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Biomedical subjects

V Baelum

Publications and source records attributed to V Baelum.

72 records · Page 4Linked to original sources

Periodontal diseases in adult Kenyans.

This study comprised 1131 persons who constitute a stratified random sample of the entire population aged 15-65 years in Machakos District, Kenya. Each person was examined for tooth mobility, plaque, calculus, gingival bleeding, loss of attachment and pocket depth on the mesial, buccal, distal and lingual surface of each tooth. The oral hygiene was poor with plaque on 75-95% and calculus on 10-85% of the surfaces depending on age. Irrespective of age, pockets greater than or equal to 4 mm was seen on less than 20% of the surfaces, whereas 10-85% of the surfaces had loss of attachment greater than or equal to 1 mm. The proportion of surfaces per individual with loss of attachment greater than or equal to 4 mm or greater than or equal to 7 mm, and pocket depths greater than or equal to 4 mm or greater than or equal to 7 mm, respectively, showed a pronounced skewed distribution, indicating that in each age group, a subfraction of individuals is responsible for a substantial proportion of the total periodontal breakdown. The individual teeth within the dentition also showed a marked variation in the severity of periodontal breakdown. Our findings provide additional evidence that destructive periodontal disease should not be perceived as an inevitable consequence of gingivitis which ultimately leads to considerable tooth loss. A more specific characterization of the features of periodontal breakdown in those individuals who seem particularly susceptible is therefore warranted.

Adolescent↗

Tooth mortality and periodontal conditions in 60-80-year-old Chinese.

The study comprised 544 persons aged 60 yr or more from two urban Residential Areas and one rural village (including a nursing home) of Beijing area. Overall, the sample accounted for 81% of the total population of elderly aged 60 yr or more in the village/areas so defined. Each person was examined for dental status, plaque, calculus, gingivitis, loss of attachment, pocket depth and tooth mobility. Edentulousness was seen in 0-29% of the persons examined, depending on age and sex. The mean number of teeth present ranged from 6.9 to 23.9, depending on age and sex, and area. The oral hygiene was poor; approximately 50% of all surfaces had immediately visible plaque deposits and calculus. About 50% of the surfaces had a loss of attachment greater than or equal to 4 mm, while less than 15% presented pockets greater than or equal to 4 mm. More than 50% of the individuals had loss of attachment greater than or equal to 4 mm on more than 40% of their surfaces. The proportion of surfaces per person with loss of attachment greater than or equal to 7 mm; and pockets greater than or equal to 4 mm, respectively, showed a pronounced skewed distribution. These findings indicate that a subfraction of individuals is responsible for a substantial proportion of the severe periodontal breakdown leading to loss of teeth. This, in turn, raises important questions as to the most appropriate strategies for the prevention and control of periodontal diseases for the Chinese population.

Aged↗

Caries experience in urban Tanzanian children 1973-84.

In 1973 and 1984 the caries status of 624 and 394 children, respectively, was recorded in an urban area of northern Tanzania where the water fluoride content was 2.0-3.5 ppm. Although slightly different scoring criteria were used, the data showed very low levels of caries, and little evidence of increases in caries experience over the 10-yr period. The distribution of caries lesions was markedly skewed, such that a minority of individuals account for most of the caries. The levels of caries were low by international standards and equivalent to those found in children from low fluoride areas of Tanzania.

Adolescent↗

Tooth mortality in an adult rural population in Kenya.

This paper reports on the pattern of tooth loss in a random sample of 1131 adults aged from 15 to 65 years in a rural area of Kenya in which access to formal dental care is minimal. We found that the majority of the population retained most of their dentition in a functional state even up to the age of 65 years: In all age groups, more than 50% had at least 26 teeth present, and more than 90% had at least 16 teeth present. The prevalence of edentulousness was less than 0.3%. The principal cause of tooth loss in all age groups was caries, and this was true for all tooth-types except incisors, for which periodontal disease was the main cause of tooth loss. The cultural practice of removing lower central incisors was observed only in those over 40 years of age. More teeth were lost due to caries among women than among men, while the reverse was true for teeth lost due to periodontal diseases. In view of the fact that most people retain most of their teeth throughout life, it is suggested that the most appropriate strategies for dental health care in this population should be those promoting self care, rather than the introduction of a formal treatment-oriented approach provided by dentists.

Adolescent↗

Pattern of periodontal breakdown in adult Tanzanians.

A total of 170 adult Tanzanians aged 30-69 yr were examined for loss of attachment, gingival recession, plaque, calculus and gingival bleeding on all surfaces of all teeth. The severity of loss of attachment varied considerably between tooth types. Irrespective of age, mandibular incisors and first and second molars were the teeth most affected by loss of attachment. In all age groups heavy plaque deposits and gingival bleeding occurred more frequently in posterior than in anterior teeth. Dental calculus was most frequently observed in the maxillary posterior and mandibular anterior teeth. The distribution of calculus within the dentition showed a close resemblance with the patterns of loss of attachment and gingival recession. The variation of the severity of periodontal breakdown within individuals indicates that the use of mean values to describe periodontal breakdown may give the impression of a greater uniformity than really exists.

Adult↗

Tooth loss as related to dental caries and periodontal breakdown in adult Tanzanians.

A total of 170 adults aged 30-69 yr from the Zanzibar and Pemba Islands (Tanzania) were examined for tooth loss, dental caries and loss of periodontal attachment. The cause of tooth loss was recorded from information given by the examinee to a Kiswahili-English interpreter. Dental caries were recorded according to the depth of the lesion, i.e. involving enamel, dentin or pulp, respectively. Loss of attachment was measured as the distance in mm from the CEJ to the bottom of the pocket. The most severely affected surface determined the state of the tooth. The mean number of teeth present ranged from 29.5 in the youngest to 23.9 in the oldest age group. The mean number of teeth missing due to dental caries ranged between 2.1 and 7.0 teeth, and exceeded by far tooth loss due to periodontal breakdown which was only observed in the two oldest age groups. In all age groups the molars were the teeth most frequently missing and also the teeth most frequently affected by dental caries. Although a substantial number of the teeth in the older age groups demonstrated an extensive loss of attachment only a few teeth, mainly mandibular incisors, were lost due to periodontal breakdown within the age range examined.

Adult↗

Posteruptive tooth age and severity of dental fluorosis in Kenya.

The purpose of the present study was to assess whether the degree of severity of enamel changes in a population exhibiting rather severe dental fluorosis may be related to posteruptive tooth age and to describe the clinical manifestations of the enamel destructions. All permanent teeth in 102 children aged 10-15 yr who were born and reared in a 2 ppm fluoride area of Kenya were examined for dental fluorosis using the TF-Index. Clinically, at time of eruption all teeth appeared chalky white, but already prior to coming into occlusion discrete pits had formed. A variety of more extensive damages to the surface enamel was found in teeth already in occlusion. In particular, the maxillary incisors exhibited extensive artificial attrition for cosmetic reasons, which make these teeth unreliable for accurate scoring of severity in the present population. An analysis of the proportion of teeth exhibiting TFI-scores 4+, 5+ and 6+ showed that children aged 13-15 yr had a significantly greater proportion of teeth with TFI-scores greater than or equal to 6 compared to children aged 10-12 yr (Wilcoxon, P less than 0.0001). This finding is unlikely to be a result of different fluoride exposures in the two age groups and indicates that even several years after eruption there is a trend towards an increasing severity of enamel surface destructions in children exhibiting pronounced degrees of subsurface enamel hypomineralization at time of eruption.

Adolescent↗

Dental fluorosis in an area of Kenya with 2 ppm fluoride in the drinking water.

We examined 102 children born and reared in an area of rural Kenya with 2 ppm fluoride in the drinking water for dental fluorosis, using the index developed by Thylstrup and Fejerskov (1978). The prevalence of dental fluorosis was 100%, 92% of all teeth exhibited a TFI score of 4 or higher, and 50% of the children had pitting or more severe enamel damage in at least half the teeth present. The fluorotic changes showed a high degree of bilateral symmetry. The intra-oral distribution of the changes corresponded to the pattern of fluoride-induced enamel changes reported by other investigators in high-fluoride areas. The high prevalence and severity of dental fluorosis in a 2-ppm-fluoride area is in accordance with recent observations on dental fluorosis being very prevalent in Kenya, even in low-fluoride areas (less than 1 ppm F). We are presently investigating the possible variables which may explain this unexpected susceptibility of large populations in Eastern Africa to fluorosis from exposure to low levels of fluoride.

Adolescent↗

Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions.

Current scoring systems for dental caries do not consider the dynamic nature of the disease. The aims of the present study were to describe a new set of clinical caries diagnostic criteria which differentiate between active and inactive caries lesions at both the cavitated and non-cavitated levels and to evaluate the reliability of this criteria system in a population with high caries experience. Ten diagnostic codes were defined: 0 = sound; 1 = active (intact); 2 = active (surface discontinuity); 3 = active (cavity); 4 = inactive (intact); 5 = inactive (surface discontinuity); 6 = inactive (cavity); 7 = filling; 8 = filling with active caries; 9 = filling with inactive caries. Distinction between active and inactive caries lesions was made on the basis of a combination of visual and tactile criteria. The inter- and intra-examiner reliability was assessed through repeated examinations of 50 children by 2 recorders over a period of 3 years. The percentage agreement of caries diagnoses varied between 94.2 and 96.2%. The kappa values ranged between 0.74 and 0.85 for intra-examiner examinations and between 0.78 and 0.80 for inter-examiner examinations; 81.6% of all misclassifications involved non-cavitated caries lesions. Disagreement between sound surfaces and non-cavitated active or non-cavitated inactive lesions (31.3 and 31.2%, respectively) was more common than disagreement between non-cavitated active and non-cavitated inactive lesions (10. 6%). The probability of reconfirming a sound, non-cavitated active or non-cavitated inactive caries lesion - given that the surface was diagnosed as either sound, non-cavitated active or non-cavitated inactive at the first examination - was 98.0, 68.7 and 72.5%, respectively. The results show that the use of a new set of clinical caries diagnostic criteria based on activity assessment can be performed with a high reliability, even when non-cavitated diagnoses are included in the criteria system.

Adolescent↗

A comparison of clinical and radiographic caries diagnoses in posterior teeth of 12-year-old Lithuanian children.

Bite-wing radiography has been recommended for use in adolescents as clinical examinations alone may lead to underestimation of carious lesions in approximal and occlusal surfaces. The aim of this study was to describe the relationship between clinical and radiographic caries diagnoses among 12-year-old Lithuanians using a new clinical scoring system which differentiates between cavitated and non-cavitated caries lesions. Eight hundred and seventy-two children were examined clinically and two standardized posterior bite-wing radiographs were taken of each participant. Bite-wing radiography contributed significantly to the total number of lesions diagnosed only at the dentin level in approximal surfaces. Clinical examination performed better than radiographic examination at the non-cavitated/enamel level, particularly on occlusal surfaces. Less than 2% of the clinically sound surfaces were diagnosed with dentin lesions/fillings radiographically. When using the cavitated level of clinical diagnosis, the frequency of 'hidden' caries lesions increased from 1.9 to 2.9% in approximal surfaces, and from 1.7 to 5. 2% in occlusal surfaces. The intra-examiner reliability data for the clinical and radiographic recordings supported the conclusion of an additional diagnostic value of bite-wings only for approximal surfaces. The findings demonstrate that the diagnostic yield of bite-wing radiography is higher for approximal than for occlusal surfaces. The efficacy of bite-wings depends on the refinement of the clinical caries diagnostic criteria. 'Hidden' caries does not seem to be a major problem when the clinical caries diagnostic criteria include non-cavitated diagnoses.

Bicuspid↗

Ten-year incidence of dental caries in adult and elderly Chinese.

Only very few longitudinal studies on dental caries are available in adults and elderly. Therefore, the aim of the present study was to describe the patterns of lesion progression in a group of adult and elderly Chinese followed over a 10-year period of time. In 1984, 587 persons aged 20-80 years were examined and by 1994, 440 of these were still available and re-examined by the same two examiners. All restorations, periodontal conditions and dental caries were recorded for all teeth and surfaces. Only caries data are reported here. Dental caries on coronal surfaces was classified as sound, non-cavitated, cavitated without or with pulp involvement or filled. On root surfaces, lesions were classified as sound, active caries or restored. Prior to analysis of the data, a series of drop-out analyses was carried out showing that most of the drop-outs were above 60 years of age at baseline, and death of participants was the major drop-out reason. A total of 2,114 teeth were lost, 36% of which had a deep dentin lesion at baseline. The distribution of persons according to number of new lesions/restorations over 10 years was highly skewed in all age groups, the prevalence increasing with age. Molars had the highest risk of becoming carious/restored over the 10-year period, and a remarkably low proportion of teeth had the same caries diagnosis after 10 years, indicative of lesion progression. When comparing the 1984 DFT/DMFT with the figures for 1994, there were no statistically significant differences indicating that the period and cohort effects cancel out each other. There was a significant increase with age of the number of new DFT. It can be concluded that dental caries is a major health problem in contemporary adult and elderly Chinese populations, and that caries incidence increases with old age.

Adult↗

Prospective study of the effect of post-brushing rinsing behaviour on dental caries.

Previous studies have indicated that rinsing the mouth with a beaker of water after toothbrushing may compromise the caries reducing effect of fluoride toothpaste. A 3-year clinical trial of daily supervised brushing with fluoride toothpaste at school was used to test the effect of post-brushing rinsing with water on caries increment. A total of 407 children, mean age 11.8 years, attending three schools in Kaunas, Lithuania were enrolled following informed consent of the children and their parents. Caries was recorded at baseline and annually for 3 years. During the study, children in two schools (A and B) performed daily supervised brushing with a 1,500-ppm fluoride toothpaste. Children in school A rinsed their mouths thoroughly with a beaker of water after toothbrushing whereas children in school B were only permitted to spit out once after brushing. Furthermore, the children in these schools were supplied with toothpaste and toothbrushes for use at home and in school. A third school (C), without daily brushing and without supply of toothpaste, served as control. Compliance with the protocol was consistently better in school B. After 3 years 276 children were available for examination. Three-year DMFS increments, including non-cavitated lesions (mean, 95% CI), were: school A, 6.8 (5.3; 8.3); school B, 6.2 (4.6; 7.8), and school C, 12.4 (10.6; 14.1). Mean increments for schools A and B did not differ significantly but were both significantly lower than those of school C (p< 0.001). It is concluded that post-brushing rinsing with water, under the conditions of this study, does not significantly affect the caries reducing effect of a fluoride toothpaste.

Analysis of Variance↗