Biomedical subjects

J A Kieft

Publications and source records attributed to J A Kieft.

17 recordsLinked to original sources

PubMed2003

Approximal caries increment: a three-year longitudinal radiographic study.

AIM: To determine, for different age groups, the approximal caries increment in a three-year longitudinal retrospective study and to investigate the relationship between the caries increment and self-reported measures for oral health behaviour, dental knowledge and attitude (cynicism, health concern and motivation). SUBJECTS: 14, 17, 20 and 23-year-olds, who participated in a clinical epidemiological survey. Bitewings were taken of approximately 52% of the participants. Longitudinally, three cohorts were followed radiographically for three years. The self-reported measures were derived from questionnaires with sufficient reliability. RESULTS: For all participants, on average, 3.7 enamel lesions and 1.2 dentine lesions were found. The number of sound surfaces, adequate restorations and the D1FS score showed significant differences over a three-year period, for all age groups. Stepwise regression analysis showed that for the explanation of the change in number of sound surfaces, number of enamel lesions and D1S between the age of 17 and 20, the variable 'health concern' contributed significantly to the regression. The change in D3FS score was explained by the variable 'behaviour', while the change in D1Fs score was explained by both 'behaviour' and 'health concern'. Neither of the dental variables, 'dental knowledge' or 'motivation' contributed significantly. For the ages 14-17 and 20-23 no significant contributions were found. CONCLUSIONS: A considerable caries increment was found in this three-year retrospective radiographic study, which was not related to dental knowledge and motivation, and only for one age group (17-20) to oral health behaviour and health concern.

Adolescent↗

PubMed2002

Radiographic prevalence of approximal enamel lesions and relationship with dentine lesions and restorations in Dutch adolescents.

AIM: The aim of this study was to assess the prevalence of approximal enamel lesions from radiographs in groups of 14, 17, 20 and 23 years old, and to determine the relation with dentine lesions and restorations present. METHOD: Per age group, the bitewings of 120 persons were randomly selected and assessed for enamel lesions from the distal surface of the first premolar to the mesial surface of the second molar. A second examiner assessed 20% of the material for enamel lesions to determine the interexaminer agreement (Cohen's kappa = 0.63). RESULTS: An enamel lesion was found in 12-15% of the unfilled surfaces. The mean number of surfaces with enamel lesions was almost three per person. For all age groups it was found that about 20% of the persons had at least four enamel lesions and the number of enamel lesions was significantly correlated with the number of dentine lesions. Of all enamel lesions 20% were found in persons without any dentinal lesions or restorations. CONCLUSION: The bitewing radiographs showed a considerable number of enamel lesions for these age groups. This seems to justify its use on a routine base as a diagnostic tool at the age of 14-16 years.

Adolescent↗

PubMed2002

[Clinical underestimation of the prevalence of approximal dentin lesions and inadequate restorations].

The aim of this study was to determine the additional diagnostic value of bitewing radiographs compared to clinical examination, with respect to the presence of dentine lesions and inadequate restorations for different age groups. Subjects were 14-, 17-, 20-, 23-years-old, or were in the age groups of 25-34 and 35-54 years, who participated in 2 clinical epidemiological surveys. After obtaining informed consent, bitewing radiographs were made of approximately 25% of the participants (n = 663). The extra diagnostic yield of the bitewing radiographs varied between a factor 1.6 and 7.2 for approximal dentine caries diagnosis of untreated surfaces, and between 2.3 and 5.9 for inadequate restorations. In conclusion, a considerable increase in the numbers of approximal dentinal lesions and inadequate restorations for all age groups was found.

Adolescent↗

PubMed2002

[Oral health care in young people insured by a health insurance fund. 2. Prevalence and treatment of malocclusions in the Netherlands between 1987-1999].

In this paper data are presented about malposition of teeth in 5-, 11-, 17- and 23-year-olds in the time period between 1987-1999. Furthermore, results are shown of a longitudinal study in youngsters 11-17-years of age of whom some were and others were not treated orthodontically. Between 1987 and 1999, the percentage of youngsters who received orthodontic treatment increased from 23% to 40%. In the same time period the percentage of youngsters 17- and 23-year-olds with a malposition of teeth decreased. In youngsters involved in the longitudinal study and treated orthodontically, a strong improvement of the tooth position was found between the age of 11 and 17. Such an improvement did not appear in the non-treated group. The outcomes are considered as an indication that orthodontic treatments have positive effects on individual and on population level.

Adolescent↗

PubMed2002

[Differences in the assessment of restorative dental care].

Caries diagnosis and assessment of restorations show a considerable variation between examiners. It can therefore be questioned whether a professional standard is available on this topic. In this study the judgement of general dental practitioners of the quality of restorative care and the number of adequately and inadequately treated teeth was compared to the judgement of dentists working in teaching institutes. Thirty general dental practitioners and 7 university dentists assessed occlusal photographs and bitewing radiographs of 20 patients with respect to the presence of caries and the quality of restorations. The general dental practitioners gave lower scores on a traditional schoolmark scale than the university dentists, but the latter scored more homogeneous. The agreement (Cohen's kappa) between pairs of examiners was similar for GDPs and experts. The expert group tended to have a more conservative attitude towards the level of restorative treatment to be judged. A univocal professional standard with respect to caries diagnosis and restoration assessment seems difficult to establish.

Clinical Competence↗

PubMed2001

[Prevalence of approximal enamel lesions on bitewing radiographs in cohorts, ages 14 to 23 years].

Bitewing radiographs are mainly used to detect carious lesions in the approximal tooth surfaces, and are an indispensable aid to clinical diagnosis. The aim of this study was to assess the prevalence of approximal enamel lesions from radiographs in groups of 14-, 17-, 20- and 23-years-old persons, and to determine the relation with dentine lesions and restorations present. Per age group the bitewings of 120 persons were randomly selected and assessed for enamel lesions from the distal surface of the first premolar to the mesial surface of the second molar. A second examiner assessed for enamel lesions 20% of the material to measure the interexaminer agreement (Cohen's kappa = 0.63). An enamel lesion was found in about 12 to 15% of the unfilled surfaces. The mean number of enamel lesions was almost three per person. For all age groups it was found that about 20% of the persons had at least 4 enamel lesions and the number of enamel lesions was significantly correlated with the number of dentine lesions. Of all enamel lesions 20% was found in persons without any dentinal lesions or restorations. The bitewing radiographs showed a considerable amount of enamel lesions for these age groups. This seems to justify its use on a routine base as a diagnostic tool at the age of 14-16 years.

Adolescent↗

PubMed2001

[Satisfied patients?].

This paper examines the difficult question how satisfied patients are with dental services. Scientific research shows that this is hard to measure. Five issues affect dental satisfaction, of which interpersonal and psychosocial factors are reported as being among the most important factors. Two case reports of dissatisfied patients are presented. It is emphasized that adequate counseling skills of the dentist, his evaluation of the expectations and wishes of the patient at the beginning of the treatment, and a sound dental, medical and psychosocial anamnesis are crucial for preventing dental dissatisfaction among patients.

Dentist-Patient Relations↗

PubMed1997

[Variations among dentists in the diagnosis of caries and assessment of dental restorations].

It is well-known that dentists differ in judgement when confronted with the same clinical situation. To study this phenomenon, 2 groups of 5 general dental practitioners have assessed the material of 20 patients, each consisting of a set of 2 bite wing radiographs and 2 photographs of the (pre)molar region. The teeth were examined for caries and the quality of the restorations, supported by a protocol which was mailed in advance. The examiner variability was expressed as Cohen's kappa, calculated per pair of GDPs and subsequently averaged per group. The interexaminer agreement was fair for the diagnosis of caries and was highest for the assessment of approximal caries on the bite wing radiograph. The agreement with respect to the quality assessment of dental restorations proved to be poor on average. The intra-examiner agreement varied widely between examiners. No difference could be established between the groups. It can be concluded that, without training and calibration, a sufficient inter- and intra-examiner agreement among GDPs is difficult to reach. Consequently, a substantial variation is found in the individual GDP's restorative treatment planning.

Clinical Competence↗

PubMed1996

Changes in caries prevalence in children and young adults of Dutch and Turkish or Moroccan origin in The Netherlands between 1987 and 1993.

In 1987, an epidemiological study was started with the aim to evaluate the development of dental health in young people insured by "Health Insurance Funds'. In The Netherlands, insurance by such funds is compulsory for individuals earning less than some income criterion (in 1995 59,000 Dutch florins) and their families, together approximately 60% of the Dutch population. Dental health care is included in the insurance. Caries data were obtained in subjects aged 5-23 years in 1987, 1990 and 1993. Mean DMFS scores of groups aged 11, 17 or 23 years in 1993 were about 40% lower than in 1987. No significant differences in mean number of dmfs of 5-year-olds in 1987 and 1993 could be observed. A breakdown by country of birth of the mother showed that the difference between indigenous Dutch juveniles and juveniles of Turkish or Moroccan origin depended on year of birth. Caries prevalence of Turkish or Moroccan children born in 1982 or later was higher than that of Dutch children of equal age; no significant difference in DMFS could be demonstrated between ethnic categories in juveniles born in 1976. In cohorts born before 1976, DMFS scores of Turkish/Moroccan juveniles were much lower than those of Dutch juveniles. It is suggested that these opposite trends were caused by the fact that subjects in the youngest cohorts had been born in The Netherlands, while the oldest cohorts spent the first years of their life in those parts of Turkey or Morocco where caries prevalence of children is low. Between 1987 and 1993 caries prevalence in 5-year-old children of Turkish or Moroccan origin decreased significantly.

Adolescent↗

PubMed1993

[Quality assurance in dentistry].

An important subject regarding the quality of dental care is the development of a system of quality assurance. This system should be focused on preservation and improvement of the quality of dentistry. Activities like peer review, continuing dental education, (re-)registration and professional specialization could make a major contribution to the establishment of such a system.

Dentistry↗

PubMed1992

Clinically undetected occlusal dentine caries: a radiographic comparison.

The occlusal bite-wing radiograph evaluations of 131 14-year-old and of 123 17- and 20-year-old Dutch persons were compared with the clinically collected observations. The clinical observations and the bite-wing radiographs were collected as part of a longitudinal epidemiological survey conducted in 1987 and 1990. Comparison of the evaluations of the first and second molar teeth showed significantly more radiolucencies in all three age groups than expected clinically. Of the clinically judged 'sound' surfaces, 26% in the 14-, 37.5% in the 17- and 50% in the 20-year-old group showed a radiolucency on the bite-wing radiograph. In the 14-, 17- and 20-year-old age group a radiolucency was noticed on the bite-wing radiograph in 32, 44 and 58% of the sealed teeth, respectively. The radiolucencies below the occlusal enamel of sealed teeth were most likely due to the problems in diagnosing occlusal dentine lesions correctly with the clinical diagnostic methods. Therefore not only approximal but also occlusal bite-wing radiograph judgement before sealant application seems to be advisable now. Because of the numbers of clinically undetected lesions it may be advisable to reconsider the criteria for occlusal diagnosis in epidemiological surveys and to judge not only the approximal but also the occlusal surfaces in epidemiological surveys when bite-wing radiographs are available.

Adolescent↗

PubMed1986