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PubMed2001

Acculturation and dental health among Vietnamese living in Melbourne, Australia.

OBJECTIVES: To describe the relationship between acculturation and oral health status, oral health knowledge and frequency of dental visits in subjects of Vietnamese background, 18 years or older, living in Melbourne, Australia. METHODS: Oral health status was measured using the DMFS index. Oral health knowledge was estimated by responses to six specific oral preventive measures: brushing, flossing, use of fluorides, diet, and dental visits. Dental visits was measured by the number of visits in the 12 months prior to the survey. Acculturation was measured along two dimensions, psychological and behavioural, using the Psychological-Behavioural Acculturation Scale. Data were analysed using multivariate analysis to identify the combined effect of eight predictors (age, gender, occupational status, education, reason for migration, proportion of life in the host country, behavioural acculturation and psychological acculturation) against the dependent variables. RESULTS: The analysis was conducted on a sample of 147 subjects and showed significant interactions between the acculturation variables and three outcome measures: dental caries, knowledge of preventive measures and dental visits. Results indicated that acculturation was an important intervening variable. Psychological acculturation was strongly related to the three oral health outcomes, although the effect of behavioural acculturation was also apparent regarding dental status. CONCLUSIONS: This study offers several insights for understanding the mechanisms by which acculturation impacts oral health status. Interventions that simplify the cultural influence of immigrant groups by focusing on socio-demographic differences and even immigration variables to define risk groups might not produce predicted changes in oral health status.

Acculturation↗

PubMed2001

The oral health of children with clefts of the lip, palate, or both.

OBJECTIVE: The purpose of this study was to assess the prevalence of dental caries, developmental defects of enamel, and related factors in children with clefts. DESIGN: This cross-sectional prevalence study used standard dental indices for assessment. SETTING: Children underwent a dental examination under standard conditions of seating and lighting in the outpatient department of a dental hospital as part of an ongoing audit to monitor clinical outcomes. PARTICIPANTS: Ninety-one children aged 4, 8, and 12 years were included in the study. OUTCOME MEASUREMENTS: Dental caries were assessed by use of the decayed, missing, and filled index for primary teeth (dmft); Decayed, Missing, and Filled index for permanent teeth (DMFT) according to the criteria as used in the national survey of children's dental health in the United Kingdom. Developmental defects were assessed using the modified Developmental Defects of Enamel Index (Clarkson and O'Mullane, 1989). Dental erosion was assessed using the criteria derived for the national survey of children's dental health. RESULTS: Caries prevalence increased with age; 63% of patients at 4 years and 34% at 12 years were caries free. The mean dmft for the 4-year-olds was 1.3 with a mean DMFT for the 12-year-olds of 1.8. All the 4-year-olds had evidence of erosion of enamel in the primary teeth (incisors and first molars) and 56% of the 12-year-olds had erosion of permanent teeth (incisors and first permanent molars). Developmental defects of enamel became more prevalent with age, with at least one opacity in 56% of 4-year-olds and 100% of 12-year-olds. Hypoplasia was not found in the primary dentition but affected permanent teeth in 38% of 8-year-olds and 23% of the 12-year-olds. CONCLUSION: This study has shown that dental disease is prevalent in these patients. These assessments not only provide a baseline on oral health parameters in young people with clefts but underline the need for a more aggressive approach to prevention of oral disease to optimize clinical outcome.

Age Factors↗

PubMed1989

[Prevalence of dental caries in native and immigrant inhabitants of Ljubljana].

The purpose of the present study was to find out the prevalence of dental caries among adolescent and adult inhabitants of Ljubljana, Yugoslavia. 1692 randomly selected subjects were examined in the age groups 15, 25, 35, 45, 55 and 65 years. Of all subjects there were 4.9% edentulous. In this research DMFT index was used in 1609 dentate persons. 28 teeth were considered. The prevalence of dental caries is very high among the citizens of Ljubljana, already at the age of 15 there is 98.3%. Mean DMFT values were found to increase with age, from 9.8 teeth at the age of 15 to 22.9 teeth at the age of 65. The mean number of missing teeth (M) increases with age as well, from 0.5 tooth at the age of 15 to 14.9 teeth at the age of 65. The mean number of decayed teeth (D) and filled teeth (F) decreases after the age of 35 due to greater number of missing teeth. Women have more decayed teeth in the age of 15 and 25, they also have more missing teeth after the age of 25, women have in all age groups more filled teeth and a higher mean DMFT values in comparison with men. Immigrant inhabitants had in majority of aged groups more decayed and more missing teeth, less filled teeth and a lower mean DMFT values in comparison with native inhabitants. The biggest difference was in the age group of 25, where immigrant men were the worst group. On the other hand immigrant inhabitants had greater number of healthy teeth in all aged groups in comparison with the native inhabitants.

Adolescent↗

PubMed2000

Explanatory models for clinical and subjective indicators of periodontal disease in an adult population.

BACKGROUND: The aim of this study was to analyze indicators of periodontal disease using: (1) community periodontal index of treatment needs (CPITN), (2) subjectively reported change of front teeth position, and 3) subjectively reported gingival bleeding. METHOD: These 3 indicators were used in models with explanatory variables from 4 domains: (A) socio-economic attributes, (B) general health and health-related lifestyle, (C) dental attitudes and behaviors, and (D) dental status expressed as (number of teeth and DFT) for the clinically-determined dependent variables. In 1992, the study was carried out cross-sectionally in all 50-year olds in 2 Swedish counties using a questionnaire (n=6343) and clinical investigation of a 20 % sub-sample (n= 1040). RESULTS: Multiple and logistic regression analysis showed that explanatory patterns varied for the clinical and subjective indicators. Use of tobacco had strong effects in all models as did high care utilization. There were few associations with socio-economic attributes. The 2 subjective indicators "changed front position" and "gingival bleeding" associated with attitudes, behaviors and subjective health. Number of teeth and DFT covaried with clinical indicators. CONCLUSIONS: The main conclusions from this study are: (1) that it is possible to find multivariate models with acceptable goodness of fit for prediction of occurrence of periodontal indicators, and (2) that the lack of relation between social attributes and the disease gives arguments for a biological provenance of periodontitis.

Attitude to Health↗

PubMed2003

The relationship between anxiety and dental treatment experience in 5-year-old children.

OBJECTIVES: To examine the relationship between dental anxiety, dental attendance and past treatment history in 5-year-old children after taking into account confounding influences. METHODS: A cross sectional study of all 5-year-old children living in Ellesmere Port and Chester. All children were clinically examined and dmft and its components were recorded. A postal questionnaire was sent to parents of participating children to identify whether children attended the dentist on a regular asymptomatic basis or only when experiencing problems. Additionally parents were asked to judge whether they and their child were anxious about dental treatment. The socio-economic status of the family was measured using the Townsend Material Deprivation Index of the electoral ward in which they resided. The bivariate relationships between anxiety and reported attendance experience, past extraction and restoration history were using chi-square and t-tests. Multiple logistic regression analyses identify predictors for dental anxiety. RESULTS: A total of 1,745 children received both a clinical examination and a questionnaire and 1,437 parents responded, a response rate of 82.3%. One in ten parents (10.8b) judged their child to be dentally anxious. Anxious children had significantly (p<0.001] more caries experience (dmft 2.58 vs 1.12). Multiple logistic regression analyses confirmed that anxious children were more likely to be irregular attenders (OR 3.33, 95% Cl 2.22, 5.00), have anxious parents (OR 1.60,95% Cl 1.09, 2.36), and to have undergone dental extraction in the past[OR 3.50, 95% CI 2.10, 5.85), after controlling for gender and socio-economic status. A past history of restoration was not a significant predictor of anxiety after controlling for other factors. CONCLUSIONS: Dental anxiety is a fairly common condition in 5-year-old children in the North West of England. It is closely associated with asymptomatic, irregular attendance pattern, a history of extraction and having a dentally anxious parent. The cause and effect dynamics of these relationships need to be determined.

Chi-Square Distribution↗

PubMed1998

Root caries and some related factors in 88-year-old carriers and non-carriers of Streptococcus sobrinus in saliva.

The prevalence of caries on exposed root surfaces in 88-year-old subjects with and without salivary levels of Streptococcus sobrinus was studied. Ninety-two individuals were examined with regard to root caries lesions and fillings. The root caries index (RCI) was calculated and related to salivary flow rate and buffer capacity, plaque score and salivary counts of Streptococcus mutans, S. sobrinus and lactobacilli. In 89 subjects with exposed root surfaces, all but 2 harbored mutans streptococci; 51 subjects carried S. mutans only, 35 both S. sobrinus and S. mutans, and 1 S. sobrinus only. The RCI was significantly higher in persons with than those without S. sobrinus (p < 0.05). Subjects with both S. sobrinus and S. mutans had higher counts of total mutans streptococci and lactobacilli than subjects with only S. mutans (p < 0.05). The RCI was significantly correlated to S. sobrinus and S. mutans (p < 0.05). The positive correlation between the RCI and S. sobrinus was still significant when the other tested variables were kept constant, whereas the correlation between the RCI and S. mutans was weaker when S. sobrinus and lactobacilli were kept constant. The D-component of the RCI (DSr%) was significantly correlated to S. sobrinus, S. mutans and lactobacilli, whereas the F-component of the RCI showed no significant correlation to any of the tested variables. A stepwise multiple correlation showed that the variance of DSr% was best explained in the S. sobrinus carriers by S. sobrinus and the salivary buffer effect, and in the non-carriers by S. mutans.

Aged↗

PubMed2004

Assessing dental caries prevalence in African-American youth and adults.

It has been well documented that dental caries affect millions of children in the USA with the majority experiencing decay by the late teens. This is especially true for low-income minorities. The objective of this descriptive study was to determine dental caries prevalence in a sample of low-income African-American youth and adults. A total of 1034 individuals were examined. They were divided into two age groups: youth, 9-19 years and adults, 20-39 years. Females comprised approximately 65 percent (64.5) of the study group. The DMFT Index was used to determine caries prevalence in this study population. The DMFT findings showed that approximately 73 percent (72.9 percent) of the youth had either decayed, missing or filled teeth. Male youth had slightly higher DMFT mean scores than female youth: male mean = 7.93, standard error = 0.77, female mean = 7.52, standard error = 0.36; however, as females reached adulthood their DMFT scores increased substantially, mean = 15.18, standard error = 0.36. Caries prevalence was much lower in male adults, DMFT, mean = 7.22, standard error of 0.33. The decayed component for female adults mean score was 6.81, a slight increase over adult males, mean = 6.58. Although there were few filled teeth in both age groups, female adults had slightly more filled teeth than male adults, females mean = 2.91 vs. males; however, adult males experienced slightly more missing teeth, mean = 5.62 as compared to adult females, mean = 5.46. n = 2.20. Both female and male adults had an increase in missing teeth. As age increased there was a significant correlation among decayed, missing and filled teeth as tested by Analysis of Variance (ANOVA), p < 0.01. A significant correlation was found between filled teeth by sex, p < .005. We conclude that caries prevalence was higher in female and male youth, but dental caries increased more rapidly in females as they reached adulthood.

Adolescent↗

PubMedDate not supplied

[Prevalence of dental caries in 6-12-year-old schoolchildren in Leon, Nicaragua].

OBJECTIVE: To determine the prevalence of caries, deft and DMFT indices (sum of decay, messing, and filling tooth in primary and permanent dentition), and the Significant Caries Index (SiC) in scholars from Leon, Nicaragua. PATIENTS AND METHOD: Dental data from a representative sample of 1,400 children were collected and analyzed in a cross-sectional study (year 2002). All subjects were clinically evaluated by one of two calibrated and standardized examiners. RESULTS: 28.6% children were caries free in both dentitions. Caries prevalence in primary teeth in 6-years-old children was 72.6% and 45.0% in permanent teeth in 12-years-old children. Mean deft and DMFT were 2.98 +/- 2.93 (n = 1,125) and 0.65 +/- 1.43 (n = 1,379), respectively. The SiC at 12 years of age was 4.12. Children with caries experience in primary teeth were more likely to have caries in permanent teeth (odds ratio = 2.48; 95% confidence interval, 1.66-3.79) than children without caries in primary teeth. CONCLUSION: Low caries prevalence and experience were observed in the permanent dentition, with a substantial proportion of filled teeth. Such favorable finding was not observed in the primary dentition. Levels of caries failed to meet the oral health goal of FDI/WHO for the year 2000 in 6-years-old. However, the levels found in 12-year-olds had already met the goal for 2000. The present findings confirmed prior reports that the caries experience in primary teeth is associated with the experience of caries in permanent teeth.

Age Factors↗

PubMed1992

Periodontal changes by HIV serostatus in a cohort of homosexual and bisexual men.

UNLABELLED: These data represent 20 months of follow-up on 114 homo/bisexual men. Periodontal changes were analyzed in relation to HIV-1 serostatus, immune status, age and plaque. Gingival index (GI), plaque index (PI), and relative attachment levels recorded by the computerized Florida disk probe were performed every 4 months. A threshold of > or = 3.0 mm of relative attachment loss (RAL) was selected as a significant longitudinal change. RAL > or = 3 mm occurred 6.16 times (95% CI = 1.95, 19.40) more frequently among subjects with T4 counts < 200 compared to subjects with counts of 200 or more. Among older subjects (age > or = 35 years), the incidence (33%) of RAL > or = 3 mm was significantly higher (p = 0.004) in more immunosuppressed subjects (T4 < 200) compared to the incidence (5%) in less immunosuppressed subjects (T4 > or = 200); this association was not significant in younger subjects less than 35 years old (p = 0.55). In 78 subjects present at all follow-up visits, averaged GI increased and were significantly higher in the seropositive subjects compared to seronegative subjects, but, GI was not related to T4 cell counts within the seropositive group. Separate linear regression of GI by PI by HIV serostatus revealed a significantly higher slope in the seropositive group compared to the seronegative group (p = 0.04), suggesting greater sensitivity to plaque in the seropositive group. CONCLUSION: immunosuppression, especially in combination with older age, may be a risk factor for attachment loss, and HIV seropositivity, independent of T4 cell counts, may be a risk factor for gingival inflammation.

Adult↗

PubMed1995

Dental health and treatment needs in institutionalized psychiatric patients in Italy.

The caries prevalence, oral hygiene status, periodontal health and the treatment needs were assessed in a group of institutionalized psychiatric patients in Catanzaro, Italy. Of the total sample of 297 subjects, 165 (55.6%) were males, the mean age was 55.1 yr, the great majority (90.6%) was able to care for themselves, on average they had been institutionalized for 12.9 yr, and almost two-thirds were schizophrenic (65%). They did not receive any assistance in daily oral hygiene procedures, only 7.4% had visited a dentist and exclusively for emergency care. A total of 33 (11.1%) patients were edentulous, and the multiple logistic regression analysis showed a highly significant increase of edentulousness with increasing age (P < 0.001). No caries-free subjects were found and among the dentate the DMFT and DMFS scores for all age groups were respectively 15.5 and 88.6. The stepwise linear regression analysis showed that the mean DMFT index increased with age (t = 6.86; P < 0.001), and in the partly or totally helpless patients it was significantly higher than in the self-sufficient patients (t = 2.78; P = 0.006). Of the 264 dentate subjects, only 25 (9.5%) had no need of dental treatment; 213 (80.7%) required extractions with a mean number per person of 6.3 and the need for conservative dental care was recorded in 154 (58.3%) patients with a mean need for patient of 2.8. Mean OHI-S score was 4.2 and the stepwise linear regression analysis showed that it increased with age (t = 5.73; P < 0.001) and with the length of institutionalization (t = 3.42; P < 0.001). Only 0.9% of the entire sample was found with healthy periodontal tissue; bleeding on probing or a higher score was found in 4.6% of examined sextants; calculus in 10.1%; shallow pockets and deep pockets in 19.6% and 64.8% of all sextants. The results of the multiple logistic regression analysis indicated that the number of subjects with deep pockets as highest score increased with increasing age (P<0.001), and with the increasing length of institutionalization (P=0.005). The findings of this study demonstrate high caries prevalence, poor oral hygiene and periodontal health, and extensive unmet needs for dental treatment. More coordinated efforts between the social and dental care sector must be maintained to serve adequately the need of this disadvantaged group.

Adult↗

PubMed1995

Tobacco use and dental disease.

The previously cited Indiana University School of Dentistry teaching monograph, "The Impact of Tobacco Use and Cessation on Nonmalignant and Precancerous Oral and Dental Diseases and Conditions," reviewed over 800 articles and concluded that tobacco use is strongly associated with many dental and oral mucosal diseases, and may contribute to others. Our study of a relatively small sample of 200 patients, of whom 33 percent were tobacco users, found statistically significant data correlating tobacco use with a higher Decayed, Missing and Filled Index (a measurement of caries and tooth loss experience of patients) and relating periodontal bone loss to smokeless tobacco use. And, while this investigation did not find a statistically significant correlation between smoking and periodontitis severity, there was a data trend in that direction. Conclusions about tooth loss in the Indiana monograph were limited to smokers; however, there was an association of ST use with gingival recession, which can become quite severe in the area in which the smokeless tobacco is placed. It might be theorized that the significantly larger number of missing teeth among ST users in our study is associated with the generally poor oral hygiene and less sophisticated outlook on health care that tobacco users often display. Indeed, of the 65 denture wearers in our study, 7.7 percent were ST users and 40.0 percent were tobacco users of some type. In view of the large amount of data in the scientific literature associating tobacco with dental diseases as summarized by the Indiana monograph, and the position of several groups such as the American Cancer Society that tobacco is one of the risk factors most associated with intraoral cancer, it would appear that dentists have a vested professional interest in promoting tobacco use cessation among their patients. Dentists should take every reasonable opportunity to persuade patients to discontinue the tobacco habit, thus preventing life-threatening malignancies as well as dental diseases.

Adolescent↗

PubMed2003

The 'Significant Caries Index' (SiC): a critical approach.

PURPOSE: This study was designed to validate the SiC index in a 12-year-old population, and also considers the level of the disease, expressed as DMFS index, with the aim of comparing the capability of the two indices for preventive and prognostic goals. MATERIALS AND METHODS: Data from a previous study (Campus et al, 2001) based on 403 12-year-old subjects (205 females and 198 males) were reconsidered, and the SiC was calculated both on DMFT and DMFS. Several background factors were evaluated: classified as socio-economic levels (SOCFAM), Oral Hygiene Habits (OHH), Onset of Toothbrushing Habits (OTH), and gingival conditions expressed as the presence of plaque or calculus. Several regression models were built-up to estimate the dependence of each index--DMFT, DMFT (SiC), DMFS and DMFS (SiC)--on background variables. The four groups, picked out by the 66th percentiles on the ranking series of DMFT and DMFS following the SiC method were compared. RESULTS: Mean+/-standard deviation, median and percentiles (p25 - p75) were 5.5+/-2.1, 5 (p25 = 4 - p75 = 6) for DMFT (SiC) and 8.9+/-5.8, 8 (p25 = 5 - p75 = 11) for DMFS (SiC). Intrinsic variability in SiC groups was lower, but the distributions remained skewed. In the multiple regression procedure, using DMFT and DMFS scores as dependent variables, OTH, bleeding and calculus were statistically significant. OHH (p < 0.05) and calculus (p < 0.05) gave a significant contribution to DMFS in the SIC group, while the model for DMFT (SiC) was not significant. In a stepwise logistic regression model, OTH, bleeding and calculus played a significant role (p < 0.05) on DMFT (SiC) and DMFS (SiC), as the likelihood for an individual to have a value > or = 66th percentile. The concordance between the two selected series was rather good (kappa = 0.82; 95%CI: 0.73 - 0.91). No association with background factors was found on the two discordant groups. However, a linear trend in proportions between the two groups across SOCFAM categories was observed (p = 0.027). CONCLUSIONS: The use of SiC may solve the problem related to skewed caries distribution. Nevertheless if only SiC is used, it can lead to a lack of relevant information especially in countries where high caries prevalence is still present.

Child↗

PubMed1996

Dental caries and dental fluorosis among 4-, 6-, 12- and 15-year-old children in kindergartens and public schools in Kuwait.

The purpose of the present study was 1) to describe the occurrence of dental caries and fluorosis among children in kindergartens and public schools in Kuwait, and determine their need for dental health care, 2) to describe changes in caries prevalence and experience from 1982 to 1993 and 3) to provide a baseline for the evaluation of the preventive oral health programmes starting in Kuwait in 1994. The study population comprised 3,500 4-, 6-, 12- and 15-year-old children in kindergartens and public schools in Kuwait, selected by stratified cluster sampling. Dental caries was scored by surface in accordance with WHO criteria, and dental fluorosis was registered by Dean's index (modified). The mean deft was 4.6 at age 4 years, and 6.2 at age 6; 8 and 11 percent of the decay had been treated by extractions or fillings in the two respective age groups. Among the 6-, 12- and 15-year-old children DMFT was 0.2, 2.6 and 3.6 respectively; 12 and 14 percent of the decayed teeth of 12- and 15-year-old children had been treated. As to the 4- and 6-year-old children, 19 and 9 percent were caries-free in the deciduous teeth, while 86, 21 and 14 percent of the 6-, 12- and 15-year-old children were caries-free in the permanent teeth. Among the 4-year-old children 47 percent had caries in the front teeth. None of the children had severe dental fluorosis, but 6 percent at 12 and 15 years showed mild to moderate, but manifest, dental fluorosis. The survey revealed that caries experience as well as caries prevalence had increased since 1982, although there was a marked increase in the number of filled tooth surfaces in all age cohorts. However, in 1993 the DMFT of 12-year-old children was still well within WHO's global goal for the year 2000, whereas the prevalence of dental caries among 6-year-old was considerably higher than the WHO goal.

Adolescent↗

PubMed2004

Dental caries experience and its relationship to social and behavioural factors among 3-5-year-old children in Uganda.

OBJECTIVE: The aim of this study was to assess the socio-demographic and behavioural correlates of caries experience and sugar intake patterns among pre-school children in Uganda. METHODS: Five hundred and eighty-nine, 3-5-year-old children (51% boys, response rate = 85%), attending nursery schools in urban and peri-urban settings in central Kampala and Nakawa, respectively, were clinically examined for dental caries using the dmft index. Visible plaque on the labial surfaces of their maxillary incisors was recorded as a proxy for oral hygiene habits. A questionnaire designed to assess socio-demographic factors and sugar habits was completed by their caregivers in face-to-face interviews. RESULTS: The mean dmft scores were 1.7, 2.4 and 3.1, and 42%, 44% and 42% had visible plaque among 3-, 4- and 5-year-olds, respectively. In Nakawa, a total of 64%, 62% and 22% of the subjects had dmft > 0, decayed teeth (dt) > 0 and missing teeth > 0, respectively. The corresponding rates in central Kampala were 56%, 55% and 17%. Multivariate analyses revealed that attending school in Nakawa, having a mother with a lower level of education, reporting the intake of cough syrup, visiting a dentist and scoring positively for plaque were associated with higher odds (1.6, 1.5, 3.7 and 2.7) for having dmft > 0. The adjusted mean frequency sugar scores varied systematically between mothers with low and high levels of education (mean scores = 11.0 vs. 10.4), and for children with negative and positive plaque scores (mean scores = 10.6 vs. 10.9). CONCLUSION: The caries experience was highest among children attending nursery schools in Nakawa and those who had had longer periods of cough syrup consumption, whereas children from the two locations were equally exposed to sugar consumption generally. Both caries experience and frequency of sugar consumption was highest among children of less-well-educated mothers.

Child Behavior↗

PubMed2000

The association of basic proline-rich peptides from human parotid gland secretions with caries experience.

To address whether there are associations between the peptide composition of human parotid saliva and dental decay (caries) experience, we have characterized the peptides from parotid ductal saliva collected from nine adults who have remained free from dental caries (mean age = 59.2; Decayed Missing Filled Surfaces index [DMFS] = 0) and nine individuals who have experienced caries (mean age = 51.2; mean DMFS = 38.4). Ethanol-soluble peptides were size-fractionated on columns of Bio-Gel P-2; the salivary peptides derived from caries-susceptible subjects appeared larger than those found in the saliva of caries-free subjects. Peptides were then resolved into 19 species by cation exchange HPLC. Sequence analysis identified 18 peptides that appear to be proteolytic cleavage products of the basic proline-rich proteins IB-4, IB-5, IB-7, IB-8b, and P-B. The peptides that were more abundant in saliva obtained from the caries-free group differed from those isolated from the caries-susceptible group. The median peptide concentration of one possible precursor protein, IB-7, was found to be higher in saliva collected from caries-free individuals than in that from caries-susceptible individuals. Although differences were found in the phenotypes of proline-rich proteins expressed by these groups of caries-free and caries-susceptible subjects, no statistically significant associations were observed among proline-rich phenotypes and the level of any peptide. Collectively, our results indicate that proteolytic processing of parotid salivary proteins differs among individuals who have remained caries-free and those who have experienced dental decay.

Case-Control Studies↗

PubMed2000

The relation between salivary IgA and caries in renal transplant patients.

OBJECTIVE: The purpose of this study was to evaluate the effect of immunosuppressive drugs on the level of salivary immunoglobulin A (IgA) in patients who have received kidney transplants and the relation between the levels of salivary IgA and dental caries incidence. STUDY DESIGN: Patients who had undergone renal transplantation (n = 28, aged 18-54) were divided into 3 groups according to postsurgical period (0-6 months [G(1)], 6-12 months [G(2)], and >12 months [G(3)]). A healthy control group (n = 10, aged 17-49) was also included in this study. Saliva samples were collected from all patients by the spitting method. After collection, the samples were frozen immediately at -40 degrees C until analysis by the single radial immunodiffusion method. All fissure caries were examined clinically, and proximal caries were examined clinically and radiographically; caries status was determined according to the decay surface index. The findings were evaluated statistically by means of correlation analysis, the Kolmogorov-Smirnov test, and the 1-way Kruskal Wallis analysis of variance method. RESULTS: Salivary IgA levels of the patients who had undergone renal transplantation were found to be significantly lower than those of the control patients (G(1) = 6.76 mg/dL, G(2) = 6.80 mg/dL, G(3) = 7.84 mg/dL, and control group = 10.84 mg/dL, P <.001). However, the caries status of the patients who had undergone renal transplantation was not different from that of the control subjects for the first year after the transplant operation. The salivary IgA values of the 3 groups of patients who had undergone transplantation were not significantly different from each other. Thus, it was observed that a decrease in the level of salivary IgA does not result in an increase in caries incidence within 12 months after renal transplantation. The caries rate in the third group of patients who had undergone renal transplantation was found to be significantly different from those in the first and second groups. CONCLUSION: Low salivary IgA levels caused by immunosuppression are not correlated or associated with higher levels of dental caries within the first 12 months after renal transplantation. However, the incidence of dental caries was higher for patients who had undergone renal transplantation than for control subjects 12 months after renal transplantation. Because of the diagnostic processes used, dental caries may not become evident until after 12 months.

Adolescent↗

PubMed1997

The relationship between the number of sound, decayed, and filled permanent tooth surfaces and the number of sealed surfaces in children and adolescents.

OBJECTIVES: The purpose of this investigation was to determine the prevalence of sound, decayed, filled, and sealed permanent tooth surfaces for children and adolescents from three fluoridated communities in British Columbia and to develop a predictive model of sealant use that included the dental caries status of tooth surfaces. METHODS: Children in grades 2 and 3 (n = 2,715) and adolescents in grades 8 and 9 (3,317) were surveyed to determine the prevalence of sound, decayed, filled, and sealed permanent tooth surfaces. The DMFS index, modified to include incipient (D1) and cavitated (D2) lesions, was used to measure the status of all tooth surfaces. The prevalence of D1D2MF and sealed tooth surfaces was estimated by age group and tooth type. Logistic regression models were developed to analyze the association between a number of independent variables and sealant use. RESULTS: About 60 percent of surveyed students had one or more sealants present, with a mean of 3.2 sealants per subject. Of all pit and fissure surfaces on permanent first molars, 23.4 percent and 20.1 percent were sealed for the 11 years and younger and 12 years and older age groups, respectively. For these same two age groups, the percentages of pit and fissure surfaces that were decayed and filled were 6.7 percent and 19.7 percent, respectively. For both age groups combined, 10.8 percent and 23.7 percent of all pit and fissure surfaces on second molars and premolars, respectively, were sealed. The prevalence of decayed and filled pit and fissure surfaces was 5.6 percent and 1.8 percent, respectively, for second molars and premolars. Premolars were being sealed at a rate of 13 to 1 compared to the number of decayed and filled surfaces. Logistic regression failed to identify meaningful predictors of sealant use. CONCLUSIONS: Results from this study found an increase in the prevalence of sealants in the three communities surveyed, yet failed to identify criteria used by dentists or auxiliaries when making decisions about sealant placement. Professional education in the appropriate use of sealants may be necessary.

Adolescent↗

PubMed2003

Clinical course of chronic periodontitis. I. Role of gingivitis.

OBJECTIVES: The purpose of this study was to determine the influence of long-standing gingival inflammation on periodontal attachment loss. On the basis of repeated examinations, the present report describes the influence of gingival inflammation on the initiation of periodontitis from 16 to 59 years of age. MATERIAL AND METHODS: The data originated from a 26-year longitudinal study of Norwegian males, who practiced daily oral home care and received state-of-the-art dental care. The initial examination included 565 individuals. Subsequent examinations took place in 1971, 1973, 1975, 1981, 1988 and 1995. Thus, the study covers the age range of 16-59 years. All tooth sites were divided into four categories according to their history of gingival inflammation over the entire observation period: sites always scoring GI = 0, GI = 1 and GI = 2 sites (GI = gingival index). Sites disclosing various GI scores at different observation periods were not considered. RESULTS: The mean cumulative attachment loss for non-inflamed (GI = 0) sites in individuals approaching 60 years of age was 1.94 mm. Sites always scoring GI = 1 yielded 2.42 mm, and sites that always scored GI = 2 exhibited 3.31 mm of periodontal attachment loss. At interproximal sites of all three groups where gingival trauma was assumed to be minimal or non-existent, only very few sites expressed attachment loss due to gingival recession (2-4%). At interproximal sites always scoring GI = 0, 20% loss of attachment was in the form of pocket formation by 59 years of age. The GI = 1 and the GI = 2 cohorts exhibited attachment loss with pocket formation in 28% and 54%, respectively. CONCLUSION: This study has shown that, as men approach 60 years of age, gingival sites that throughout the 26 years of observation bled on probing had approximately 70% more attachment loss than sites that were consistently non-inflamed (GI = 0). Before 40 years of age, there was a slight increase in periodontal attachment loss due to pocket formation, but after this, the frequency increased significantly. Loss of attachment due to gingival recession was very small in all three groups. The fact that sites with non-inflamed gingiva also exhibited some loss of attachment and pocket formation may be explained by fluctuation in the variations of tissue status during long observation intervals combined with the presence of subclinical inflammation.

Adolescent↗