Database: EMBASE <: international biomedical and pharmaceutical literature, 1988 - May 2000. [Trial access until 3/2001. Feedback welcome to medical.library@umich.edu] Search Strategy (You Saved Citations 1-26 From Set 92): ----------------------------------------------------------------------------- 1 Reproducibility of results/ 8828 2 exp risk/ 142555 3 Models, statistical/ 3445 4 Prevalence/ 28128 5 Discriminant analysis/ 1694 6 Forecasting/ 840 7 exp Cohort studies/ 6595 8 Evaluation studies/ 746 9 Risk-taking/ 9719 10 exp Health behavior/ 12119 11 reproducib:.mp. 30773 12 risk:.mp. 292899 13 forecast:.mp. 2095 14 or/1-13 359129 15 False negative reactions/ or False positive reactions/ 4291 16 (sensitivity or specificity).ti,ab. 171235 17 (predictive adj value$1).mp. 15190 18 (predictive adj validit:).mp. 597 19 (likelihood adj ratio:).mp. 1149 20 (false adj (negative$1 or positive$1)).ti,ab. 13376 21 double blind method/ or single blind method/ 32928 22 random$.ti,ab. 140380 23 random allocation/ 2503 24 (single blind$3 or double blind$3 or triple blind$3).ti,ab. 38568 25 exp "sensitivity and specificity"/ 173587 26 (controlled adj trial:).mp. 104667 27 (practice adj guideline:).mp. 19351 28 (consensus adj development adj conference:).mp. 169 29 or/15-28 564723 30 exp Tooth demineralization/ 7492 31 demineralization.mp. 879 32 caries.mp. 1798 33 caires.mp. 0 34 craies.mp. 0 35 careis.mp. 1 36 carise.mp. 0 37 (teeth adj3 cavit:).mp. 32 38 (tooth adj3 cavit:).mp. 97 39 (dental adj3 cavit:).mp. 85 40 (dentin adj3 cavit:).mp. 19 41 (enamel adj3 cavit:).mp. 10 42 (teeth adj3 decay:).mp. 58 43 (tooth adj3 decay:).mp. 58 44 (dental adj3 decay:).mp. 47 45 (dentin adj3 decay:).mp. 0 46 (enamel adj3 decay:).mp. 1 47 (active adj decay).mp. 5 48 (rampant adj3 decay:).mp. 4 49 (recurrent adj3 decay:).mp. 5 50 (white adj spot:).mp. 231 51 carious.mp. 109 52 cariology.ti,ab. 2 53 (non-cavitated adj3 lesion:).mp. 0 54 (noncavitated adj3 lesion:).mp. 1 55 Tooth remineralization/ 788 56 (dental adj3 fissure:).mp. 14 57 (tooth adj3 fissure:).mp. 8 58 (teeth adj3 fissure:).mp. 1 59 caries-free.mp. 29 60 cariesfree.mp. 0 61 Cariogenic agents/ 3 62 precavit:.mp. 2 63 (filled adj3 teeth).mp. 45 64 (filled adj3 tooth).mp. 9 65 (oral adj fissure:).mp. 17 66 (tooth adj3 remineraliz:).mp. 1 67 (teeth adj3 remineraliz:).mp. 5 68 dft.mp. 542 69 dfs.mp. 980 70 dmf:.mp. 1235 71 cariogeni:.mp. 164 72 or/30-71 12313 73 72 and 14 and 29 413 74 limit 73 to (human and english language) 356 75 limit 74 to (child < unspecified age > or preschool child < 114 1 to 6 years > or school child < 7 to 12 years > or adolescent < 13 to 17 years >) 76 exp Tooth, deciduous/ 142 77 Dentition, primary/ 411 78 Dentition, mixed/ 411 79 ((primary or deciduous or mixed) adj5 (tooth or teeth or 650 dent: or odont:)).mp. 80 or/76-79 1002 81 74 and 80 13 82 75 or 81 118 83 from 82 keep 1-118 118 84 74 not 82 238 85 "Root caries"/ 1483 86 ("root" adj3 (carie: or lesion:)).mp. 382 87 exp Tooth root/ 302 88 ((tooth or teeth or enamel or dentin) adj5 ("root" or apex 613 or apices)).mp. 89 ((amelocemental or cemental or cementum) adj5 (carie: or 21 lesion:)).mp. 90 Dental cementum/ 120 91 or/85-90 2448 92 84 and 91 26 93 from 92 keep 1-26 26 *************************** <1> UI - 2000105137 AU - Bell J AU - Zador D IN - Dr. J. Bell, The Langton Centre, 591 South Dowling St., Surrey Hills, NSW 2010; Australia. E-Mail: jamesb@sesahs.nsw.gov.au. TI - A risk-benefit analysis of methadone maintenance treatment. SO - Drug Safety Vol 22(3) (pp 179-190), 2000. AB - Methadone maintenance treatment for heroin (diamorphine) addiction has been extensively researched. There is consistent evidence that while in treatment, heroin addicts are at a lower risk of death, are less involved in crime, and feel and function better than while using heroin. Despite the research evidence supporting methadone treatment, there remains widespread public scepticism about this form of treatment. This scepticism is frequently expressed in terms of the perceived risks of methadone treatment. The perceived risk that methadone treatment may maintain people in an addicted lifestyle is not supported by research literature. The risks of treatment include an increased risk of death during induction into treatment, and risks of diversion of drugs to the black market. For some patients, adverse effects of methadone pose a problem and the availability of new pharmacotherapies may provide useful options for these patients. Risks can be reduced and benefits increased by directing greater attention to the quality of treatment. [References: 58] <2> UI - 2000027386 AU - Hobdell MH AU - Lalloo R AU - Myburgh NG IN - M.H. Hobdell, University of Texas-Houston, Dental Branch, 6516 John Freeman Avenue, Houston, TX 77030; United States. E-Mail: mhobdell@mail.db.uth.tmc.edu. TI - The human development index and per capita gross national product as predictors of dental caries prevalence in industrialized and industrializing countries. SO - Annals of the New York Academy of Sciences Vol 896 (pp 329-331), 1999. <3> UI - 1999285288 AU - Sgan-Cohen HD AU - Horev T AU - Zusman SP AU - Katz J AU - Eldad A IN - H.D. Sgan-Cohen, Department of Community Dentistry, School of Dental Medicine, Hebrew University-Hadassah, P.O. Box 12272, Jerusalem 91120; Israel. TI - The prevalence and treatment of dental caries among Israeli permanent force military personnel. SO - Military Medicine Vol 164(8) (pp 562-565), 1999. AB - A survey was conducted to determine dental caries prevalence and treatment among 1,095 25- to 44-year-old permanent force Israeli military personnel. Caries experience, by decayed, missing, and filled permanent teeth (DMFT), was 11.66, with an average of 1.37 untreated caries, 2.40 extracted teeth, and 7.90 treated teeth. Caries was positively associated with age (p < 0.001). Females demonstrated statistically higher DMFT levels than males (p = 0.009). Negative associations were detected for education levels and untreated and extracted components (p < 0.001), and a positive association was detected for the treated caries component (p < 0.001). Permanent military personnel treated by private dentists exhibited 17.6% untreated caries, compared with 9.4% among personnel treated in the army. Officers had lower levels of untreated caries (8.6%) than others (13.3%). Among the present population, 77% had attended a dental clinic in the preceding 2 years. Permanent force personnel are offered free, comprehensive, and accessible dental treatment. The data emphasize a need for further dental health education. [References: 19] <4> UI - 1999285287 AU - Cook LJ IN - L.J. Cook, Agcy. for Hlth. Care Policy/Research, Department of Health/Human Services, 6000 Executive Boulevard, Rockville, MD 20852; United States. TI - The implications of protocol-based care on dental services in the military. SO - Military Medicine Vol 164(8) (pp 556-561), 1999. AB - Downsizing, limited resources, and increasing costs provide challenges to the military health system. Variations in the diagnosis and treatment of dental disease add to the demands on the delivery system to provide access and ensure quality for uniformed personnel. Evidence-based dentistry is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. An evidence-based practice combines individual clinical expertise with the best external evidence available from systematic review of research findings. It provides a scientific basis for patient care, planning and implementation of health services, and development of health policy. Practice guidelines formulated on scientific evidence can reduce variations in the diagnosis and treatment of various dental conditions. A risk assessment protocol for treating dental caries can reduce operative dental treatment recommended at the initial examination and decrease the need for restorative care during a military career. [References: 32] <5> UI - 1999269267 AU - Anttila SS AU - Knuuttila MLE AU - Sakki TK IN - S.S. Anttila, Institute of Dentistry, University of Oulu, Aapistie 3, FIN-90220 Oulu; Finland. TI - Depressive symptoms favor abundant growth of salivary lactobacilli. SO - Psychosomatic Medicine Vol 61(4) (pp 508-512), 1999. AB - Objective: The purpose was to study the growth of lactobacilli in subjects with depressive symptoms in the total 55-year-old population of Oulu (a medium-sized town in Finland); 780 people participated. Methods: The dental examination included measurements of salivary lactobacillus growth with the Dentocult-LB method; measurements of salivary flow rate, pH, and buffering capacity; and assessment of oral health status. Depressive symptoms were determined with the Zung Self-Rating Depression Scale (ZSDS). Participants were also asked about their health, medication, smoking, and dietary habits. Results: The prevalence of high lactobacillus counts (>=100,000 CFU/ml) was 22% among women and 31% among men (p = .02). Thirty- seven percent of the subjects with a high rate of depressive symptoms (ZSDS score of >=40) and 23% of those with an ZSDS score of <=39 had high counts of lactobacilli (p = .003). A logistic regression analysis with improvement of goodness of fit was made to confirm the relation between abundant lactobacilli and a high rate of depressive symptoms. After the confounding factors had been added stepwise into the logistic regression model, depressive symptoms were still significantly associated with abundant lactobacillus growth. Conclusions: The association between high lactobacillus counts and depressive symptoms suggests that depressed subjects are at risk of having caries and possibly other dental diseases that should be recognized in the treatment of these patients. [References: 35] <6> UI - 1998389862 AU - Dolan TA AU - Peek CW AU - Stuck AE AU - Beck JC IN - T.A. Dolan, University of Florida, College of Dentistry, JHMHC Box 100405, Gainesville, FL 32610-0405; United States. E-Mail: tdolan@dental.ufl.edu. TI - Functional health and dental service use among older adults. SO - Journals of Gerontology Series A-Biological Sciences & Medical Sciences Vol 53(6) (pp M413-M418), 1998. AB - Background. Although socioeconomic barriers to receiving adequate dental care have been well documented, physical frailty as a risk factor for not visiting the dentist has not been fully explored. This study prospectively examines the relationship between functional health and dental service use, taking into account sociodemographic characteristics, general and dental health status, and prior dental utilization behavior. Methods. Data from a randomized trial of a comprehensive geriatric assessment and prevention program in community-dwelling adults age 75+ years living in Santa Monica, CA, collected between 1988 and 1993, were analyzed. A series of discrete- time proportional hazards models were used to assess the effects of functional status, sociodemographic characteristics, and general health and dental health measures on dental service use. Results. Functional status was negatively associated with dental service use, and the conditional probability of a first visit to the dentist after baseline decreased over time. When additional measures of general health, dental health, and socioeconomic status were introduced, the effect of functional status was mitigated but remained significant. In the most fully specified model, which took dental visitation behavior prior to the beginning of the study into account, the effect of functional limitation remained significant. Conclusions. Even in this relatively well-educated group of older persons with higher than average dental service use, impaired functional status was associated with lower levels of dental service use over time. [References: 23] <7> UI - 1998346085 AU - Bourgeois D AU - Nihtila A AU - Mersel A IN - Dr. D. Bourgeois, Oral Health Programme, Division of Noncommunicable Diseases, World Health Organization, 1211 Geneva 27; Switzerland. TI - Prevalence of caries and edentulousness among 65-74-year-olds in Europe. SO - BULL WHOO, Vol 76(4) (pp 413-417), 1998. AB - Reviewed in this article are epidemiological studies included in the WHO Global Oral Data Bank for noninstitutionalized European adults aged 65-74 years for the period 1986-96. Edentulous percentages, decayed, missing, filled teeth (DMFT) index, and data on the mean number of teeth are presented. At least one representative study had been carried out in 48% of the countries, with the quantity of information from countries with developed market economies being similar to that from countries with economies in transition. The proportion of 65-74-year-olds who were edentulous varied from 12.8% to 69.6%, the mean number of teeth ranged from 15.1 to 3.8, and the DMFT index from 22.2 to 30.2. The observed disparities in the oral health status among older European adults suggest that it may be possible to develop and implement oral health policies that take into account geographical and socioeconomic differences in populations. [References: 15] <8> UI - 1998054678 AU - Chow AW IN - Dr. A.W. Chow, Division of Infectious Diseases, G. F. Strong Research Laboratories, Vancouver Hosp. Hlth. Sci. Center, 2733 Heather Street, Vancouver, BC V5Z 3J5; United States. E-Mail: tonychow@unixg.ubc.ca. TI - Odontogenic infections in the elderly. SO - Infectious Diseases in Clinical Practice Vol 6(9) (pp 587-596), 1997. <9> UI - 1998052944 AU - Hobdell MH AU - Myburgh NG AU - Lalloo R AU - Chikte UME AU - Owen CP IN - Dr. M.H. Hobdell, Faculty of Dentistry, WHO Oral Health Collaborating Centre, University of the Western Cape, Cape Town; South Africa. TI - Oral disease in Africa: A challenge to change oral health priorities. SO - Oral Diseases Vol 3(4) (pp 216-222), 1997. AB - Colonial and other unsustainable oral health strategies exported to Africa have failed to improve oral health in the region. An alternative way of interpreting and responding to the problems of oral health in Africa is presented. It begins with a systematic interpretation of the health information available, using the application of the basic epidemiological principle of defining a specific health problem by describing its prevalence, severity (morbidity, mortality) and age adjusted distribution in the population. African oral disease priorities determined in this way are shown to be fundamentally different from those perceived previously. It is recommended that this new approach be used in customising a viable set of oral health policies and intervention strategies for each individual African community. [References: 33] <10> UI - 97258521 AU - Anderson L AU - Shaw J-M AU - McCargar L IN - Dr. L. McCargar, 4-10 Agriculture Forestry Centre, University of Alberta, Edmonton, Alta. T6G 2P5; Canada. E-Mail: maccarger@afns.ualberta.ca. TI - Physiological effects of bulimia nervosa on the gastrointestinal tract. SO - Canadian Journal of Gastroenterology Vol 11(5) (pp 451-459), 1997. AB - Bulimia nervosa is an eating disorder characterized by frequent bouts of binge eating followed by compensatory behaviour for preventing weight gain (purging). It is estimated that 3% to 5% of young women are affected by bulimia nervosa, and its prevalence is increasing. Bulimia nervosa afflicts both sexes and all races. It can lead to serious medical complications. The expression of the disease in the gastrointestinal tract may have a critical role in the diagnosis of bulimia nervosa. Physiological effects of bulimia nervosa on the gastrointestinal tract include dental caries and enamel erosion; enlargement of the parotid gland; esophagitis; changes in gastric capacity and gastric emptying; gastric necrosis; and alterations of the intestinal mucosa. Identification of any of these factors may aid in establishing an early diagnosis, which has been shown to increase the likelihood of recovery. [References: 79] <11> UI - 97140924 AU - Renvert S AU - Dahlen G AU - Snyder B IN - Dr. S. Renvert, Kristianstad Univ. Coll. Hlth. Scis., Box 98, S-291 21 Kristianstad; Sweden. TI - Clinical and microbiological effects of subgingival antimicrobial irrigation with citric acid as evaluated by an enzyme immunoassay and culture analysis. SO - Journal of Periodontology Vol 68(4) (pp 346-352), 1997. AB - The purpose of the present study was to compare at enzyme immunoassay with culture samples from untreated and non-surgically treated periodontal pockets and to assess the clinical and microbiological effects of citric acid irrigation as a supplement to scaling and root planing. The enzyme immunoassay used in this study is a chairside diagnostic tool aimed at identifying the presence of P. gingivalis, P. intermedia, and A. actinomycetemcomitans. Six sites with pocket depths <= 6 mm in each of 16 patients were monitored for 24 weeks using clinical and microbiological parameters. In two out of the six sites, scaling and root planing was supplemented with subgingival citric acid irrigation of the pocket after completion of the mechanical treatment. The sensitivity of the immunoassay in relation to culture was calculated to 85.5% and the specificity to 90.2%. The immunoassay corresponded to a detection level of 104 as estimated by culture. Sites treated with a combination of scaling and irrigation with citric acid demonstrated a similar healing pattern as sites treated with scaling and root planing alone. The profile of the marker bacteria was almost parallel for the two groups. The results of this investigation thus indicated that the immunoassay can be used as a screening tool for selected periodontal pathogens and that adjunctive irrigation with citric acid has no measurable clinical or microbiological effects. [References: 45] <12> UI - 96313118 AU - Liu R-S AU - Chu L-S AU - Yen S-H AU - Chang C-P AU - Chou K-L AU - Wu L-C AU - Chang C-W AU - Lui M-T AU - Chen K-Y AU - Yeh S-H IN - Department of Nuclear Medicine, National PET-Cyclotron Center, Taipei Veterans General Hospital, 201 Sec. 2, Shih-Pai Road, Taipei 11217; Taiwan. TI - Detection of anaerobic odontogenic infections by fluorine-18 fluoromisonidazole. SO - European Journal of Nuclear Medicine Vol 23(10) (pp 1384-1387), 1996. AB - Odontogenic infections are a potential risk for patients who receive cervicofacial radiotherapy and should be treated before irradiation. Anaerobic microbial infections are the most common causes. This study assessed the value of the hypoxic imaging agent fluorine-18 fluoromisonidazole (FMISO) in detecting anaerobic odontogenic infections. Positron emission tomography (PET) imaging was performed at 2 h after injection of 370 MBq (10 mCi) of FMISO in 26 nasopharyngeal carcinoma patients and six controls with healthy teeth. Tomograms were interpreted visually to identify hypoxic foci in the jaw. All patients received thorough dental examinations as a pre-radiotherapy work-up. Fifty-one sites of periodontitis, 15 periodontal abscesses, 14 sites of dental caries with root canal infection, 23 sites of dental caries without root canal infection, and seven necrotic pulps were found by dental examination. Anaerobic pathogens were isolated from 12 patients. Increased uptake of FMISO was found at 45 out of 51 sites of periodontitis, all 15 sites of periodontal abscess, all 14 sites of dental caries with root canal infection, all seven sites of necrotic pulp and 15 sites of dental caries without obvious evidence of active root canal infection. No abnormal uptake was seen in the healthy teeth of patients or in the six controls. The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy of FMISO PET scan in detecting odontogenic infections were 93%, 97%, 84%, 99% and 96%, respectively. 18F-fluoride ion bone scan done in three patients showed that 18F-fluoride ion plays no role in the demonstration of anaerobic odontogenic infection. FMISO PET scan is a sensitive method for the detection of anaerobic odontogenic infections, and may play a complementary role in the evaluation of the dental condition of patients with head and neck tumours prior to radiation therapy. <13> UI - 96306384 AU - Walker ARP AU - Segal I AU - Hill MJ AU - Leeds AR AU - Dimitrov BD AU - Wasan HS AU - Goodlad RA IN - Human Biochemistry Research Unit, Department of Tropical Diseases, Sch Pathology Univ Witwatersrand, Johannesburg 2000; South Africa. TI - Fibre and colorectal cancer [3]. SO - Lancet Vol 348(9032) (pp 956-959), 1996. <14> UI - 96212513 AU - Zador D AU - Lyons Wall PM AU - Webster I IN - Gladstone Hall Health Services, 114 Ewart Street, Dulwich Hill, NSW 2203; Australia. TI - High sugar intake in a group of women on methadone maintenance in South Western Sydney, Australia. SO - Addiction Vol 91(7) (pp 1053-1061), 1996. AB - Nutritional assessment comprising dietary and anthropometric measurements was conducted in a group of 86 women attending a methadone maintenance clinic in South Western Sydney, Australia. Dietary data were obtained by two 24-hour recall interviews using a standardized interview format. Nutrient intake was analysed using the NUTTAB data base of Australian foods (1992). Mean age of the sample was 29.8 (range 18-46) years and mean body mass index was 22.7 (range 16.2-43.4) kg/m2. The diet of the study group was characterized by a low energy intake of 6.48 MJ (95% CI 6.02-6.94), a high sugars intake of 122 g (95% CI 112-132), a high percentage of total energy (31%, 95% CI 29-32) derived from sugars, and a low dietary fibre intake of 10.7 g (95% CI 9.7-12.3). This eating pattern may contribute to the high prevalence of dental caries and chronic constipation observed in the group. The results also support anecdotal evidence of a craving for sweetness described by addicts. Despite the low energy intake, body mass indices of the group were no different from the normal population. It is possible that 2 days' intake was insufficient to accurately measure accustomed diet in this group of women. Alternatively, the low intake may be a consequence of their largely sedentary life-styles. <15> UI - 95116340 AU - Hunt RJ AU - Drake CW AU - Beck JD IN - School of Dentistry, University of North Carolina, CB 7450, Chapel Hill, NC 27599; United States of America. TI - Eighteen-month incidence of tooth loss among older adults in North Carolina. SO - American Journal of Public Health Vol 85(4) (pp 561-563), 1995. AB - This study investigated tooth loss in North Carolina adults 65 years of age or older. A random sample of 335 Blacks and 284 Whites participated in dental examinations and interviews at baseline and again after 18 months. Blacks were more likely than Whites to lose at least one tooth (36% vs 19%), and they lost more teeth on average (1.0 vs 0.4). Several oral disease conditions and symptoms were related to tooth loss, but many other hypothesized factors were not. Risk models were inconclusive in the identification of factors related to risk of tooth loss. <16> UI - 95042850 AU - Papas AS AU - Joshi A AU - Palmer CA AU - Giunta JL AU - Dwyer JT IN - Tufts Univ. Sch. of Dental Med., SCH Box 3, One Kneeland Street, Boston, MA 02111-1513; United States of America. TI - Relationship of diet to root caries. SO - American Journal of Clinical Nutrition Vol 61(2) (pp 423S-429S), 1995. AB - A Nutrition and Oral Health Study was conducted on 141 middle-aged and elderly adults (54% female and 46% male; aged 47-83 y. x- = 67; 51% college educated; and 89% white). This study reports on the relationship between root caries and diet. Nutritional composition was derived from two 3-d food diaries. Root caries was measured according to the 1985 Adult Survey Diagnostic Criteria of the National Institute of Dental Research. When the individuals were segregated by their root DES (decayed and filled surfaces) status into highest (>=7) and lowest (<=1) quartiles, the sucrose consumption was significantly higher in the higher DFS group. Mean energy consumption and mean number of teeth were the same in both groups. When the individuals were segregated by sucrose consumption into highest (>=89 g) and lowest (<= 31 g) quartiles, DFS root status was significantly higher (P < 0.01) in the highest quartile group (7 g) vs the lowest group (4 g). By using data from subjects with two food diaries, a stepwise-linear-regression model for root caries showed that 4.2% of the variance for root critics was explained by sucrose, 2.8% by plaque, 3.8% by total number of teeth, and 5.6% by gingival recession. These data suggest that root caries has a similar dietary etiology to coronal caries. <17> UI - 95042849 AU - Papas AS AU - Joshi A AU - Belanger AJ AU - Kent Jr RL AU - Palmer CA AU - DePaola PF IN - Tufts Univ. Sch. of Dental Medicine, SCH Box 3, One Kneeland Street, Boston, MA 02111-1513; United States of America. TI - Dietary models for root caries. SO - American Journal of Clinical Nutrition Vol 61(2) (pp 417S-422S), 1995. AB - A stepwise multiple logistic regression was computed to assess which of the nutritional variables differentiate the healthy and diseased group of participants in the Forsyth Specialized Caries Center (n = 275). Variables considered as candidates for the model included the consumption per week of sugars, starch, cheese, fruits and fruit juices, noncarcinogenic foods, and dairy products. Two variables - sugars and cheese - were statistically significant by the stepwise procedure. Increased intake of sugar was associated with being in the root caries group, whereas high intake of cheese was negatively associated with root caries. Thus, cheese seems to have a protective effect after sugar intake is controlled for. Odds ratios were computed to quantify the influence of the variables. An increase of two exposures of sugar per day corresponded with an odds ratio of 1.26. The odds ratio continues to increase with sugar intake so that an increase to five exposures per day gives an odds ratio of 1.79. This model is consistent with past in vitro studies suggesting that cheese protects against caries formation when sugar intake is trolled for and that increasing frequency of sugar intake increases the odds of root caries. <18> UI - 94091071 AU - Navia JM IN - School of Public Health, University of Alabama, CBB B60A, 702 20th Street South,Birmingham, AL 35294; United States of America. TI - Carbohydrates and dental health. SO - American Journal of Clinical Nutrition Vol 59(3 SUPPL.) (pp 719S-727S), 1994. AB - Carbohydrates, together with fats and proteins, provide the necessary energy needs for humans, and constitute, therefore, an integral part of a normal diet. An etiological model for caries that considers local and host factors is presented, high-lighting the interaction of bacteria, saliva, minerals, and trace elements with food residues and with other intrinsic environmental and behavioral characteristics of the host. Consideration of this complex multifactorial etiology precludes the identification of any one factor as the only one to be singled out in prevention and management of oral disease. Sugar is, unquestionably, a risk factor for caries, and, therefore, its total substitution with energetic or nonenergetic sweeteners has been found useful. However, partial substitutions of fermentable sugars may have limited practical value in controlling caries prevalence. Caries preventive programs that take into consideration not one, but several etiologic factors, will be effective and beneficial to the general population. <19> UI - 93299881 AU - Jette AM AU - Feldman HA AU - Douglass C IN - New England Research Institute, 9 Galen St.,Watertown, MA 02172; United States of America. TI - Oral disease and physical disability in community-dwelling older persons. SO - Journal of the American Geriatrics Society Vol 41(10) (pp 1102-1108), 1993. AB - Objective: The aim of this epidemiologic investigation was to determine whether poor oral health in older persons was associated with physical disability. Design: The study was a cross-sectional survey involving inhome interviews and dental examinations of older persons. Setting: A random sample of 68 cities and towns was selected from the six New England states, with stratification according to population size. Participants: The study sample consisted of 1,156 community-dwelling (non-institutionalized) individuals aged 70 and over, randomly selected from the Medicare beneficiary lists for each city and town. Measurements: Oral health was assessed by three dichotomous indices: edentulism (no teeth); current caries, including either coronal or root decay; and periodontal disease, as measured by gingival pocket depth. Physical disability was indicated by the subject's self-report of difficulty in the areas of personal care (eating, bathing, dressing, and using the toilet) and mobility (walking, bed transfer, getting outside). Additional independent variables included age, sex, number of teeth, education, living alone, oral hygiene practices, and time since last dental visit. Results: We found a direct association between specific areas of physical disability and current caries and edentulism. The risk of poor oral health did not increase with advancing age once the related risk factors were controlled for. Those subjects with mobility disabilities were at increased risk of tooth loss; those with personal care limitations were at increased risk of current caries. Conclusions: Physical disability should be added to the list of known risk factors for oral disease among the older population. Our findings call attention to the need for health care providers to screen for oral health problems among disabled older persons. Further gerontologic research is needed to identify the mechanisms linking physical disability with oral disease in older persons. <20> UI - 93298261 AU - Larmas M IN - Dept Preventive Dent and Cardiology, Institute of Dentistry, University of Oulu,SF-90220 Oulu; Finland. TI - Plaque-mediated disease: Basic and clinical studies on the value of salivary monitoring. SO - Annals of the New York Academy of Sciences Vol 694 (pp 252-264), 1993. <21> UI - 93207516 AU - Billings RJ IN - Eastman Dental Center, 625 Elmwood Avenue,Rochester, NY 14620; United States of America. TI - An epidemiologic perspective of saliva flow rates as indicators of susceptibility to oral disease. SO - Critical Reviews in Oral Biology & Medicine Vol 4(3-4) (pp 351-356), 1993. <22> UI - 93065116 AU - Locker D IN - Department of Community Dentistry, Faculty of Dentistry, University of Toronto, 124 Edward Street,Toronto, Ont. M5G 1G6; Canada. TI - Smoking and oral health in older adults. SO - Canadian Journal of Public Health. Revue Canadienne de Sante Publique Vol 83(6) (pp 429-432), 1992. AB - This paper examines the relationship between smoking and oral health in older adults. The data are taken from a cross sectional study of oral health and treatment needs among persons aged 50 years and over living independently in four Ontario communities. Data was obtained from 907 subjects. Half of these reported a history of smoking and one fifth were current smokers. Current smokers were more likely to have lost all their natural teeth than those who had never smoked. Among those retaining one or more natural teeth, current smokers had fewer teeth, fewer functional units, more crown surfaces with decay and more decayed root surfaces. Periodental indicators showed that the extent and severity of periodontal disease were more marked among current smokers when compared with those who had never smoked. Current smokers also showed a higher prevalence of mucosal disorders and needed more dental treatment. Regression analysis suggested that the links between smoking and oral disorders differ according to the disease in question. <23> UI - 93031952 AU - Sinusas K AU - Coroso JG AU - Sopher MD AU - Crabtree BF IN - Family Practice Residency Program, Middlesex Hospital, 90 S Main St,Middletown, CT 06457; United States of America. TI - Smokeless tobacco use and oral pathology in a professional baseball organization. SO - Journal of Family Practice Vol 34(6) (pp 713-718), 1992. <24> UI - 90365932 AU - Ballantine BN AU - Costigan F AU - Anderson RJ IN - Occupational Health Department, British Gas Plc, 59 Bryanston Street, London W1A 2AZ; United Kingdom. TI - A survey of the dental health of the workers on two groups of offshore installations. SO - Journal of the Society of Occupational Medicine Vol 40(4) (pp 143-148), 1990. AB - The study of the medical evacuation records from offshore installation workers indicated that dental pathology may be a significant problem. This investigation was set up to gather more accurate information. The intention was to examine the mouths of as many of the workforce as possible. This covered both day and night shifts and both tours of duty. The examinees numbered 493 out of an offshore population of 967. Half of the examinees attended the dentist regularly. Eight per cent of those examined had been evacuated for dental reasons. Thirty-six per cent were in the author's high or medium occupational risk groups. There are opportunities for action to be taken to improve the situation. <25> UI - 90227528 AU - Williams RC IN - Harvard School of Dental Medicine, Boston, MA 02115; United States of America. TI - Periodontal disease (Reply). SO - New England Journal of Medicine Vol 323(2) (pp 134-135), 1990. <26> UI - 90139574 AU - White SC AU - Kaffe I AU - Gornbein JA IN - Section of Oral Radiology, UCLA School of Dentistry, Los Angeles, CA 90024; United States of America. TI - Prediction of efficacy of bitewing radiographs for caries detection. SO - Oral Surgery, Oral Medicine, Oral Pathology Vol 69(4) (pp 506-513), 1990. AB - Although bitewing (BW) radiographs play an indispensable role in the detection of interproximal caries, it is not always clear when they should be made. The present study was designed to test the hypothesis that a person's caries and restorative history may be predictive of his or her caries future. Full-mouth radiographic examinations (FMX) and subsequent BW radiographs from 349 adults (age 20 or more) selected at random were examined. Possible risk factors for caries recorded for each patient included the number and type of carious lesions and the restorative experience of the patient. Linear logistic regression models were evaluated to estimate the efficacy of the possible risk factors as predictors of the presence of caries on the BW radiographs. Of the 349 adults examined, 91 (26%) had one or more new carious lesions at the time of their BW examination. The probability of caries in this population at the time of the BW examination increases both with lengthening interval between the FMX and the BW radiographs and with the number of restorations at the time of FMX. A regression model was adopted that estimates the probability of caries being detected on BW radiographs. We found that to provide the most good for the most patients (minimize cost), the threshold level for ordering follow-up radiographs should be when the probability of detecting caries is 5%. It may be seen that even when a person has no caries or restorations at the time of the FMX there will be a 5% chance that BW radiographs will reveal the presence of caries 1.5 years later. The 5% threshold is reached sooner in the presence of caries or restorations.