Biomedical subjects

J M Brodeur

Publications and source records attributed to J M Brodeur.

At least 19 recordsLinked to original sources

PubMed2001

Oral functional characteristics and gastrointestinal pathology: an epidemiological approach.

One of the main problems for aged people is that of having a balanced diet, improved by correct conditioning of the alimentary bolus. Does the masticatory status influence the appearance of gastrointestinal disorders? Such a question justifies the present study. The present work concerned all the patients (211) of eight geriatric institutions, and was completed by a retrospective approach (case-control study). The main result brought by the case-control study, showed that poor oral functional characteristics represent a risk for gastrointestinal pathology (age being neutralized; odds ratio (OR): 2.62). This result indicates that the loss of teeth must be compensated by functionally effective dentures. Not only will the patients' physical and psychic health improve but also medical and public health problems will be solved.

Adult↗

PubMed2001

Periodontal diseases among Quebec adults aged 35 to 44 years.

BACKGROUND: Very little information is available on periodontal diseases in Canadian adults. The purpose of this study was to estimate the prevalence of periodontal problems in Quebec adults aged 35 to 44. METHODS: A total of 2,110 randomly selected Quebec adults were examined between September 1994 and July 1995. The participation rate was 77% for the questionnaire and 44.5% for the oral examination. Measurements for gingival bleeding, calculus, epithelial attachment and periodontal pocket depths were taken for each tooth. RESULTS: More than 80% of examined persons presented with gingival bleeding on at least one tooth, and 75% presented with calculus on at least one tooth. The CPITN indicated that only 5.2% of individuals had no treatment needs, and that one out of 5 necessitated complex treatment. People with low family income, men and persons living in metropolitan areas are at higher risk of having at least one tooth with a pocket >6 mm. Dental health behaviours (regular dental visits, brushing and flossing frequency) were not significantly associated with the presence of periodontal pockets. Finally, individuals were relatively unaware of their periodontal problems. CONCLUSION: Increasing the population s awareness of periodontal diseases will be a major task for public health workers. The dental profession and the dental industry need to develop awareness campaigns to improve prevention, management and control of periodontal problems. It is especially important to target people at risk, in particular men and low-income groups. As well, dental schools and continuing education courses should focus on this problem with the aim of modifying dental practices.

Adult↗

PubMed2000

Community periodontal index of treatment needs and prevalence of periodontal conditions.

BACKGROUND/AIMS: In 1977, the World Health Organization (WHO) proposed a new index, the community periodontal index of treatment needs (CPITN) to evaluate the periodontal treatment needs of populations. The aim of this study is to compare different approaches of recording and presenting the CPITN. METHODS: A sample of 2110 subjects aged 35-44 years were examined between September 1994 and July 1995, throughout the province of Quebec, Canada. For each tooth (3rd molars excluded), the presence of bleeding and calculus, the level of epithelial attachment, and the depth of periodontal pockets were measured. Periodontal pocket depths were measured from the edge of the free gingiva, at 2 sites (mesiovestibular and vestibular), as well as all around the tooth. RESULTS: Only 8.5% of adults had at least one tooth with a 6 mm or deeper periodontal pocket when probing on 2 sites, whereas if probing is done all around the tooth, this percentage is 2.5x higher (21.4%). The partial recording of pocket depths (10 index teeth recommended by WHO, or 2 quadrants chosen at random) resulted in an underestimation of the prevalence of subjects with at least one tooth with a periodontal pocket (CPITN score 3 and 4). Among subjects with at least one tooth with a 6 mm or deeper periodontal pocket, 12% were not detected with the 10 index teeth recording, and 25% go undetected with the measure on 2 quadrants. Finally, using the % of subjects with periodontal pockets overestimates the prevalence of deep pockets compared with using sextants. Indeed, close to 30.0% of sextants have no treatment needs, whereas only 5.2% of subjects are in this category. Similarly, 7.7% of sextants have at least one tooth with a 6 mm or deeper periodontal pocket, yet there are 3x more subjects in this category (21.4%).

Adult↗

PubMed2000

[The Edinburgh Postnatal Depression Scale: the validity of its Quebec version for a population low socioeconomic status mothers].

This paper investigates the construct validity and reliability of a Quebec version of the Edinburgh Postnatal Depression Scale (EPDS) for a population of low-socioeconomic-status mothers. This scale was constructed for the specific purpose of measuring mothers' symptoms of depression during the postnatal period in an effort to alleviate the validity problems that could arise from depression scales intended for the general population. Two hundred and twenty-four mothers participating in a Quebec prevention program, "Naître égaux, grandir en santé" (Martin & Boyer, 1995) filled out the EPDS between the 22nd and the 35th day postpartum. A confirmatory factor analysis, conducted with LISREL, gives a 2-factor structure for the EPDS, the first representing symptoms of depression and the second symptoms of anxiety. This structure differs from the one presented by Cox, Holden, and Sagovsky (1987), authors of the EPDS. It corresponds, however to the results of other authors who looked at the EPDS with confirmatory factor analysis (Pop, Komproe, & van Son, 1992) and indicates a good construct validity. The reliability of the scale also appears satisfactory, with a Cronbach alpha co-efficient of 0.82.

Adolescent↗

PubMed1999

A "case control" study on the rôle of HLA DR4 in severe periodontitis and rapidly progressive periodontitis. Identification of types and subtypes using molecular biology (PCR.SSO).

HLA DR4 antigens have been considered as a risk factor in periodontal disease. The aim of this "case control" study was to verify and to provide fuller clarification of such data. "Cases" or patients had to be aged between 20 and 48 years. They presented at least 5 sites spread over several teeth with an attachment loss equal or greater than 6 mm, and 10 sites spread over several teeth with periodontal pockets equal to or greater than 5 mm. Verification with a WHO probe showed an individual CPITN score of 4. Moreover, subjects whose average CPITN score for the 6 sextants was less than 3 were excluded from the study. Among these "severe periodontitis" patients, a subgroup was distinguished composed of subjects aged 20-35 years who presented, in accordance with the cases by Katz and co-workers, 5 or more teeth showing pocket depths of 6 mm or more. The dental chartings of these subjects showed an attachment loss of more than 3 mm on certain teeth over an inter-exam period of 1-3 years. They all displayed obvious loss of bony support in the affected sites. This constituted the "rapidly progressive periodontitis" subgroup. The "controls" were all over 20 years of age, and it was clinically verified that they were free of periodontal disease. There were 48 "cases" and 55 "controls". HLA typing of patients and controls was performed using "sequence oligoprobe hybridization after polymerase chain reaction" in accordance with the 11th International Workshop. This method allowed the detection of DR4 alleles as well as DR4 subtypes. The ethno-geographic origin of the subjects, considered as a confounding variable, was neutralized by stratified analysis. Subtypes 0401, 0404, 0405 and 0408 tended to be more frequent (p=0.08) in the cases (Severe Periodontitis). Focusing on analysis of "rapidly progressive periodontitis" in subjects aged 20-35 years, a very significant Mantel-Haenszel chi2 was obtained (p=0.0058) which led to a Mantel-Haenszel standardized odds ratio (OR) equal to 17. The 95% confidence interval was 1.03<0.R.<180.10. In conclusion, this supports previous reports and gives further clarification: in particular subtypes 0401, 0404, 0405 and 0408 can be considered as a risk factor for "rapidly progressive periodontitis". It should be noted that these determinants have been implicated in rheumatoid arthritis.

Adult↗

PubMed1999

Understanding the intention of dentists to provide dental care to HIV+ and AIDS patients.

OBJECTIVE: The aim of this study was to understand the intention of dentists to provide dental care to HIV+/AIDS patients. METHODS: A representative sample of 791 dentists from the province of Quebec completed a questionnaire assessing their intention to provide dental care to individuals with HIV+/AIDS as well as their attitudes, perceived social norm, perceived behavioral control, perceived behavioral norm and personal normative belief regarding this behavior. Past experience with providing dental care (habit) to HIV+/AIDS patients, fear of AIDS and socio-demographic characteristics were also assessed. RESULTS: Overall, dentists have a strong intention to provide dental care to HIV+/AIDS patients. Nevertheless, 25% of the respondents expressed a low intention to provide dental care to these patients. The main factors explaining 71% of the variance in intention were perceived behavioral control (beta=0.52, P<0.0001), personal normative belief (beta=0.33, P<0.0001) and habit of treating HIV+/AIDS patients (beta=0.12, P<0.0001). CONCLUSION: To improve the motivation of dentists to treat HIV+/AIDS patients, emphasis should be placed on increasing self-efficacy to cope with the difficulties of providing dental care to HIV+/AIDS patients as well as on the importance of acting in agreement with the Dental Association's Code of Ethics.

Adult↗

PubMed1998

Comparison between the DMF indices and two alternative composite indicators of dental health.

The DMFT and DMFS indices employed in the majority of oral epidemiological studies have several limitations. In response to this problem, Sheiham et al. (Community Dent Health 1987;4:407-14) proposed two alternative dental health indicators: the number of functioning teeth (hereafter referred to as FS-T) and tissue health (T-Health). Using data from an epidemiological study on the dental health status of adults aged 35-44 from Quebec (N=2110), this article compares the alternative indices with the conventional DMFT and DMFS indices. By comparing Pearson's correlation coefficient for the four indices in this study with the number of decayed, missing and filled surfaces, it is noted that the FS-T index bears the strongest correlation to the three variables. It is also the only index whose correlation coefficient is greater than 0.3 for each of the three DMFS components. A risk group was created for each index, composed of the 18% of people demonstrating the poorest index. The risk group's FS-T index results in an average of 4.3 decayed surfaces (compared with 2.6 for the DMFT), 92.7 missing surfaces (74.4 for the DMFT) and 9.0 filled surfaces (compared with 26.9 for the DMFT). Using linear regression analysis with each index as a dependent variable, and people's socio-demographic characteristics, regular use of dental services and perception of dental health as independent variables, it appears that the percentage of the explained variance (R2) is 21.2% for the FS-T index, 13.8% for the T-Health index, 12.3% for the DMFS index and only 7.6% for the DMFT index.

Adult↗

PubMed1998

[Inter-dentist variability in the provision of fissure sealants].

It has been recognized that the diagnosis and treatment of caries vary so widely among dentists that patients increasingly feel the need to inform themselves and to compare recommended treatments before accepting one. This phenomenon is all the more present in pit and fissure surfaces intervention choices, where there is a wide variety of available treatments. This article will attempt to highlight the factors explaining the pit and fissure treatment variation. The lack of knowledge on pit and fissure sealant effectiveness and indications as well as dentists' clinical experiences have given rise to different myths and prejudices that have had an impact on the variability of treatment decision making. When in doubt about the necessity to execute a treatment, each decision to withhold treatment results in an incomplete care episode. A dentist's lack of comfort with withholding treatment may stop him from offering preventive care and cause him to follow a restoration-oriented practice. It is therefore increasingly urgent to achieve agreement among dentists, especially as current knowledge on the subject is giving way to new research.

Attitude of Health Personnel↗

PubMed1997

Restorative treatments received by children covered by a universal, publicly financed, dental insurance plan.

OBJECTIVES: This study sought to identify risk markers associated with the provision of new restorations in children and to investigate whether the carious status of a tooth surface is associated with the restorative decisions of dentists. METHODS: A total of 911 schoolchildren in grades one, two, and three were randomly selected from the island of Montreal, Quebec, Canada. Dental examinations were carried out in 1990, 1991, and 1992. Tooth surfaces of first permanent molars were classified as sound, noncavitated, and cavitated. The carious status of a tooth was matched with restorative decisions reported to the insurance board. RESULTS: The presence of a carious cavity was a strong risk marker for placement of new restorations (odds rations > or = 4.11). After one year, less than 2 percent of sound tooth surfaces of first permanent molars were restored and about 21 percent of noncavitated tooth surfaces were restored. When new class I restorations placed in maxillary first permanent molars within 3-6 months after the baseline examination were evaluated, we found that between 73 percent and 86 percent of these new restorations were placed in sound or noncavitated tooth surfaces. A similar trend also was observed in mandibular first permanent molars. Poor agreement between epidemiologic diagnosis and restorative decisions was found. The restorative profile of dentists was a significant risk marker for placement of new restorations. CONCLUSION: The majority of new restorations in first permanent molars were placed in sound and noncavitated tooth surfaces because of the ubiquitous prevalence of these tooth surfaces and the validity problems of current caries diagnosis methods.

Child↗

PubMed1997

[Treatment cost savings with universal coverage of dental pit and fissure sealants in Québec].

Approximately 95 per cent of caries or fillings in the first permanent molars of eight-year-old children are found on pit and fissure surfaces. In 17-year-old adolescents, these account for 68 per cent. This article evaluates two treatment approaches based on their respective cost: one that does not use sealants and one that uses sealants for pit and fissure surfaces and amalgam fillings for restorations involving other surfaces. Compared to the current situation in which sealants are rarely used, applying dental sealant to three out of four first permanent molars reduces the cost of treatment by 31 per cent. Therefore, pit and fissure sealants are recommended as a universal preventive measure for children. In the long run, this could generate savings of up to $7 million in the public and private sectors for each age group in Quebec.

Adolescent↗

PubMed1996

Indicators of masticatory performance among elderly complete denture wearers.

The literature on current techniques for evaluating the masticatory capacity leads to categorizing them into two groups: objective masticatory tests and questionnaires that evaluate the subject masticatory capacity. This study examines how a simple questionnaire on the reported capacity to chew certain food can predict the masticatory performance of edentulous elderly patients. The masticatory performance of 367 completely edentulous elderly persons was measured with the Swallowing Threshold Test Index and compared with their reported masticatory capacity previously measured with a questionnaire on the capacity of the individual to chew nine food items. A total of 47.4% of the individuals had a low masticatory performance. This problem was more frequent in women (51.7%) than in men (41.8%). In measuring the reported masticatory performance with seven of the nine food items listed in the questionnaire, this indicator predicted the masticatory performance with a sensitivity of 65.5% and a specificity of 81.9%. However, even though the measure of prosthesis retention/stability is related to the masticatory performance, it was not a good predictor.

Age Factors↗

PubMed1996

[Use of dental services and the percentage of persons possessing private dental insurance in Québec].

The utilization of dental health services and the percentage of adult members of a private health dental insurance plan are generally lower in Quebec than in the other Canadian provinces. In this study, results of a telephone survey of a representative sample of Quebec adults aged 18 and over (N = 8,042) show that 58 per cent of interviewed individuals visited a dentist (53 per cent) or a denturologist (five per cent) during the 12 months preceeding the interview. A multivariate analysis indicates that the most strongly associated factors related to the utilization of dental health services are, in decreasing order, edentulousness, income and level of education. About one third (36 per cent) of those surveyed had dental insurance coverage. Age and income are the most strongly associated factors concerning the membership to a dental health insurance plan. Finally, among those with dental insurance coverage, 71 per cent had visited a dentist or a denturologist during the last 12 months compared to 51 per cent of those not insured.

Adolescent↗

PubMed1996

[Trends in the level of edentulism in Quebec between 1980 and 1993].

Level of edentulism is a good indicator of a populations' bucco-dental health. Thus, the evolution of this phenomena enables us to seek any modification of adults' bucco-dental health. The percentage of adults in Quebec aged 18 and over who are completely edentulous decreased from 26 per cent in 1980 to 20 per cent in 1993. During the same period, the percentage of adults aged 18 and over who are only partially edentulous decreased from 18 per cent to 13 per cent. We note on one hand that this decrease is more prominent among younger adults and among anglophones and on the other hand that income and education are more strongly associated with edentulism in 1993 than in 1980. In 1980, individuals with lower levels of education were three times more edentulous (partially or totally) than those with higher levels of education (73 per cent versus 25 per cent). In 1993, this ratio increased to six times (72 per cent versus 12 per cent). It appears, therefore, that while edentulism has generally decreased in Quebec, it is more concentrated among certain high risk groups.

Adolescent↗

PubMed1995

Prosthetic relining and dietary counselling in elderly women.

A reduced consumption of hard-textured fibrous foods may promote the development of digestive disturbances in more susceptible elderly people who wear prostheses having deficient masticatory function. The purpose of this study was to evaluate the effects of a program combining denture relining and dietary counselling on the masticatory performance, fibre intake, and prevalence of digestive symptoms in elderly women with low chewing efficiency. This program was provided to 55 women between 55 and 74 years of age. Chewing ability was assessed quantitatively with the Swallowing Threshold Test Index (STTI), and qualitatively according to the participants' experience in chewing five specific foods. Nutritional data were collected using a food frequency questionnaire. The mean value of the STTI was significantly increased at three weeks and at six to nine months after completion of relining by 37 and 31 per cent, respectively. Subjects included one more food in their diet at the end of the six- to nine-month period only. Fibre intake from vegetables was significantly increased by 18 per cent, while colonic and gastrointestinal symptoms were both reduced. Prosthetic relining increased the masticatory performance of elderly women, but not to a functional level. In addition, dietary counselling stimulated subjects to eat foods that had previously been avoided. These observations suggest that the improvement of chewing efficiency, combined with dietary counselling, could reduce the presence of digestive symptoms.

Aged↗

PubMed1994

Fibre intake in elderly individuals with poor masticatory performance.

The effects of masticatory performance on food selection and nutrient intake in non-institutionalized elderly subjects wearing dental prostheses were investigated. A poor masticatory performance was associated with significantly lower intakes of insoluble and dietary fibre for both sexes (as compared to subjects with a good masticatory performance) and with lower intakes of vitamin A in women only. Further, 37 per cent of subjects with low masticatory performance were taking gastrointestinal drugs, as compared to 20 per cent of subjects with good performance. A reduced consumption of hard-textured fibrous foods due to the deficient masticatory performance of elderly people wearing prostheses may promote the development of gastrointestinal disorders in susceptible individuals.

Aged↗

PubMed1993

Nutrient intake and gastrointestinal disorders related to masticatory performance in the edentulous elderly.

The effects of chewing efficiency on nutrient intake and the prevalence of gastrointestinal disorders were determined in edentulous elderly subjects. Three hundred sixty-seven noninstitutionalized individuals aged 60 years and over were interviewed. Denture masticatory performance and the collection of dietary information were assessed with the "Swallowing Threshold Test Index" and a food-frequency questionnaire. Approximately half (47%) of the participants exhibited a low masticatory performance classification. Thirty-nine percent used the same prosthesis for more than 10 years and 28% were taking some medication for gastrointestinal disorders. Lower intakes of fruits and vegetables for both sexes and of vitamin A by women were observed in subjects with poor masticatory performance. Furthermore, subjects with poor masticatory performance took significantly more drugs (37%) than those with superior performance (20%). A reduced consumption of high-fiber foods could therefore induce the development of gastrointestinal disorders in edentulous elderly subjects with a deficient masticatory performance.

Aged↗

PubMed1992

Efficacy of APF treatments without prior toothcleaning targeted to high-risk children.

A clinical field trial was conducted, over a 2-yr period, to evaluate the efficacy of bi-annual APF gel topical applications without previous prophylaxis in reducing dental caries among high-risk children living in non-fluoridated communities. 488 children 6 yr old, presenting at least three cavities on proximal surfaces of their primary teeth, were randomly assigned to two groups. The experimental group received bi-annual topical APF gel applications and the control group received a placebo. All treatments were given at school without any prior toothcleaning. The APF gel provided a 34.3% reduction in caries incidence (P-value = 0.03) among the children with 3-14 cavities on their primary teeth at the beginning of the study. However, the treatment did not show any efficacy in reducing caries incidence among the higher-risk children having initially more than 14 cavities. These findings suggest that the efficacy of APF gel applications without previous prophylaxis varies according to the individual risk of the subjects and that more comprehensive programs should be targeted to very high-risk children.

Acidulated Phosphate Fluoride↗

PubMed1992

Prevalence of non-cavitated and cavitated carious lesions in a random sample of 7-9-year-old schoolchildren in Montreal, Quebec.

This report describes the prevalence of non-cavitated and cavitated carious lesions in 911 randomly selected children in grades one through three on the Island of Montreal, Quebec, Canada. The criteria for diagnosis were developed for a longitudinal epidemiological study of restorative treatment decisions by dentists practising under a provincial dental insurance program for children. The intra- and inter-examiner reliability correlation coefficients of the two examiners were excellent (Kappa > or = 0.80). The most frequent carious lesion found in the examined children were non-cavitated carious lesions (incipient) within 1.5 of the gingival line on smooth tooth surfaces, and stained or non-cavitated carious lesions on pits and fissures. Out of 911 children in the study, 19.6% had sealants. Children whose parents completed a university education had a significantly lower prevalence of non-cavitated and cavitated carious lesions and fillings, and a significantly higher mean number of sealants than children whose parents had only primary school education. Education status of the parents was a significant risk marker of children with high caries experience and these children had a significantly higher mean number of non-cavitated carious lesions. This study has found that non-cavitated carious lesions are significantly more prevalent than cavitated carious lesions in children.

Chi-Square Distribution↗