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Biomedical subjects

R A Bagramian

Publications and source records attributed to R A Bagramian.

At least 19 recordsLinked to original sources
PubMed1995

A survey of tooth injury experience and attitudes to prevention in a group of Singapore schoolboys.

A survey of 246 boys aged 12-17 years (mean 13.8 years) determined the sports played, dental injury experience, knowledge and usage of and attitudes towards mouthguard wearing. Most played basketball and soccer. Twenty-one suffered 1 injury episode, 7-2 and 10-3 or more tooth injuries. Twenty-six subluxations, 19 fractures and 1 avulsion were reported. The sports with the highest prevalence of dental injury were boxing and wrestling (33%), soccer (20%), and basketball (19%). While 144 (56%) of boys knew about mouthguards, none wore one. Only 64 (25%) would wear a mouthguard if given one. Most dental injuries were minor, but four high-risk sports (> 19% injury prevalence) would justify preventive measures, including education for injury prevention and encouragement of mouthguard use.

Adolescent↗
PubMed1989

Relation of sources of systemic fluoride to prevalence of dental fluorosis.

The prevalence of dental fluorosis in a nonfluoridated area was determined and related to the reported fluoride ingestion histories of the children examined. A convenience sample of 543 schoolchildren in rural areas of Michigan was examined for fluorosis using the Tooth Surface Index of Fluorosis. Questionnaires that asked about previous use of fluorides were sent to parents of all children examined. The response rate was 76 percent (412 usable questionnaires). A criterion for inclusion in the data analysis stipulated that only fluorosed surfaces that occurred bilaterally would be included. Fluorosis was found on 7 percent of all tooth surfaces and only in the mild form. Twenty-two percent of the subjects were classified as having fluorosis. Dietary supplement was the only fluoride that was found to be significantly related to the occurrence of fluorosis. A greater proportion of the subjects with fluorosis listed physicians, rather than dentists, as the source of fluoride prescriptions. The results demonstrate similarities to the fluorosis reported in other studies in nonfluoridated areas, but also suggest the need to minimize the occurrence of fluorosis through proper assessment of a child's fluoride exposure and the judicious use of additional fluoride.

Administration, Oral↗
PubMed1989

Relationship of dental caries and fluorosis to fluoride supplement history in a non-fluoridated sample of schoolchildren.

A random sample of 206 Michigan children, aged from 9 to 13, were examined for fluorosis from a larger group of 2038 children participating in a dental project. Clinical examinations included caries data (DMFS) and assessment of fluorosis by use of the Tooth Surface Index of Fluorosis (TSIF). Separate examiners were used for each index. The response rate of a questionnaire mailed to parents to gather information on residence histories, use of fluoride supplements, and antibiotics was 78%. The prevalence of fluorosis was about 20% among the respondents. Of the 4868 tooth surfaces examined, 9.2% were affected by fluorosis. In all cases, dental fluorosis was judged as mild, with most occurrences on the posterior teeth. No instances of moderate or severe fluorosis were found. The caries experience of respondents was 1.69 +/- 2.73 DMFS. Caries experience does not appear to be significantly related to income, education, or fluoride supplement use. Approximately 52% of respondents were reported to have taken fluoride supplements with various degrees of consistency. Parents' education was positively related to both prevalence of fluorosis (odds ratio = 2.2) and use of fluoride supplements (odds ratio = 2.7). No significant relation was revealed with evidence of fluorosis and use of supplements. This study shows a relatively mild level of dental fluorosis in a sample of children from a non-fluoridated area. Dental fluorosis in this group does not appear to be related to use of fluoride supplements or differences in caries experience.

Adolescent↗
PubMed1988

Fissure sealant knowledge and characteristics of parents as a function of their child's sealant status.

A survey was conducted to identify and compare sealant knowledge and sources of sealant information of parents whose children had and had not received fissure sealants. The socioeconomic characteristics of these individuals were also compared. The sealant group was composed of the parents of children found to have a sealant on at least one permanent tooth during dental examinations of 2,036 elementary schoolchildren in southwestern Michigan. Another group of children was selected from the same population and matched to the children with sealants by child's age, sex, school location, and community. Surveys were returned by 210 of 260 sets of parents (81% response rate). Significant differences were found between the two groups with regard to parents' ages and levels of income. Parents of children with sealants had more correct information about the procedure and 74 percent of these individuals reported that the dental office was their primary source of information. For the group without sealants, 48 percent of respondents reported no source of sealant information. Findings suggest that dental personnel may strongly influence dissemination of information about sealants and utilization of this preventive procedure.

Adolescent↗
PubMed1988

Oral health status, knowledge, and practices in an Amish population.

This study was conducted in the summer of 1985 to assess the oral health status, knowledge, and practices of an Amish population in southwest Michigan. Dental caries experience, periodontal health, and oral hygiene status were recorded using decayed, missing, and filled surfaces (DMFS), periodontal index (PI), and simplified oral hygiene index (OHI-S). Data on oral health knowledge and practices were collected by interviews using a structured questionnaire. Results showed significantly lower levels of disease among Amish. DMFS scores for 5-17-year-old Amish children were almost half that of the US general population (NIDR 1979-80). PI score of all ages combined was 2.0, which was 3.6 times lower than a national sample (1971-74). Lower levels of disease in Amish could be related to their way of life and dietary patterns. A relatively higher level of unmet need for prosthodontic care, inadequate oral health knowledge, and barriers to dental care in the study population emphasize the need for dental public health and health education programs.

Adolescent↗
PubMed1985

Self-reported health behavior and dental knowledge of a migrant worker population.

In conjunction with operation of a summer school-based dental program in Michigan, 101 children from migrant families, primarily Mexican-American, completed questionnaires relating demographic background, past dental experience, and knowledge of caries preventive methods. A smaller number of available mothers were asked these questions plus others relating to family dental problems, diet and knowledge of periodontal disease. Adults and children reported similar demographic backgrounds. Most children (68.7%) listed brushing as the best way to prevent cavities as did 60% of the mothers. Less than 2% of the children considered use of fluoride in any form as the best way to prevent cavities and only two of 20 mothers mentioned fluoride in this context. Members of this selected population were weak in their knowledge of the relation between a sweet diet and caries, the relation between oral hygiene and periodontal health, and the role of fluorides in caries prevention.

Adult↗
PubMed1984

Oral health of children of migrant farm workers in northwest Michigan.

A considerable number of Hispanic agricultural workers come to Northwest Michigan during the summer every year to harvest fruit and vegetable crops. The Department of Community Dentistry of The University of Michigan School of Dentistry helps provide dental services for these migrant workers and their families. Some 203 five-to-14-year-old children of migrant farm workers were examined for caries and periodontal condition and the results compared with recent national surveys. Traditional indicators of dental caries experience (DMFT/dft and DMFS/dfs indices), periodontal disease (PI), and oral cleanliness (OHI-S) were used by one examiner. These migrant children presented higher numbers of decayed teeth and lower numbers of restored teeth than United States schoolchildren generally. Migrant children also presented less caries-free teeth and higher PI and OHI-S scores than United States children generally.

Adolescent↗
PubMed1982

A 5-year school-based comprehensive preventive program in Michigan, U.S.A.

The objectives were to demonstrate that a combination of preventive regimens could significantly reduce dental disease in a school population, to demonstrate the feasibility of a school-based program in relation to sustained benefits. There were 1286 students in 1st and 6th grades enrolled in the study. Subjects were stratified by grade, sex, and race and randomly placed in a treatment or education group. Procedures included ingestion of fluoridated water, oral hygiene education program, dental examinations, prophylaxis, acidulated phosphate fluoride gel (1.23%) applied in trays, pit and fissure sealants (bis-GMA) on occlusal surfaces of all eligible posterior teeth, and provision of all restorative care. Fluoride and sealant procedures were repeated at 6-month intervals. After 3 years the treatment group was randomly divided to provide a group that would not continue with treatment and serve as a comparison. The study population was enrolled in 18 schools and clinical procedures were provided on-site, using mobile dental vans. Five-year results indicate high degree of success with fall-off of benefits to those for whom treatment was terminated. This pilot program gives strong evidence for the possibility of implementing school-based dental programs. The study also indicates that prevention programs must be comprehensive and continuous for maximum benefit to occur.

Child↗
PubMed1979

Effectiveness of combined preventive methods on erupting teeth in children in a fluoridated community.

Several preventive methods were used in combination to reduce dental caries in children residing in a fluoridated area. The method included dental health education, prophylaxis, pit and fissure sealants, topical fluoride and restorative care. Prophylaxis, sealant and fluoride procedures were repeated every 6 months. Sealant was applied to all fully erupted caries free posterior teeth in the mouth. This report compares results obtained for teeth that erupted after the study began with those teeth that were already present at the time treatment procedures were applied. Percent reductions in caries increment for newly erupted teeth at the end of 3 years for treated 6th graders was 77.5% in DMFT and 79.2% DMFS as compared to 71% and 58.3% for previously erupted teeth. Results for children in 1st grade did not how such beneficial results. Permanent first molars in younger children appear to be highly susceptible to caries. Sealant retention for newly erupted teeth follows the same pattern as for teeth previously erupted.

Adolescent↗
PubMed1979

Combination of school-based primary and secondary preventive dental programs in the United States and other countries.

School-based programs in the United States are very limited. Other countries in the world have established programs for many years which provide comprehensive services to school-age children. In this country philosophical and professional pressures have maintained school-based programs only in the area of primary prevention. Most treatment programs involving secondary prevention are not school-based and are targeted at specific population groups rather than all children. The basic questions of whether primary and secondary preventive school-based programs can be successful have been examined in this paper. The evidence based on the pilot program presented here is that these programs can be successful. They are well accepted by parents and children, they provide quality care at a reasonable cost, and, most importantly, they can reduce dental disease. It's time for a committment by the profession and the nation to establish school-based dental programs for the health and welfare of our children.

Child↗
PubMed1979

Pattern of sealant retention in children receiving a combination of caries-preventive methods: three-year results.

Sealant retention varied according to site of the tooth. Figures for intact sealant were particularly low for permanent first molars among first graders and for permanent second molars among sixth graders at the end of three years. Although a large percentage of these teeth needed sealant reapplications, the percentages of teeth that were lost to caries were as low as 12.2% and 12.8%, respectively. Deciduous molars had the best rate (60.9%) of complete retention and also the highest percentage (20.2%) of loss caused by caries. However, in sixth graders, the premolars had the highest percentage (46.7%) of complete retention and, at the same time, the lowest caries rate (5.6%). The sealant retention pattern has remained the same during the three-year period.

Child↗
PubMed1978

A combined approach to preventing dental caries in schoolchildren : caries reductions after 3 years.

A combination of preventive methods have been used to reduce dental caries in children residing in a fluoridated area of Southeastern Michigan. These children had very low restorative treatment levels. The methods used include dental health education, prophylaxis, pit and fissure sealants, topical application of fluoride and restorative care. Prophylaxis, sealant and fluoride procedures were repeated every 6 months. Sealant was applied to all caries-free posterior teeth in the mouth. Three-year results show reduction of occlusal caries increments of nearly 73% for both 1st and 6th school grades. Although at baseline examination there was no statistically significant difference between the two groups in mean DMF teeth and surface scores, the difference in mean increments at the end of 3 years was statistically significant (P less than 0.01). Percent reductions in caries increment for permanent first molars in 1st graders were 65.6 for DMF teeth and 66.7 for DMF surfaces. Corresponding figures for permanent teeth among 6th graders were 71% and 58.3%.

Child↗
PubMed1977

Sealant effectiveness for children receiving a combination of preventive methods in a fluoridated community: two-year results.

A series of preventive methods in combination have been used to reduce dental caries in children including dental health education, prophylaxes, pit and fissure sealants, topical application of fluoride and restorative care. Prophylaxes, sealant, and fluoride procedures are repeated every six months. Two-year results show reductions of occlusal caries increments of 74.3% for first graders and 77.1% for sixth graders. Sealant loss, as defined in this study, varied from 33% to 90% with the highest loss occurring in the newly erupted permanent molars during the first six months of the project. These high sealant loss rates are thought to be related to the age of the population which was designed to include children at the ages of peak eruption of permanent molar teeth (ages six and twelve). These teeth were often only minimally erupted and maintaining the dry field required for sealant retention was extremely difficult. However, in spite of these high rates of sealant loss, caries reduction on occlusal surfaces was highly significant in comparision to that of children who did not receive sealants.

Adolescent↗
PubMed1977

Provider expectations and consumer perceptions of the importance and value of dental care.

Seventy-eight inner city mothers of third and fourth grade children in three racial groups--white, black, and American Indian--known to need dental treatment for disease on permanent teeth, were interviewed at home by a trained community resident interviewer. Sixty-two per cent of the mothers were on public assistance. Information relating to the mothers' perceptions of the importance and value of dental care both for herself and for her children were collected. Utilization data were obtained via two dental examinations conducted one year apart. Data were also collected from a sample of provider dentists via mail questionnaire. A yield of 315 usable questionnaires was obtained, a return rate of 53 per cent. Provider-dentists felt that low socioeconomic consumers do not value dental services, as compared to other types of consumer goods and services, and that they do not believe dental care is important. Low income mothers in the same city reported that they did value dental care and believed it important. Expectations of and orientations toward the importance of dental care were found discongruent between the two groups of respondents. These discongruities on the dentist-patient relationship are discussed as a barrier to utilization. Although financial resources were available to many of the study families, only 49 per cent of these children received the needed care. It is suggested that the psychological cost to a patient of seeking care in inhospitable settings may act as a barrier to utilization.

Attitude of Health Personnel↗
PubMed1976

A combined approach to preventing dental caries in schoolchildren: caries reductions after one year.

A prototype school-based dental program is being conducted in a low-middle-income, urban area, as a demonstration project to test the combined effect on dental caries of several preventive measures. Procedures include ingestion of fluoridated water (1.0 ppm), topical application of acidulated phosphate fluoride, application of a pit and fissure sealant, early detection of caries and restoration of affected teeth, and dental health education (oral hygiene and dietary counseling program). The four-year project began in early 1973. A group of 1,200 children in the first and sixth grades was randomly separated into a treatment and a comparison group. All children participate in a dental health education program and consume fluoridated water. Dental care is provided on site at 18 schools, with the use of two mobile vans, saving time and expense in school hours lost and transportation costs. A hygienist coordinates the oral hygiene and dietary programs in classrooms with the help of teachers trained in workshops. Supervised toothbrushing, flossing, and use of disclosing agents are carried on in the classrooms. First-year caries increment data in permanent teeth indicate a high degree of success. Occlusal surfaces of permanent teeth in children in the treatment group, contrasted to those in children in the comparison group, showed an average reduction in caries of 84%. The encouraging results obtained at the end of one year indicate that a school-based preventive dentistry program may have great potential for preventing and controlling dental caries in schoolchildren.

Adolescent↗
PubMed1975

Dental health status of third grade children and their families within the context of a community's dental health care system.

Utilizing structure, process, and outcomes as conceptual dimensions of appraisal of quality, data were analyzed to present an evaluation of the quality of a community's dental health care system as reflected in a population subgroups' dental health status. Data were collected from 838 Caucasian third-graders and their parents through interviews, mail questionnaires, and dental screening examinations. Indicators of structure were: status of community water fluoridation in the study community, dentist to population ratio, and dental care resources in the public sector available to eligible residents. Process indicators of quality were: 1) screening, case finding, examinations, and quality of restorations as measures of provider behaviors, and 2) complaints, compliance, conditioned behaviors, level of dental health knowledge, and utilization of dental services as measures of client behaviors. Outcomes, subjected to analysis included indices indicative of dental disease experience. Variables operationally defined as indicators of the subgroup's dental health status were subjected to a descriptive analysis and were then crosstabulated with the socioeconomic status of the child's family to identify socioeconomic differences in the process of obtaining care and in dental health outcomes. Findings indicate which elements in a community's prevailing dental health care system function well and which would need alteration to maximize dental health for the subgroup.

Adult↗