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PubMed1995

Quantitative determination of immunologic components of salivary gland secretion in long-term, event-free pediatric oncology patients.

OBJECTIVES: Chemotherapy influences the human immune system. Salivary alterations occur during cancer treatment. In this article we examine the salivary immunoglobulin content in pediatric patients who were long-term event-free and correlate these findings with different oral factors. STUDY DESIGN: Fifty-two children of a study group and 63 children of a control group were examined at our University Hospital. Caries prevalence and plaque index were scored. Whole saliva samples were taken for determination of slgA and IgG concentrations and Streptococcus mutans and Lactobacillus counts. For statistical analysis the Dental Survey Plus (Providence Software Services, Bristol, England) software package was used. RESULTS: Concentrations of slgA and IgG were within normal limits in both groups; slgA level increased with age. A negative correlation between slgA concentration and caries experience was not found in all age groups. No correlation with other salivary parameters was found. CONCLUSION: Salivary content of slgA and IgG can return to normal after cytotoxic therapy in these children. Salivary IgA seem to play a role in the development of dental caries in this population.

Adolescent↗

PubMed2006

Can the development of new dental caries in Danish schoolchildren be predicted from surveillance data in the School Dental Service?

BACKGROUND: Dental screening programmes for Danish children generally target all children, irrespective of their individual caries risk. The standard screening interval is approximately 12 months. A valid systematic screening tool based on routine information sources is however indispensable, if more selective screening strategies should be developed to target the children at highest risk. OBJECTIVE: To estimate the precision with which Danish schoolchildren at high risk for developing dental caries within 1 year can be identified based on information from routine registers. METHODS: Based on data from the Danish National Board of Health's Recording System for the Danish Child Dental Services and from the Central Office of Civil Registration, 3705 schoolchildren aged 7-12 years were followed through 1994-1996. Dental health information as of 1994 and changes 1994-1995 were applied in multiple logistic regressions together with social data as of 1995 to estimate the individual 1-year (1995-1996) risk of developing caries. RESULTS: In 1995, 37.4% of the children had a DMFS index above 0, and during the following year 21.8% of all children developed new caries. The individual child's 1-year caries risk could be estimated relatively accurately at baseline as indicated by the area (76%) under the receiver operating characteristic curve. About 40% of children with an estimated risk of 20% and above developed new caries, whereas 90% of the rest of the children did not do so. CONCLUSION: Based on information from Danish routine registers children at low caries risk may be identified relatively precisely. This may form the basis for the continuous development and targeting of high-risk strategies, in which the screening for caries among children of estimated low risk may be postponed at least 1 year.

Area Under Curve↗

PubMed1991

[Oral health of 15-year-old students living in non-fluoridated public school sectors on l'Ile de Montreal in 1987].

Using data from a cross-sectional survey on 570 fifteen year old students living in non-fluoridated public school sectors on the Island of Montreal in 1987, the effect of terminating the restorative aspect of public dental health care insurance for twelve to fifteen year old students is examined. This study also highlights the level and quality of dental caries treatment on the twelve to fifteen year old group. The main point to be made is that there was an improvement in the DMFT index values of fourteen and fifteen year old students in metropolitan areas. In reality, fourteen year old children had a DMFT index of 6.45 in 1983-1984, while the fifteen year old children in the 06A region (non-fluoridated area) had a DMFT of 6.07 in 1987. Since the metropolitan fluoridated area had been eliminated from the results in 1987, it is quite obvious that the 6.07 result obtained overestimates the actual prevalence of dental caries in the metropolitan area in 1987. On the other hand, the progress which had been recorded between 1977 and 1984 by francophones in relation to anglophones was partially lost in 1987. Furthermore, this study has demonstrated that the prevalence and level of dental caries treatment are highly associated with the language spoken at home and also with the family's socio-economic status.

Adolescent↗

PubMed1984

Use of dental floss by Finnish students.

In order to elucidate dental care behavior related to interdental cleaning, a group of first-year students were invited to a free dental examination. 186 of the students invited (76%) were examined clinically and roentgenologically. The mean DMFS-index of the students was 22.6 (+/- 12.6). They were also asked about their use of dental floss. 35% of the students reported using dental floss, but only 2% reported daily usage. 45% of the students had been taught how to use dental floss, and 83% of these had been taught by dental personnel. Teaching had no effect on the reported frequency of use. There were no statistically significant differences in the occurrence of dental plaque and gingivitis between those who used dental floss and those who did not. The subjects were unable to use dental floss on 1 out of every 3 filled proximal surfaces of the first molars. No correlation could be found between dental caries experience and the reported use of dental floss.

Adult↗

PubMed2004

The dental caries experience of 14-year-old children in England and Wales. Surveys co-ordinated by the British Association for the Study of Community Dentistry in 2002/2003.

OBJECTIVE: This paper reports the results of standardised clinical caries examinations of 77,693 14-year-old children from across England, Wales, Jersey and the Isle of Man. These 2002/3 coordinated surveys are the latest in a series which seeks to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine (D3) threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: These demonstrated, once again, a wide variation in prevalence across the area surveyed, with mean values for D3MFT for the current English government offices (of the National Health Service) and the local Health Boards in Wales ranging from 0.99 in the South East to 2.10 in Wales (2.41 in the Isle of Man). The mean value for across England and Wales was 1.48 (D3T=0.56, MT=0.10, FT=0.82). Overall 49 per cent of 14-year-old children in England and Wales had evidence of dentinal caries experience (D3MFT>0), the regional/country means ranged between 37 per cent (South-East) and) and 60 percent in Wales (65 per cent, Isle of Man). The mean D3MFT for those with disease at this threshold was 3.03. Trends over time demonstrate an improvement of 4% in overall D3MFT for England and Wales, there has been only small improvement in mean MT since 1994/95, while FT and care index have fallen. The number of fillings provided in 2002/3 and thus the care index, remains low, on average across England and Wales, only 55% of the dentinal caries experience identified by survey examinations of permanent teeth was seen as fillings (range in individual areas: 28% to 83%). CONCLUSION: These findings demonstrate a modest overall improvement in oral health, but a continuing need for more effective preventive strategies and treatment services for permanent teeth in this important age group. An average of half of the 14 year old children examined being affected by dentinal decay and a mean of three permanent teeth decayed into dentine for those children affected at this level of diagnosis is a poor start to charting oral health in the 21st Century in England and Wales.

Adolescent↗

PubMed2006

The dental caries experience of 11-year-old children in Great Britain. Surveys coordinated by the British Association for the Study of Community Dentistry in 2004 / 2005.

OBJECTIVE: This paper reports the results of standardized clinical caries examinations of 11-year-old children from across England and Wales, Scotland, Isle of Man, and Jersey in 2004/5. These co-ordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating strategic health authorities (SHAs), primary care trusts (PCTs), health boards (HBs), and local health boards (LHBs). Caries was diagnosed at the caries into dentine threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: The results again demonstrated a wide variation in disease prevalence and care strategies across Great Britain. Mean values for D3MFT within the current English strategic health authorities ranged from 0.19 in Harlow to 1.32 in North Manchester and in Salford; in Wales mean values ranged from 0.69 in Vale of Glamorgan to 2.09 in Blaenau Gwent; while in Scotland they ranged from 0.59 in Orkney to 1.77 in Western Isles. Mean D3MFT across England was 0.64 (D3T = 0.32, MT = 0.06, FT = 0.25), across Wales it was 1.09 (D3T = 0.48, MT 0.11, FT = 0.50), and across Scotland values were 1.29 (D3T = 0.52, MT = 0.17, FT = 0.60). Overall, 31.3% of children in England & Wales and 47.1% of children inspected in Scotland had evidence of caries experience in dentine (D3MFT > 0, including visual dentine caries). As in previous surveys, the distribution of caries was highly skewed. Thus the mean caries experience for those with dentinal decay in England and Wales was 2.12, as opposed to the overall mean of 0.66; in Scotland the corresponding values were 2.74 and 1.29. Trends over time demonstrate an improvement in overall mean D3MFT for England and Wales since the 2000/2001 of 12-year-olds, although part of this difference is accountable to the younger age, at examination, in this survey. The mean value for those with dentine decay experience was also marginally less at 2.12 compared with 2.35 in the previous survey. (Figures for Scotland were not included in the 2000/2001 survey.) The care index was also found to be marginally lower than previously at 41% compared with 48% but again the younger age of the children would influence this value. CONCLUSION: Dental health of 11-year-old children has been surveyed in Great Britain, Jersey, and the Isle of Man: being a slightly younger mean age than in previous BASCD surveys. Geographic variation in oral health is marked at both the local and national levels. Overall, the provision of operative care for those with dentinal decay is around 42%. While many children enjoy good oral health, sizable groups remain within the population of 11-year-old children who have a clinically significant burden of preventable dental disease.

Age Factors↗

PubMed1999

Multiple sclerosis, dental caries and fillings: a case-control study.

OBJECTIVES: To investigate the association between multiple sclerosis, dental caries, amalgam fillings, body mercury and lead. DESIGN: Matched case-control study. SETTING: Leicestershire in the years 1989-1990. SUBJECTS: Thirty-nine females with multiple sclerosis (of recent onset) were matched with 62 controls for age, sex and general practitioner. METHODS: Home interview of cases and controls within which there was an assessment of the DMFT index and blood and urine mercury and lead levels. RESULTS: The odds of being a MS case increased multiplicatively by 1.09 (95% CI 1.00, 1.18) for every additional unit of DMFT index of dental caries. This represents an odds ratio of 1.213 or a 21% increase in risk of MS in relation to dental caries in this population. There was no difference between cases and controls in the number of amalgam fillings or in body mercury or lead levels. There was a significant correlation between body mercury levels and the number of teeth filled with amalgam (controls: r = +0.430, P = 0.006, cases: r = +0.596, P = 0.001). CONCLUSION: There was evidence of excess dental caries among MS cases compared with the controls. This finding supports the strong geographical correlation between the two diseases. A further study of this association is recommended.

Adult↗

PubMedDate not supplied

[Streptococcus mutans: its relation to cariogenic activity].

This research was carried out with the purpose of learning about relationship between degree of infection by Streptococcus mutans in saliva and prevalence of caries and further incidence in a one year term. A total of 931 children aged 2-3 years of Havana City and Sancti Spiritus Province, and 10 different series of school children aged 6-12 years of both provinces, with a total of 848 children, were studied. A direct significant relationship between degree of infection by S. mutans and prevalence of caries (percentage of affected children and co/COPD index) was found in the groups under study. Likewise, in the relationship between previous degree of infection and incidence of caries, differences were significative in children aged 2-3 years and in six of the 10 series of school children, with a correlation (r) of 0.216. It is analyzed that despite that degree of infection by Streptococcus mutans is the parameter with higher correlation with cariogenic activity, its predictive value is not enough by itself, therefore, a joint valuation with other parameters also related to cariogenic activity is required, in order to be able to reach necessary validity in the prognosis.

Child↗

PubMed1997

Oral health status among secondary school students in Harare, Zimbabwe.

In 1993 a demonstration oral care programme to evaluate the ART procedure for dental caries under field conditions began among secondary school students in Greater Harare. The programme was preceded by an oral epidemiological survey. Of the 569 students examined, with a mean age of 13.9 years, 58.7 per cent were caries free. The mean DMFS and DMFT scores were 1.4 and 1.1, respectively. Very few missing and filled teeth were observed. Excluding those with pulp involvement, small dentinal lesions which could not be penetrated with an excavator at the time of examination, constituted 49 per cent of the mean DMFS score. 84 per cent of dentinal lesions needing treatment were judged to be treatable using the ART procedure. Using the index of Green and Vermillion (1964), the mean plaque score was 5.6 with substantial variation observed between the schools. Calculus was observed among 89.5 per cent of the students examined. 18 per cent of them had a central diastema in the maxilla. Crowding or spacing in the upper and lower anterior region of the jaws was observed in 67.5 per cent and 60.5 per cent of the students, respectively. 15.8 per cent were dissatisfied with the position of their teeth whilst 15 per cent indicated that they would like to undergo corrective treatment. It was concluded that these secondary students lack preventive and curative oral care and that the vast majority of the dentinal lesions observed could be treated using the ART procedure.

Adolescent↗

PubMed2003

Influence of diagnostic adjuncts to the measurement of caries prevalence at different caries thresholds.

OBJECTIVES: To determine the influence of diagnostic adjuncts (dental brushing and drying) in dental caries diagnosis. To analyse the underestimation levels in epidemiological examinations when compared to traditional dental setting examinations. To evaluate the influence of including noncavitated (NC) carious lesions in the estimation of the disease. PARTICIPANTS: 51, 12-year-old children. INTERVENTIONS/METHODS: Four epidemiological exams performed in an outdoor setting and one performed in a traditional dental setting (visual-tactile method associated or not with diagnostic adjuncts). MAIN OUTCOME MEASURES: DMFS (Decayed, Missing and Filled Surfaces) index, according to the WHO criteria. RESULTS: When compared to exams carried out in a traditional dental setting, the epidemiological examinations showed no significant statistical differences for the DMFS score (p>0.05), presenting underestimation levels lower than 10% (except for the low prevalence caries group in the WHO exam). For the DMFS, previous dental brushing was more relevant than previous dental drying, although drying was the most important resource for NC diagnosis (p<0.05). CONCLUSION: The visual/tactile method, with or without diagnostic adjuncts, can diagnose cavitated lesions efficiently, but not NC lesions. However, for the low caries prevalence group, the implementation of dental brushing prior to an exam could be suggested.

Analysis of Variance↗

PubMed1988

Oral health status, knowledge, and practices in an Amish population.

This study was conducted in the summer of 1985 to assess the oral health status, knowledge, and practices of an Amish population in southwest Michigan. Dental caries experience, periodontal health, and oral hygiene status were recorded using decayed, missing, and filled surfaces (DMFS), periodontal index (PI), and simplified oral hygiene index (OHI-S). Data on oral health knowledge and practices were collected by interviews using a structured questionnaire. Results showed significantly lower levels of disease among Amish. DMFS scores for 5-17-year-old Amish children were almost half that of the US general population (NIDR 1979-80). PI score of all ages combined was 2.0, which was 3.6 times lower than a national sample (1971-74). Lower levels of disease in Amish could be related to their way of life and dietary patterns. A relatively higher level of unmet need for prosthodontic care, inadequate oral health knowledge, and barriers to dental care in the study population emphasize the need for dental public health and health education programs.

Adolescent↗

PubMed1992

Progression of periodontal pockets in the age cohort 35-44 years.

In 1985 the Health Department of the Italian Telephone Company decided to launch an oral health programme for all its employees and their relatives, with the collaboration of the WHO Collaborating Centre of the Clinica Odontoiatrica Ospedale S. Paolo, Milan. The programme started with an epidemiological survey of dental and periodontal condition; following data analysis, the company also contracted with private dentists to provide oral care. Four years later, in 1989, several studies were set up to evaluate the programme. The WHO Collaborating Centre Milan was requested to evaluate the periodontal care given to a sample of persons living in the Milan area. Seventy-seven individuals with established periodontal lesions were selected out of a group of 678 aged between 35 and 44 years examined in 1985. The same periodontal and dental indices used in 1985, CPITN (Community Periodontal Index of Treatment Needs) and DMFT (decayed, missing, filled teeth), were re-evaluated in these 77 persons and information about any periodontal care since 1985 was collected and checked against the reimbursement records of the Telephone Company. There was an increase in the percentage of persons with deep pockets (from 55.8 to 72.7 per cent), and of the mean of sextants affected (from 0.9 to 1.9). These individuals had been treated for dental problems, as demonstrated by an increase in the F component and a reduction of the D component of the DMFT, but had undergone virtually no treatment for periodontal problems. This may be considered as a longitudinal study on the natural progression of periodontal pathology in individuals with established periodontal lesions.

Adult↗

PubMed1986

A dental caries severity index for primary teeth.

Criteria for scoring the caries attack on each surface of an affected primary tooth are described. The score for each carious surface ranges from 1 to 3. The score per tooth is a sum of the surface scores. The caries severity index (csi) is the mean of the scores of all carious teeth in the population examined. Three groups of children aged 5-6.5 yr were examined. In Jerusalem, with a water fluoride concentration of 0.4 ppm, 54 children had a csi of 2.99 and a defs of 10.19. In a semirural African town, Soshanguva, with a 0.2 ppm fluoride concentration, 103 children had a csi of 3.10 and a defs of 5.75. In a nearby rural African area with a water fluoride concentration well above the optimum, 86 children had a csi of 1.93 and a defs of 1.99. Interexaminer and intraexaminer reproducibility of the csi were good. The csi expresses the severity of the caries attack on affected teeth and gives additional information to that of the def indices.

Child↗

PubMed1999

On the reporting of dental health, time for dental care, and the treatment panorama.

The thesis included five methodological studies and one caries epidemiological investigation, the general aim being to study how to measure and report dental health, time for dental care, treatment panorama, and dental care outcomes, within a Public Dental Service organization. The specific aims were to monitor dental clinic activities using a time study method, to apply time study results of a dental health-related patient group system for the 3-19 year age groups, and to compare time study results with corresponding results from computerized systems used for reporting dental care. Other specific aims were to compare longitudinal caries index data results between cohort and cross-sectional samples, to analyse caries index for extreme caries groups among adolescents leaving organized dental care, and--using time series methods--to analyse dental health development of the 15-19 year age groups. Results from the time studies portrayed the dental clinic as a working unit, showed that reported values can represent dental care only for intervention procedures, and indicated that clinic patterns were not adapted to the health situation of the patient groups. Longitudinal cohort attempts gave different values from those of the cross-sectional year classes, which should be the primary focus when presenting caries index mean values in dental health reviews. Caries-free groups from 15 to 19 years of age seem to be stable in their caries development in about 60%-80% of cases; while the 20% groups with the highest index values accounted for about 80% of all approximal lesions. In times of major economic adjustment, dental health for adolescents in Göteborg was an example of sustainable dental health development. A model system for monitoring, analysing, and reporting dental health and dental care outcomes within a dental care-giving organization calls for several conditions, for example, a dental health-related patient group system, and a rationale for the choice of dental team models. These areas could be gathered into a system where contemporary socio-economic factors and dental research results interact with performed dental care, and also with different methods for reporting and evaluating dental health, dental care costs, and the demand for dental care competence.

Adolescent↗

PubMed1991

[The periodontal findings and microflora in insulin-dependent (type 1) diabetics].

In 42 insulin-dependent type-I diabetics (age: 25.1 +/- 6 years; history of diabetes: 6.7 +/- 6.6 years) and in 118 control patients (age: 26.1 +/- 5.7 years) the oral health status including a periodontal examination was assessed. In addition, diabetic patients served to study the microflora in gingival pockets and on the mucosa of the cheek. The dental examination comprised the assessment of oral hygiene (Approximal Plaque Index, API), gingival inflammation (Sulcus Bleeding Index, SBI, and Gingival Index, GI) and of loss of attachment. Special medical history forms were used to gather information about the quality of metabolic equilibration and about laboratory values pertinent to diabetes. A significant positive correlation was found between poor metabolic adjustment (high glykosylized HbA1) and loss of attachment (r = 0.527). A significant relation was also detected between the administered insulin dose and gingival conditions (r = 0.404). The plasma leukocyte level was positively correlated to the SBI value (r = 0.546) as well as to the GI value (r = 0.496). Bacteriological investigation of subgingival samples revealed an increased amount of gram-positive, anaerobic rods (27.5%), especially corynebacteria (7.4%). Their numbers showed a narrow correlation to SBI (mean value: 48.1%) and GI (mean value: 1.9).

Adolescent↗

PubMed1985

Relationship between alignment conditions of teeth in anterior segments and dental health.

The purpose of the study was to examine the association between alignment conditions of anterior teeth and dental health in 15-year-old adolescents. The study group consisted of 74 females and 70 males with 6 anterior teeth in both jaws. The following parameters were assessed: plaque index (P1I), gingival index (GI), probing depth (PD), space index (SpI), filled surfaces (FS), and the NONAS-i.e., the number of non-aligned proximal tooth surfaces in each jaw counted on model casts. Statistical examination of the data was performed using chi 2 tests of association and homogeneity and correlation coefficient analyses. In both sexes and both jaws, anterior tooth segments with none or few non-aligned teeth had a more favourable periodontal state than segments with an increased number of non-aligned teeth. Likewise, tooth segments with none or few non-aligned teeth had a reduced frequency of proximal fillings compared to segments with an increased number of non-aligned teeth. In males, the distribution of restorations in the anterior segment of the lower jaw was relatively homogeneous in the 3 groups.

Adolescent↗

PubMed1990

Dental caries status and treatment needs of the permanent dentition of 6-12-year-olds in Hong Kong.

An oral health survey was conducted in 1986 on a representative sample of primary school children in Hong Kong. 1483 Chinese children of both sexes, aged 6-12 yr, attending 56 primary schools were surveyed. The DMFT index for the 6-yr-olds was 0.1, and for the 12-yr-olds it was 1.5. Forty percent of the 12-yr-olds were clinically caries-free. The permanent molars constituted 90% of the total caries experience of the 12-yr-olds. Over 90% of the caries lesions were found in pits and fissures. The dental caries treatment need in the permanent dentition was low and of the simple type. A great reduction in the dental caries experience of the permanent dentition of children has occurred since the introduction of water fluoridation 25 yr ago. In addition to treatment care, preventive measures should be provided by the School Dental Care Service for children with a high caries risk.

Age Factors↗

PubMed2006

Caries and fluorosis in 6- and 9-year-old children residing in three communities in Iran.

OBJECTIVES: The aim of this study was to investigate the caries and fluorosis prevalence among 6- and 9-year-old students in three communities in Iran with varying urbanization and fluoride in piped water. METHODS: Data were obtained from 523 dental examinations of 6- and 9-year olds in an upper middle class district in Teheran (T) (0.3 mg F/l), the city of Semnan (S) (1.3 mg F/l), and the village Dibaj (D) (0.2 mg F/l). RESULTS: Children in the naturally fluoridated town showed slightly higher dmfs/dfs (SD) values for both 6-year olds [S: 9.1 (9.2), T: 7.2 (7.4), D: 7.1 (6.1)] and 9-year olds [S: 6.0 (6.2), T: 4.4 (4.2), D: 5.0 (4.7)], whereas the mean dmft/dft values as well as the numbers of caries-free children were comparable. A lower prevalence of dental restorations was reported for both Semnan and Dibaj compared with Teheran. A higher prevalence of fluorosis [Tooth Surface Index of Dental Fluorosis (TSIF) 3-7] was observed in the naturally fluoridated town compared with the low-fluoridated communities. CONCLUSIONS: The ingestion of naturally fluoridated water (1.3 mg F/l) seemed to have a negligible effect on caries prevalence, but resulted in higher prevalence of dental fluorosis. It is emphasized that the study population was not adjusted for socioeconomic status, availability of dental care nor for exposures to other sources of fluoride. Nevertheless, it can be concluded that caries prevalence in Iran is quite low compared with that in other countries in the Middle East and that the elevated fluoride levels in the drinking water in Semnan may contribute to the development of mild to severe fluorosis.

Child↗