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PubMed1989

Dental caries, visible plaque, and gingival bleeding in young adult Danes in alternative dental programs.

From 16 to 19 years of age three groups of young adults received alternative dental programs on termination of the Public Child Dental Health Service (PCDHS) in different municipalities: public group, n = 386; mixed group, n = 161; and private group, n = 261. Dental caries status at the start of the study was assessed from the standard PCDHS records, and caries, plaque, and gingivitis were examined in an epidemiologic survey at the end. Caries experience at 16 years was 11.6 DMFS, highest in the mixed group and increased in all groups during the study. Initial placement in caries severity zones did not change. Visible plaque index (VPI) and gingival bleeding index (GBI) showed that plaque and gingival bleeding were present in most subjects, but rather few surfaces were affected. Association between gingival bleeding and non-use of dental services was found. Overall, it is concluded that none of the alternative programs differed from each other in having measurable effects on the oral health status.

Adolescent↗

PubMed1990

[Dental health among homebound mental (psychiatric) patients].

The purpose of the present study was to describe the dental health behavior, oral health and dental treatment needs in a group of chronic, homebound mental patients. 84 patients were interviewed with regard to oral hygiene and utilization of dental services, by means of a standardized questionnaire. Furthermore, 56 patients were examined clinically. About 20% did not brush their teeth regularly. A similar group had not payed regular dental visits for the last 3 years although they were not edentulous. The dental examinations showed an average DMFS of 84.6. One out of four persons were edentulous and 45% of the dentate participants had periodontal pockets deeper than 5 mm. Restorative need was found for 71%, 12% were in need of fillings of more than 15 surfaces, whereas 45% were in need of scaling or advanced periodontal treatment. Finally, 15% exhibited need of their first removable denture. An index for the overall dental treatment need showed that 63% were in great need for dental treatment. The findings indicate significant dental needs in non-institutionalized persons with mental disease. A hospital based dental team combined with mobile primary dental health care are proposed as a possible solution to the dental health problems of deinstitutionalized psychiatry.

DMF Index↗

PubMed1996

[The structural properties of the saliva in the modelling of a cariogenic situation].

A cariogenic situation was modeled by soft acidification by hydrochloric acid in vitro in mixed salivary pool of 10 subjects aged 16-18, and the values of pH and active concentration of sodium ions, optic density, and concentration of inorganic phosphorus were studied. Soft acidification of human mixed saliva was found to result in its structural disorders. The saliva of subjects with negligible caries was more stable to unfavorable exposure than mixed saliva of subjects with a higher CFL index. Experiments showed that pH of 6.2 is the critical value causing evident destruction of the saliva and reducing its mineralizing potential. These data may be used in studies of the molecular mechanisms of caries development.

Adolescent↗

PubMed1988

Salivary gland function in patients on chronic lithium treatment.

Salivary gland function was studied in 14 manic-depressive patients treated with lithium carbonate (Li) for 4 to 120 months. Function level was evaluated by means of sialometry, dynamic salivary scintigraphy, and sialography. Daily Li dose, serum Li concentration, duration of Li therapy, and caries activity index were correlated with the salivary function parameters studied. Hyposalivation was noted in 71% of the patients, showing good correlation with the scintigraphic (r = 0.94) and sialographic (r = 0.87) results. Duration of Li therapy was poorly correlated with the degree of salivary gland dysfunction and with the caries activity index, whereas the correlation between duration of therapy and each of the three salivary function parameters was erratic. Because four of the patients exhibited normal salivation, we suggest that there are some additional factors (e.g., genetic or thyroid function level) that might be involved in salivary dysfunction connected with Li therapy.

Adult↗

PubMed1998

Oral and dental health status of children with cleft lip and/or palate.

OBJECTIVE: To ascertain the oral and dental health status of children with cleft lip and/or palate. DESIGN: Oral and dental examinations were carried out on 114 selected children with cleft lip and/or palate, using standard criteria and indices. SETTING: These children were examined at two cleft palate clinics in the United Kingdom. PATIENTS: All children examined were between the ages of 3 and 18 years. RESULTS: Sixty one (53.5%) of the subjects exhibited no evidence of previous caries experience, but as many as 20% exhibited active decay. The mean caries experience in the deciduous dentition (dmfs) was 2.3, and that in the permanent dentition (DMFS) was 0.9. Caries experience of the Caucasian children of the sample was lower (mean dmfs 1.9) than that of the Asian children (mean dmfs 5.5). The mean simplified debris index of the sample was 0.9, and the mean gingival bleeding index was 0.4. Children with cleft lip and palate had generally poorer oral and gingival health than those with isolated clefts of the lip or palate. CONCLUSION: Twenty percent of the sample had active decay. These children had poor oral health in the surgically repaired anterior segment.

Adolescent↗

PubMed2003

Needs for dental treatment in handicapped children.

The study covered 96 handicapped children, 3-17 years old. Complex dental treatment was performed in all children: under general anaesthesia in 45.83% and ambulant treatment in 54.17%. The study found high frequency of dental caries both in deciduous and permanent teeth. Mean numbers of tooth decay, extractions and fillings (d, m, f and D, M, F for deciduous and permanent teeth, respectively) were high. The dental treatment index was low, unsatisfactory especially in deciduous teeth. Dental care provided for handicapped children needs to be intensified, with special attention paid to preventive measures. It is important to make the parents of handicapped children with systemic disease aware of early prevention and treatment.

Adolescent↗

PubMed2005

Socio-economic influence on caries experience and CPITN values among a group of Italian call-up soldiers and cadets.

PURPOSE: Dental care in Italy is carried out mainly by private professionals and therefore the collection of epidemiological data on dental health is not often possible. Thus, the aim of this study was to collect the DMFT and CPITN values in a population of young Italian male subjects, namely call-up soldiers and cadets, and relate them to the socio-economic status of the subjects. MATERIAL AND METHODS: The sample was made up of two groups from different Italian academies: call-up soldiers: 1184 male call-up soldiers aged from 19 to 25; cadets: 2477 cadets aged from 19 to 25. The level of education was evaluated by means of a questionnaire which the soldiers had to fill in before being examined. Two trained dentists carried out the epidemiological survey following WHO guidelines. Data elaboration was carried out at the 'WHO Collaboration Centre of Milan for Epidemiologist and Community Dentistry'. Data on DMFT were compared by ANOVA. A p value < 0.01 was considered as statistically significant. RESULTS: The mean DMFT value observed was 3.69 +/- 3.31. The differences between the two groups were statistically significant for D e F components (p < 0.05). The caries-free rate is lower in the call-up soldiers group (12.57%) than that reported for the cadets group (25.26%) and the difference was statistically significant (p < 0.01). Statistically significant differences were observed in DMFT values between the two groups stratified by educational level. A healthy periodontium was observed in more than 50% of the sample. In the call-up soldiers group, 40.95% had healthy periodontal conditions; 40.25% of the subjects showed bleeding on probing; 19.03% presented with calculus; and 2.77% presented periodontal pockets 4-5 mm deep. In the cadets group, 57.95% had healthy periodontal conditions; 38.18% of the subjects showed bleeding on probing; 3.52% presented with calculus; and 0.35% presented periodontal pockets 4-5 mm deep. The differences in proportion between the two groups were always statistically significant except for the bleeding score where an almost similar percentage for both groups was recorded. CONCLUSION: The results showed that call-up soldiers have a higher DMFT index and the D value is higher in less educated subjects. Bleeding on probing did not vary either between call-up soldiers and cadets or among socio-economic subgroups. Such results have underlined the need of a systematical information campaign on oral hygiene in Italian schools.

Adult↗

PubMedDate not supplied

[Dental caries in schoolchildren of the Federal District].

OBJECTIVE: To estimate the prevalence and severity of dental caries and the dental treatment necessities of school children in Mexico City. The studied population was surveyed for dental caries in 1988 to obtain data necessary for the National Program of Salt Fluoridation in Mexico. MATERIAL AND METHODS: The population was selected with a sample frame based on a list of Kindergartens and primary schools registered at the Ministry of Public Education in 1988. The oral cavity examination was based on diagnostic criteria marked by the World Health Organization. RESULTS: A total of 4475 scholars of 5 to 12 years of age were included in the study. Dental caries prevalence in the population reached 90.5%. The index of treatment necessities was high (79.6%). The mean of caries index in scholars of 12 years of age was DMFT = 4.42 (SD = 3.2) and DMFS = 6.53 (SD = 4.8). CONCLUSIONS: Results emphasize the pertinence of a widely reaching preventive program of such as salt fluoridation. Additionally, strategies to improve access of the school children population to dental services must be elaborated.

Age Distribution↗

PubMed2004

Oral health in Tunisia.

Current WHO methods were employed to estimate the prevalence of toothbrush possession, tea drinking, tobacco habits, fluorosis, dentofacial anomalies, periodontal diseases, dental caries as well as treatment needs in schoolchildren in Tunisia, the smallest country in North Africa. Fluorosis was endemic in some regions. Dentofacial anomalies were more frequent than in the other countries of the Eastern Mediterranean Region (EMR). The prevalence of periodontal disease was high despite the high percentage of toothbrush possession. Altogether 60% of 12-year-olds and 70% of 15-year-olds required oral hygiene instruction, 44% and 15% respectively required scaling. Dental caries was also relatively frequent, but indices were low and the dental therapeutic index was very low. Of the 6-12- and 15-year-olds, 52%, 44% and 52%, respectively needed restorative care. Moreover, 19% of 6-year-olds, 20% of 12-year-olds and 5% of 15-year-olds required extractions. None of 6-year-olds, 3% of 12-year-olds and 5% of 15-year-olds required other dental treatment such as pulpal treatment and prosthetics. A comparison with a survey carried out 13 years ago indicated that dental caries seemed to be decreasing. The DMF at age 12 was lower than WHO goals for the Year 2000 and of the Eastern Mediterranean Region countries. The findings showed an unequal distribution of oral health personnel, with the southern part of the country being particularly underserved.

Adolescent↗

PubMed2003

Epidemiological dental indices and self-perceived oral health in adolescents: ecological aspects.

The aim of this study was to investigate the correlations between epidemiological indices (objective) and self-perceived oral health (subjective) in adolescents at school level, and to study gender differences in epidemiological indices and in self-perceived oral health. The study comprised two sets of data from Skaraborg County, Sweden: 1. Self-reported questionnaires answered by adolescents at all senior level schools (n = 9,559, 13-15 years). 2. Epidemiological indices based on clinical registrations of oral health in 13-15-year-old adolescents were collected in all 17 municipalities (n = 7,899). Simple and partial Pearson correlation coefficients were used to study correlations between subjective and objective oral health in the adolescents at school level. Gender differences in adolescents' subjective and objective oral health were estimated using a logistic regression model. The correlations between epidemiological index registrations and self-perceived oral health were weak. The strongest correlations were found between epidemiological indices and self-perceived gingival bleeding: 0.416 between the DS (decayed surfaces) index and self-perceived bleeding. Girls were less likely to be satisfied with the appearance of their teeth than boys were in municipalities with clinical good oral health OR 0.76 (95%) CI 0.59-0.98) and with poor clinical oral health OR 0.74 (CI 0.57-0.94). No gender differences were found in the epidemiological index registrations. The currently used epidemiological indices did not reflect adolescents' own perceptions of their oral health at school level and they could not recognize or identify gender differences. Surveillance of oral health in young people should include information on self-perceived oral health.

Adolescent↗

PubMed1988

Epidemiology of root surface caries in patients treated for periodontal diseases.

The prevalence of root surface caries was estimated in 83 patients surgically treated for periodontal disease and some relating factors were analyzed. The overall root caries index (RCI) was 6.28%. Anterior teeth in the mandible were significantly less affected than other groups of teeth. Root surfaces, divided into subgroups according to surgical treatment and length of exposure, showed no significant differences in RCI. No correlation was found between DFS-index and RCI. RCI increased with age. Concomitantly in older people more time had elapsed between the periodontal treatment and the present clinical examination. Salivary S. mutans counts and a combination of higher salivary S. mutans and lactobacilli counts were good indicators for the presence of root surface caries.

Adult↗

PubMed2003

[Changes in the prevalence of dental caries in schoolchildren in three regions of Mexico: surveys from 1987-1988 and 1997-1998].

OBJECTIVE: To compare the prevalence and severity of dental caries found in epidemiological surveillance studies conducted in three areas of Mexico in two different periods, 1987-1988 and 1997-1998. METHODS: The 1987-1988 survey was done with representative samples of schoolchildren 6 to 10 years old in two states, Nuevo León and Tabasco, as well as in the country's Federal District (which includes Mexico City). The Federal District's 1987-1988 sample also included schoolchildren who were 12 years old. The total number of students examined in the 1987-1988 period was 7 590. The 1997-1998 survey included schoolchildren who were 6-10 years old and 12 years old, in all three of the areas. The total number of students included in the 1997-1998 survey was 8 164. To compare the prevalence and severity of dental caries in the two periods, the average value for the index of decayed, missing, and filled teeth (DMFT) was used with all of the age groups. RESULTS: The values of the DMFT indices were significantly lower in the 1997-1998 period for all of the age groups studied (P < 0.05 for all the age groups). In the 1997-1998 period both Tabasco and Nuevo León achieved the goal recommended by the World Health Organization of an average of no more than three decayed, missing, and filled teeth among the 12-year-olds, with DMFT indices of 2.67 and 1.72, respectively. However, in the Federal District in that 1997-1998 period the DMFT index exceeded the recommended level, with a value of 3.11. CONCLUSIONS: The reduction seen in the DMFT indices could be due to several factors, including the consumption of fluoridated salt, the use of dentifrices and fluoride rinses, and broader access to dental services.

Child↗

PubMed1982

The relationship between past caries experience and tooth color determined by an opto-electronic method.

The susceptibility of a tooth to dental caries has been proposed to depend on tooth color. So far there has, however, been no reliable method for tooth color determination. The aims of this study were to evaluate the reliability of an opto-electronic method and to examine the relationship between tooth color and past caries experience. The color of upper right central incisors of 64 school-children was determined using an opto-electronic tri-stimulus color comparator. The intra- and interexaminer reliability of the method was evaluated in vitro and in vivo being 85% and 83%, respectively. To assess the past caries experience the DMFS-index was calculated. Oral hygiene and dietary habits were also assessed. No significant difference in DMFS scores was obtained between the 'white teeth' group and the 'yellow teeth' group. The conclusion is, that the practical importance of possible colorrelated differences in caries resistance is negligible due to the multifaceted nature of dental caries.

Adolescent↗

PubMed2003

Dental diseases in a Jordanian population on renal dialysis.

OBJECTIVE: The aim of this study was to examine the levels of periodontal disease and dental caries in individuals on renal dialysis in a Jordanian population. METHOD AND MATERIALS: A total of 47 individuals (mean age = 42.9 years, standard deviation [SD] 12.5) were examined for plaque deposits, gingivitis, periodontitis, and dental caries using the Silness and Löe plaque index (PII), Löe and Silness gingival index (GI), probing pocket depth (PPD), and decayed, missing, or filled teeth (DMFT), respectively. Gingival recession also was recorded using the distance from the cementoenamel junction to the gingival margin. Patients were categorized into three subgroups based on their renal dialysis histories: on dialysis for less than 1 year; on dialysis for 1 to 3 years; or on dialysis longer than 3 years. RESULTS: There were no statistically significant differences in PII, GI, PPD, and gingival recession among the three subgroups examined. The GI revealed that 55% scored more than 2, indicating moderate to severe gingivitis. None of the individuals in this study displayed an absence of gingival inflammation. DMFT index showed that there were statistically significant differences between subjects on renal dialysis for less than 1 year and subjects on dialysis for 1 to 3 years and more than 3 years. The group DMFT index mean was 8.5 (SD 2.88). CONCLUSION: Gingival and dental diseases are prevalent in the renal dialysis population. The dental community's awareness of the implication of poor oral health within this population should be elevated and daily oral health maintenance should be reinforced by the dialysis team.

Adult↗

PubMed1978

[DMF/S study of children with different duration of diabetes (author's transl)].

The objective of this study was to determine the DMF/S indices of 101 children, make regression analyses, and compare the regression coefficients of subjects, in whom diabetes mellitus became manifest before the beginning of secondary dentition, with the regession coefficients of patients with a duration of diabetes as long as three years. It has been found that in the case of manifestation of diabetes before the commencement of secondary dentition the D3-4 MF/S index was significantly lower compared to subjects with a duration of diabetes up to a maximum of three years and the DMF/S index of individual subjects was anything but low despite a specific diet.--From our present knowledge of the pathogenesis of caries it is possible to conclude that a high incidence of caries in the case of early manifestation of diabetes is due primarily to a lack of therapeutic cooperation of the patient.

Age Factors↗

PubMed2001

Dental caries and gingivitis in schoolchildren from the municipality of Porto Alegre, Brazil in 1975 and 1996.

This study assesses changes in the prevalence of dental caries and gingivitis in a population of Brazilian schoolchildren in 1975 and 1996. The study was carried out in the municipality of Porto Alegre, Brazil, and included all 8- to 10-year-old children attending the second, third, and fourth grades at the same public school. Data were recorded from 233 children in cohort 1975 and from 185 children in cohort 1996. Only the children from cohort 1996 benefited from fluoridated water and regular use of fluoridated toothpaste. Caries experience was registered clinically and radiographically and summarised in DMFT and DMFS indices. The gingival status was described according to the GBI-index. Over a period of 21 years, the percentage of caries-free children increased significantly in all age groups; sevenfold at the age of 8, ninefold at the age of 9 and fourfold at the age of 10. Dental caries has almost disappeared from front teeth and premolars and was mainly located at the groove-fossa-system of permanent first molars. A seventy percent reduction in DMFS scores was observed. A significantly higher percentage of filled surfaces was registered in cohort 1975 than in cohort 1996 (P=0.001). The gingival bleeding index did not diminish during the study period, indicating that children's oral hygiene did not improve. Since the children had neither better access to dental care nor improved oral hygiene, it is tempting to believe that their access to fluorides contributed most to the marked decline in caries prevalence.

Brazil↗

PubMed1999

The dental caries status of Scottish adolescents reported to be regular attenders. Initial results from a primary dental care based research network.

AIM: To investigate the caries status of, and the delivery of care to, a group of regularly attending adolescent dental patients. To conduct research in primary dental care. A subsidiary aim was to compare the caries status of this sample to population samples. SETTING: General dental practices across Scotland. DESIGN: A 3-year cohort study. SUBJECTS: 41 volunteer general dental practitioners and 616 adolescent patients (mean age = 12.1 years at baseline) defined by the practitioners as 'regular' attenders. RESULTS: All practices remained in the study. 403 subjects were seen at both baseline and final examination and 329 were examined at all 4 annual examinations. The mean D3MFT (dentine caries threshold) was 1.8 at baseline and 3.9 at the final examination, three years later. Of the 541 subjects seen at baseline 62% had experienced either restored or unrestored dentinal caries. Thirty-four percent of all those examined at baseline had all the unrestored dentinal caries. The majority of the disease was to be found in the molar teeth, particularly the first permanent molars. The provision of sealants was relatively high with 85% of subjects having at least one sealed tooth by the final examination. Although disease levels were related to socio-economic status, the Care Index was not. CONCLUSIONS: The 'regularly attending' subjects had a better normative level of dental health than their peers in the Scottish population. However, wide variation was found. The project also demonstrated the feasibility of undertaking research in partnership with general dental practitioners.

Adolescent↗

PubMed1997

Analytic approaches to longitudinal caries data in adults.

The objective of this paper is to consider current methods for analyzing longitudinal caries data in adults. To illustrate these methods, we used data from the Piedmont dental study, a prospective investigation of the oral health of older adults. Longitudinal dental data sets comprise repeated observations of an outcome (often clustered within randomly selected primary sampling units), and a set of covariates for each of many subjects, in whom clustering can occur as a result of measuring teeth, or surfaces, within people. One objective of statistical analysis is to predict the outcome variable as a function of the covariates, while accounting for the correlation among the repeated observations for a given subject and the effect of clustering within subjects, as well as between subjects within primary sampling units, such as communities, schools, hospitals, or other such units. We considered two statistical approaches: generalized estimating equations and survey regression models. We also examined the impact of varying diagnostic criteria for caries estimation between epidemiologists and clinicians. One approach is to perform the usual time(x) exam score minus time0 score analysis for the baseline and final examinations, while an alternative is to analyze trends among interim examinations. Finally, because caries studies in which the onset of the disease is the endpoint face the problem of censoring due to subject attrition and/or tooth loss, we recommend the incidence density (time-to-event) analytic strategy to address this problem. This approach was found to be most suitable for longitudinal studies of older adults since it accounts for the time each surface remains at risk for the event of interest, making use of interim exam data until the moment the subject and/or the tooth are no longer available for examination. We also included a discussion on biases that occur upon application of the usual methods of estimating caries experience in missing teeth and crowns, which often ignore the classification error in the estimation. We propose a method to adjust for misclassification of the M-component of the DMFS index. In the case where one can observe true reversals or remineralization of caries lesions, we recommend an adjustment formula to account for reversals that are most likely due to examiner misclassification. We provide examples to demonstrate the applicability of the methods for covariates subject to outcome misclassification.

Adult↗