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PubMed1984

Measurement of dental caries experience--modification of the DMFT index.

The DMFT index is one of the simplest and most commonly used indices in epidemiologic surveys of dental caries. It quantifies dental health status based on the number of carious, missing and filled teeth. The index, however, does not provide an accurate description of previous dental care. Nor does it provide information regarding the severity of the carious attack or the indicated treatment. Thus, a revision of the DMFT index was developed. This involved a division of the "D" component into four separate categories. With the addition of these categories, the index remains simple, and yet provides a description of one's previous dental experience. It further shows the extent of dental services needed by the population, which can be interpreted in terms of treatment hours and costs. This modified index has been successfully utilized in a dental epidemiologic survey of 1672 schoolchildren, 14-16 yr of age. It was apparent that the additional components provided significant data for treatment planning as well as dental health status.

Adolescent↗

PubMed2003

Xerostomic medications and oral health: the Veterans Dental Study (part I).

OBJECTIVES: To quantify the adverse effects of the number of xerostomic medications on dental caries, oral mucosa, and periodontal disease. DESIGN: Secondary analysis of a cross-sectional study of the Veterans Dental Study. SETTING: Four New England area VA outpatient clinics. SUBJECTS: The sample consists of 345 male veterans participating in The Veteran's Dental Study who also had pharmacy records. MAIN OUTCOME MEASURES: Oral health data included total surfaces of coronal caries, a modification of the root caries index, mean oral mucosa scores, and Community Periodontal Index of Treatment Need (CPITN). Oral health parameters were measured and recorded in clinical dental examinations. EXPOSURES: Intake of xerostomic medications 14-385 days prior to the dental examination. STATISTICAL ANALYSES: The relationships between exposure and outcome were analyzed via linear and logistic regression methods adjusting for possible confounding factors such as disease burden index, alcohol consumption, dental care, and smoking status. RESULTS: Veterans who were taking at least one xerostomic medication were almost three times more likely to have mean mucosa scores in the worst 25 percentile than veterans taking no xerostomic medications, OR = 2.63 (confidence interval [CI] 1.34, 5.16, p = 0.03) after adjusting for age, number of teeth, disease burden index, income, smoking and alcohol use. Participants who were taking at least one xerostomic medication experienced higher but non-significant increases in coronal (OR = 1.21; CI. 0.66, 2.25) and root caries (OR = 1.10 CI. 0.54, 2.24) measured by numbers of total decayed surfaces. CONCLUSION: There were significant deleterious effects of xerostomic medications on oral mucosa. However, xerostomic medications do not appear to increase coronal caries, or periodontal index measured by CPITN among ambulatory, community dwelling participants who were able to perform routine preventive oral care.

Adult↗

PubMedDate not supplied

Caries prediction by multiple salivary mutans streptococcal counts in caries-free children with different levels of fluoride exposure, oral hygiene and sucrose intake.

The aims of this study were to assess whether multiple salivary mutans streptococcal (ms) counts have a higher predictive power than a single one, and whether the predictive power of the test is different at different levels of fluoride exposure, oral hygiene and sucrose consumption. Three salivary ms tests were performed at 3-month intervals (positive test: salivary ms >/=5x10(5) cfu/ml) on a sample of 304, initially caries-free, 6- to 7-year-olds. Plaque index was also assessed and the parents filled out a questionnaire concerning sucrose-containing eating events and fluoride exposure. Sensitivity, specificity and Youden's index (J) were used to compare the predictive power. Thirty-six percent of the children developed caries during the 2-year follow-up. The highest J value for a single ms test (the second) was 0.24 (sensitivity 29.1%, specificity 95.4%). The multiple ms test with the highest J value (0.29) was obtained by the dichotomies 0 vs. 1-3 positive tests (sensitivity 50.0%, specificity 79.9%) and 0-1 vs. 2-3 positive tests (sensitivity 31.8%, specificity 97.4%). The predictive power of the multiple test was passable for children with low fluoride exposure and high plaque index (sensitivity 57.4%, specificity 93.7%, J 0.51), while it was low for the other groups. Sucrose exposure did not significantly affect the predictive power of the ms test.sion.

Chi-Square Distribution↗

PubMedDate not supplied

[The comparative efficacy of local anticaries agents].

A total of 857 7-year-old children were examined, divided into 9 groups. A certain prophylactic agent was used in every group. Caries augmentation intensity and reduction indexes, determined in a year after prophylactic treatment, evidence that 2% sodium fluoride solution was the most effective caries inhibiting agent. 1% fluoride gel and fluoride varnish were also found effective means of caries prevention.

Cariostatic Agents↗

PubMed1985

Evaluation of oral problems in divers performing electrical welding and cutting under water.

A study of 118 professional commercial divers, using an inquiry form, revealed that 55% of the divers complained about a metallic taste in the mouth when working with electrical equipment under water. A nationwide clinical examination of 40 divers was performed to see if the metallic taste during work reflected any alteration in the oral cavity. The clinical appearance of the dental amalgam restorations differed significantly between divers who had been working with electrical equipment and divers who had not. A number of other dental indexes were assessed and showed no differences between the two groups. These included salivary secretion rate, buffering capacity, secondary caries, plaque index, bleeding index, and cultures of S. mutans and Lactobacillus. Relatively high levels of the two organisms were noted, indicating that the group of divers examined should be considered as a caries risk groups.

Adult↗

PubMed2005

Dental fluorosis and dental caries in permanent teeth: rural schoolchildren in high-fluoride areas in the Shaanxi province, China.

OBJECTIVES: To study the dental fluorosis and caries in the permanent teeth of 12 to 13-year-old children in fluorosis-endemic areas; to assess the relationship between fluorosis and the fluoride content of the drinking water and the relationship between caries and the fluoride content of the water; finally, to analyze the effect of fluoride intake and water stored in clay pots on dental fluorosis. MATERIAL AND METHODS: 477 children were divided into 5 groups (A to E) according to the fluoride concentration of the waters, i.e. by 0.4, 1.0, 1.8, 3.5, and 5.6 mg F/l, respectively. Dental fluorosis was assessed by TF score and caries by the DMF-T index. A questionnaire was used to obtain information about water storage and other information relevant to children's fluoride intake. RESULTS: A positive relationship was found between the mean TF scores and the water fluoride concentration. In groups B and D, the TF score was higher in 13-year-olds than in 12-year-olds. Caries prevalence and mean DMF-T ranged from 2.6% and 0.03 (group E) to 22.1% and 0.38 (group A). Storage of water in clay pots seemed to increase the severity of fluorosis slightly, and to decrease the caries prevalence. CONCLUSIONS: Defluoridation of drinking water, or--alternatively--the provision of low-fluoride water sources, should be given high priority in the examined Shaanxi rural areas. Fluoride concentration of drinking water should be maximum 0.6 mg/l. Storage of water in the local clay pots may increase the severity of dental fluorosis.

Adolescent↗

PubMed1980

Assessing root caries in populations: the evolution of the root caries index.

This paper traces the history of the epidemiologic assessment of root caries over the past 30 years. This history clearly points out that a critical junction has been reached between the state-of-the art for the reporting of root caries and the demand placed on research and service components of the oral health system. If progress is to be made, it is imperative that a uniform reporting method for root caries be adopted. This paper introduces the Root Caries Index (RCI) as an index that should prove to be a feasible and utilitarian method for reporting root caries data in descriptive and analytic epidemiologic studies as well as assessing the results of preventive and treatment agents, clinical trials. The Root Caries Index represents, in the evolution of a root caries measurement method, a refinement of the delineation of the true intraoral "population at risk" to the disease process. The resulting index is a true attack rate for supragingival root caries lesions. This development should permit more meaningful comparison of populations, clearer interpretations regarding risk factors, and more precise assessment of preventive and treatment agents.

Adolescent↗

PubMed1997

Evaluation and use of an index of oral health status.

OBJECTIVES: The goals of this investigation were (1) to evaluate the Oral Health Status Index in relation to demographic characteristics, socioeconomic status, and preventive behaviors of an adult population; and (2) to understand how individual index components performed as indicators of oral health status compared to the composite index. METHODS: The Oral Health Status Index (OHSI) was used on a probability sample of adults, aged 18-93 years, living in the Detroit tricounty area. Data were collected on 509 subjects via in-home dental examinations. Bivariate and multivariate analyses were used to compare the OHSI and its components, including decayed, missing, and replaced teeth, free ends, and moderate and severe periodontal disease measures. RESULTS: The mean OHSI score for subjects was 77.3 (SE = 1.83) with a range of -8.0 to 100.0. In regression analyses, OHSI scores were positively correlated with subjects' education level, self-rated oral health scores, and frequency of dental checkups and negatively correlated with age, nonwhite race, and smoking. Of the index components, missing teeth performed well as an indicator of oral health status. Missing teeth were positively correlated with age, nonwhite race, and smoking and negatively correlated with education level, self-rated oral health, and use of Medicaid. About 53 percent of variance in OHSI scores was explained by the multivariate models, compared to 46 percent for missing teeth. CONCLUSIONS: Choosing an indicator of oral health status likely will depend upon the characteristics of the population to be studied. As a composite measure of oral health status, the OHSI performed acceptably; however, missing teeth, an index component, also worked well. Continued evaluation of the OHSI is warranted.

Adolescent↗

PubMed1996

[Evaluation of the prevalence of dental caries in school-children from an urban area of Southeastern Brazil].

An epidemiologic survey of dental caries was undertaken in the town of Paulínia. S. Paulo state, south-eastern Brazil, in 1994, for the purpose of comparing the present prevalence with that registered during the previous study of 1980. The children examined numbered 1,416, were of both sexes and aged 7-14. Ten dentists, preciously trained, used DMF.T and DMF.S dental caries indexes. A level of prevalence of dental caries 67.8% below that of 1980 was found. Further, there had been an inversion of DMF.T index components. Whereas in 1980 the component caries was higher (69.5%), while the filing component prevailed (79.0%) in 1994. The missing tooth component has disappeared altogether in this recent survey.

Adolescent↗

PubMedDate not supplied

Validation of the children's Oral Health Status Index (COHSI).

The findings presented here provide support for the validity of the Children's Oral Health Status Index. The COHSI is a good predictor of dentists' ranking of the oral health of pairs of children when there are at least ten points difference between the scores.

Adolescent↗

PubMed1993

The dental health of adults in an integrated urban development in Addis Ababa, Ethiopia.

Two hundred and forty-three Ethiopian adults (18 years-old and over) were examined for caries, periodontal disease, malocclusions and enamel opacities. These adults were the parents of children cared for by an independent charitable organisation, the Ethiopian Gemini Trust. The prevalence of dental caries was generally low with a mean DMFT for the sample of 2.7 (+/- 0.2) and a mean DMFS of 6.7 (+/- 0.6), although one adult had a DMFS of 62. A high proportion of the adults (83.5 per cent) had calculus, but only 2 per cent had deep pocketing. Twenty-three per cent of the adults had a malocclusion and for 6 per cent of these this was moderate to severe. The most prevalent enamel defects were hypoplasias and diffuse opacities with 22 per cent of adults having one or more index teeth affected. Access to dental services was virtually non-existent as judged by the clinical status of these adults.

Adolescent↗

PubMed1984

Caries prevention using a 1.2% sodium monofluorophosphate dentifrice in an aluminium oxide trihydrate base.

A 3-year clinical trial was carried out in France just after fluoride toothpaste was allowed to be sold on the mass market. The aim was to assess the caries preventive effect of a toothpaste containing the maximum fluoride level permitted by the EEC (1.2% SMFP). The trial started with 1318 10-12-yr-old children from a wide socioeconomic background in a typical French community. Test toothpaste was given to 659 children whereas the remaining 659 children obtained the same toothpaste without the fluoride additive. The brushing was unsupervised and performed by the children at home. Dental caries was assessed by clinical and radiographic examinations. 1061 children completed the trial. An interview carried out at the final examination identified a group of 116 uncooperative children (less than five brushings a week on average) who were not included in the statistical analysis. The following mean reductions were found: 26% for DMFT, 27% for DMFS, and 39% for DMFSU. The DMFS index for approximal, buccal-lingual and occlusal surfaces showed caries reductions of 32%, 25%, and 22%, respectively. The trial demonstrated a highly significant effectiveness of the 1.2% SMFP toothpaste in a French population.

Aluminum Oxide↗

PubMed2002

Caries experience of some countries and areas expressed by the Significant Caries Index.

OBJECTIVES: To calculate and present the caries prevalence for some countries/states among 12-year-olds, expressed as Significant Caries Index (SiC Index) and to analyse the relationship between the mean DMFT and the SiC Index for these countries. SiC Index is the mean DMFT of the one-third of a population with the highest caries values. METHODS: An Excel(R) application for calculating SiC was developed (http://www.whocollab.od.mah.se/expl/siccalculation.xls) and indices were calculated from the data collected for 14 countries and one state from the Country/Area Profile Programme (http://www.whocollab.od.mah.se/index.html). To investigate the provinces of a country that had already reached the proposed SiC Index goal of 3 DMFT among the 12-year-olds, data for 17 counties and a city from Sweden were collected and the respective mean DMFT and SiC Indices calculated. RESULTS: The mean DMFT varied from 1.0 to 8.5 and the SiC Index varied from 2.8 to 13.7 in the national data. Jamaica, Senegal and Sweden were the only three countries that showed SiC Indices that were less than 3 DMFT. The mean DMFT varied from 0.5 to 1.4 and the SiC Index varied from 1.4 to 3.6 in the Swedish county/city data examined. A strong linear relationship between the mean DMFT and the SiC Index was found for the populations presented in this study. CONCLUSION: The SiC Index is an indicator that reflects the situation among the most caries-exposed individuals and could be included in future population-based oral health surveys together with the mean DMFT.

Bolivia↗

PubMed2002

Oral and clinical characteristics of a group of patients with Turner syndrome.

OBJECTIVE: The loss of the X chromosome in girls with Turner syndrome (TS) affects the shape and the size of craniofacial structures. Few studies have been reported on female patients with TS in South America. Records of odontologic alterations of 23 Argentinian patients with TS were compared with those of 25 girls in a control group, and associations were made with medical indications. STUDY DESIGN: Oral clinical diagnoses were completed with periapical, occlusal, panoramic, and orthopantomograms; urine and blood determinations were performed by conventional methods. RESULTS: Blood phosphorus and calcium levels were altered, and osteoporosis was detected. In some patients, TS was associated with autoimmune thyroiditis. Control subjects had normal blood and urine values. The decayed, missing, and filled permanent surfaces index for temporary teeth was statistically higher for the control group. About 78% of the patients had hypoplasia, 65% had reduced root length and bifurcated roots, and 100% had high arch palate. Incisor asymmetry was also observed. CONCLUSIONS: Medical and laboratory indexes are essentially indicative of hormone alterations. TS patients have a particular oral anatomy that could be closely related to an alteration in calcium and phosphorus metabolism.

Adolescent↗

PubMed2005

Use of the Significant Caries Index in quantifying the changes in caries in Switzerland from 1964 to 2000.

OBJECTIVES: To follow the changes in the Significant Caries Index (SiC) and the DMFT during the period 1964-2000 in children aged 12 and 15 in the Canton of Zurich. METHODS: Examinations of random samples of children in 16 communities of the Canton were repeated every 4 years from 1964 onwards using the same standards for diagnosing caries. RESULTS: In the 12-year-olds, the children in the low tertile had virtually no DMF-experience from 1980 on. On the contrary, the SiC, based on the children in the highest tertile, decreased until 1996. At the age of 15, the zero-average in the low tertile was reached in 1992 but the SiC continued to decrease until 2000. In the 12-year age group the reduction of the SiC from 1964 to 1996 was 81.3% and for the overall DMFT it was 89.7%. The corresponding reductions for the 15-year-olds, in this case from 1964 to 2000, were 77.0 and 88.4%, respectively. The DMFT-counts in the total samples had substantially higher coefficients of variation than those in the highest tertile. As a consequence, the SiC had relatively smaller confidence intervals than the average DMFT. CONCLUSIONS: The SiC is a very useful measure of dental caries experience. On the basis of the results in the 15-year-old group, the target of an SiC below 5.0 is proposed. The decline of the SiC demonstrates that even in the high-risk children caries experience has been reduced substantially.

Adolescent↗

PubMed1992

Dental predictors of high caries increment in children.

A comprehensive set of dental variables was investigated to find the "best" combination of predictors for high caries increment in 7/8-year-old and 10/11-year-old children. Four populations with widely different caries prevalence were studied. Logistic regression analysis supplied multiple-input models by stepwise selection of predictors. A "low number of sound primary molars" was the best and most consistent predictor of high caries increment. The second best predictors were "high numbers of pre-cavity lesions on permanent first molars" (discolored pits and fissures in the younger age group and white spots on the smooth parts of buccolingual surfaces in the older age group). Inclusion of radiological variables did not substantially increase the quality of prediction. For practical application, models with various multiple inputs selected by stepwise procedures were compared with "fixed" three-input models. These three-input models resulted in predictive quality nearly equal to those of the multiple models. Traditional one-input models, containing DMFT or dmft, were inferior to the three-input models, particularly in the older age class. The lower the caries prevalence of the source data, the better was the prediction. As a summary measure characterizing the predictive performance of a model, we used the index "area under the receiver operating characteristic curve" A. For the 1984 data and the three-input models, the area was approximately 80%, and for the 1972 data, the area was 65-70%.

Age Factors↗

PubMed1992

Benefits and risks of fluoride supplementation: caries prevention versus dental fluorosis.

To assess the risks (dental fluorosis) and the benefits (caries prevention) of fluoride (F) tablets and F toothpaste, we surveyed 2003 schoolchildren aged 5-20 years old (mean = 10.82, SD = 3.40). Children were scored for dental caries by means of the decayed, missing, filled teeth index (DMFT index). Frequent use of F toothpaste (toothbrushing frequency) is poorly linked to caries (Spearman r = 0.05, P = 0.02) and dental fluorosis (r = 0.05, P = 0.03). Children who use F tablets regularly and appropriately exhibit mild fluorosis more often than non- or occasional users (odds ratio = 9.58), and have a mean DMFT index 50% lower than other children. We conclude that using F tablets is an effective means of preventing caries. When used appropriately in non fluoridated areas, using F tablets results in minor damage.

Adolescent↗

PubMed2006

Progression of proximal caries in children with different caries indices: a 4-year radiographic study.

AIM: This was to investigate survival rate, median survival time and differences in the progression of different stages of proximal caries in 196 children, aged 6 to 8 years old, with different caries index at baseline examination. METHODS: Based on DMFS/dmfs values, children were categorized as low, moderate and high caries index groups. Subjects with DMFS/dmfs smaller or equal to half of a child's age were classified as low caries index group, children with DMFS/dmfs greater to half and smaller than or equal to the child's age as moderate, while those with DMFS/dmfs greater than the child's age as high. Proximal caries and its progression were diagnosed from bitewing radiographs taken at 1-year intervals over a period of 4 years. The mesial surface of the first permanent molars, mesial and distal surfaces of the first and second primary molars and distal surfaces of the primary canines were examined. Sound surfaces, caries lesions in the external and internal half of the enamel and external, middle, internal third of the dentine as well as filled, extracted and exfoliated teeth were recorded. STATISTICS: A life table analysis was performed to estimate survival rate and median survival time of each state of proximal caries and differences between the groups in the progression of the proximal lesions were tested with the Wilcoxon pairwise comparison statistic. RESULTS: There were statistically significant differences in the caries rate of the sound proximal surfaces of the primary teeth between the low and high caries index groups. Also, statistically significant differences between these two groups were found in the progression of the external half of the enamel caries in the first permanent molars and in the primary teeth. CONCLUSIONS: A high caries index increases the risk of developing caries in the sound proximal surfaces of posterior primary teeth and causes faster progression of the external half of the enamel lesions in the first permanent molars and posterior primary teeth.

Child↗