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PubMed2002

Attitudes to dental care among parents of uncooperative vs. cooperative child dental patients.

The aim of this cross-sectional questionnaire study was to investigate four aspects of parents' attitudes to dental care (knowledge, child's oral health behavior, priorities and responsibility). One study group (n = 50) of parents of uncooperative child dental patients (aged 8-12 yr) was compared to a reference group (n = 113) of parents of ordinary child dental patients of similar age, and to a second study group (n = 36) of parents of uncooperative younger child patients (aged 4-7 yr). Study group parents had significantly lower socio-economic status and a higher level of dental fear as compared to parents of ordinary child patients. We found indications of a poorer dental knowledge and a differing responsibility-taking profile among study group parents. Their children also had sweets more often. As compared to parents of younger children, the older study group parents had lower socio-economic status and showed a lower responsibility-taking related to the child's treatment refusal. In conclusion, parents of uncooperative children differ from parents of ordinary child dental patients, not only in socio-economic status and dental fear, but also in aspects such as dental knowledge and responsibility-taking. These differences were partly related to the child's age.

Age Factors↗
PubMed2001

Prevalence and correlates of traumatic injuries to the permanent teeth of schoolchildren aged 9-14 years in Belo Horizonte, Brazil.

A cross-sectional survey was carried out on 3702 boys and girls aged 9-14 years, attending public and private primary schools in Belo Horizonte, Brazil. A multi-stage sampling technique using an equal probability scheme was adopted to select the children. The response rate for the total sample was 97%. Dental examinations were carried out by one dentist (MISC). Intra-examiner agreement was very good. The prevalence of dental injuries increased from 8% at the age of 9 years to 13.6% at 12 and 16.1% at 14 years. Adjusted results showed that children from high socio-economic backgrounds were 1.4 (95% CI = 1.15-1.79) times more likely to present with a dental injury than children with low SES. Boys were 1.7 times (95% CI = 1.41-2.16) more likely to have dental injuries than girls. Children with an overjet size greater than 5.0 mm were 1.37 times (95% CI = 1.06-1.80) more likely to have a dental injury than children with an overjet size equal or lower than 5.0 mm. Finally, children with an adequate lip coverage were 0.56 times (95% CI = 0.44-0.72) less likely to have a traumatic dental injury than those with inadequate lip coverage.

Adolescent↗
PubMed2001

Factors associated with the temporomandibular disorder, pain dysfunction syndrome (PDS): Manchester case-control study.

OBJECTIVES: To determine the individual and combined effects of potential risk factors in relation to the temporomandibular disorder, Pain Dysfunction Syndrome (PDS). DESIGN: Case-control study. MATERIAL AND METHODS: Cases were new referrals to the temporomandibular disorder clinic of the University Dental Hospital of Manchester, diagnosed with PDS. Controls were randomly selected from 24 dental practices. Using a postal questionnaire information was collected on socio-demographic, local mechanical, psychological factors, co-morbidities and illness behaviour. The adjusted participation rate was similar in cases and controls (64%), and 131 cases and 196 controls finally participated in the study. RESULTS: Compared with the controls, the cases were more likely to report that their teeth felt as though they did not fit together properly [odds ratio (OR) 8, 95% Confidence Interval (CI) 6-13] and report history of facial trauma (OR 3, 95% CI 2-6). Both diurnal and nocturnal grinding were significantly associated with PDS, and individuals who reported grinding their teeth both during the day and at night had a risk of 6; 95% CI 3-13 for PDS compared with those who did not. A history of orthodontic treatment, having any dentures, having missing teeth, use of chewing gum or biting the fingernails did not show any relationship with PDS. People who took medication for the bowels had a higher risk of PDS (OR 2, 95% CI 1-4). Participants with frequent headaches had a threefold increase in risk of having PDS (OR 3, 95% CI 2-5) while having pain in parts of the body other than the head was associated with an OR of 3 (95% CI 2-5). An increased propensity to have PDS was seen in those individuals with higher levels of psychological distress (OR 3; 95% CI 1-4 in the highest category, test for trend P < 0.001) and sleep disturbance (OR 5; 95% CI 2-94 in the highest category, test for trend P < 0.001). Aspects of illness behaviour, such as disease conviction (OR 4; 95% CI 2-9 in the highest category) and perception of illness (0.3; 95% CI 0.2-0.5) were associated with PDS. The result for the denial scale became statistically significant after adjustment for age and gender (2; 95% CI 1-3). CONCLUSIONS: The current case-control study provides complementary epidemiological information on oro-facial pain (OFP) and supports a multifactorial aetiology of PDS, with factors from many domains, including local mechanical factors, psychological and co-morbidities. People with PDS were characterized by frequent headaches, history of facial trauma, teeth grinding, sleep problems, pain elsewhere in the body and high levels of psychological distress. From the results of current study and available evidence it seems inappropriate to consider PDS in isolation and future research should adopt a multidisciplinary approach to OFP.

Adolescent↗
PubMed2004

Inter- and intraindividual variability in recognition memory: effects of aging and estrogen use.

Traditionally, studies of cognitive aging have focused on comparing the average performance of younger and older adults, whereas variability around the mean has been attributed to task-irrelevant noise. The present study examined the hypothesis that variability in memory performance increases with age and that estrogen helps temper age-related increases in variability. Postmenopausal estrogen users, estrogen and progestin (est + prog) users, and nonusers, as well as younger women, completed 16 blocks of an item-source memory task. Older women showed greater variability than younger women on measures of dispersion and consistency. Estrogen users, but not est + prog users, performed more consistently than nonusers. Overall, age-related increases in variability differed with the type of variability measured, and estrogen use, but not est + prog use, appeared to reduce age-related increases in at least 1 form of variability.

Adolescent↗
PubMed2002

The York review--a systematic review of public water fluoridation: a commentary.

Following the election of the British government in May 1997, a policy document outlining proposals to improve the health of the nation was published. This document placed a major emphasis on reducing inequalities in health and recognised the continuing poor state of oral health in deprived communities. However, whilst acknowledging the benefits of water fluoridation as a caries preventive measure, the Department of Health suggested that most of the research had been carried out some years ago and furthermore, recognised that strong views were held both for and against fluoridation.

Cariostatic Agents↗
PubMed2002

Physiognomy and teeth: an ethnographic study among young and middle-aged Hong Kong adults.

OBJECTIVES: To determine knowledge and beliefs about traditional physiognomy (judging an individual's character from their facial appearance) concerning teeth among young (17-26) and middle-aged (35-44) Hong Kong adults. METHODS: In a cross sectional ethnographical telephone survey, 400 adults were interviewed about 16 traditional physiognomy concerning teeth (in consultation with a Feng Shui specialist). RESULTS: Most completed the interview (93%, 373). Over half the study group (63%, 234) claimed they had heard of aspects of physiognomy concerning teeth, and a quarter (24%, 88) believed in such ideologies. Variations in knowledge and beliefs were apparent among people of different age (P < 0.01), gender (P < 0.05), educational attainment (P < 0.01), economic status (P < 0.01), place of birth (P < 0.01) and religion (P < 0.01). Their knowledge and belief in aspects of physiognomy concerning teeth was also associated with reported use of dental services (P < 0.01). CONCLUSION: Among young and middle-aged adults in Hong Kong, knowledge and beliefs concerning traditional physiognomy regarding teeth is strong, and socio-demographic variations exist in these perceptions. These findings have implications for all those involved in the delivery of dental care in multicultural societies and in raising cultural awareness about traditional health beliefs.

Adolescent↗
PubMed2002

Food and drink consumption, sociodemographic factors and dental caries in 4-5-year-old children in Amman, Jordan.

OBJECTIVE: To investigate the association between type of food and drink consumption, sociodemographic factors and prevalence and severity of caries in 4-5-year-old Jordanian children. METHOD: Two-stage random sampling procedure was used to select children enrolled in kindergartens in Amman. Clinical examinations were carried out by one examiner. Mothers completed a questionnaire relating to sociodemographic factors and food and drink consumption. RESULTS: Snack foods were consumed by a high percentage of children. Amongst the most popular 'high in NME sugar snacks', confectionery was reported to be regularly consumed by 76% and biscuits and cakes by 71% of them. More than 50% had carbonated drinks. Children from a lower social class, attending a kindergarten with lower tuition fees had more dessert, squashes and more teas with sugar. When all variables were considered, consumption of confectionery was independently associated with caries prevalence and consumption of teas with sugar was independently associated with caries severity. CONCLUSION: The types of foods and drinks consumed as snacks by young Jordanian children were similar to those of Western countries. In the absence of more widespread oral health promotion measures and in the presence of high prevalence and severity of caries,the oral health of Jordanian children is a matter of concern.

Beverages↗
PubMed1994

Residual orthodontic treatment need in a sample of 15- and 16-year-olds.

This study investigated the residual unmet orthodontic need, both normative and perceived, in young adults who had passed the age at which orthodontic treatment would have normally commenced. A total of 506 15- and 16-year-olds attending eight secondary schools were screened by a single trained examiner using the 'Index of Orthodontic Treatment Need' (IOTN). There were 154 (30.4%) subjects classified as being in need of orthodontic treatment using IOTN and 82 of these (16% of the sample) were found to be in need of orthodontic treatment but had no recollection of orthodontic treatment ever being discussed with them. Children with malocclusion, who had received no orthodontic advice, came from across the range of socio-economic groups, were more likely to be male, and were less likely to be happy with their appearance than their unaffected peers.

Adolescent↗
PubMed1999

Radiomorphometric indices of the mandible in a British female population.

OBJECTIVES: To examine the radiomorphometric indices of the mandible on panoramic radiographs in a population of British female patients, to identify their normal ranges and to investigate their relationships with age, detentition and social class. METHODS: Five indices, cortical width at the gonion (GI) and below the mental foramen (MI), the panoramic mandibular index (PMI), the mandibular cortical index (MCI) and one new index (measurement of cortical width at the antegonion; AI), were measured bilaterally on 500 panoramic radiographs of females by one trained observer. The measurements were analysed for ease of application, repeatability, relationships with age, dentition and social class and interrelationships between the variables. RESULTS: All quantitative indices (GI, MI, PMI, AI), showed a significant, negative correlation with age. MCI showed an age-related distribution. Mandibular dentition exerted a significant influence on some indices, but social class had no influence. Intra-observer repeatability of MI, PMI and AI was fair (precision < 20%) but that for GI was poor. Intra-observer agreement in MCI assessments was excellent. CONCLUSIONS: The age-related changes in mandibular radiomorphometric indices and their variation within each age band lend support to their potential use in identification of skeletal osteopenia. However, problems with repeatability and measurement precision identified in the pilot study, notably with GI, may be a considerable obstacle to their use in general practice.

Adult↗
PubMed2002

Orthodontic treatment outcomes in the long term: findings from a longitudinal study of New Zealanders.

The aim of this study was to use a health services research (HSR) approach to examine the longer-term outcomes of orthodontic treatment. Participants in a longstanding population-based New Zealand cohort study (the Dunedin Multidisciplinary Health and Development Study) were allocated to one of four malocclusion severity categories on the basis of orthodontic data collected at age 12. The outcome of that care by age 26 was evaluated using the key indicators of equity (was it fair?); efficacy (did it work?); effectiveness (did it work in the longer term?); and safety (was it associated with a greater subsequent experience of caries, periodontal disease, or tooth loss?). Data were available for 452 Study members, of whom 56.2% were in the minor/none category, 29.0% were in the definite category, 10.2% were in the severe category, and 4.6% were in the handicapping treatment-need category. No clear differences in treatment uptake by socioeconomic status were apparent, and the proportion treated increased across the malocclusion severity categories, as did the proportion that showed an improvement following treatment. By age 26 a difference between those who had and those who had not been treated was evident, with the percentage of those rating their dental appearance as above average increasing with increasing severity of the age-12 orthodontic treatment need. This was also true for the percentage that considered their orthodontic treatment to have been successful. There were no significant differences in caries experience, periodontal disease occurrence, or tooth loss between those who had and had not been treated by age 26. This study has found the equity, efficacy, effectiveness, and safety of orthodontic treatment in the Dunedin cohort to be acceptable.

Adolescent↗
PubMed2001

Factors affecting the initiation of substance abuse treatment in managed care.

AIMS: A long-standing concern of clinicians in addiction treatment is that a large number of individuals who are admitted to treatment do not return to actually begin the program. We identified characteristics that predict treatment initiation. DESIGN: In-person structured interviews were conducted with consecutive admissions to a large outpatient program (N = 1204), and the health plan's automated registration data were used to determine treatment attendance. We compared those who returned to begin treatment with those who did not. SETTING: The study was conducted at the Chemical Dependency program of a large group model health maintenance organization (HMO). PARTICIPANTS: Study subjects were individuals age 18 or over admitted to the program. MEASUREMENT: Study variables included DSM-IV alcohol and drug dependence and abuse, Addiction Severity Index problem severity, motivation and treatment entry measures. FINDINGS: Those who were drug-dependent were less likely to begin treatment than those dependent only on alcohol. Measures of motivation, such as work-place pressures and the patient's perception of the importance of alcohol treatment, predicted starting treatment for individuals who were alcohol-dependent only or alcohol- and drug-dependent. Among patients who were dependent only on alcohol, women were more likely than men to start treatment, and for those who were drug-dependent, being employed and having higher drug severity scores predicted starting treatment. CONCLUSIONS: Screening at intake may identify those at risk of not returning after admission to start treatment. Clinicians may consider making additional efforts during the intake process to engage individuals who are unemployed and have drug (as opposed to alcohol) disorders and less motivation.

Adolescent↗
PubMed2001

The reliability of self-reported age of onset of tobacco, alcohol and illicit drug use.

AIMS: To examine the reliability of self-reported age of first substance use experiences among national samples of adult and child respondents. DESIGN: Survey responses from seven waves of the National Longitudinal Survey of Youth (NLSY) were examined. PARTICIPANTS: Adult and child NLSY respondents reporting age of first tobacco, alcohol, marijuana, cocaine and/or crack use during two or more survey interviews. MEASUREMENTS: Four indicators of reliability: intraclass correlation coefficients (ICC), mean and absolute mean differences in reported age and reports consistent within 1 year. FINDINGS: The adjusted mean ICC for all comparisons was 0.69. The adjusted mean difference in self-reported age of first substance use was -0.52 years and the adjusted absolute mean difference was 2.00 years. The adjusted percentage of all comparisons reporting ages consistent within 1 year was 55.28%. More consistent reports were provided by adults, and in response to questions posed over 2 years as opposed to longer time intervals. Respondent answers to questions concerned with first use of marijuana were generally found to be most reliable; questions concerned with first use of crack were least reliable and reports of tobacco, alcohol and cocaine were intermediate. Logistic regression analyses also identified age, race, gender, education and poverty status as predictors of consistent reporting. CONCLUSIONS: Self-reports of age of first substance use experiences, as currently collected via survey questionnaires, are of sufficient reliability for most current epidemiological applications. For inquiries where age of substance use onset is itself a research focus, however, researchers should invest additional effort in improving the reliability of measurement.

Adolescent↗
PubMed2003

C-reactive protein: associations with haematological variables, cardiovascular risk factors and prevalent cardiovascular disease.

C-reactive protein (CRP) has been proposed as a risk factor for cardiovascular disease; however, this association is confounded by mutual relationships with both classical and haematological cardiovascular risk factors. We, therefore, measured CRP with a high-sensitivity assay in stored plasma samples from 414 men and 515 women in the north Glasgow MONICA (MONItoring trends in CArdiovascular diseases) survey, to study its correlation with haematological variables, classical risk factors and prevalent cardiovascular disease. CRP correlated with age, oral contraceptive use, menopause and most classical cardiovascular risk factors (except blood pressure). CRP also correlated with plasma levels of the pro-inflammatory cytokine interleukin 6, and haematocrit, viscosity, red cell aggregation, white cell count, and coagulation factors [fibrinogen, factor (F) VII in women, FVIII, FIX] and inhibitors (antithrombin and protein C in women; protein S) but not coagulation activation markers. CRP was significantly associated with prevalent cardiovascular disease in both men (P = 0.03) and women (P = 0.009), however, the association became non-significant after adjustment for firstly classical risk factors, then fibrinogen. We conclude that correlations with classical and haematological risk factors account for a substantial component of the association of CRP with prevalent cardiovascular disease, but there is evidence of a residual, independent effect among women.

Adult↗
PubMed2002

Evidence for reversal of the caries decline among Norwegian children.

OBJECTIVE: The purpose of the present study was to report on caries status and to explore possible reasons for changes in caries experience among 5- and 12-year-old Norwegian children. DESIGN: National cross-sectional and time trend study. METHODS: Aggregated data from the Public Dental Services and from official statistics were used. Information was available on the total number of children, the proportion receiving treatment, sale of fluoride tablets, socio-economic background, caries prevalence and dmft/DMFT scores. RESULTS: The prevalence of caries among 5-year-olds reached a low of 30.4% in 1997 and increased to 38.9% in 2000. The mean dmft scores increased from 1.1 to 1.5. Conversely, the prevalence of caries among 12-year-olds decreased from 55.4% in 1997 to 52.2% in 2000 and the mean DMFT score from 1.7 to 1.5. Bivariate analyses at county level revealed significant associations, which for the most part disappeared in multivariate analyses. The sale of fluoride tablets had a significant effect on caries prevalence among 5-year-olds in 1998, in 1999 and in 2000. Infant mortality was associated with the dmft score in 1999. The only consistently significant predictor of caries experience at 12 years of age was caries prevalence at age 5. CONCLUSIONS: There has been a highly significant increase in caries experience among 5-year-olds (P < 0.001) and a levelling off among 12-year-olds over the past 3 years. Considering the association between caries prevalence at age 5 and caries experience at 12 years of age, there is a need for reassessment of the caries preventive programmes for children in Norway.

Age Factors↗
PubMed2002

Variability in the response of HDL cholesterol to exercise training in the HERITAGE Family Study.

In the HERITAGE Family Study, 675 sedentary, healthy, white and black men and women, aged 17 to 65 years, performed 20 weeks of supervised cycle ergometer exercise at the same relative intensity and weekly volume. As a group, subjects had normal mean baseline lipid levels for North Americans with the exception of below average high density lipoprotein cholesterol (HDL-C) levels. A significant mean increase in plasma HDL-C of 3.6 % was observed; however, there was marked variability in responsiveness to training, ranging from a mean 9.3 % decrease in Quartile 1 of HDL-C response to a mean 18 % increase in Quartile 4 (P < 0.0001 by ANOVA). Parallel changes in HDL(2)-C and HDL(3)-C, apolipoprotein A-I levels, and lipoprotein lipase activity were noted across quartiles. The change in HDL-C across quartiles was inversely related to baseline HDL-C (p < 0.0001) and to changes with training in plasma triglycerides (p = 0.0007). No significant differences in HDL-C response were observed across quartiles by sex, race, age, or increase in VO(2)max with training; however, weak positive associations were observed with age-adjusted education level and with reduction in abdominal fat and increase in VO(2)max at the ventilatory threshold following training. Multivariate regression analysis including baseline variables and training responses only accounted for 15.5 % of the variability in the HDL-C response to training. Thus, marked variability was found in the HDL-C response to the same endurance exercise training stimulus with only a modest amount of the response predictable by identified nongenetic factors.

Adaptation, Physiological↗
PubMed2006

Correlations between motor performance and cognitive functions in children born < 1250 g at school age.

Very low birth weight born children manifest a higher prevalence of motor and cognitive impairments than term children. Seventy-four prospectively enrolled children born < 1250 g underwent testing of motor (Zurich neuromotor assessment ZNA: timed motor performances and associated movements) and cognitive functions (Kaufman-ABC) at age six years. Children with cerebral palsy or mental retardation were excluded. Adaptive motor tasks (pegboard and dynamic balance) and visuomotor cognitive functions were specifically impaired, and a distinct correlation pattern between motor and cognitive abilities was detected. The adaptive fine motor task (pegboard) correlated with visuomotor functions of the Kaufman-ABC ("triangles", r = 0.35; "matrix analogies", r = 0.39), while pure motor tasks of the ZNA (repetitive, alternating, and sequential movements) did not in spite of impaired motor performance. Timed motor performance below the 10th percentile correlated strongly with cognitive delay (IQ < 85: adaptive fine motor: OR 6.0 [95% CI] 4.7-7.3; adaptive gross motor: OR 7.0 [CI 5.6-8.4]; static balance: OR 9.6 [CI 8.2-11.0]). In conclusion, motor deficits in children born < 1250 g without severe disabilities correlate with specific cognitive impairments, in particular of the visuomotor domain. The correlation pattern may indicate specific dysfunction in visuomotor transformation, the intermediate process between visual-perceptual input and motor output. Early assessment of both motor and cognitive functions using standardized assessment tools is important to determine the extent and combination of specific developmental disturbances and to tailor therapeutic intervention.

Child↗
PubMed2000

Prevalence and determinants of periodontal disease in Portuguese adults: results from a multifactorial approach.

The purpose of the present investigation was to study prevalence of periodontal disease among 30 to 39-years-old from Oporto in the north of Portugal. In addition, an attempt was made to elucidate possible periodontal disease determinants in this population. A random sample consisting of a total of 322 individuals was drawn based on electoral lists. The attendance rate was 61%. The CPITN index was used and the results indicate a high prevalence of periodontal disease and a substantial need for periodontal treatment in this population, with 41% of the individuals investigated having one or more sites with a CPITN score 4 (pockets deeper than 5.5 mm). Dental visiting habits, gender (lower CPITN scores for females) and oral hygiene were the determinants most significantly associated with variation in CPITN scores.

Adult↗