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Biomedical subjects

J P Carlos

Publications and source records attributed to J P Carlos.

At least 19 recordsLinked to original sources
PubMed1990

Recent trends in dental caries in U.S. children and the effect of water fluoridation.

The decline in dental caries in U.S. schoolchildren, first observed nationwide in 1979-1980, was confirmed further by a second national epidemiological survey completed in 1987. Mean DMFS scores in persons aged 5-17 years had decreased about 36% during the interval, and, in 1987, approximately 50% of children were caries-free in the permanent dentition. Children who had always been exposed to community water fluoridation had mean DMFS scores about 18% lower than those who had never lived in fluoridated communities. When some of the "background" effect of topical fluoride was controlled, this difference increased to 25%. The results suggest that water fluoridation has played a dominant role in the decline in caries and must continue to be a major prevention methodology.

Adolescent↗
PubMed1989

Methodological and nutritional issues in assessing the oral health of aged subjects.

Despite several serious methodological difficulties in epidemiological research on the oral health of elderly subjects, sufficient data are available to conclude that the prevalence of dental diseases is high in persons aged greater than 65 y in the US. An estimated 41% are completely edentulous, and dental caries, including root-surface caries, and destructive periodontal disease are widespread. Whether nutrition is related to the oral health problems of older persons is unclear: this question has received little research attention, and the results have generally been equivocal. There is some evidence that loss of teeth may be associated with suboptimal intake of nutrients and with changes in food preference.

Aged↗
PubMed1989

Advances in the epidemiological study of oral-facial diseases.

Both demographic patterns and disease distribution are changing rapidly in the United States. These developments have led to the recognition that the epidemiology of many conditions is poorly understood, and that other research has thus been hindered. Four areas of epidemiological study were chosen for detailed analysis of how new technology will affect the conduct of future research. These areas, selected because information about them will be increasingly needed in an aging society, were periodontitis, temporomandibular disorders (TMD) and other orofacial pain, salivary gland disturbances, and health services research. The potential effect of new technology was examined in the short, intermediate, and long term. While the nature of epidemiological study is unlikely to change with the advent of new technology, the scope of potential studies will become broader. Advances in diagnostic techniques from elsewhere will permit far more precise diagnosis than is possible at present. Computer technology will permit an efficient system of epidemiological surveillance to provide current data on trends in tooth loss, caries, and periodontitis--data which will complement the results of national surveys. Analytical studies to produce hypotheses on the etiology of oral conditions, especially in such poorly-understood areas as chronic pain and TMD, will help direct clinical research in those areas.

Computers↗
PubMed1988

Periodontal disease in adolescents: some clinical and microbiologic correlates of attachment loss.

The influence of several clinical and microbiological variables on the site-specific risk of attachment loss was studied in Navajo Indian adolescents aged 14-19. Diagnoses were made at mesio-buccal sites of the four first permanent molars. Case-control analytical methods were used, with A. actinomycetemcomitans, B. gingivalis, and B. intermedius considered the "risk" variables, and with calculus, gingival bleeding, age, and gender treated as possible confounders. The presence of B. intermedius significantly increased the likelihood that attachment loss would be diagnosed at a site (odds ratio = 2.86). However, this association was confounded by calculus and gingival bleeding; when either or both were present, the effect of B. intermedius was markedly weaker. Step-wise multiple logistic regression analyses showed that, of the variables considered, the combination of calculus, gingival bleeding, and B. intermedius gave the most parsimonious explanation of the presence of attachment loss. The chance that attachment loss would be diagnosed was increased five times when calculus was present, 16.5 times in the presence of both calculus and gingival bleeding, and 37 times when these variables plus B. intermedius were observed at a particular site.

Actinobacillus↗
PubMed1987

Periodontal disease in adolescents: epidemiologic findings in Navajo Indians.

A cross-sectional epidemiologic survey was conducted of 618 Navajo Indians, aged 14-19, resident in a boarding school in New Mexico. Periodontal status was assessed by clinical measurements of attachment level and gingival bleeding, and evidence of alveolar bone loss from standardized bitewing radiographs. Attachment level and gingival bleeding were measured at 24 posterior interproximal sites (six sites in each quadrant): the mesio-buccal aspect of the second molar; the disto-buccal and mesio-buccal aspects of the first molar and second premolar; and the disto-buccal aspect of the first premolar. Alveolar bone level was measured from radiographs at the corresponding approximal surfaces of the same teeth. Attachment loss was considered present when the distance from the CEJ to the base of the pocket was greater than 1 mm; bone loss was considered present when the radiographic distance from the CEJ to the alveolar crest was greater than 2 mm, and gingival bleeding was considered present if bleeding occurred immediately after gentle probing. Attachment loss was evident at one or more sites in 88.7% of the population, 45.9% of the subjects had attachment loss at eight or more sites, and 101 subjects (16.3%) had one or more sites with at least 4.0 mm of attachment loss. Bone loss was present at one or more sites in 89.2% of the population, 28.6% had eight or more affected sites, and 4.7% (29 subjects) had one or more sites with at least 2.0 mm of bone loss. Gingival bleeding was evident at one or more sites in 70.6% of the population, and 19.7% had eight or more affected sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Oral health effects of smokeless tobacco use in Navajo Indian adolescents.

Recent reports have suggested that the use of smokeless tobacco is increasing in adolescents, and is particularly high in Native Americans, causing concern about possible effects on oral health. In this study, 226 Navajo Indians, aged 14-19, were interviewed regarding their use of smokeless tobacco (ST), cigarettes, and alcohol. Midbuccal and mesiobuccal sites on all fully erupted permanent teeth (excluding third molars) were examined for the presence of gingival bleeding, gingival recession, calculus, and loss of periodontal attachment. The oral mucosa was examined for evidence of leukoplakia. 64.2% (145) of the subjects (75.4% of the boys and 49.0% of the girls) were users of ST. Of these, over 95% used snuff alone or in combination with chewing tobacco. 55.9% used ST one or more days per week. 52.2% consumed alcohol, usually beer or wine, and 54.0% smoked cigarettes. 25.5% (37) of the users and 3.7% (3) of the non-users had leukoplakia. The duration (in years) and frequency of ST use (days per week) were highly significant risk factors associated with leukoplakia. However, the concomitant use of alcohol or cigarettes did not appear to increase the prevalence of these lesions. No consistent relationship was observed between the use of ST and gingival bleeding, calculus, gingival recession, or attachment loss, either when comparing users to non-users or when comparing the segment where the tobacco quid was habitually placed to a within-subject control segment. In view of these results, there is little doubt that smokeless tobacco is significantly related to the etiology of leukoplakia. As some evidence exists that smokeless tobacco use is a significant risk factor associated with oral carcinoma, intervention programs to discourage the use of smokeless tobacco by adolescents should be a public health priority.

Adolescent↗
PubMed1986

The extent and severity index: a simple method for use in epidemiologic studies of periodontal disease.

Periodontal indices such as the PI, PDI and CPITN ignore a substantial amount of the information ordinarily available in epidemiologic studies of periodontal disease. The extent and severity index (ESI) is an attempt to preserve the maximum amount of information from a clinical examination consistent with the need to achieve a reasonable degree of data reduction. The ESI uses estimates of attachment level from probing measurements of 14 sites in one maxillary quadrant and 14 in the contralateral mandibular quadrant. The index is calculated to summarize jointly the extent and the average severity of disease within the group being studied. Application of this bi-variate statistic to a set of epidemiologic data was carried out to illustrate its use. This analysis suggested that disease extent and disease severity are not highly redundant measures and thus provide independently meaningful information. The ESI is a simple, reproducible method which appears to yield an informative description of the periodontal disease status of a population. Use of the index requires only minimal training of examiners. The index is intended to permit direct comparisons among epidemiologic studies of different populations and by different investigators.

Adolescent↗
PubMed1982

The prevention of dental caries: ten years later.

By any standards, progress toward caries prevention has been impressive during the past decade. It is arguable that more information on the precise etiology of caries and on potential new preventive methods has been acquired during the 1970s than in any comparable period previously. Substantial advances have been made toward the understanding of the complex interaction among oral microorganisms, host resistance, and dietary substrate in the initiation and progression of a caries lesion. The various mechanisms of action of the fluoride ion have been further elucidated; vaccination against caries and a reduction in the cariogenic potential of sweet foods have both become realistic possibilities. Conspicuous successes have also been achieved in the application of existing knowledge. At least 12 million more children than in 1971 are receiving partial protection against caries through self-applied fluoride programs. Other effective preventive methods, including adhesive sealants and, possibly, antimicrobial agents, could be widely and advantageously utilized if manpower and regulatory constraints were overcome, as their scientific feasibility has, for the most part, already been demonstrated. Of course, it would be naive to predict the early disappearance of dental caries as a major health problem. This will occur only gradually, and will require a much more extensive use of preventive methods--those already available as well as those still being developed by research. Nevertheless, a major step toward the goal of caries prevention has already been taken, and there is good reason to expect even more rapid progress during the 1980s.

Bacterial Vaccines↗