3-year survival rates of small Class I restorations were 99% and 92% respectively. The corresponding figures for large Class I restorations were 90% and 77%. After 3 years, 72% of the sealants were either partially or completely retained. Only 2% of the sealed teeth developed fissure caries and these involved teeth where the sealants had been lost. Similar success rates were found using USPHS criteria. CONCLUSIONS: The ART approach for preventing and treating tooth decay in Chinese school children was shown to be appropriate, effective and acceptable. The 3-year survival rates of the restorations were high but were related to the size and type of the restoration.

Adolescent↗

Oral health status of patients 5-6 years after placement of cobalt-chromium removable partial dentures.

This study is a clinical survey of cobalt-chromium (Co-Cr) removable partial denture (RPD) wearers that aimed to investigate the effects of denture wearing on oral tissues. A random sample of patients who had received their dentures 5-6 years previously from a dental teaching hospital in Hong Kong was selected. Those who had been constantly wearing the RPDs were examined by one calibrated examiner under an optimal clinical setting. The patients' dental, periodontal and mucosal status were assessed. A total of 87 patients were examined. Mucosal lesions under the Co-Cr RPDs were uncommon in this study sample. However, there was a high prevalence of plaque, gingivitis and gingival recession, especially in dento-gingival surfaces in close proximity (within 3 mm) to the dentures. Thus, there is a special need for regular oral hygiene reinforcement, scaling and prophylaxis among RPD wearers. Despite a low caries incidence in the study sample, root caries were found to be associated with contact with the RPDs (P < 0.05) but coronal caries were not. It is recommended that coverage of the exposed root surfaces by RPD components should be avoided. Also, topical fluorides should be regularly applied onto exposed root surfaces as a preventive measure.

Adult↗

Oral health status and treatment need of 11-13-year-old urban children in Tibet, China.

OBJECTIVE: To describe the oral health status and treatment need of 11-13-year-old children in urban Tibet and to determine if there was a difference in oral health status between the Tibetan and Han children. SURVEY DESIGN AND SUBJECTS: The two largest primary schools in Lhasa, Tibet, were selected and all children aged between 11 and 13 years were surveyed. Each child was interviewed and clinically examined in the schools, using portable equipment, by one of four calibrated examiners. The examination procedures and diagnostic criteria used followed those recommended by the World Health Organization. RESULTS: 347 children (207 Tibetans and 140 Han) were surveyed. Over 90% of the children claimed to brush their teeth at least once a day. Three-quarters had never visited a dentist. Caries prevalence was 44% in the Tibetans and 24% in the Han (P<0.001). The mean DMFT scores of the Tibetans and Han were 0.8 and 0.4 respectively (P<0.001). Only 1% of the children in both ethnic groups had healthy gums (highest CPI score = 0) and about two-thirds of them had calculus. One-third of the children were in need of treatment for dental caries and most of the required treatment items were one-surface fillings but 10% of the children needed extraction. CONCLUSION: Dental caries and treatment need level of both Tibetan and Han children in Tibet was low but their periodontal health status was unsatisfactory.

Adolescent↗

Clinical evaluation of polyacid-modified resin composite posterior restorations: one-year results.

OBJECTIVE: The aim of this investigation was to evaluate the clinical performance of a new compomer restorative system, Dyract AP, placed in combination with Non-Rinse Conditioner and Prime & Bond NT in permanent posterior teeth. METHOD AND MATERIALS: Fifty Class II and 41 Class I restorations were placed in 39 patients by 1 dentist. The restorations were evaluated directly, with modified US Public Health Service criteria, and indirectly, with color slides and polyvinyl siloxane impressions, at baseline and 6 months and 1 year after placement. Preoperative and 1-year postoperative bitewing radiographs were also taken. RESULTS: All 82 restorations available for 1-year evaluation were in situ. No postoperative sensitivity or pulpal problems were reported. Four Class II restorations (4.9%) failed because of partial fracture or recurrent caries. The percentages of Alfa score for each criterion were color match, 95.1%; marginal discoloration, 57.3%; marginal integrity, 35.4%; anatomic form, 98.8%; and surface texture, 91.5%. The average wear rate of Dyract AP was low (18.5 +/- 11.7 microns at 6 months and 35.7 +/- 13.6 microns at 12 months). CONCLUSION: The excellent handling characteristics, the good clinical performance, and the improved wear resistance suggest that this compomer will provide reliable direct tooth-colored restorations in stress-bearing areas.

Acid Etching, Dental↗

Dental caries status of preschool children in Hong Kong.

OBJECTIVE: To describe the dental caries status of preschool children in Hong Kong and factors which affect their caries status. DESIGN: 658 preschool children aged 4 to 6 years from six randomly selected kindergartens in Hong Kong were surveyed in December 1997. A questionnaire to investigate possible explanatory variables for caries status was completed by their parents. Dental caries was diagnosed according to the criteria recommended by the World Health Organization (1997). RESULT: Caries experience as measured by the mean number of decayed, missing and filled primary teeth (dmft) of the 4-, 5-, and 6-year-old children were found to be 0.9, 1.8, and 3.3 respectively. Overall, 61% of the children had a zero dmft score. Children born in Mainland China had a higher mean dmft score (4.6) than those born in Hong Kong (1.4). Statistically significant correlations were found between the children's dental caries status and their oral health practices as well as their socio-economic background. Parents' education level, dental knowledge and attitudes were also associated with the children's dental caries experience. CONCLUSION: In general, the caries status of Hong Kong Chinese preschool children was similar to that of children in industrialised countries and was better than that of children in the nearby areas. However, special dental programmes should be made available to children from lower socio-economic classes and new immigrants from Mainland China because they are the high risk groups for caries in Hong Kong.

Attitude to Health↗