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PubMed1990

Validation of oral status indicators.

In planning programmes and developing policy, dental public health officials rely on epidemiological data in the form of composite measures such as the DMFT index. However, the DMFT is often not sufficiently sensitive to detect differences in oral health between population groups. Measures that selectively weight components of the DMFT may be better dental indicators. Sheiham, Maizels and Maizels (1987) suggested a functional measure (FM) that weights filled and sound teeth equally and a tissue health (T-health) measure that differentially weights decayed, filled, and sound teeth. For the present analysis, these indicators were divided by 28 to make their range 0 to 1. The modified indexes are called FMI and THI. Carpay et al. (1988) also suggested a dental health index (DHI) that scores a subset of teeth. Data from 797 participants in the 1980 Iowa Survey of Oral Health that included eight independent variables were used to perform stepwise regression on DMFT, FMI, THI, and DHI to assess how well the independent variables correlated with these four dental indicators. R-square values were 0.37 for FMI and 0.36 for THI, but only 0.19 for DHI and 0.12 for DMFT, suggesting that the FMI and THI were more sensitive as dental health indicators. In addition, calculations made on aggregate data published from three national surveys show that the FMI and THI can detect changes in oral health over time. Because the FMI and THI are as easy to measure and calculate as the DMFT, but appear to be more sensitive, they show promise as indicators of oral health status.

Adolescent↗

PubMedDate not supplied

[The flow and concentration of proteins in human whole saliva].

OBJECTIVE: To determine the average salivary flow rates and total protein concentrations in a population of the State of Mexico. MATERIAL AND METHODS: A gravimetric and spectrophotometric analysis was applied to 120 subjects in total resting and stimulated whole saliva and results were correlated with the DMFT and CPITN indexes. RESULTS: Subjects allowed average salivary flow rate (ml/min +/- SD). in non-stimulated human whole saliva (HWS) of 0.397 +/- .26 and in stimulated HWS of 0.973 +/- .53. Average protein concentration was (mg/ml +/- SD) 1.374 +/- .45 in non-stimulated HWS and 1.526 +/- .44 in stimulated HWS. Females showed a lower percentage of salivary flow and greater protein concentrations. No correlations were observed between flow and total protein concentration, and DMFT and CPITN; however, correlations were present with other variables. CONCLUSIONS: These findings could be associated to degree of nutrition, genetic characteristics and level of oral disease in our population. Present results represent the first step to create a database in sialochemistry to identify risk indicators of specific oral and systemic diseases.

Adolescent↗

PubMed2005

Combined determination of selected radiological and morphological variables relevant for dental age estimation of young adults.

The mineralisation of third molars is one of the main criteria for dental age estimation of living subjects in criminal proceedings. Since the mineralisation of third molars is usually completed by the age of 19 or 20 years, this feature cannot be used to ascertain whether a person has attained the forensically relevant age of 21 years. This study examined whether determination based on an orthopantomogram of a combination of features relevant to dental age estimation of adults, supplies forensically useful information for ascertaining whether a person has attained 21 years of age. The features considered include the DMFT index of all permanent teeth, the DMFT index of all permanent teeth excluding third molars, the DFT index of third molars projecting beyond the occlusal plane, the eruption of third molars and the periodontal recession of second molars. A total of 650 conventional orthopantomograms of German subjects aged 18-30 years were evaluated. The statistical evaluation of our results was based on a discriminant analysis. It was carried out with two classes defined by two age groups: < or = 21 years and > 21 years. The probability of correct classification was 69.7% for males and 71.4% for females. It can be concluded that an evaluation of the variables reviewed in this paper does not by itself yield sufficient data to determine with the accuracy required in criminal proceedings whether a person has attained 21 years of age. The additional radiographic examination of the medial clavicular epiphyseal cartilage is recommended.

Adolescent↗

PubMed1998

Changes in dental health and dental health habits from 3 to 5 years of age.

OBJECTIVES: This study sought to determine how dental health and dental health habits change from 3 to 5 years of age and to consider whether preventive dental health care helped in preventing or halting caries in children. METHODS: The study included 67 maternity health care clinics, 72 well-baby clinics, and 69 dental health care clinics. Of the 1,292 newborn children, 1,003 (90.8%) were included in this study. RESULTS: Preventive dental health care contributed to dental caries being halted in only 13.2 percent of those children who had enamel caries at 3 years of age. The dmft index did not increase in 22.6 percent of those children who had dentinal caries at 3 years of age. For all others, the disease became more severe. Toothbrushing habits of 3-year-old children were very consistent over the two years studied. Children were at a risk for caries when their mothers had nine years of basic education, when they already had plaque and caries at 3 years of age, and when the frequency of eating sweets increased the most during the two-year study period. CONCLUSIONS: Among 3-year-old children, plaque is an indicator of caries risk and therefore should be a key element in health education. Those children who already have evidence of caries at 3 years of age should be the target of preventive dental services because of their increased risk.

Child, Preschool↗

PubMed1999

A study of the relationship between caries activity and the status of dental caries: application of the Dentocult LB method.

OBJECTIVE: To clarify the relationship between caries activity and the status of caries of primary teeth and the relationship between the quantity of Lactobacillus in the oral cavity and the status of dental caries. METHODS: The status of caries of primary teeth in 164 children ages 3 to 5 was examined. Caries incidence, mean DFT, and Caries Severity Index (CSI) were calculated. Based on the quantity of Lactobacilli in the saliva of preschool children detected with the Dentocult LB method of caries activity, four grades were classified: Grade 0 = 10(3) CFU/mL, Grade I = 10(4) CFU/mL, Grade II = 10(5) CFU/mL, and Grade III = 10(6) CFU/mL. RESULTS: The results showed that 34.15% of the children had caries status beyond Grade I. There were significant differences of caries status, DFT, and CSI among different grades, all of which increased with grades. There was a high correlation between grades and caries incidence, DFT, and CSI in the 164 preschool children. CONCLUSION: As a Caries Activity Test (CAT), detection of Lactobacilli may reveal the status of dental caries and provide valuable information for the prevention and treatment of dental caries.

Chi-Square Distribution↗

PubMed1997

Proposed methods for improving the efficiency of the DMFS index in assessing initiation and progression of dental caries.

Recent changes in the epidemiology of dental caries and advances in the development of new diagnostic measurement techniques have stimulated interest in improved methods of assessing changes in dental caries status. Traditional methods for assessing change focus primarily on the development of new lesions at the cavitation level and incorporate incomplete information on the progression of existing cavitated lesions. A methodology to expand the clinical recording of dental caries in clinical studies to include 1) both non-cavitated and cavitated lesions and 2) the surface area affected for restorations is suggested. New indices are proposed to estimate changes in the number of new lesions, the progression of existing carious lesions, and the total change in caries status for a subject. It is anticipated that the new indices will produce more efficient methods of assessing change in caries status in longitudinal clinical studies. The degree of improvement can be estimated directly. Improvements in efficiency may reduce the duration or number of subjects required in caries clinical trials.

Adolescent↗

PubMedDate not supplied

[Intervention for integrated dento-periodontal prevention].

An epidemiological survey has been achieved on elementary and secondary schoolchildren of five different areas in the territory of Ussl no 16 in Lecco. The study, performed on a randomly sample of 458 children aged 6, 10, 12 years, used the epidemiological indexes DMFT/dmft and CPITN to monitor dental and periodontal status. The treatment needs of the subjects was monitored too and the amount of Streptococco mutans in 6 years old schoolchildren, using spittle drawning, was investigated. The results seem to show that the DMFT/dmft values are on a moderate level as regards the European goals, while the amount of dental and periodontal treatment performed is very low. The gingivitis prevalence is high, as well as scaling is required in many children. The analysis of the spittle samples drawned in 6 years old schoolchildren points out high levels of Streptococcus mutans as regard those collected in other similar studies achieved by our Department. According to the results analysis, two sorts of preventive intervention were planned to have the maximum preventive efficacy according to the disease level located in the different areas.

Child↗

PubMed2003

School league tables: a new population based predictor of dental restorative treatment need.

AIM: To test whether dental restorative treatment need was related to the school league tables and level of social deprivation of the school ward. DESIGN: An ecological study using clinical data aggregated at school level, collected in the school dental screening examinations (1996-97), National Census (1991) and the results of the UK school league tables--Key Stage 2 SATs (1996-97). SETTING: State primary schools in the Greenwich District of SE London, UK (1996-97). SUBJECTS: 12,854 pupils (6-11 years of age) in 62 schools. OUTCOME MEASURE: The percentage of 6 to 11 year old pupils per school requiring dental restorative treatment. RESULTS: Deprivation as measured by the overall Jarman Under Privileged Area Index (UPA) of the school ward was not associated with dental restorative treatment need (p > 0.05). Only two components of the Jarman Index, level of unemployment and the number of lone parent families in the school ward were found to be significantly associated with dental restorative treatment need (p < 0.05). Results of stepwise multiple linear regression analysis showed that the association with the school league table results in all three subjects, English, Mathematics and Science remained statistically significant after adjusting for levels of unemployment and single parents. Results of multiple linear regression analysis showed that a high level of dental restorative treatment need was significantly associated with poor school league table results in English, Mathematics and Science (p < 0.05) after adjusting for the overall Jarman score of the school ward. A separate analysis for the 11-year-old pupils aggregated by school (n = 46 schools) gave similar results. CONCLUSIONS: Aggregate measures of academic achievement may be a potential indicator of dental restorative treatment need.

Child↗

PubMed1989

Evaluation of a dental preventive program for Danish chocolate workers.

The purpose of the present study was to develop and evaluate a preventive dental program at two Danish chocolate factories. The program was undertaken within the setting of an occupational health service in order to control oral occupational diseases. Eighty-nine persons (80%), 19-61 yr of age, participated in a 2-yr follow-up study. Preventive care was offered to the workers by a dental hygienist. Clinical prophylaxis was given at four visits the first year and two visits the second year. Health education was based on active involvement of the participants and safety committee or safety group members in order to stimulate self-care activities at the factories. The outcome of the program was evaluated by clinical recordings of visible plaque index (VPI), gingival bleeding (GB), calculus index (CI), and DMFS. Data on dental conditions were recorded at baseline, after 12, and after 24 months. Questionnaires were completed by the workers each time in order to obtain data on dental knowledge, attitudes, dental health behavior, social network activities, and perceptions of the process. The results showed improvement in dental health in terms of stepwise reductions in VPI, GB, CI, and DS. For example, mean GB decreased from 36% of the teeth scored at baseline to 9% at 24 months and mean DS decreased from 2.3 to 0.7. Positive developments of dental health behavior were observed. The proportion of workers reporting daily toothbrushing at work increased from 6% to 24% during the program and the proportion of workers using dental floss regularly increased from 24% to 47%. However, the changes in dental knowledge and attitudes were rather diffuse.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1999

Renal hemodialysis patients: oral, salivary, dental and periodontal findings in 105 adult cases.

OBJECTIVES: A study of the dental, periodontal, oral mucosal and salivary condition of adult patients with chronic renal failure (CRF) receiving hemodialysis (HD). MATERIAL AND METHODS: A total of 105 patients on HD were studied, together with 53 healthy age and sex-matched controls. Indices employed included carious, absent and obturated teeth index (CAO index), plaque index, calculus index and loss of periodontal attachment. Whole and parotid salivary secretions were also measured. RESULTS: The CAO index was not significantly higher among HD patients than controls (14.9 +/- 8.7 vs 13.3 +/- 7.9, respectively; t = 1.1; P = 0.3). However, plaque and calculus indices were significantly higher in HD patients (2.1 +/- 0.8 and 2.3 +/- 0.6, respectively) than controls (1.3 +/- 0.8 and 1.6 +/- 0.9) (P < 0.001). Loss of periodontal attachment was similar in both groups (4.9 +/- 2.5 vs 4.2 +/- 2.5 in the HD patients and controls, respectively) (t = 1.8; P = 0.07). There was no more oral mucosal pathology in HD patients than in controls (chi-square = 5.8; P = 0.3). Stimulated salivary secretion was significantly higher in controls than HD patients for both whole (t = -5.2; P < 0.001) and parotid (t = -2.6; P = 0.01) salivas. CONCLUSIONS: The results show significantly higher plaque and calculus indices and lower salivary secretion among the HD patients than in healthy controls.

Adult↗

PubMed2004

[Dental pain as the reason for visiting a dentist in a Brazilian adult population].

OBJECTIVE: The occurrence of orofacial pain and chronic pain are frequent subjects for study today, but few studies have been made on dental pain in Brazil. The objective of the study was to assess the prevalence of dental pain and the associated factors as the reason for visiting a dentist among adults. METHODS: A cross-sectional study was carried out among 860 workers aged 18-58 years at a cooperative located in the State of Santa Catarina, in 1999. The clinical examinations and interviews were carried out by dentists who had received prior guidance. Complaints of dental pain as the reason for the last visit to a dentist were analyzed as the dependent variable, in relation to the socioeconomic and demographic conditions, access to dental services, shift pattern and caries (via the DMFT index), as the independent variables. Non-conditional multiple logistic regression analysis was utilized. RESULTS: The prevalence of dental pain as the reason for the last visit to a dentist was 18.7% (CI 95%: 15.9-20.1) and the mean DMFT index (decayed, missing and filled teeth) was 20.2 (CI 95%: 19.7-20.7), with 54% represented by the 'missing' component. The following were independently associated with the presence of dental pain: schooling of less than or equal to eight years (OR=1.9; CI 95%: 1.1-3.1); four to fifteen teeth lost due to caries (OR=2.6; CI 95%: 1.4-4.9); 16 to 32 teeth lost due to caries (OR=2.5; CI 95%: 1.1-5.8); and not having visited the company's dental service (OR=2.8; CI 95%: 1.6-5.1). CONCLUSIONS: Dental pain reflects the severity of the dental caries, expressed by the 'missing' component of the DMFT and non-usage of the company's dental services. These factors are determined by social conditions and represented by the schooling level.

Adolescent↗

PubMed1993

A panoramatomographic study of the teeth and jaws of Finnish university students.

A random sample of panoramic radiographs was taken of 1027 (386 male and 641 female) university students. All the students were born between 1965 and 1971. The following were examined: caries, apical radiolucencies, endodontically treated teeth, marginal and vertical bone loss, third molars, supernumerary, missing, and persisting teeth, bone structure, condyles, maxillary sinuses and soft tissue calcifications. In the inter- (of two examiners) and intra-examiner variation Kappa indices varied between 0.15 and 1.00, and agreement percentages from 52, to 100. Kappa index was poor (0.15) in evaluation of the bone structure. The mean DMFT index for the students was 8.4. A sound dentition was found in 6.6%, and 48.4% of the students were free of caries. The mean number of carious lesions was 1.1. There were 50 retained roots (49 from primary teeth). 76.6% of the students had one or more unerupted wisdom teeth and 22.7% had radiologic changes typical of pericoronitis in the region of the mandibular third molars. 16.2% of the students had at least one missing wisdom tooth. Bone structure was normal in 92.4% of the students, idiopathic osteosclerosis being the most common divergence (3.5%). Arthrotic changes in the condyles were found in 9% of the students. In eight cases there was erosion of the condyles, which was diagnosed as arthritis. Styloid ligament calcifications were found in 21.5% of the students. In the maxillary sinuses, male students exhibited changes 1.7 times more often than female students (26.3% in males and 15.1% in females).

Adult↗

PubMedDate not supplied

Factors which influence the oral condition of chronic schizophrenia patients.

The oral health status of 249 individuals with chronic schizophrenia was evaluated by means of the Oral Hygiene Index (OHI-S) and Decayed, Missing and Filled Teeth scores (DMFT). The patients were subdivided as to chronicity of illness and venue of psychiatric treatment (158 inpatients > 10 years' hospitalization, 34 inpatients < 10 years' hospitalization, and 57 outpatients). The severity of schizophrenia was determined by: the Brief Psychiatric Rating Scale (BPRS), the intensity of negative symptoms of schizophrenia [as measured by the Brief Psychiatric Rating Scale, Negative Symptoms (BPRSNEGS)], and the equivalent dose of chloropromazine (EDC). This study demonstrated that inpatients had greater amounts of dental disease than outpatients. The extent of dental disease among inpatients as measured by both the OHI-S and DMFT scores was directly related to the intensity of schizophrenia (BPRS), magnitude of negative symptoms associated with schizophrenia (BPRSNEGS), and length of hospitalization. DMFT scores were directly related to EDC value.

Adult↗

PubMedDate not supplied

Predictors of oral health quality of life in older adults.

There is limited information regarding oral health status and other predictors of oral health-related quality of life. An association between oral health status and perceived oral health-related quality of life (OHQOL) might help clinicians motivate patients to prevent oral diseases and improve the outcome of some dental public health programs. This study evaluated the relationship between older persons' OHQOL and their functional dentition, caries, periodontal status, chronic diseases, and some demographic characteristics. A group of 733 low-income elders (mean age 72.7 [SD = 4.71, 55.6% women, 55.1% members of ethnic minority groups in the U.S. and Canada) enrolled in the TEETH clinical trial were interviewed and examined as part of their fifth annual visit for the trial. OHQOL was measured by the Geriatric Oral Health Assessment Index (GOHAI); oral health and occlusal status by clinical exams and the Eichner Index; and demographics via interviews. Elders who completed the four-year assessment had an average of 21.5 teeth (SD = 6.9), with 8.5 occluding pairs (SD = 4.6), and 32% with occlusal contacts in all four occluding zones. Stepwise multiple regressions were conducted to predict total GOHAI and its subscores (Physical, Social, and Worry). Functional dentition was a less significant predictor than ethnicity and being foreign-born. These variables, together with gender, years since immigrating, number of carious roots, and periodontal status, could predict 32% of the variance in total GOHAI, 24% in Physical, 27% in Social, and 21% in the Worry subscales. These findings suggest that functional dentition and caries influence older adults' OHQOL, but that ethnicity and immigrant status play a larger role.

Aged↗

PubMed1999

Fluoride exposure and dental fluorosis in Newburgh and Kingston, New York: policy implications.

OBJECTIVES: This analysis was conducted to determine the changes in the effect of exposure to fluoridation and other sources of fluoride on dental fluorosis in children attending Newburgh and Kingston school districts in New York State. METHODS: Data for this analysis were obtained from two surveys conducted in the 1986 and 1995 school years. Analyses were limited to 3500, 7-14-year-old lifelong residents of a fluoridated or a nonfluoridated community. Dean's classification and DMFS index were used for recording dental fluorosis and caries, respectively. A questionnaire was used to collect fluoride exposure data. Regression procedures were used to estimate the effect of fluoridation, fluoride supplements, and brushing before the age of 2 years on dental fluorosis. RESULTS: Children examined in 1996 were at higher risk for both questionable and very mild to severe dental fluorosis if they received fluoride from water or daily tablet use, or started brushing before the age of 2 years. The increase in risk from 1986 to 1995 was greater for African-American children. CONCLUSION: This analysis showed that the risk of developing dental fluorosis did not decline over time in these communities. Continuous exposure to water fluoridation had an observable effect on dental fluorosis. However, implementation of fluoridation in Newburgh Town did not result in an increase in dental fluorosis prevalence.

Adolescent↗

PubMed2005

[Association between primary dental care and municipal socioeconomic indicators].

OBJECTIVE: To test associations between primary dental care indicators and municipal socioeconomic and dental service provision indicators. METHODS: An ecological study was carried out in the 293 municipalities of the State of Santa Catarina, Brazil, between 2000 and 2003. The primary dental care indicators utilized were: (1) coverage; (2) the ratio between preventive dental procedures and the size of the population aged zero to 14 years; and (3) the ratio between the numbers of extractions of permanent teeth and individual dental procedures within primary dental care. The variables investigated were: number of dentists per 1,000 inhabitants; number of dentists within the public health service per 1,000 inhabitants; fluoridation of the water supply; child development index; human development index; and the size of the population in the municipality. Analyses were performed using the Kruskall-Wallis and Chi-square tests. The Spearman test was used to evaluate correlations between the variables. RESULTS: The coverage was 21.8%, the ratio of preventive dental procedures among the population aged zero to 14 years was 0.37 and the proportion of tooth extractions in relation to the total number of individual dental procedures was 11.9 %. Lower rates of tooth extraction were associated with higher numbers of dentists within the public health service (p<0.01). Higher rates of tooth extraction were associated with lower human development indices for the municipalities (p<0.01). CONCLUSIONS: Greater coverage was associated with higher numbers of dentists within the public health system. Municipalities with worse socioeconomic conditions were associated with greater tooth extraction rates. Oral health policies must target municipalities that present worse socioeconomic indicators.

Adolescent↗

PubMed1998

The relationship of dental calculus to caries, gingivitis, and selected salivary factors in 11- to 13-year-old children in Chiang Mai, Thailand.

Thai children have been shown to accumulate large amounts of dental calculus. The purpose of this study was to examine the relationship of calculus to caries and gingivitis, and salivary conditions which may contribute to calculus accumulation. Four-hundred and thirty-nine (439) children from 18 schools in Chiang Mai were selected for this study. The children were given oral examinations to determine calculus index (CI); decayed, missing, and filled surfaces (DMFS); decayed, missing, and filled teeth (DMFT); gingival index (GI); and plaque index (PI). Children with mean CI scores > or =1 (206) were assigned to the calculus group; the 233 children with mean CI scores of <1 to the noncalculus group. Saliva was collected from 60 randomly-selected children in each group. Unstimulated and stimulated whole saliva and stimulated parotid saliva were assessed for flow rate, pH, and buffer capacity using 2 methods. Results showed that calculus status was not significantly associated with caries, but that there was a high association between gingivitis and plaque status with calculus accumulation (P < 0.001). There were no significant differences in saliva flow rate, pH, or buffer capacity between calculus and noncalculus groups. The lack of association between calculus status and caries indicated these 2 conditions have different etiologies and suggests the importance of plaque and calculus prevention programs, in addition to caries control efforts, to maintain oral health of Thai children.

Adolescent↗

PubMed1992

A multivariate model to predict caries increment in Montreal children aged 5 years.

A study was carried out in Montreal (Canada) to predict caries development over the period of one year in primary teeth of kindergarten children (mean age 5 years 8 months +/- 4 months) living in a non-fluoridated area. The 302 children were examined at school on two occasions, one year apart. At the first examination selected predictors were collected: caries experience, salivary S. mutans and lactobacilli, buffer capacity, debris index, parents' education, fluoride consumption and family structure (one or two parents). Regression analysis was performed to select the significant factors. A total of 143 children developed new caries over the study period; the mean increment for the whole group was 2.1 dmfs. Sensitivity (Sn) and specificity (Sp) were calculated for each predictor and for the final model. The best model comprised only two factors, caries experience and lactobacillus. This could identify 81.8 per cent of children who would develop new caries during the next 12 months (Sn) and 77.4 per cent of those who would not (Sp). Among the single predictors caries experience alone reached 78.3 per cent for sensitivity and 77.4 per cent for specificity. None of the other predictors, except parents' education, was very good at predicting caries increment over one year.

Chi-Square Distribution↗