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The Authors evaluate social-economical level, dmft-DMFT, Pl.I., G.I. and alimentary habits of a school-children sample. The findings from the present study indicate that social-economic level influences both prevalence values of dental-periodontal pathology and alimentary habits.
A survey of the dental health and need for treatment of 796 children, one in 10 of those in the 1st and 3rd years of high schools in a health administrative area, was carried out using a comprehensive, computerized, epidemiological information system. The system was designed to aid in planning and evaluating services and expressed treatment need on the Resource Related Index as well as utilizing conventional indices. A baseline profile of the dental condition of children in four districts was obtained. This was compared with findings from other surveys. The problem of interexaminer reliability was also discussed.
The caries prevalence, periodontal health, and oral hygiene status were assessed in 124 drug addicts aged 18-34 yr in Mercato San Severino (Salerno), Italy. The years of drug addiction ranged from 1 to 15 yr. The majority used heroin (96%) but all the subjects indicated that they had used more than one drug. The percentage of drug addicts caries free was 6.5%, ranging from no caries free subjects in the group over 29 yr of age, to 11.4% in the group aged 26-29 yr old. Mean DMFT and DMFS scores for all age groups were 12.9 and 36.2, respectively; mean Periodontal Index (PI) and mean Simplified Oral Hygiene Index (OHI-S) scores were 1.37 and 1.71, respectively. The poor dental health in this target group indicates the need for more extensive collaboration between the social and dental health care sectors.
The bases for the construction of sociodental indicators is discussed in the paper, considering several available indexes of oral health status (dental caries, periodontal disease, malocclusion, oral hygiene, and other oral conditions) as well as measures of quality of services. Very little research exists relating any of the above measures to social indicators such as personal life-style or cultural and ecological factors. Such expansion would enable dental indicators to be useful for purposes of policy decisions. Combining any dental indicators or set of indicators with a potential global social health index is discussed in terms of potential problems obscuring dentistry's cost to society. Dentistry, in addition, is offered as a system in microcosm-one which can be useful for purposes of polishing methodology for the social health indicator movement.
OBJECTIVE: To develop a simple quantitative measure of dental health inequality. METHOD: Define equality based on statistical theory and construct a formula to compare actual and theoretical disease distributions. RESULT: A new index (DHII) is proposed, based on the ratio of the distribution of the actual disease to a (theoretical) Poisson distribution. An example using caries data is provided. CONCLUSION: Use of DHII will allow quantitative measurement of dental health inequality.
An epidemiological investigation on dental caries was undertaken with 810 children of nursery school, kindergarten, elementary and junior high school age in the town of Fuji, saga prefecture which is a mountain village with less movement of the population. From this investigation the following results were obtained regarding the dental caries prevalence and the status of treatment: 1. As for the dental caries prevalence of deciduous teeth, the dft index was 8.8 at age 3, whereas it was 10.7 at age 5. 2. As for the dental caries prevalence of the permanent teeth, the DMFT value was 7.7 at age 12, whereas it was 9.9 at age 14. 3. As for differences based on set, concerning the deciduous teeth, none was not recognized except for the caries prevalence indices at age 11 for the dft index, at age 6 and 11 for the dfs index, and at age 11 for the ft index. 4. As for differences based on sex, concerning the permanent teeth, none was not recognized except for the caries prevalence indices at age 5 and 9 for the DFT and DFS indices, and at 7 for the FT and F tooth rate. 5. There was a tendency toward as significant increase in dental caries in the deciduous teeth. 6. There was a tendency toward as increase in dental caries in permanent teeth from the commencement of eruption and rapid aggravation approximately from the upper grades of elementary school. 7. In the status of treatment of dental caries in deciduous teeth, the ft index was 4.1 at age 6. 8. In the status of treatment of dental caries in permanent teeth, the FT index was 4.5 at age 14. 9. There was no statistically significant difference among kindergarten and nursery school children except for the dft and dfs indices at age 4.
The caries experience and the plaque and gingival conditions of 14-year-old children participating in fortnightly fluoride (0.2 % NaF) mouth rinsing (88 subjects) were compared with observations in children performing supervised toothbrushing with a fluoride (0.5 % NaF) solution 4-5 times per year (n = 90). Most of the children, 84 and 90% respectively, had participated in these programs for the previous 6 years. Caries was assessed only on radiographs. The mean number of decayed surfaces was 5.8 (s.d. = 4.1, n = 88) and 5.4 (s.d. = 4.1, n = 90). The mean numbers of decayed and filled surfaces were 19.3 +/- 9.2 and 27.9 +/- 10.2 for subjects with rinsing or brushing. This significant difference could not be ascribed to sex, social class, years of residence in the towns, number of dentists performing the previous treatments, toothbrushing habits, use of fluorides at home, or amount of plaque. All children had gingivitis. There were no differences in the mean number of Plaque Index score 2 or the number of Gingival Index score 2 between the children with the different preventive programs. The girls' oral hygiene was better than the boys', but the gingival conditions were the same. Sex, social class, and toothbrushing techniques tended to have a slight influence on the amount of plaque.
This paper addresses the long-term effect of two dental delivery systems established during the Rural Dental Health Program (RDHP) in 1975. At that time 725 children in grades K-2 were assigned randomly to an enriched dental health education program or regular health education program and to a SCHOOL- or COMMUNITY-based dental delivery system. Seven years after funding for RDHP ended, children originally assigned to the COMMUNITY group utilized more professional services and showed a higher level of dental knowledge than children assigned to the SCHOOL group. In addition, COMMUNITY-based children had, on average, twice as many sealed teeth. While the follow-up study did not reveal any statistically significant difference in the clinical oral health indices (DMFS, gingival index, calculus index, plaque index, periodontal probing depth, and orthodontic treatment priority index) the COMMUNITY-based children's higher level of professional dental service utilization, greater number of sealed teeth, and increased dental knowledge should lead to a higher level of oral health in the long run.
Disease varies in different populations based on sociodemographic variables, and there is limited understanding of this interaction. The purpose of this methodological study was to determine the validity of the Oral Health Status Index, a disease-based index, on a Hispanic population by comparing it with the NIDCR epidemiological measures of disease, with the addition of demographic and behavioral variables. The epidemiologic data were collected according to the criteria defined by the NIDCR, including: a modified Decayed Missing Filled Surfaces Index, gingival inflammation, calculus, and destructive periodontal disease measures. The demographic and behavioral variables were gathered from 240 interviews with Hispanic adults in two community clinics. Bivariate analysis was used to determine relationships between the descriptive epidemiologic, demographic, and behavioral variables and the Oral Health Status Index (OHSI). There were statistically significant differences (p < 0.05) in mean OHSI scores among the demographic variables age, education, income, and place of birth; and the behavioral variables alcohol consumption, flossing, and acculturation. Multiple regression analysis with the OHSI as the dependent variable showed that the statistically significant (p < 0.001) epidemiologic predictors were: percentage of Decayed Teeth/Decayed, Filled Teeth; Number of Replaced Teeth/Missing Teeth; and millimeters of mesial attachment loss. These collectively explained 47.49% of the variance in the regression. The addition of demographic variables to the epidemiologic regression identified age (p < 0.05), gender (p < 0.01), and place of birth (p < 0.01) as significant predictors that explained an additional 4.12% of the variance, collectively bringing the total explained variance to 51.61%. The behavioral variables did not contribute significantly to predicting the OHSI regression score. The Oral Health Status Index in this study is validated by its correlation with both the epidemiologic measures and the demographic variables. This combination of variables separated the Hispanics into Mexicans and Central/South Americans.
This study reports on the causative factors of dental erosion in selected high- (n = 19) and low-erosion (n = 19) subgroups of a larger random sample (n = 95) of young male Saudi military inductees. By means of a questionnaire, the role of various possible factors related to oral health in general, and to dental erosion in particular, was assessed for each participant. Clinical examination included recordings of severity of dental erosion and fluorosis, presence of buccal cervical defects and first permanent molar 'cuppings', DMFT and DMFS, visible plaque index, and gingival bleeding index. In addition, bitewing radiographs, study casts, and intraoral color transparencies were obtained for each individual. Logistic regression analysis showed a strong correlation between the presence of dental erosion and a high level of consumption of cola-type soft drinks. Other statistically significant associated factors, although of less predictive strength, were type of cleaning aid and gingival bleeding index. In subgroup comparisons, dental problems (primarily pain), number of buccal cervical defects, and number of missing teeth were significantly greater in the high- than in the low-erosion subgroup.
In December 1973 water fluoridation was discontinued in Tiel, the Netherlands. Six years later an epidemiological study was started, with the aim to investigate the consequences. In the period from 1979 to 1988 a yearly caries investigation was carried out in 15 year old children born and living in Tiel and children living in the control town of Culemborg, where the drinking water had never been fluoridated. The 15 year old children in 1979-1980 in Tiel had a 18% higher caries experience than the same age group in 1968-1969, to whom fluoridated water had been available from birth onward. In the same period a 28% decrease of the caries was found in Culemborg. In 1979-1980 the DMFS-index in Tiel was still 36% lower than in Culemborg. Between 1979-1980 and 1987-1988 the caries experience decreased in both towns.
OBJECTIVE: To find the prevalence of caries in the 12-year-old school population of the city of Barcelona. DESIGN: An epidemiological crossover survey of dental caries in a representative sample of children in Barcelona. PARTICIPANTS: 739 children in the 7th year of basic education, who were twelve years old at the moment of the examination and came from 35 schools in the city of Barcelona, were examined. MEASUREMENTS AND MAIN RESULTS: Prevalence of caries was 52% (60% in girls and 45% in boys) and the CAOD index (teeth with caries, absent because of caries or permanent teeth with fillings) was 1.37 (1.70 for girls and 1.12 for boys). 51% of the permanent teeth affected by caries had been filled. The distribution of the CAOD index showed that 23% (almost a quarter of the population studied) of 12-year old schoolchildren in Barcelona had 3 teeth or more affected by caries. In the logistical regression analysis, gender (being a girl, OR = 1.69) and the absence of a regular programme of fluoride mouthwashes (OR = 1.69) were associated with having a higher caries index (CAOD equal to or above 3). CONCLUSIONS: The results show caries indices which are generally low and a tendency to stability. The programmes of fluoride mouthwashes seem to be effective in decreasing the incidence of caries.
OBJECTIVES: 1. To compare the prevalences of fissure sealants in similar groups of 14-15-year-old, regularly-attending patients treated under fee-for-service in 1989 and capitation in 1994. 2. To calculate the effect of including sealants in the restorative index on estimates of interventional treatment carried out on 14-15-year-old regularly attending patients treated by general dental practitioners in 1994. DESIGN: A randomised epidemiological study. SETTING: Secondary schools in the Wycombe, Doncaster and Hereford/Worcester areas. METHOD: Random samples of 14-15-year-old, regularly attending patients treated by dentists practising under capitation in three contrasting areas of England were examined in 1994 for the presence of decayed, missing and filled teeth and fissure sealants. Restorative indices were calculated with and without the inclusion of sealants. The latter were compared with restorative indices calculated without the inclusion of sealants on regularly attending patients of the same age group when the dentists in the same three areas were working under fee-for-service in 1989. RESULTS: The prevalence of fissure sealants increased between 1989 and 1994 from 16% to 30% in Wycombe, from 13% to 50% in Doncaster and from 25% to 47% in Hereford/Worcester. Without fissure sealants the restorative indices fell between 1989 and 1994 from a range of 76.5-94.4 to 63.3-87.1. When sealants were included in the restorative indices for 1994, they ranged from 79.5-92.9. CONCLUSIONS: There were increases in the prevalences of fissure sealants between 1989-1994. When these sealants were included in the calculation of restorative indices for 1994, the level of restorative care provided by general dental practitioners remained relatively high since the introduction of capitation. Although there has been some increase in the level of untreated disease, if the restorative index is calculated without the inclusion of sealants then there is a risk of underestimating the treatment provided by general dental practitioners to control the carious process. Dentists appear to be redirecting their efforts into newer treatment/preventive items.
The aim of this study was to develop an index for selection of those subjects able to increase the discriminatory ability of experimental clinical trials of caries prophylactic agents. The index, DMFS(e), excludes from the calculation of initial DMFS all occlusal surfaces of permanent first molars and any of those teeth extracted due to caries. Data from four clinical trials, three with placebo and one with an active control, were examined retrospectively. Subjects were initially aged 11-12 yr. The efficiency of the DMFS(e) index was compared to DMFS for selection of discriminating subgroups by the calculation of minimum sample sizes required to attain statistical significance (alpha = 0.05, beta = 0.2). For each trial, the DMFS(e) index was more efficient. Specific criteria were established for those subjects who consistently failed to contribute to the study results. Following exclusion of those subjects, considerable saving in minimum sample size was achieved, the greatest reduction occurring in the active control trial.
Fifty two children who had had cancer and been treated with chemotherapy, and who were long term event free, were examined for caries prevalence, gingival health, and oral hygiene and compared with a control group. A higher dental caries prevalence for the 14-17 year age group was noted. The restorative index was significantly lower in the age group 10-13. There were no significant differences in gingival index, plaque index, or toothbrushing frequency. It is concluded that these patients should be considered as at high risk for caries after cancer treatment. Professional dental follow up should be integrated in the medical follow up.
To determine the prevalence of nonfluoride enamel hypomineralization in the permanent first molars, we examined 488 7- to 13-year-old children. We further examined the impact of such defects on the treatment need by evaluating the number of caries lesions, restorations and extractions of the target teeth. Nonfluoride hypomineralization(s) were seen in 94 children (19.3%). The severity of defects varied from mild lesions with local color change to more severe ones where the hypomineralized tissue had been replaced by a restoration or the tooth had been extracted. Further examination of 65 children with nonfluoride hypomineralization showed that the defects had significantly increased the treatment need of the target teeth compared with the age- and sex-matched controls (p<0.001). Consequently, also the DMFT index of the whole dentition was higher in the children with hypomineralizations than in the controls (p<0.05). The results indicate that nonfluoride hypomineralizations have a significant impact on treatment need in the present child population with low caries activity.
The prevalence of dental caries in France is not known on a nationwide basis, despite the fact that a number of epidemiological studies have been conducted in various parts of the country. The aim of the present study was to provide a national baseline examination of the dental health of children in 1987 since, beginning in November, 1986, the sale of fluoridated salt began in France. A multi-stage probability sample of 19,366 children was selected as representative of the 6-to-15-year-old population. The sample covered all the 95 departments of France. Teams of well-calibrated examiners were constituted in each of the sixteen Faculties of Dental Surgery of France. The prevalence of caries for each age group was determined by means of DMFT, DMFS, dft, and dfs indices. Periodontal conditions were assessed by means of the Plaque Index (Silness and Löe, 1964), the Calculus Index (Marthaler, 1966), and the Gingival Index (Löe and Silness, 1963). Calculation of the mean DMFT index showed, respectively, 0.5 and 1.0 new carious teeth per year under and over the age of 11. The mean values of the DMFT index at ages 6, 12, and 15 were, respectively, 0.5, 4.2, and 6.9. Under the age of 11, the mean DMFS index increased by one between each successive age group and by nearly two over the age of 11. The mean values of the DMFS index at ages 6, 12, and 15 were, respectively, 0.8, 7.6, and 13.0. The percentage of caries-free children decreased from 32.2% at age 6 to 7.9% at age 15.
The pH and active concentration of sodium ions were measured by the potentiometric method and optic density and concentration of inorganic phosphorus by photoelectrocolorimetry in mixed salivary pools of 10 subjects aged 16-18 years. A cariogenic situation was simulated in these pools by slight acidification with hydrochloric acid solution, which led to structural changes. Oral fluid of subjects with negligible caries is more resistant to unfavorable effects than mixed saliva of subjects with a higher index of decayed/lost teeth. Experimental studies revealed that pH = 6.2 is the critical value of hydrogen index, at which structural properties of saliva are positively disturbed and its mineralizing potential decreases. The data contribute to elucidation of the molecular mechanisms of caries development.