The dental caries experience of 5-year-old children in Great Britain. A survey coordinated by the British Association for the Study of Community Dentistry in 1989-90.
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Biomedical subjects
Publications and source records attributed to T B Dowell.
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Dental personnel in London were surveyed for their uptake of hepatitis B vaccine and willingness to provide dental care to carriers of hepatitis B virus (HBV). Most respondents were aware of current recommendations about vaccination, and three fourths of dentists had been vaccinated against HBV. However, only half of dental ancillary staff members had been vaccinated against HBV. Three fourths of the London dentists surveyed, despite their immunity against HBV, were unwilling to treat HBV carriers.
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A group of 437 subjects from a random sample of 737 persons, over 75 yr of age and living independently in the southwest of England, were interviewed about their oral health concerns and desires for dental treatment. Most of the subjects could have received dental treatment without unusual risk, although a third of the sample said they could not move around or attend a dentist without assistance. A dentist had visited the homes of only 2% of the sample, while 22% expressed a desire for this service. Nearly half of those interviewed complained of a mouth problem and a third were experiencing oral pain, yet the majority had not been to a dentist for at least 10 yr, and had no wish to see a dentist. Many of the subjects, even among those with complaints, said they had not visited a dentist recently because they had nothing wrong, while only a small proportion (3%) of the sample identified fear, expense or transport as a barrier to dental treatment. The results indicate that elderly people do not have many oral health concerns or expectations.
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Surface enamel fluoride levels were measured in deciduous canine teeth from Bristol, with non-fluoridated water supplies, and Birmingham, with fluoridated water supplies. Three populations studied were from Bristol (teeth shed before 1960), Bristol (after 1975) and Birmingham (after 1975). Up to 75 micron from the enamel surface, fluoride concentrations of post-1975 Bristol and Birmingham teeth were, respectively, X 1.3 and 3.4 greater than those of pre-1960 Bristol teeth. The increase in the Bristol teeth is presumably due mainly to the increased use of fluoride-containing toothpastes, that in Birmingham to fluoridated water plus the use of fluoride toothpastes. No difference in the rates of penetration into enamel of acid-gel induced, caries-like lesions were found between the two Bristol populations; Birmingham teeth showed a reduction of 10 per cent in penetration rate. It is suggested that raised fluoride levels in surface enamel do not reduce solubility sufficiently to account, by themselves, for the recent nationwide marked reduction in caries in children. Possibly, the raising of plaque fluoride levels is a more important factor, affecting demineralization, remineralization and bacterial activity.
The rapid growth in the use of panoramic radiographs provoked this survey of the reasons why general dental practitioners in Avon take such views. Of the 193 dentists who responded, 42 (22%) took one or more panoramic radiographs during a specified week. A total of 195 patients, 8% of those x-rayed, had a panoramic radiograph taken either alone or in combination with other views. Panoramic radiographs were stated to have been taken primarily for the diagnosis of caries (48%) and surgical (24%), periodontal (20%), orthodontic (20%) and endodontic/apical assessment. These findings are discussed with respect to published guidelines on the use of panoramic radiographs and the teaching of radiology in dental schools.
This survey investigated the reasons why general dental practitioners take radiographs. 179 (54%) dentists responded and provided information for 2359 patients who were radiographed during a specified week. Of those patients aged less than 15 yr, 62% were radiographed primarily for orthodontic purposes and 22% for caries. In older age groups, caries was the predominant reason for taking radiographs but endodontic assessment assumed increasing importance with age and accounted for 37% of radiographs in patients aged more than 45 yr. Only 8% of patients were radiographed for periodontal reasons. These findings are discussed with respect to the changing pattern of disease and treatment provided in general dental practice.
This paper deals with the orthodontic aspects of a wider survey undertaken to determine the use of radiographs in general dental practice in the county of Avon. During the sample week 218 patients had radiography for orthodontic purposes of whom 184 were below the age of 15 years. There were marked differences in the radiographs used by general practitioners and specialist orthodontists and the possible reasons for these differences are discussed.
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