Biomedical subjects

Gregg H Gilbert

Publications and source records attributed to Gregg H Gilbert.

42 records · Page 3Linked to original sources

PubMed2002

Comparison of two methods of estimating 48-month tooth loss incidence.

OBJECTIVES: This paper quantifies validity of self-reported tooth loss, compares incidence using two methods (semiannual self-report, biannual clinical examination), and compares conclusions about risk factors for tooth loss using these two methods. METHODS: The Florida Dental Care Study included persons who at baseline had at least one tooth. In-person interviews and clinical examinations were conducted at baseline, 24 months, and 48 months, with semiannual telephone interviews in between. RESULTS: Agreement between self-reported and clinically derived tooth loss was high, although some statistically significant differences by certain baseline characteristics were evident. On a nominal scale (some tooth loss, none), kappa was 0.88 and percent concordance was 94 percent. On a ratio scale, Spearman's correlation was 0.90. Using self-report, the incidence estimate would have been 34 percent, as compared to 36 percent based on clinical examination. In a single bivariate (loss by self-report, loss by clinical examination) multiple logistic regression, conclusions about statistical significance and magnitude of seven risk factors for tooth loss did not differ. CONCLUSIONS: Validity of self-reported incidence was excellent. The self-reported method allowed for semiannual estimates and was less resource intensive. Substantive conclusions about tooth loss using either method were similar, although validity did differ between persons with certain baseline characteristics.

Analysis of Variance↗

PubMed2002

Predictors of chewing difficulty onset among dentate adults: 24-month incidence.

OBJECTIVES: Chewing ability is an important measure of health-related quality of life, yet few studies have examined predictors of chewing difficulty in community-based samples. This study describes longitudinal patterns of chewing difficulty and identifies predictors of chewing difficulty onset. METHODS: The Florida Dental Care Study (FDCS) was a longitudinal study of oral health and related behaviors. Interviews and a clinical exam were conducted with a sample that included persons who had at least one tooth and were aged 45 years or older (n = 873). The five-item chewing index of Leake (1990), with minor revision, was the outcome of interest. RESULTS: Approximately 21 percent of baseline participants reported chewing difficulty and about 34 percent reported difficulty during the study. Having infected or sore gums, loose tooth, loose crown or bridge, toothache pain, lower numbers of opposing pairs of teeth, dry mouth, and being female were significant predictors of incident chewing difficulty. CONCLUSIONS: Self-reported oral disease and tissue damage and toothache pain were strong predictors of decline in chewing ability. Additionally, women were identified as a high-risk group for incident chewing difficulty. Future research should elaborate further the pathways through which these factors affect oral function.

Aged↗

PubMed2002

Predicting tooth loss during a population-based study: role of attachment level in the presence of other dental conditions.

BACKGROUND: Our objectives were to quantify: 1) the association between incident tooth loss and prior periodontal attachment level; and 2) the contribution to tooth loss made by non-periodontal conditions in increasingly periodontally involved teeth. METHODS: The Florida Dental Care Study was a prospective cohort study of persons who at baseline had at least 1 tooth and were 45 years or older. In-person interviews and clinical examinations were conducted at baseline, and at 24 and 48 months, with telephone interviews at 6-month intervals in between. A regression model was used to simultaneously quantify tooth-specific predictors of tooth loss, with person-level factors taken into account. RESULTS: Of the 687 persons who participated for a 48-month clinical examination, 36% lost 1 or more teeth during follow-up, and 5.0% of all teeth were lost. Attachment level up to 2 years before tooth loss was strongly predictive of incident tooth loss, with increases in risk for each millimeter in attachment loss. Certain other tooth-specific conditions (tooth mobility, bulk restoration fracture, decayed surfaces, filled surfaces, tooth type and arch location, root fragment) were strongly and independently associated with increased risk for tooth loss, while others were not (prosthetic crown coverage, cusp fracture, root surface defect). Propensity to choose extraction over other treatment alternatives, as reported by participants at baseline, was also strongly predictive of tooth loss. CONCLUSIONS: Increasingly severe attachment level was consistently associated with an increased risk for tooth loss in this sociodemographically diverse sample, with or without other tooth-specific conditions taken into account.

Aged↗

PubMed2001

Orofacial pain symptoms: an interaction between age and sex.

This study investigated sex and age cohort differences in the subjective report of orofacial pain symptoms in a stratified sample of community dwelling adults. The subjects were 724 participants in the Florida Dental Care Study, a longitudinal study of oral health among dentate adults, age 45 and older at baseline. Pain prevalence and subjective ratings were assessed for a range of orofacial pain sites using a standardized telephone interview. The results suggest that the 6-month prevalence of jaw joint pain (8.3%), face pain (3.1%), toothache pain (12.0%), painful oral sores (15.6%), and burning mouth (1.6%) found in the FDCS sample are similar to United States population estimates. In addition, prevalence for pain when chewing and temperature sensitivity were also reported as 23% and 24% respectively, suggesting that these two seldom documented painful experiences are common. Female respondents reported higher 6-month prevalence for multiple symptoms and painful oral sores, with trends also observed for female sex as a risk factor for jaw joint pain and face pain, whereas males were more likely to report temperature sensitivity. A higher percentage of females rated their pain as severe enough to impact behavior for jaw joint pain, toothache pain, and painful oral sores. Few overall age effects were found, with the exception of higher prevalence of temperature sensitivity and pain when chewing in the 45--64-year-old group, compared to respondents in the 65+ age cohort. However, the most interesting finding was that when sex by age cohort comparisons were made, with the exception of painful oral sores, all significant differences in pain ratings were found within the 45--64-year-old cohort and not the 65+ group. This finding clarified inconsistencies found in earlier studies in the orofacial pain literature where sex differences in pain ratings were found in several adult samples of a wide range of ages but not in a sample of older adults.

Adult↗

PubMedDate not supplied

A prospective study of the validity of self-reported use of specific types of dental services.

OBJECTIVE: The purpose of this study was to quantify the validity of self-reported receipt of dental services in 10 categories, using information from dental charts as the "gold standard." METHODS: The Florida Dental Care Study was a prospective cohort study of a diverse sample of adults. In-person interviews were conducted at baseline and at 24 and 48 months following baseline, with telephone interviews at six-month intervals in between. Participants reported new dental visits, reason(s) for the visit(s), and specific service(s) received. For the present study, self-reported data were compared with data from patients' dental charts. RESULTS: Percent concordance between self-report and dental charts ranged from 82% to 100%, while Kappa values ranged from 0.33 to 0.91. Bivariate multiple logistic regressions were performed for each of the service categories, with two outcomes: self-reported service receipt and service receipt determined from the dental chart. Parameter estimate intervals overlapped for each of the four hypothesized predictors of service receipt (age group, sex, "race" defined as non-Hispanic African American vs. non-Hispanic white, and annual household income < 20,000 US dollars vs. > or = 20,000 US dollars), although for five of the 10 service categories, there were differences in conclusions about statistical significance for certain predictors. CONCLUSIONS: The validity of self-reported use of dental services ranged from poor to excellent, depending upon the service type. Regression estimates using either the self-reported or chart-validated measure yielded similar results overall, but conclusions about key predictors of service use differed in some instances. Self-reported dental service use is valid for some, but not all, service types.

Black or African American↗

PubMedDate not supplied

Orofacial pain: patient satisfaction and delay of urgent care.

OBJECTIVE: Accomplishing the Healthy People 2010 goal of eliminating disparities in oral disease will require a better understanding of the patterns of health care associated with orofacial pain. This study examined factors associated with pain-related acute oral health care. METHODS: The authors used data on 698 participants in the Florida Dental Care Study, a study of oral health among dentate adults aged 45 years and older at baseline. RESULTS: Fifteen percent of the respondents reported having had at least one dental visit as the result of orofacial pain. The majority of the respondents reportedly delayed contacting a dentist for at least one day; however, there was no difference between respondents reporting pain as the initiating symptom and those with other problems. Once respondents decided that dental services were needed, those with a painful symptom were nearly twice as likely as those without pain to want to be seen immediately. Rural adults were more likely than urban adults to report having received urgent dental care for a painful symptom. When orofacial pain occurred, those who identified as non-Hispanic African American were more likely than those who identified as non-Hispanic white to delay care rather than to seek treatment immediately, and women were more likely then men. Having a pain-related oral problem was associated with significantly less satisfaction with the services provided; non-Hispanic African American respondents were less likely than non-Hispanic white respondents to report being very satisfied, and rural residents were less likely than urban residents. Furthermore, men were more likely than women to suffer with orofacial pain without receiving either scheduled dental care or an urgent visit. CONCLUSIONS: Barriers to care are complex and likely to be interactive, but must be understood before the goals of Healthy People 2010 can be accomplished.

Black or African American↗