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Biomedical subjects

G D Slade

Publications and source records attributed to G D Slade.

At least 55 records · Page 3Linked to original sources
PubMed1996

Oral conditions and their social impact among HIV dental patients.

This study aimed to assess oral health status and the social impact of oral conditions among dental patients with HIV infection in comparison with general dental patients receiving public-funded care in Adelaide, South Australia. DMFT and CPITN indices were recorded by one dentist at a clinic for HIV dental patients. The data were compared with information from an existing survey of general dental patients. Social impact was assessed using the Oral Health Impact Profile questionnaire and responses from HIV dental patients were compared with responses from a telephone interview survey of Adelaide residents. HIV patients were aged 21 to 49 years (median = 34), 90.7 percent were male and 29.6 percent had stage 4 HIV infection. Oral candida was present among 32.0 percent, hairy leukoplakia among 24.1 percent, HIV gingivitis among 18.5 percent, and HIV periodontitis among 33.3 percent. The DMFT index and its components did not differ significantly between HIV and general dental patients, while CPITN scores were lower among HIV patients (p = 0.01). However social impact among HIV patients was frequent: 64.6 percent reported toothache, 43.7 percent avoided foods, and 16.7 percent avoided going out because of dental problems. HIV patients reported significantly greater levels of social impact than the Adelaide sample (p < 0.01). Patients to this clinic frequently presented with severe and disabling oral conditions which were not adequately captured using standard clinical indices.

Adult↗
PubMed1996

Variations in the social impact of oral conditions among older adults in South Australia, Ontario, and North Carolina.

Previous studies among older adults have demonstrated that oral disease frequently leads to dysfunction, discomfort, and disability. This study aimed to assess variations in the social impact of oral conditions among six strata of people aged 65 years and older: residents of metropolitan Adelaide and rural Mt Gambier, South Australia; residents of metropolitan Toronto-North York and non-metropolitan Simcoe-Sudbury counties, Ontario, Canada; and blacks and whites in the Piedmont region of North Carolina (NC), United States. Subjects were participants in three oral epidemiological studies of random samples of the elderly populations in the six strata. Some 1,642 participants completed a 49-item Oral Health Impact Profile (OHIP) questionnaire which asked about impacts caused by problems with the teeth, mouth, or dentures during the previous 12 months. The percentage of dentate people reporting impacts fairly often or very often was greatest among NC blacks for 41 of the OHIP items. Two summary variables of social impact were used as dependent variables in bivariate and multivariate least-squares regression analyses. Among dentate people, mean levels of social impact were greatest for NC blacks and lowest for NC whites, while people from South Australia and Ontario had intermediate levels of social impact (P < 0.01). Missing teeth, retained root fragments, root-surface decay, periodontal pockets, and problem-motivated dental visits were associated with higher levels of social impact (P < 0.05), although there persisted a two-fold difference in social impact across the six strata after adjustment for those factors Among edentulous people, there was no statistically significant variation in social impact among strata. The findings suggest that there are social and cultural factors influencing oral health and its social impact, and that those factors differ most between dentate blacks and whites in NC.

Black or African American↗
PubMed1996

Epidemiology of periodontal diseases.

This review summarizes findings from 46 reports selected from over 130 epidemiologic studies published in 1993 and 1994. Recent findings from longitudinal studies are consistent with the concept that periodontal destruction proceeds in random bursts at specific sites and demonstrate that some individuals have an elevated risk of attachment loss. These and other studies provide further evidence that cigarette smoking is a significant risk factor. New studies have quantified the risk of tooth loss due to periodontal disease, and there is better knowledge about HIV-associated periodontal diseases. Familial studies suggest that both environmental and genetic factors contribute to individual variations in etiologic factors (such as plaque) and periodontal diseases. Several studies propose an intriguing link between periodontal diseases and coronary heart disease, which may be mediated through risk factors common to both diseases, and as a direct consequence of the contribution of periodontal bacteria and their products to atherosclerosis.

Arteriosclerosis↗
PubMed1996

Reactor paper.

Explore the source record for details and available documents.

Dental Care↗
PubMed1996

Provision of public dental services in urban, rural and remote locations.

Geographic remoteness is a barrier in the receipt of comprehensive dental care, and contributes to inequalities in oral health among adults in Australia. The aim of this study was to determine whether dental care provided through the public sector varied between geographic locations. Data were collected from a cross-sectional sample of 10,230 visits made by dentate patients aged 18 years or more. On the basis of residential postcode, patients were categorised into urban, rural or remote locations. Public dental care provided to adults in non-urban locations was more likely to include restorative, oral surgery and prosthodontic services, but less likely to include preventive services.

Adolescent↗
PubMed1996

Water fluoridation in Australia.

This paper reviews the rationale, context and support for water fluoridation in Australia, and examines current Australian evidence concerning the caries-preventive effects of fluoridation and trends in dental fluorosis. Nearly two thirds of the Australian population resides in an area with adjusted levels of fluoride in the water supply. However, public knowledge about fluoridation is poor and opinion polls demonstrate declining support for fluoridation. In the press and scientific literature there has been questioning of fluoridation, although the most recent Australian review reasserted its safety and effectiveness. Results from Australian oral epidemiological studies consistently support the accumulated evidence on the effectiveness of water fluoridation. This includes recent evidence that lifetime exposure to fluoridation is associated with average reductions of 2.0 dmfs and between 0.12 and 0.30 DMFS per child compared with non-exposed children. Water fluoridation has been found to reduce socio-economic inequalities in caries, reducing the differential between high and low socio-economic status groups by approximately 1.0 dmfs and 0.2 DMFS per child. The prevalence of dental fluorosis may have increased, prompting renewed consideration of overall exposure to fluorides. Action is currently being taken to reduce the exposure to discretionary fluoride among pre-school children as part of a targeted approach to adjusting the benefit-risk relationship of exposure to fluorides for that age group. Community water fluoridation continues to be the most effective and socially equitable measure for caries prevention among all ages by achieving community-wide exposure to the caries preventive effects of fluoride.

Adult↗
PubMed1995

Periodontal attachment loss among adults aged 60+ in South Australia.

This study aimed to provide oral epidemiological data describing periodontal destruction among older adults in South Australia. A cross-sectional survey design was employed and periodontal assessments were made among 801 persons aged 6+ drawn at random from the non-institutionalized population. Measurements of pocket depth (PD) and gingival recession (GR) were made at three sites on all teeth and used to compute loss of attachment (LOA). An average of 17 teeth per person were measured. LOA of 4+ mm at one or more sites was observed among 89.1% of persons. A mean of 78.1% of sites per person had LOA of 2+ mm (extent) and the mean LOA at sites with LOA of 2+ mm was 3.09 mm (severity). Extent and severity were greater for males and for persons aged 80+ years. Extent was virtually identical for mesio-buccal and disto-lingual sites, while severity was virtually identical for mid-buccal and disto-lingual sites. Patterns of GR and PD varied according to the jaw and type of tooth. Maxillary first and second molars had the greatest mean LOA, and the majority of LOA in the maxilla was due to PD. In the mandible there was less variation in LOA among anterior and posterior teeth, and LOA tended to be more equally divided between GR and PD. Levels of periodontal destruction of South Australia were broadly similar to results from North American studies of older adults which have used full-mouth periodontal assessments.

Age Factors↗
PubMed1995

Dental caries experience and use of prescription medications among people aged 60+ in South Australia.

Medication has long been implicated as a potential risk factor for dental caries among elderly people, although epidemiological studies have reported inconsistent associations between medication usage and dental caries experience. This paper aimed to describe the frequency of medication usage, and to examine associations between medication usage and dental caries experience among non-institutionalized persons aged 60+ years in South Australia. A cross-sectional survey design was used to collect interview data about prescription medication usage from 1,650 people. Oral examinations were conducted among 848 people to obtain information about coronal and root canes experience. The number of prescribed medications taken ranged from 0 to 17, and the mean number taken was 1.8 (sd, 1.9). This was higher in older subjects and females. Four medication categories accounted for almost three-quarters of the medications taken; of those, cardiovascular drugs (including diuretics) accounted for three, with analgesics the only non-cardiovascular class. Subjects taking 3 or more prescription medications had a higher Root Caries Index (RCI, mean = 14.43; P < 0.01) than those taking one or two (mean = 11.50), and those who were taking none (mean = 12.02). Examination of particular medication types revealed that people who took antidepressants and antiulcer drugs had significantly higher RCI values (P < 0.05). There was only a moderate association between medication usage and root caries experience which may be attributable to xerogenic effects of medication, or non-causal associations with underlying medical conditions.

Aged↗
PubMed1995

Differences between racial groups in the impact of oral disorders among older adults in North Carolina.

OBJECTIVES: This study investigated variations in impact of oral disorders between older black adults and older white adults living in North Carolina. METHODS: Using the Oral Health Impact Profile (OHIP) questionnaire, 440 participants aged 70 and older provided data on their perceptions of the impact of oral disease on aspects of their lives during the previous 12 months. RESULTS: For 22 of the 49 items queried in the OHIP questionnaire, older blacks reported more frequent impact than older whites (P < .05). For none of the OHIP items did whites report more frequent impact. The impacts reported were diverse and included items reflecting pain, physical disability, psychological disability, and social disability. When the number of items occurring fairly often or very often were summed for dentate participants, blacks reported more items than did whites (3.7 vs 1.1, P < .0001). This difference decreased to 2.7 vs 2.0 (P < .346) after controlling statistically for greater mean periodontal pocket depth, more unreplaced missing teeth, and more episodic dental visits among blacks. CONCLUSIONS: Older dentate blacks reported more impact from oral problems than older dentate whites. The differences in reported impact likely are linked to differences in oral status and dental visit history between these two racial groups in North Carolina.

Black or African American↗
PubMed1995

Associations between exposure to fluoridated drinking water and dental caries experience among children in two Australian states.

OBJECTIVES: This study assessed associations between exposure to fluoride in water and dental caries experience among children in two Australian states. METHODS: Cross-sectional data were obtained from 9,690 South Australian children aged 5-15 years and 10,195 Queensland children aged 5-12 years. School dental service practitioners recorded DMFS and dmfs data. A questionnaire to parents gained information about residential history that was used to calculate children's percent of lifetime exposed to fluoridated water. RESULTS: Greater exposure to fluoride in water was associated with lower dmfs and DMFS in both states (P < .01), although in South Australia the effect for DMFS was statistically significant only after controlling for extent of unknown fluoridation exposure and for fluoride supplements. Caries-fluoridation associations were stronger for dmfs compared with DMFS and for Queensland (5% of population fluoridated) compared with South Australia (70% of population fluoridated). Effects for DMFS persisted after controlling for socioeconomic factors. CONCLUSIONS: Fluoridation was associated with lower caries experience. The weaker association with DMFS in South Australia may be due to less caries and more fissure sealants in that state, and is consistent with a "diffusion" effect, whereby a high proportion of the population exposed to fluoridation diminishes differences among exposure groups.

Adolescent↗
PubMed1995

Methodological aspects of a computer-assisted telephone interview survey of oral health.

Despite the reported benefits of computer-assisted telephone interview (CATI) methods, experiences from their use in Australian oral health surveys have not been described. This report aimed to present methodological aspects of a CATI survey conducted in the five mainland states. A response rate of 66 per cent was obtained, yielding 4050 completed interviews. Analysis revealed generally small levels of non-response bias: persons who avoided or delayed dental treatment because of cost and non-health card holders were harder to contact, while non-English speakers and persons aged 20-29 years were less likely to participate. A total of 1770 person hours of interview time was spent on the survey: 64.5 per cent of that time was spent on the telephone with an average of 10 minutes 17 seconds per call (13 minutes 37 seconds per completed call). Only seven questions had missing data for more than 1 per cent of respondents. Comprehension of questions and cooperation with the interview was rated by interviewers as 'good' or 'very good' for more than 90 per cent of respondents. The CATI method was highly efficient and yielded good quality data for the survey.

Adolescent↗
PubMed1994

Social impact of oral conditions among older adults.

Oral symptoms and their effects on well-being provide an indication of the social impact of oral disease and can be used to document the burden of illness within populations. This report presents findings about the social impact of oral disease among a random sample of 1217 non-institutionalized persons aged 60 years and over living in Adelaide and Mt Gambier. They completed a questionnaire containing 49 questions about the effect of oral conditions on dysfunction, discomfort and disability. Over 5 per cent of dentate persons and over 10 per cent of edentulous persons reported impacts such as difficulty in chewing, discomfort during eating and avoidance of foods 'fairly often' or 'very often' during the previous 12 months. Impacts on social roles and interpersonal relationships were reported by up to 5 per cent of persons. Edentulous persons reported social impact more frequently, particularly in areas related to chewing and eating. Older age was associated with significantly greater amounts of impact among dentate persons, while edentulous males reported significantly more impact than edentulous females. There were larger variations among dentate persons according to their dental utilization patterns, with the highest levels of impact reported by individuals who usually attended for dental problems and who had attended the previous year. The high frequency of social impact reported in this study no doubt reflects extensive levels of disease experience, including high rates of missing teeth and edentulism, among older adults.

Age Factors↗
PubMed1994

Development and evaluation of the Oral Health Impact Profile.

The capacity of dental clinicians and researchers to assess oral health and to advocate for dental care has been hampered by limitations in measurements of the levels of dysfunction, discomfort and disability associated with oral disorders. The purpose of this research was to develop and test the Oral Health Impact Profile (OHIP), a scaled index of the social impact of oral disorders which draws on a theoretical hierarchy of oral health outcomes. Forty nine unique statements describing the consequences of oral disorders were initially derived from 535 statements obtained in interviews with 64 dental patients. The relative importance of statements within each of seven conceptual subscales was assessed by 328 persons using Thurstone's method of paired comparisons. The consistency of their judgements was confirmed (Kendall's mu, P < 0.05). The reliability of the instrument was evaluated in a cohort of 122 persons aged 60 years and over. Internal reliability of six subscales was high (Cronbach's alpha, 0.70-0.83) and test-retest reliability (intraclass correlation coefficient, 0.42-0.77) demonstrated stability. Validity was examined using longitudinal data from the 60 years and over cohort where the OHIP's capacity to detect previously observed associations with perceived need for a dental visit (ANOVA, p < 0.05 in five subscales) provided evidence of its construct validity. The Oral Health Impact Profile offers a reliable and valid instrument for detailed measurement of the social impact of oral disorders and has potential benefits for clinical decision-making and research.

Adolescent↗
PubMed1993

Oral health status and treatment needs of non-institutionalized persons aged 60+ in Adelaide, South Australia.

There has been a growing recognition of the need to obtain information about the oral health of older Australians. The aim of this report is to provide descriptive epidemiological information about the oral health and treatment needs of non-institutionalized older adults in Adelaide. Data from interviews with 178 persons aged 60+ were obtained from a pilot study. Clinical data were available for 106 persons who participated in oral examinations. Among the 52.9 per cent of dentate persons, the prevalence of root decay (27.1 per cent) was slightly higher than coronal decay (23.6 per cent). Some 28.1 per cent of dentate persons had a serious periodontal condition, defined as the presence of four or more teeth with at least 5 mm or more of periodontal attachment loss and periodontal pocketing of 4 mm or more at one or more of those teeth. The majority of persons (83.8 per cent) wore one or two dentures. Disorders associated with dentures were frequent, affecting 77.4 per cent of upper denture wearers and 72.5 per cent of lower denture wearers. Persons who were older, who had lower educational attainment or lower household incomes were disadvantaged in aspects of oral health status and dental caries. However, there were no consistent associations between chronic medical conditions and oral disorders. Despite the high prevalence of oral impairment, reflecting extensive disease activity in the past, high levels of untreated disease were relatively uncommon. Instead, a high prevalence of oral disorders created a substantial need for basic forms of dental treatment in this group.

Aged↗
PubMed1990

Differences in oral health status between institutionalized and non-institutionalized older adults.

Differences in oral health status between independent and institutionalized adults have been difficult to interpret because the latter population is typically older and has a higher proportion of women, confounding any association between institutionalization and disease levels. We undertook an analysis of oral disease amongst institutionalized (n = 149) and non-institutionalized (n = 246) samples of older adults randomly selected from the population in East York, Ontario. When the confounding effects of age and gender were controlled by constructing 67 matched pairs, institutionalized people were more than twice as likely to be edentulous (OR = 2.17, 95% CI = 1.09-4.29). This association was confirmed using data from all subjects in a logistic regression model. Analysis of covariance of data from dentate subjects revealed that the institutionalized seniors had fewer filled teeth (P less than 0.05, controlling for age and sex), but there were no statistically significant differences in the number of teeth which were missing, decayed, or requiring extraction. These findings suggest that antecedent, sociodemographic factors prior to institutionalization are responsible for the higher probability of oral disease in this group of older adults.

Age Factors↗
PubMed1989

Prevalence of and factors associated with root decay in older adults in Canada.

We collected data on the oral health status and treatment needs of a random sample of persons aged 50 years and over. Data on root decay were obtained from the 183 subjects who were dentate. All remaining teeth were examined for root decay and restorations, whether root surfaces were affected by recession or not. Analysis was undertaken by case and root surface, with separate analyses of decayed (DS), and decayed and filled (DFS) root surfaces. One or more root surfaces with untreated decay were found in 37.2% of subjects, while one or more decayed or filled root surfaces were found in 56.8%. The mean number of decayed surfaces was 1.3 per person, and the mean number of decayed and filled root surfaces was 2.6. Multiple and logistic regression analyses showed that oral health variables were more important predictors of the presence and severity of root decay than demographic, general health, or dental care factors.

Age Factors↗
PubMedDate not supplied

The oral health status and treatment needs of adults aged 65+ living independently in Ottawa-Carleton.

We report the findings from a dental survey of a random sample of 299 senior citizens living in Ottawa-Carleton. Those examined were younger, less likely to have a regular dentist, and more likely to have oro-facial pain, difficulty chewing, and to perceive a need to visit a dentist compared with those responding to the enrollment phone interview. Among the 65% of seniors who were dentate, 37% had dental decay; men and seniors with low incomes had more decay (p less than 0.05). Periodontal disease was worse among older seniors, men and poor seniors (p less than 0.05). One third of all seniors reported recent oro-facial pain, 50% had difficulty chewing foods and 30% reported some social impact resulting from their oral health. The resources required to treat the prevalent disorders were considerable and differences between dentate and edentulous people were negligible. Senior citizens expressed attitudes which indicate that they value dental health and would like help to achieve it.

Aged↗