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Biomedical subjects

H Löe

Publications and source records attributed to H Löe.

At least 19 recordsLinked to original sources
PubMed1995

The natural history of periodontal disease. The correlation of selected microbiological parameters with disease severity in Sri Lankan tea workers.

The purpose of this study was to assess the prevalence of A. actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia, and their association with periodontal disease states in a population sample from Sri Lanka. Based on clinical parameters, a total of 536 sites in 268 male Sri Lankan tea workers were categorized as healthy, or showing gingivitis only, moderate or advanced periodontitis. Bacterial samples were obtained from all sites and the three target bacteria identified by indirect immunofluorescence. P. intermedia, P. gingivalis and A. actinomycetemcomitans were found in 76%, 40% and 15% of the subjects, respectively. Of the 536 periodontal sites, 10.5% were categorized with "no disease", 14% "gingivitis only": 59% with moderate and 16% with advanced periodontitis. The prevalence of P. gingivalis and P. intermedia was significantly higher in sites with moderate and advanced periodontitis than in sites with no disease or gingivitis only. A. actinomycetemcomitans was not found in healthy sites, but occurred with equal frequency in sites with gingivitis, moderate and advanced periodontitis. The association between these three bacteria and periodontal diseases in Sri Lankan tea laborers was similar to that described for other non-industrialized and industrialized countries.

Adolescent↗
PubMed1995

Changing paradigms in restorative dentistry.

Dramatic improvements in oral health have occurred during the last twenty years. Success is most noticeable in children and young adults, but also extends to the general population. The impact from declining disease rates, improved restorative materials and techniques, new diagnostics and treatments, a broad array of preventives, and better ways to deliver products and services to the public are demonstrated in the decline in the number of restorative procedures performed each year, including a 40% decline in the use of amalgam over the last eleven years. The new paradigm for restorative dentistry calls for an increasingly conservative approach to treatment. The question now is not primarily whether amalgam, composite, or any other material will fill a cavity. The real issue is to make the distinction between caries as a disease and caries as a lesion. Treating caries as a disease requires a new approach to patient management. A diagnosis of caries requires that a patient risk profile be established. We can no longer be limited in our efforts to merely restore the individual tooth surface. This paper discusses the need to cure disease and restore the total integrity of our patients' oral health.

Adolescent↗
PubMed1992

The natural history of periodontal disease in man: prevalence, severity, and extent of gingival recession.

This paper describes the occurrence and levels of gingival recession in 2 cohorts of individuals participating in parallel longitudinal studies in Norway (1969-1988) and Sri Lanka (1970-1990), covering the age range from 15 to 50 years. In the Norwegian cohort gingival recession had begun early in life. It occurred in greater than or equal to 60% of the 20 year-olds and was confined to the buccal surfaces. At 30, greater than or equal to 70% had recession, which still was found mainly on buccal surfaces. As the group approached 50 years of age, more than 90% had gingival recession; greater than or equal to 25% of the buccal surfaces were involved, greater than or equal to 15% of lingual, and 3 to 4% of the interproximal surfaces. In the Sri Lankan cohort greater than or equal to 30% exhibited gingival recession before the age of 20 years. By 30 years, 90% had recession on buccal, lingual, and interproximal surfaces; and at 40 years, 100% of the Sri Lankans had recession. As they approached 50 years, gingival recession occurred in greater than or equal to 70% of the buccal, greater than or equal to 50% of the lingual, and 40% of the interproximal surfaces. Based on the special features of the two cohorts, the working hypothesis is advanced that there is more than one type of gingival recession and probably several factors determining the initiation and development of these lesions.

Age Factors↗
PubMed1991

The natural history and clinical course of calculus formation in man.

This paper describes levels and progression of supra- and subgingival calculus undisturbed by active professional intervention or home care between 1970 and 1985 in Sri Lanka, or when removed at regular intervals between 1969 and 1988 in Norway. In the Sri Lankan tea laborers, both supra- and subgingival calculus formation started before age 14 years. At 40 years of age, all participants and almost all teeth and tooth surfaces had calculus. Tea laborers who both smoked tobacco and chewed betel had significantly higher calculus scores than those who only had one of these habits, and those who neither chewed nor smoked had the lowest calculus scores. Teeth with calculus showed a significantly higher rate of loss of attachment than teeth that remained calculus free. For the Norwegians who had enjoyed regular dental care throughout their lives, supragingival calculus did not increase in frequency from adolescence to the forties. Approximately 70% of the interproximal surfaces were calculus free after 40-50 years of age. Subgingival calculus scores, although low, showed some increase with longer times of exposure. On average, each person had 0.4 interproximal surfaces with subgingival calculus as they approached 50 years of age. In this Norwegian population, subgingival calculus had no impact on loss of attachment.

Adolescent↗
PubMed1991

Early onset periodontitis in the United States of America.

A National Survey of the Oral Health of U.S. children aged 5 to 17 was conducted by the National Institute of Dental Research during the 1986-87 school year. Eleven thousand and seven adolescents aged 14 to 17 years received a periodontal assessment. Their patterns of loss of periodontal attachment as assessed by probing at mesial sites were used to classify adolescents as cases of early onset periodontitis. Approximately 0.53% of adolescents nation-wide were estimated to have localized juvenile periodontitis (LJP), 0.13% to have generalized juvenile periodontitis (GJP), and 1.61% to have incidental loss of attachment (LA) (greater than or equal to 3 mm on 1 or more teeth). The total number of adolescents affected were not trivial. Close to 70,000 adolescents in the U.S. were estimated to have LJP in 1986-87. More destructive GJP affected an estimated 17,000 adolescents. Another 212,000 adolescents were estimated to have incidental LA. Blacks were at much greater risk for all forms of early onset periodontitis than whites. Males were clearly more likely (4.3 to 1) to have GJP than females when other variables were statistically controlled. Gender associations were more complicated for LJP because gender interacted with race. Black males were 2.9 times as likely to have LJP as black females. In contrast, white females were more likely than white males to have the disease by about the same odds. When interactions among demographic variables exist, caution must be taken in comparing results from different studies.

Adolescent↗
PubMed1991

Errors in measuring parameters associated with periodontal health and disease.

The intra-examiner reliability for the Plaque Index (PII), Calculus Index (CI), Gingival Index (GI), and periodontal loss of attachment (LA) was evaluated in 2 different physical and clinical environments. Examiner reliability for each index was consistently better when clinical evaluations were performed in an office setting on subjects who had low levels of periodontal disease than under more difficult field conditions evaluating subjects with higher disease levels. In an office environment intra-examiner reliabilities were very good for subject-based averages (intraclass r's were 0.85, 0.83, 0.81, and 0.78 for GI, PII, LA, and CI, respectively); they were moderate to good for site-based scores (kappas were 0.63, 0.54, and 0.47 for CI, GI, and PII). Under field conditions reliabilities ranged from excellent to fair for subject-based averages (intraclass r's of 0.98, 0.86, 0.76, and 0.33 for LA, CI, GI, and PII, respectively); for site-based scores they ranged from moderate to fair (kappas of 0.50, 0.49, and 0.21 for GI, CI, and PII, respectively). Small but significant systematic errors were detected under field conditions for the PII and CI, and for the PII in the office environment as well. The results observed suggest that the examination process can affect the clinical status of the surface or site when replicate assessments of plaque and calculus are conducted within a 24-hour period. Our results also confirm that measurement error standard deviation for loss of attachment evaluated with a periodontal probe can be maintained at 0.13 mm for whole-mouth means and 0.54 mm for individual sites, even when examining subjects with substantial periodontal disease under field conditions.

Analysis of Variance↗
PubMed1990

Teeth for life: oral disease prevention in research and practice.

All branches of dentistry have benefited in recent years from the rapid advances made in scientific research. Caries has been reduced in industrialized countries thanks to the combined efforts of epidemiologists, chemists, experimental and clinical scientists, identifying fluoride and refining fissure sealants. Genetic engineering may be pointing the way towards a possible caries vaccine as well as enhancing regimens against periodontal diseases. In addition research has provided advances in preventing and treating soft-tissue pathologies. Over the next 20 years a research and action programme aims to eliminate toothlessness in the USA.

Adolescent↗
PubMed1989

Forty years of progress.

The celebration of the 40th anniversary of the National Institute of Dental Research (NIDR) provides an opportunity for reviewing the growth of dental research over the decades. The Institute owes its origin to public and professional concern over the dental health of Americans and the prospect that a Federal investment in dental research could pay off. The early years of the Institute were devoted to studies of fluoride and dental caries, with notable achievements in clinical trials of water fluoridation and caries microbiology. During the 1960s came the discovery that the periodontal diseases, like dental caries, were bacterial infections that could be prevented. Basic and clinical research expanded, and the research manpower pool grew with the addition of microbiologists, immunologists, salivary gland investigators, and other basic biomedical and behavioral scientists. The Institute created special broad-based Dental Research Institutes and Centers to foster interdisciplinary research, and continued to expand its research base. A national survey undertaken by NIDR in the late 1970s showed major declines in caries prevalence in schoolchildren. Recent NIDR surveys of adults and older Americans as well as a second children's survey have demonstrated overall improvements in oral health and a continued decline in childhood caries.(ABSTRACT TRUNCATED AT 250 WORDS)

History of Dentistry↗
PubMed1989

Periodontal diseases in the U.S. in 1981: prevalence, severity, extent, and role in tooth mortality.

Prevalence, severity, and extent of periodontal diseases as well as the role of periodontal diseases in tooth mortality are described for persons 19 years and older in the U.S. in 1981. The data were collected with a household probability sample of non-institutionalized persons living in the contiguous 48 states. Plaque and calculus scores were collected for six index teeth. All permanent teeth present and capable of being assessed were scored for gingivitis; pocket depths were measured on the mesial of each tooth with a periodontal probe. Examinations were conducted by trained dentists calibrated on specific criteria. Only 15% of persons in the U.S. in 1981 were free from any sign of periodontal diseases. Periodontitis (pockets greater than or equal to 4 mm) affected approximately 36% of the population. Advanced periodontitis (pockets greater than or equal to 6 mm) was present in 8% of the population and was usually found on only one or two teeth when present. End-stage periodontal destruction requiring extraction of teeth was found in only 4% of all persons while less than 20% of all missing teeth were listed as missing due to periodontal disease.

Adult↗
PubMed1989

An estimate of periodontal treatment needs in the U.S. based on epidemiologic data.

It has generally been assumed, based on previous epidemiologic and utilization studies as well as the increasing elderly population, that there would be an increasing need for periodontal treatment. Analysis of a more recent household epidemiologic survey conducted in 1981 indicates that the need for treatment of periodontitis is less than previous estimates. These epidemiologic data have been translated into treatment needs through a series of conversion rules derived from previous studies and current patterns of treatment, and applied to the 1985 U.S. population. The total periodontal services needed for scaling, surgery, and prophylaxes would require 120 to 133 million hours and $5 to $6 billion annually if the total population were treated for periodontitis over a 4-year period. Only 11% of the total hours needed would be for scaling and surgery whereas 89% would be needed for prophylaxes. Expenditures for periodontal treatment total approximately 10% of the amount being spent on dental care in 1985. On the basis of these data, it seems unlikely that there will be a substantial increase in the need for periodontal treatment in a growing and aging U.S. population. These figures represent the upper limits of treatment need and are reduced by factoring in current utilization of periodontal treatment.

Adult↗