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PubMed2004

Patterns of ethnic, linguistic, and geographic heterogeneity of palmar interdigital ridge counts in the Indian subcontinent.

Published data on palmar interdigital ridge counts (a-b, b-c, and c-d) among 57 populations from the Indian subcontinent were analyzed with reference to ethnic, socioeconomic, linguistic, and geographic affiliations of the studied populations. The spatial autocorrelation analysis suggests significant correlation between dermatoglyphic and geographic distances. The congruence with the ethnic semblance of the groups is also apparent in the data, and, in fact, the multiresponse permutation procedure did suggest highly significant within-group homogeneity, confirming the biological validity of the social and ethnic criteria used in the analysis. The plots of populations on the first two principal components, accounting for 92% of the total variance, complement and support the results based on the other analyses, which show certain ethnic and geographic patterns. These findings can serve as baseline information for future studies on population variation in India, particularly studies based on molecular genetic markers, a trend that has already gained momentum.

Dermatoglyphics↗
PubMed2003

Multiple birth rates according to different socioeconomic levels: an analysis of four hospitals from the city of Sao Paulo, Brazil.

This population based study compares the rates of multiple births in the 1990s in four hospitals of different socioeconomic levels. It is well known that women from higher socioeconomic groups have easiest access to infertility therapies because of greater financial resources. The hospital of lower socioeconomic level presented multiple birth rates of approximately 8 per thousand during the decade, which may be considered as the natural one. The other three hospitals presented increased rates that were positively correlated to socioeconomic level. This increase occurred mainly due to dizygotic twins and to triplets and was as high as 4.8 per thousand in 1999. Maternal age was also positively correlated to socioeconomic level for singletons as well as for twins. However, during the decade the mean maternal age increased only in the two hospitals with better socioeconomic levels. Gestational order decreased as socioeconomic levels increased, mainly for twins and triplets. The percentage of singletons with low birthweight and very low birthweight decreased as socioeconomic level increased. However, twins presented with an equal distribution in the four hospitals, indicating that better socioeconomic level did not affect the incidence of low birthweight and very low birthweight among twins. Fetal death rate decreased as socioeconomic level increased but twin/singleton fetal death ratio is three times greater in the hospital of higher socioeconomic level suggesting that even in ideal conditions of medical and hospital facilities, the mortality of twins continues to be much higher than that of singletons.

Adult↗
PubMed2001

Is use of exogenous estrogen associated with temporomandibular signs and symptoms?

BACKGROUND: Studies of historical data suggest a link between exogenous estrogen use and referral for treatment for temporomandibular disorders, or TMDs. The purpose of the authors' study was to determine the association between exogenous estrogen use and signs and symptoms of TMD assessed by direct physical examination in a randomly selected community sample of primarily postmenopausal women. METHODS: A calibrated clinical examiner examined a stratified random sample of 510 women aged 37 to 82 years using the Craniomandibular Index, or CMI. All medications that subjects were taking at the time of the examination were identified by interview and examination of subjects' medication containers on two occasions. One hundred seventy-four subjects were taking medications containing estrogen, and 336 were taking no such medications. RESULTS: The muscle and joint signs and symptoms of women taking and not taking estrogen were not significantly different after the authors controlled for sociocultural, demographic and health care utilization variables. Estrogen use also failed to distinguish women receiving relatively high and low scores on the CMI. CONCLUSION: Estrogen replacement therapy does not place women at increased risk of developing TMDs. CLINICAL IMPLICATIONS: Clinicians need not be concerned that patients taking oral contraceptives or replacement estrogens are at increased risk of developing TMDs.

Adult↗
PubMed2002

Oral health status of rural adults in the United States.

BACKGROUND: Many sociodemographic indicators of oral health disparity in the United States have been documented. Rural residence, however, has not been researched thoroughly, though it has been considered to be a potential indicator of disparity. The authors conducted this study to present information on the effects of rural residence on oral health in the United States. METHODS: The authors conducted their analyses using data from adults aged 18 to 64 years from the 1995, 1997 and 1998 National Health Interview Surveys and the Third National Health and Nutritional Examination Survey, 1988-94. The authors present national estimates for various oral health status indicators including dental insurance coverage, unmet care needs, frequency of dental visits, caries experience and prevalence of edentulism by rural/urban residence. RESULTS: The authors found that adults living in rural areas were more likely to report having unmet dental care needs and were less likely to have had a dental visit in the past year compared with adults living in urban areas. The prevalence of edentulism among rural adults was 16.3 percent-almost twice that of urban adults. Caries experience also was more likely to be greater among adults residing in rural areas. CONCLUSIONS: Oral health disparities exist among U.S. adults living in rural and urban areas. Compared with urban residents, rural residents were less likely to report a dental visit in the past year and were more likely to be edentulous. PRACTICE IMPLICATIONS: By understanding the rural/urban differences in adult oral health status, practitioners, policy-makers and rural health advocates will have better information to use to promote activities that better meet the needs of rural adults in the United States.

Adolescent↗
PubMed2002

Use of dental services: an analysis of visits, procedures and providers, 1996.

BACKGROUND: While many studies have provided data on Americans' access to dental care, few have provided a detailed understanding of what specific treatments patients receive. This article provides detailed information about the types of dental services that Americans receive and the types of providers who render them. METHODS: The authors provide national estimates for the U.S. civilian noninstitutionalized population in several socioeconomic and demographic categories regarding dental visits, procedures performed and the types of providers who performed them, using household data from the 1996 Medical Expenditure Panel Survey, or MEPS. RESULTS: Data show that while the combination of diagnostic and preventive services adds up to 65 percent of all dental procedures, the combination of periodontal and endodontic procedures represents only 3 percent. Additionally, while 81 percent of all dental visits were reported as visits to general dentists, approximately 7 percent and 5 percent of respondents who had had a dental visit reported having visited orthodontists or oral surgeons, respectively. CONCLUSION: MEPS data show the magnitude and nature of dental visits in aggregate and for each of several demographic and socioeconomic categories. This information establishes a nationally representative baseline for the U.S. population in terms of rates of utilization, number and types of procedures and variations in types of providers performing the procedures. These nationally representative estimates include data elements that describe specific dental visits, dental procedures and type of provider, and they offer details that are useful, important and not found elsewhere. PRACTICE IMPLICATIONS: By understanding these analyses, U.S. dentists will be better positioned to provide care and better meet the dental care needs of all Americans.

Adult↗
PubMed2001

[Self-perception of oral health status by the elderly].

OBJECTIVE: To assess the self-perception of oral health status of the elderly and to analize the clinics, subjectives and sociodemographic factors that interfer in this perception. METHODS: Results are based on interviews and clinical assessment of 201 subjects aged 60 years and over, who were dentate, functionally independents and used to go to a health care center in the town of Araraquara, SP, Brazil. A questionnaire with questions about social characteristics of the sampled population, their oral health status self-perception and the Geriatric Oral Health Assessment Index (GOHAI) was applied. All subject underwent a clinical examination to determine the prevalence of the main oral diseases. Statistical analyses were performed to determine the association between social and clinic variables, and the GOHAI index with their oral health self-perceptions. In addition, analyses were made to identify self-assessment predictors. RESULTS: The clinical examination revealed that dental caries and periodontal disease had a significant prevalence, though 42.7% of the sample assessed their oral health status as regular. Social class, the GOHAI index, and the decayed and missing teeth were all associated with the self-assessment. The multivariate analysis showed that the self-assessment predictors were the GOHAI index, missing teeth and Community Periodontal Index and Treatment Needs index. These predictors accounted for 30% of the self-assessment variability. CONCLUSIONS: As the oral health self-perception had minor influence on the clinical conditions, developing educational and preventive actions for the elderly population are recommended.

Aged↗
PubMed2004

[Dental caries experience in children at public and private schools from a city with fluoridated water].

The aim of this study was to verify the relationship between type of school as a measure of socioeconomic conditions and caries prevalence among preschoolers and schoolchildren in Rio Claro, São Paulo State, Brazil, a city with fluoridated water supply. The data were secondary, from a sample of 888 children 5 to 12 years old enrolled in private and public schools. Caries was measured by the dmft and DMFT indices as well as the Care index. Qui-square and Mann-Whitney tests were utilized with 5% significance. In 5-year-old children, mean dmft was 2.50, and 42.20% were caries-free. At age 12, mean DMFT was 2.70 and 28.90% were caries-free. Caries prevalence rates in public schoolchildren as compared to private were 74.50% and 61.20%, respectively (p < 0.0001), and the dmft and DMFT scores were the highest in public schoolchildren (p < 0.05). The Care Index was higher in private schoolchildren (71.20%) as compared to public (52.80%). Highest caries rates were found among public schoolchildren, so the variable type of school proved sensitive for discriminating different oral health conditions; however limitations need to be recognized, suggesting that other variables should be assessed.

Age Distribution↗
PubMed2002

The effect of restorative treatment on children's behavior at the first recall visit in a private pediatric dental practice.

Clinicians anecdotally believe that children, who have an invasive dental procedure after the initial office visit, often exhibit negative behavior at the recall examination. The purpose of this study was to document the behavior of children having the first recall visit at a private pediatric dental practice to determine if the restorative dentistry experience influenced behavior at recall. All children presenting for the first recall visit in the private practice of the author were included in the study (n = 271). Patient age, method of payment as an indicator of socio-economic status and whether or not they had restorative dental treatment subsequent to the initial visit was recorded by the author, who was also the treating dentist. Behavior was evaluated using the scale formulated by Sarnat, which rates behavior in 5 categories from completely cooperative to completely uncooperative. Behavior at the initial visit was also recorded and retrieved from retrospective examination of patient records The results showed that 3 to 6 year olds, who underwent restorative dentistry, exhibited more negative behavior than those who did not. No difference in behavior was found in those children under 3 years or over 6 years of age. Depending on the age, behavior at the first recall visit may be influenced by having undergone a restorative dental procedure after the initial examination.

Age Factors↗
PubMed2003

Birth weight and gestational age of newborns with cleft lip with or without cleft palate and with isolated cleft palate.

The birth weight and gestational age of 1368 newborns with isolated cleft lip with or without cleft palate and 582 with isolated cleft palate were compared to those of matched healthy controls. The results indicate that fetuses with oral clefts are at elevated risk of having low and very low birth weight, but not of having a premature birth. Speculations on a relationship between these findings and the presence of oral clefts are presented.

Adult↗
PubMed1995

Compliance with supportive periodontal treatment in private periodontal practice. A 14-year retrospective study.

The purpose of this study was to determine the degree of compliance with supportive periodontal treatment (SPT) recommended in private periodontal practice and to determine if any significant differences existed in the characteristics of compliant, non-compliant, and erratically compliant patients. The study covered a period of 14 years (1977 to 1991) and included 521 patients who were classified by sex, age, socioeconomic class, disease severity, treatment rendered, and the year maintenance began. Compliance was categorized into four groups: complete compliance, erratic compliance, patients who discontinued SPT, and patients who never presented for SPT. Females began SPT more often than males (P = 0.054). Only 27.4% of the patients were in complete compliance at the end of the study. A significantly greater percentage of females (P = 0.032) and patients who had been treated by only scaling and root planing (P = 0.014) were in complete compliance. Drop-out rates from SPT tended to decrease during the first 6 years from 13.9% in the first 2 years to 9% in the sixth year. Thereafter, the percentage of patients presenting for SPT stabilized at 48.4% after 6 and 43.2% after 11 years. Younger patients (P = 0.04), those who had received only scaling and root planing (P = 0.008), and individuals in socioeconomic class I (P = 0.017) had a significantly lower tendency to drop out. The results confirm that compliance to SPT in private periodontal practice is far from ideal. Suggestions for improving compliance are discussed.

Adult↗
PubMed2002

The effect of sociocultural status on periodontal conditions in pregnancy.

BACKGROUND: The effects of sociocultural status on periodontal conditions in pregnant women have been reported by a number of researchers and there have been speculations about the effects of hormonal changes, patients' systemic health, and socio-cultural characteristics on periodontal health during pregnancy. METHODS: This study evaluates the periodontal condition of 61 pregnant women at their first, second, and third trimesters, and the relation between the demographic (age, professional level, education) and clinical variables (previous periodontal care, frequency of tooth brushing). The clinical indices, including plaque index, gingival index, and probing depth measurements were repeated at the first, second, and third trimesters. The statistical tests used were stepwise analysis and paired sample test. RESULTS: The results of the study showed that the plaque index, gingival index, and probing depth scores increased gradually in the first, second, and third trimesters, although oral hygiene instructions were given to the entire study population. The level of statistical significance was established at P <0.05. When the clinical parameters and demographic variables were compared, only educational level and periodontal care seemed to be statistically significant (P<0.05). CONCLUSIONS: Our clinical index scores were related to the educational level of the study population. When the educational level of the study group decreased, the plaque, gingival index, and probing depth scores contrarily increased. Also non-attendance for previous periodontal care increased the scores of plaque index and probing depth. In view of the results of our study, it might be suggested that simple preventive oral hygiene programs may help maintain healthy gingiva during pregnancy.

Adolescent↗
PubMed2004

The effects of ovulation induction during infertility treatment on gingival inflammation.

BACKGROUND: Ovulation induction is the most common method of infertility treatment in which the ovaries are stimulated to produce multiple follicles. The aim of this study was to assess the effects of three drug protocols of ovulation induction: clomiphene citrate (CC) alone, CC combined with follicle stimulating hormone (FSH), and CC combined with human menopausal gonadotropin (HMG) on the gingival tissues of women who were undergoing infertility treatment. METHODS: Study population was composed of 18 women using CC for three menstrual cycles or less and 16 women using CC for more than three cycles; 21 women using CC-FSH; and 24 women using CC-HMG who had at least four cycles of CC alone the previous year. All subjects were clinically examined for plaque levels (plaque index), gingival inflammation (gingival index), bleeding on probing, and gingival crevicular fluid volume. The results were compared with a control group of 20 women matched for age, educational and professional level, and oral habits and who had never used ovulation drugs. RESULTS: Despite similar plaque levels (P>0.05), women using CC for more than three cycles and combined protocols of CC-FSH and CC-HMG had higher levels of gingival inflammation (P<0.01, P<0.001 and P<0.001, respectively), bleeding (P<0.001), and GCF volume (P<0.001) when compared to the control group and to the users of CC for three cycles or less. CONCLUSIONS: The results of this study have shown that ovulation induction, which is the most common method in the management of infertility, exacerbates gingival inflammation, bleeding, and GCF volume and that the duration of the usage of these drugs is strongly associated with the severity of gingival inflammation.

Adolescent↗
PubMed2000

Predictors of owner response to companion animal death in 177 clients from 14 practices in Ontario.

OBJECTIVE: To identify predictors of grief and client desires and needs as they relate to pet death. DESIGN: Cross-sectional mail survey. SAMPLE POPULATION: 177 clients, from 14 randomly selected veterinary practices, whose cat or dog died between 6 and 43 days prior to returning the completed questionnaire. PROCEDURE: Veterinary practices were contacted weekly to obtain the names of clients whose pets had died until approximately 200 clients were identified. Clients were contacted by telephone, and a questionnaire designed to measure grief associated with pet death was mailed to those willing to participate within 1 to 14 days of their pet's death. The questionnaire measured potential correlates and modifiers of grief and included three outcome measures: social/emotional and physical consequences, thought processes, and despair. Demographic data were also collected. RESULTS: Approximately 30% of participants experienced severe grief. The most prominent risk factors for grief included level of attachment, euthanasia, societal attitudes toward pet death, and professional support from the veterinary team. CONCLUSIONS AND CLINICAL RELEVANCE: Bivariate and multivariate analyses highlighted the impact owners' attitudes about euthanasia and professional intervention by the veterinary team had on reactions to pet death. Owners' perceptions of societal attitudes, also a predictor of grief, indicate that grief for pets is different than grief associated with other losses.

Adolescent↗
PubMed2004

Family and ability correlates of academic grades: social status group differences.

In a continuation of work by Marjoribanks (2003), using a sample of 150 seventh grade students, relationships among Parent Involvement as defined by factor scores of four measures of parents' involvement completed by teachers: teacher-parent contacts, teacher-parent communication, parents' involvement at home, and parents' participation in school, Intellectual Ability as defined by Verbal Intelligence using the Yuste's Differential and General Aptitudes Battery-M, and Academic Grades as defined by the average grade for all subject matter were examined. Analysis showed different predictive models for children's academic achievement as a function of social status. For children of low and middle social status, Intellectual Ability was the single predictor. For children of high social status the predictors were Parents' Involvement and the interaction of Parents' Involvement and Intellectual Ability.

Adolescent↗