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Biomedical subjects

R G Rozier

Publications and source records attributed to R G Rozier.

At least 37 records · Page 2Linked to original sources
PubMed1995

Community risk indicators for dental caries in school children: an ecologic study.

A statewide survey of NC schoolchildren found wide variation in dental caries prevalence among sampled classrooms. This study examined factors associated with this variation using classrooms as a surrogate for the larger community, in order to identify community risk indicators (CRI). In all, 172 classrooms (3400 students) in Grades K-6 were available for analysis. Initially, 56 sociodemographic, environmental, health system, and clinical factors were evaluated for their association with caries prevalence (K-3: average dfs + DMFS; 4-6: average DMFS) using univariate and bivariate analyses. Of these, 21 factors met our criteria for evaluation using WLS multivariate regression. For Grades K-3 (n = 108), population density, parental education, and coastal residence were negatively associated with caries scores, while age, and medical and dental, Medicaid expenditures were positive. For Grades 4--6 (n = 64), age and fs:dfs ratio were positively associated with caries scores while population density, population:dentist ratio, and years of natural fluoride exposure were negative. CRIs for both models, when compared to individual models, explained a substantial portion of the variation in caries prevalence, 31% for Grades K-3 and 51% for Grades 4-6. Results suggest that a risk assessment model based on community rather than individual variables is feasible and further refinement may reveal factors useful in identifying high risk communities.

Adolescent↗
PubMed1994

Evaluation of Guamanian dental caries preventive programs after 13 years.

OBJECTIVE: To address the high prevalence of dental caries in Guamanian children, a school-based fluoride mouthrinse program, a clinic-based pit and fissure sealant program, and community water fluoridation were phased in over a 13-year period. The purpose of this paper is to evaluate the impact of these programs on the prevalence of dental caries. METHODS: Cross-sectional samples representative of schoolchildren in grades 1 through 8 were selected in 1976, 1979, 1984, 1986, and 1989. These years include the starting years for each of the three interventions and varying follow-up periods for each. About 1,000 children in each of the survey years were examined to derive DMF surface scores. RESULTS: After eight years of fluoride mouthrinsing, DMFS scores were reduced by 25.4 percent in 6-14-year-olds. With two additional years of fluoride mouthrinsing and with pit and fissure sealants, overall DMFS scores declined an additional 44.4 percent. In 1989, three years after community water fluoridation was initiated on the island and continuation of the other two programs, there was a further decline in overall DMFS scores of 34.5 percent. Over the entire study period--during which there were 13 years of fluoride mouthrinsing in the schools, five years of sealant application, and three years of community water fluoridation--DMFS scores declined 72.8 percent overall (5.14 surfaces per child) and 71.9, 71.0, and 78.8 percent for occlusal, buccal-lingual, and proximal surfaces, respectively. CONCLUSIONS: An intensified preventive dentistry program introduced on an island with high caries prevalence twice that of the US mainland was successful, and contributed to a reduction in the prevalence of caries to a level equivalent to that of the United States at the end of the study period.

Adolescent↗
PubMed1994

The prevalence of dental sealants in North Carolina schoolchildren.

OBJECTIVES: This study reports the prevalence of dental sealants derived from a survey of schoolchildren in North Carolina, and its variation according to several sociodemographic characteristics. METHODS: A single-stage, stratified probability sample of grade K-12 classrooms in the state yielded a sample of 8,026 students. Clinical examinations were performed on 83 percent of the sample. Estimates for sealant prevalence and their variation according to seven sociodemographic variables were determined. RESULTS: About 117,000 children in the state, or 12 percent of those 6-17 years of age, have sealants. The prevalence of sealants varied according to geographic region of residence and the socioeconomic status of whites. Prevalence was affected little by age, sex, degree of urbanism, or socioeconomic status of those with races other than white. CONCLUSIONS: While underutilized, there are indications in these data that sealant use is increasing, thus having the potential to contribute to further declines in the prevalence of dental caries in the state. Those factors included in this study and associated with the prevalence of sealants suggest that major gains in sealant use will need to address not only those specific barriers preventing their use by the profession or public, but broader issues preventing the utilization of dental services in general.

Adolescent↗
PubMed1994

Epidemiologic indices for measuring the clinical manifestations of dental fluorosis: overview and critique.

Several indices have been used to describe the clinical appearance of dental fluorosis. The purpose of this paper is to describe and compare the three principal ones in use today: those developed by Dean (1934, 1942), Thylstrup and Fejerskov (1978), and Horowitz et al. (1984). A recent index (Fluorosis Risk Index) developed by Pendrys (1990) is also included in this review. The continued use of Dean's classification system and derived index (CFI) for more than a half century is testimony to its simplicity and utility. The index has been criticized because the unit of analysis is the person, because criteria are unclear for some categories, or that they lack sensitivity, particularly for severe fluorosis, and because of the way in which data are summarized and reported. The Thylstrup and Fejerskov Index is appealing to clinicians and epidemiologists alike in that it corresponds closely to histological changes that occur in dental fluorosis and to enamel fluoride concentrations, thereby having biological validity. The TSIF described by Horowitz et al. makes a useful contribution because it provides clearer diagnostic criteria and provides for an analysis based on esthetic concerns. The Fluorosis Risk Index appears to be particularly useful for analytical epidemiologic studies, because it is designed to permit a more accurate identification of associations between age-specific exposures to fluoride and the development of dental fluorosis. All three indices in common use today provide useful indices for the study of dental fluorosis. The utility of the Fluorosis Risk Index will be determined as it receives wider use. The selection of one of these indices for use in an epidemiologic study depends in large measure on the purpose of the study. Research needs to continue on the validity of these indices, particularly for mild fluorosis, and on the public's perception of the cosmetic appearance of teeth with different severity levels of fluorosis.

Epidemiologic Methods↗
PubMed1994

Incidence of attachment loss in community-dwelling older adults.

Since 1985, only four studies have been published that present data on attachment loss in populations. The purpose of this study was to present the incidence of attachment loss over an 18-month period in a representative sample of community-dwelling older adults. In addition, the utility of multivariate prediction models to distinguish between people who will and will not experience disease progression was explored. The Piedmont 65+ Dental Study of the Elderly is a longitudinal investigation of a random sub-sample of over 1,000 community-dwelling people over the age of 65 in five contiguous North Carolina counties. The five dentists who conducted the in-home examinations and interviews at baseline also participated at 18 months and examined the same subjects. The overall attrition rate for blacks was 27% and the rate for whites was 23%. At 18-months, the baseline attachment level scores for those subjects who were lost from the study were not significantly different from the scores of those who remained in the study. A change in attachment loss of 3 mm or more over the 18 months was set as a conservative estimate of actual change taking place. Blacks were significantly more likely to experience attachment loss irrespective of the number of sites involved (P < .05). Approximately half the people had at least one losing site and about one-third of the blacks and one-fourth of the whites had at least two losing sites. A total of 24% of blacks and 16% of whites had 3 or more losing sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Black or African American↗
PubMed1993

Relationship between epidemiologic coronal caries assessments and practitioners' treatment recommendations in adults.

Caries incidence determinations in adults reflect dentists' treatment decisions as well as epidemiologists' caries assessments because many patients receive treatment between the two assessments that are required to determine incidence. Yet knowledge of the relationship between epidemiologically assessed caries and practitioners' treatment recommendations is poor. In this study, the proportions of practitioners recommending treatment for a tooth, and the reasons for those recommendations, were compared across teeth grouped by their caries status as determined from an epidemiologic assessment. On average, for a tooth deemed carious by epidemiologic assessment, a mean of almost 90% of examining practitioners recommended treatment. Most but not all of these recommendations for treatment of teeth with epidemiologically determined caries were for caries-related reasons. Among teeth classified as sound by epidemiological assessment, the mean proportion of dentists recommending treatment was 11%. For restored, non-carious teeth a mean of 35% of examining dentists recommended treatment. Across all noncarious teeth, 25% of all treatment recommendations were related to caries. The mean patient F increment (number of newly filled surfaces) that would result from treatment recommendations practitioners indicated as being associated with caries was slightly less than one-half of the total F increment. Thus, F increments may substantially overestimate caries incidence.

Adult↗
PubMed1992

Factors associated with parental acceptance of dental sealants.

Whereas a number of surveys have documented oral disease preventive behaviors and associated factors, little is known about public knowledge and beliefs about dental sealants. In this study, factors associated with the presence of sealants were studied in first and second graders residing in Columbia, SC. From a sample of 1,119 children, 88 were found clinically to have sealants; 508 did not have, but needed them. Parents of the sealant children (n = 87) and of a random sample of the no-sealant children (n = 289) were interviewed by telephone to obtain information regarding (1) factors related to parents' inclination to obtain sealants for their children, (2) ability of the family to obtain oral disease preventive services, and (3) the influence of others in the family's decision-making efforts. Analysis of 16 factors thought to be related to sealant presence revealed that parents were more likely to obtain dental sealants for their children if dentists or their staffs recommended them, if the parents were knowledgeable about dental sealants, if the parents were more highly educated, and if the parents had dental insurance coverage. Parents were less likely to obtain dental sealants for their children if they heard about them from mass media. The latter finding is unexpected and may have been influenced by conflicting or negative opinion expressed by some dental practitioners through mass media or other channels of communication.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Effect of crown margins on periodontal conditions in regularly attending patients.

Subgingival margins of cast restorations have been associated with increased gingival inflammation and probing depth, but it is not known if such effects would be seen among patients receiving regular professional care. In this study, 831 regularly attending patients in 35 North Carolina dental practices were examined. Plaque, gingival inflammation, calculus, and probing depth were assessed on facial and mesiofacial surfaces of the Ramfjord teeth. Surface-specific analyses showed significantly greater (p less than 0.05) gingival inflammation and deeper probing depths with subgingival cast restoration margins for nearly all surfaces examined. Less frequently, decreases in plaque and calculus were associated with the presence of crowns. Intact surfaces in patients with cast restorations were not significantly different from the same surfaces in patients without cast restorations. Even among patients receiving regular preventive dental care, subgingival margins are associated with unfavorable periodontal reactions.

Crowns↗