Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Sep 2000.> Search Strategy (You Saved Citations 1-300 From Set 76): ----------------------------------------------------------------------------- 1 exp Poverty/ 7653 2 poverty.mp. 8523 3 exp Social class/ 11645 4 exp Socioeconomic factors/ 122078 5 SES.mp. 1193 6 exp Minority groups/ 3365 7 exp Ethnic groups/ 49004 8 income:.mp. 17466 9 (socioeconomic adj3 status:).mp. 5517 10 (education: adj3 (level: or status:)).mp. 8503 11 (occupation: adj3 status:).mp. 1187 12 "HEAD START".mp. 306 13 "WIC".mp. 290 14 exp Public assistance/ 17247 15 exp Social welfare/ 27301 16 (public adj assistance).mp. 255 17 (welfare adj3 assistance:).mp. 41 18 (welfare adj3 dependenc:).mp. 33 19 (welfare adj3 status:).mp. 77 20 (welfare adj3 recipient:).mp. 84 21 (women adj infant adj2 children).mp. 9 22 medicaid.mp. 6293 23 employment.mp. 21251 24 unemployment.mp. 3405 25 downsiz:.mp. 331 26 down-siz:.mp. 62 27 education/ 5985 28 or/1-27 225135 29 exp Tooth demineralization/ 22604 30 demineralization.mp. 1614 31 caries.mp. 15267 32 caires.mp. 1 33 craies.mp. 0 34 careis.mp. 4 35 carise.mp. 0 36 (teeth adj3 cavit:).mp. 422 37 (tooth adj3 cavit:).mp. 217 38 (dental adj3 cavit:).mp. 276 39 (dentin adj3 cavit:).mp. 254 40 (enamel adj3 cavit:).mp. 182 41 (teeth adj3 decay:).mp. 374 42 (tooth adj3 decay:).mp. 321 43 (dental adj3 decay:).mp. 249 44 (dentin adj3 decay:).mp. 12 45 (enamel adj3 decay:).mp. 20 46 (active adj decay).mp. 9 47 (rampant adj3 decay:).mp. 14 48 (recurrent adj3 decay:).mp. 30 49 (white adj spot:).mp. 507 50 carious.mp. 2073 51 cariology.ti,ab. 56 52 (non-cavitated adj3 lesion:).mp. 15 53 (noncavitated adj3 lesion:).mp. 2 54 Tooth remineralization/ 472 55 (dental adj3 fissure:).mp. 98 56 (tooth adj3 fissure:).mp. 50 57 (teeth adj3 fissure:).mp. 97 58 caries-free.mp. 602 59 cariesfree.mp. 17 60 Cariogenic agents/ 728 61 precavit:.mp. 8 62 (filled adj3 teeth).mp. 510 63 (filled adj3 tooth).mp. 116 64 (oral adj fissure:).mp. 6 65 (tooth adj3 remineraliz:).mp. 28 66 (teeth adj3 remineraliz:).mp. 24 67 dft.mp. 411 68 dfs.mp. 1246 69 dmf:.mp. 6389 70 cariogeni:.mp. 1783 71 or/29-70 32194 72 28 and 71 1663 73 limit 72 to (human and english language and yr=1990-2000) 740 74 limit 73 to child < 6 to 12 years > 338 75 ("93099748" or "94086857" or "96176352").ui. 3 76 75 or 74 338 77 from 76 keep 1-300 300 *************************** <1> UI - 20321848 AU - Retnakumari N IN - Dept. of Pedodontics and Preventive Dentistry, Govt. Dental College, Thiruvananthapuram. TI - Prevalence of dental caries and risk assessment among primary school children of 6-12 years in the Varkala municipal area of Kerala. SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1999 Dec;17(4):135-42 AB - This epidemiological survey attempted to establish the prevalence and severity of dental caries among primary school children of Varkala municipal area. The prevalence of dental caries was 68.5% with a standard error (SE) of 1.64% and 95%, confidence interval (CI) 65.18, 71.82. The highest caries prevalence was found among 10 year age group (75.9%) and lowest in the 8 year age group (63%). The highest dmft score was found in 9 year age group 2.73 +/- 0.443 and highest DMFT score was found in 12 year age group 2.06 +/- 0.3824. Statistically significant association was found with dental caries and oral hygiene status (Odds Ratio (OR) 3.59, 95% CI, 2.53, 5.06 and oral cleanliness OR 2.73, 95% CI 2.96, 3.82). Statistically significant association was found between low socioeconomic status and prevalence of caries (O.R. 1.89, 95% CI--1.28, 2.8). <2> UI - 20316558 AU - Lalloo R AU - Myburgh NG AU - Hobdell MH IN - Oral Health Centre, Faculty of Dentistry, University of the Western Cape, South Africa. TI - Dental caries, socio-economic development and national oral health policies. SO - International Dental Journal 1999 Aug;49(4):196-202 AB - A relationship between a population's level of socio-economic development and dental caries has often been assumed. Proxy measures such as sugar consumption have been used to reflect this. This study tests the hypothesis that there is a relationship between dental caries and the level of socio-economic development, using recent international data. It goes on to explore the implications of this relationship for the development of national oral health policies. Dental caries data was obtained from the WHO, Global Oral Epidemiology Data Bank for the period 1981-1996. Socio-economic data was obtained from the United Nations Development Programme (UNDP). Countries were ranked according to the Human Development Index (HDI) and their GNP. The study confirms the existence of a relationship between dental caries and development. Caries is a good proxy measure for socio-economic development. Countries in the throes of socio-economic transition have the highest DMFT scores. <3> UI - 20305622 AU - Martin-Iverson N AU - Pacza T AU - Phatouros A AU - Tennant M IN - School of Oral Health Sciences, University of Western Australia. TI - Indigenous Australian dental health: a brief review of caries experience. [Review] [17 refs] SO - Australian Dental Journal 2000 Mar;45(1):17-20 AB - The indigenous community in Australia is an at risk population for oral diseases such as dental caries. The majority of communities are isolated and dental services in these areas are limited. Oral hygiene standards are poor and this combined with a diet rich in refined carbohydrates has led to high incidences of dental caries. In addition, diabetes, which is related to obesity (and a diet high in sugar and fat) has been linked to increases in oral disease. Caries prevalence was found to be low in areas where fluoridation levels in the water were high. The fact that the fluoride supplementation appears to improve oral health to a significant degree suggests that implementation of fluoride treatment programmes for school children and, where viable, fluoridation of water sources would be appropriate. In addition, dental education programmes should receive high priority. As with the rest of the community, these preventive measures will result in less need for emergency dental treatment in the future, better oral health for the community and reduced financial burden on the State. It is under these circumstances that oral health planners and providers must, in consultation with the relevant community representatives, develop appropriate mechanisms to address the needs of this group. The development of strategies that integrate with the plethora of general health strategies currently being implemented is just one means of achieving improved oral health outcomes for indigenous Australians. [References: 17] <4> UI - 20232723 AU - Graham DB AU - Webb MD AU - Seale NS IN - Dental Service, Children's Medical Center of Dallas, USA. TI - Pediatric emergency room visits for nontraumatic dental disease. SO - Pediatric Dentistry 2000 Mar-Apr;22(2):134-40 AB - PURPOSE: This study described the incidence and predisposing, enabling, and need factors of outpatients in a pediatric ER who sought care for nontraumatic preventable dental disease and analyzed treatment rendered by attending physicians and associated hospital charges for treatment. METHODS: Chart review of outpatients discharged from the ER of a children's hospital during 1996-97, using ICD-9 diagnostic codes for dental caries, periapical abscess and facial cellulitis yielded the data for this investigation. RESULTS: During 1996-97, 149 patients made 159 ER visits. The most common diagnoses were ICD-9 codes 521.0 for dental caries (48%) and 522.5 for periapical abscess (47%). Medicaid recipients used the ER at an intermediate level between patients with no payor source and those with private insurance. Almost one-half of the accounts changed status during the billing process, with the majority being entered as private pay upon admission, but changing to bad debt or charity after the registration records were processed and collection was attempted. Most patients were treated empirically by the ER physicians according to their presenting signs/symptoms. CONCLUSION: This study confirmed that parents utilize the ER as their child's primary dental care source. <5> UI - 99313124 AU - Moss ME AU - Lanphear BP AU - Auinger P IN - Eastman Department of Dentistry, The University of Rochester School of Medicine and Dentistry and Children's Hospital Medical Center, NY 14642, USA. moss@prevmed.rochester.edu TI - Association of dental caries and blood lead levels [see comments]. CM - Comment in: JAMA 1999 Jun 23-30;281(24):2340-2, Comment in: JAMA 2000 Jan 25;283(4):476-7; discussion 477 SO - JAMA 1999 Jun 23-30;281(24):2294-8 AB - CONTEXT: Experiments show that dental caries rates are higher among lead-exposed animals, but this association has not been established in humans. OBJECTIVE: To examine the relationship between blood lead levels and dental caries. DESIGN: Cross-sectional survey conducted from 1988 to 1994 that included a dental examination and venipuncture blood lead assay. SETTING AND PARTICIPANTS: A total of 24901 persons aged 2 years and older who participated in the Third National Health and Nutrition Examination Survey, which assessed the health and nutritional status of children and adults in the United States. MAIN OUTCOME MEASURES: For children aged 2 to 11 years, the sum of decayed and filled deciduous or primary surfaces; for persons aged 6 years and older, the sum of decayed and filled permanent surfaces; for those 12 years and older, the sum of decayed, missing, and filled surfaces. RESULTS: The log of blood lead level was significantly associated with the number of affected surfaces for both deciduous and permanent teeth in all age groups, even after adjusting for sociodemographic characteristics, diet, and dental care. Among children aged 5 to 17 years, a 0.24-micromol/L (5-microg/dL) change in blood lead level was associated with an elevated risk of dental caries (odds ratio, 1.8; 95% confidence interval, 1.3-2.5). Differences in blood lead level explained some of the differences in caries prevalence in different income levels and regions of the United States. We estimated the population attributable risk of lead exposure to be 13.5% and 9.6% of dental caries occurring in 5- to 17-year-olds exposed to the high and moderate levels, respectively. CONCLUSIONS: Environmental lead exposure is associated with an increased prevalence of dental caries in the US population. Findings may help explain the distribution of caries by income and region of the United States. <6> UI - 20175450 AU - Agrawal M AU - Ghildiyal R AU - Khopkar S IN - Department of Pediatrics, T.N. Medical College and B.Y. Nair Hospital, Mumbai, Maharashtra, India. TI - Health status of school girls from affluent population of Mumbai. SO - Indian Pediatrics 1999 Jan;36(1):75-8 <7> UI - 20235761 AU - Venugopal T AU - Kulkarni VS AU - Nerurker RA AU - Damle SG AU - Patnekar PN IN - Department of Pediatrics, Dr. R.N. Cooper Municipal General Hospital, Mumbai. TI - Epidemiological study of dental caries. SO - Indian Journal of Pediatrics 1998 Nov-Dec;65(6):883-9 AB - A total of 2000 children (1-14 year age group) attending pediatric OPD, school clinic & well body clinic of Dr. R.N. Cooper Municipal Hospital & K.E.M Hospital, Mumbai were examined for caries prevalence and 35.6% had dental caries. Parental income was not shown to have any bearing on caries prevalence. Parental literacy, particularly maternal literacy was shown to influence caries prevalence in children. The prevalence was low in well-nourished children and in those taking vegetarian type of diet. Frequency of sweet consumption was shown to be associated with prevalence of dental caries. In 1-4 year age group it was noted that bottle fed children were more affected by dental caries. Tooth brush with paste was the commonest method used for cleaning their teeth in all age groups in our study. Caries prevalence was low in those children using tooth brush than in those using tooth powder. Those children who were using neem datun were found to be less affected with dental caries. Dental caries was also found to be low in those who rinsed their mouth with water after food. <8> UI - 20191322 AU - Burt BA AU - Keels MA AU - Heller KE IN - Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. bburt@umich.edu TI - The effects of a break in water fluoridation on the development of dental caries and fluorosis. SO - Journal of Dental Research 2000 Feb;79(2):761-9 AB - Durham, NC, fluoridated since 1962, had an 11-month cessation of fluoridation between September, 1990, and August, 1991. The purpose of this study was to assess the effects of this break on the development of caries and fluorosis in children. Study participants were continuously-resident children in Kindergarten through Grade 5 in Durham's elementary schools. There were 1696 children, 81.4% of those eligible, for whom a questionnaire was completed and clinical data recorded. Age cohorts were defined by a child's age at the time that fluoridation ceased. Caries was recorded in children in the Birth Cohort through Cohort 3, and fluorosis for children in Cohorts 1 through 5. Caries was assessed in the primary first and second molars according to the decayed-filled index; fluorosis on the labial surfaces of the upper permanent central and lateral incisors was assessed by the Thylstrup-Fejerskov (TF) index. Mother's education was associated with caries; higher education of the mother had an odds ratio of 0.53 (95% CI 0.40, 0.76) for caries in the child. No cohort effects could be discerned for caries. Overall prevalence of fluorosis was 44%. Prevalence in Cohorts 1, 2, 3, 4, and 5 was 39.8%, 32.3%, 33.0%, 62.3%, and 57.1%, respectively. These cohort differences remained statistically significant in regression analysis. It was concluded that while the break had little effect on caries, dental fluorosis is sensitive to even small changes in fluoride exposure from drinking water, and this sensitivity is greater at 1 to 3 years of age than at 4 or 5 years. <9> UI - 20205076 AU - Kowash MB AU - Pinfield A AU - Smith J AU - Curzon ME IN - Department of Paediatric Dentistry, Leeds Dental Institute, University of Leeds. TI - Effectiveness on oral health of a long-term health education programme for mothers with young children. SO - British Dental Journal 2000 Feb 26;188(4):201-5 AB - AIM: To determine the effect of dental health education (DHE) on caries incidence in infants, through regular home visits by trained DH Educators over a period of 3 years. METHOD: A randomly selected cohort of 228 children born between 1st January and 30th September 1995, in a low socioeconomic/high caries suburb of Leeds (UK) were divided into the following groups: A) DHE focused on diet; B) DHE focused on oral hygiene instruction (OHI) using fluoride toothpaste; and C) DHE by a combined diet and OHI message. DHE was given using an interview and counselling for at least 15 minutes at home every 3 months for the first 2 years and twice a year in the third year of the study. A fourth group D was given diet and OHI, at home, once a year only. All children and mothers were examined for caries and oral hygiene. A fifth group E (control) received no DHE and were never visited but examined at 3 years of age only. RESULTS: In the groups of children visited regularly only two developed caries and three had gingivitis (all in group A). In group E, however, 33% of children had caries and nine (16%) had gingivitis. The differences in caries levels and caries risk factors between study and control groups were statistically significant (P < 0.001). Mothers of the study groups also showed an improvement in their own levels of gingivitis, debris and calculus scores by the second and third examinations (P < 0.001). CONCLUSION: Regular home visits to mothers with infants, commencing at or soon after the time of the eruption of the first deciduous teeth, was shown to be effective in preventing the occurrence of nursing caries. <10> UI - 20151850 AU - Roberts-Thomson KF AU - Spencer AJ IN - Department of Dentistry, The University of Adelaide. TI - Public knowledge of the prevention of dental decay and gum diseases. SO - Australian Dental Journal 1999 Dec;44(4):253-8 AB - In 1992, a mail survey was conducted among South Australians aged 10 years and older to assess the knowledge of prevention of dental caries and gum diseases and to explore its variation by sociodemographic factors. The survey provided 838 completed questionnaires. Questions were asked on perceptions of importance of a number of preventive measures, the main purpose of water fluoridation and sources of information. Respondents rated four myths for preventing dental caries as the most important: 97 per cent rated regular tooth brushing; 87 per cent rated regular dental visits; 85 per cent rated calcium in the diet; and 78 per cent rated eating fibrous foods as definitely or probably important. Only 56 per cent of respondents rated drinking water with fluoride as definitely or probably important for preventing dental caries, and only half (50.2 per cent) identified the main purpose of water fluoridation as the prevention of decay. Respondents rated regular tooth brushing (96 per cent) and regular dental visits (87 per cent) as important for the prevention of gum diseases. However, the myth of massaging the gums was rated as important by 67 per cent. Higher percentages of females, older adults and those with lower educational attainment rated the myths for preventing caries as important. Younger people were less able to specify the main purpose for fluoridation of water supplies. The persistence of myths and the low rating of the importance of scientifically efficacious measures are major challenges for oral health promotion. <11> UI - 20174349 AU - Mac Cormac C AU - Kinirons M IN - Division of Paediatric and Preventive Dentistry, School of Dentistry, Belfast. TI - Characteristics of children referred to a general anaesthetic service in Northern Ireland. SO - Journal of the Irish Dental Association 1999;45(4):119-23 AB - General anaesthetics are still frequently given to children for dental extractions and this method of treatment is most prevalent in regions such as Northern Ireland where high levels of dental disease persist in children. The aim of this study was to establish the social and dental characteristics of the children receiving general anaesthetics for dental extractions. Parents of children referred to the community dental extraction service in the Craigavon and Banbridge area of Northern Ireland completed a closed-ended questionnaire. In the sample there was a significantly lower level of maternal education than seen in the general population. There was a significantly higher level (p < 0.01) of dental anxiety seen in the sample group of children compared to the general population. For the primary dentition the corrected dmft values were higher than in the general population as was the untreated decay component while lower numbers of filled and of extracted teeth were seen. In the permanent dentition the caries experience and levels of extractions were similar to those seen in the general population while the level of untreated decay was higher and the mean number of fillings was lower. There was a similar pattern of attendance as that seen in the general child population. <12> UI - 20106113 AU - Wilson N AU - Quigley R AU - Mansoor O IN - Ministry of Health, Wellington, New Zealand. nwilson@actrix.gen.nz TI - Food ads on TV: a health hazard for children?. SO - Australian & New Zealand Journal of Public Health 1999 Dec;23(6):647-50 AB - OBJECTIVE: To examine the nutritional quality of food in television food advertisements that are targeted at children. METHOD: We videotaped 42 hours of children's programs and analysed the food advertisements' content and nutrient composition using the New Zealand Food Composition Database. RESULTS: Of 269 food advertisements, 63% were for foods 'high in fat and/or sugar'. Children who ate only the advertised foods would eat a diet too high in fat, saturated fat, protein, free sugars and sodium. Furthermore, their diets would have suboptimal levels of fibre and suboptimal intakes of a number of important micronutrients (depending on age), including magnesium, selenium and vitamin E. The food products advertised on this channel rarely included nutritious low-cost foods that are necessary for food security in low-income groups. There were also no food advertisements that included any of the healthy foods consumed by Maori and Pacific peoples. CONCLUSIONS: Food advertisements targeted at children generally reflect the dietary pattern associated with an increased risk of obesity and dental caries in childhood; and cardiovascular disease, diabetes and cancers in adulthood. <13> UI - 20144643 AU - Brown LJ AU - Wall TP AU - Lazar V IN - American Dental Association, Health Policy Resources Center, Chicago, Ill. 60611, USA. TI - Trends in total caries experience: permanent and primary teeth. SO - Journal of the American Dental Association 2000 Feb;131(2):223-31 AB - BACKGROUND: This article is the last in a series of three that focuses on recent changes in the caries status of children aged 18 years or younger in the United States. METHODS: This study is based on analyses of data regarding total carious (treated and untreated) permanent and primary teeth among children 6 to 18 years old and children 2 to 10 years old from the first and third National Health and Nutrition Examination Surveys, or NHANES I and NHANES III. The NHANES is periodically conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. RESULTS: The cumulative number of carious permanent teeth, both treated and untreated, among 6- to 18-year-olds decreased 57.2 percent, from 4.44, as measured in NHANES I, to 1.90, as measured in NHANES III. The cumulative number of carious primary teeth, both treated and untreated, among 2- to 10-year-olds decreased 39.7 percent, from 2.29, as measured in NHANES I, to 1.38, as measured in NHANES III. CONCLUSIONS: Since the 1970s, the cumulative number of carious permanent and primary teeth, both treated and untreated, has declined substantially among children in the United States. PRACTICE IMPLICATIONS: Effective prevention has reduced caries in children. As a result, dental practice will be more focused on maintaining intact dentitions than on repairing teeth damaged by disease. <14> UI - 20128564 AU - Irigoyen ME AU - Maupome G AU - Mejia AM IN - Departamento de Ciencias de la Salud, Universidad Autonoma Metropolitana Unidad Xochimilco, Mexico D.F., Mexico. meirigo@cueyatl.uam.mx TI - Caries experience and treatment needs in a 6- to 12-year-old urban population in relation to socio-economic status. SO - Community Dental Health 1999 Dec;16(4):245-9 AB - OBJECTIVE: To report caries experience in the permanent dentition among Mexico City elementary school children and undertakes a comparative analysis of dental caries experience and treatment needs of children of different socio-economic status (SES). RESEARCH DESIGN: SES was established according to an official measure of economic well-being, that of the family income being high enough to allow the child to attend school in a private institution as opposed to a public school. PARTICIPANTS: A probabilistic sample of 4,048 6- to 12-year-old children (47.2% females) was examined using the 1987 WHO caries criteria (546 attended private schools and 3,502 were public school children). RESULTS: The proportion of caries-free 12-year-old children was 28.6% and 9.5% in the private and public schools, respectively (P < 0.01). In 12-year-old children, DMFT was 2.78 (SD 2.9) and 4.64 (SD 3.2) in the private and public school groups, respectively (P < 0.001). Higher treatment needs were found among public schoolchildren (TN = 83.0%) compared with private schoolchildren (TN = 27.6%) (P < 0.001). CONCLUSIONS: Dental caries and treatment needs were considerably higher in children of lower SES. Differences in dietary patterns and toothpaste use could be the more likely explanations for these findings, indicating markedly unequal burdens of disease according to socio-economic status. Special efforts should be developed to improve the oral health status in Mexico City children by implementing preventive health promotion and treatment programmes. <15> UI - 20146493 AU - Hobdell MH AU - Lalloo R AU - Myburgh NG IN - University of Texas-Houston, Dental Branch 77030, USA. 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 1999;896:329-31 <16> UI - 99394255 AU - Deery C AU - Fyffe HE AU - Nuttall NM AU - Nugent ZJ AU - Pitts NB IN - Dundee Dental Hospital & School, University of Dundee. TI - The dental caries status of Scottish adolescents reported to be regular attenders. Initial results from a primary dental care based research network [see comments]. CM - Comment in: Br Dent J 1999 Oct 9;187(7):348 SO - British Dental Journal 1999 Jul 24;187(2):95-100 AB - AIM: To investigate the caries status of, and the delivery of care to, a group of regularly attending adolescent dental patients. To conduct research in primary dental care. A subsidiary aim was to compare the caries status of this sample to population samples. SETTING: General dental practices across Scotland. DESIGN: A 3-year cohort study. SUBJECTS: 41 volunteer general dental practitioners and 616 adolescent patients (mean age = 12.1 years at baseline) defined by the practitioners as 'regular' attenders. RESULTS: All practices remained in the study. 403 subjects were seen at both baseline and final examination and 329 were examined at all 4 annual examinations. The mean D3MFT (dentine caries threshold) was 1.8 at baseline and 3.9 at the final examination, three years later. Of the 541 subjects seen at baseline 62% had experienced either restored or unrestored dentinal caries. Thirty-four percent of all those examined at baseline had all the unrestored dentinal caries. The majority of the disease was to be found in the molar teeth, particularly the first permanent molars. The provision of sealants was relatively high with 85% of subjects having at least one sealed tooth by the final examination. Although disease levels were related to socio-economic status, the Care Index was not. CONCLUSIONS: The 'regularly attending' subjects had a better normative level of dental health than their peers in the Scottish population. However, wide variation was found. The project also demonstrated the feasibility of undertaking research in partnership with general dental practitioners. <17> UI - 99381492 AU - Watt R AU - Sheiham A IN - Department of Epidemiology and Public Health, University College London Medical School. TI - Inequalities in oral health: a review of the evidence and recommendations for action [see comments]. [Review] [69 refs] CM - Comment in: Br Dent J 1999 Sep 11;187(5):237-8 SO - British Dental Journal 1999 Jul 10;187(1):6-12 AB - Reducing inequalities in health has become one of the main health policy issues in the late 1990s. The Labour Government set up an independent inquiry into inequalities in health under Sir Donald Acheson to make recommendations on approaches to reducing health inequalities. This paper reviews the evidence on inequalities in oral health in Britain. Dramatic improvements in dental health in children and young adults have taken place in the past 30 years. The levels of caries in permanent teeth of children is low. Widening inequalities in oral health however exist between social classes, regions of England, and among certain minority ethnic groups in pre-school children. The main social class and minority ethnic differences in dental caries is in pre-school children. Wide district and regional differences also exist in prevalence of caries in young children. The area differences relate very strongly to deprivation. In adults the differences in decay experience is less unequal than in children but there are marked social class inequalities in edentulousness. Dental caries decreased in all social classes in the United Kingdom. The main causes of the inequalities are differences in patterns of consumption of non milk extrinsic sugars and fluoridated toothpaste. Improvements in oral health that have occurred over the last 30 years have been largely a result of fluoride toothpaste and social, economic and environmental factors. Oral health inequalities will only be reduced through the implementation of effective and appropriate oral health promotion policy. Treatment services will never successfully tackle the underlying cause of oral diseases. [References: 69] <18> UI - 20113834 AU - Crall JJ AU - Szlyk CI AU - Schneider DA IN - Department of Pediatric Dentistry, University of Connecticut Health Center, Farmington 06030-1610, USA. crall@nso.uchc.edu TI - Pediatric oral health performance measurement: current capabilities and future directions. SO - Journal of Public Health Dentistry 1999 Summer;59(3):136-41 AB - This paper offers an overview of performance measurement in health care, provides a synopsis of the findings and recommendations of an Oral Health Expert Panel organized by the National Committee for Quality Assurance (NCQA) under contract with the Health Care Financing Administration (HCFA), and discusses challenges and possible future directions for pediatric oral health care performance measures development. Existing performance measures for pediatric oral health care are extremely limited; however, several new measures have been proposed and are in various stages of development and testing. Measures capable of being implemented in the short-term focus on access and use of services, rely on administrative data sources, and represent refinements and enhancements of current measures. Measures proposed for future implementation focus more on the effectiveness of care, consumer assessments of care and plan performance, and the value of services provided to enrolled children. Recommendations are targeted toward high-risk children who, for the most part, are covered by public programs (e.g., Medicaid and the Children's Health Insurance Program). Nevertheless, the entire set of recommended measures is considered to be relevant to all pediatric populations and applicable to all forms of dental care coverage, including state-administered programs and commercial third party arrangements. <19> UI - 20114140 AU - Brown LJ AU - Wall TP AU - Lazar V IN - American Dental Association, Health Policy Resources Center, Chicago, Ill. 60611, USA. TI - Trends in untreated caries in primary teeth of children 2 to 10 years old. SO - Journal of the American Dental Association 2000 Jan;131(1):93-100 AB - BACKGROUND: This article is the second in a series of three that focus on recent changes in the caries status of children and adolescents in the United States. METHODS: This study is based on analyses of data regarding untreated carious primary teeth among children 2 to 10 years of age from the first and third National Health and Nutrition Examination Surveys, or NHANES I and NHANES III. The NHANES is conducted periodically by the National Center for Health Statistics of the Centers for Disease Control and Prevention. RESULTS: Overall, the number of carious primary teeth among children 2 to 10 years old decreased from 1.42 as measured in NHANES I to 0.63 as measured in NHANES III. The number of carious primary teeth in children 2 to 10 years old also decreased across four demographic variables: age, sex, race and poverty level. CONCLUSIONS: The number of untreated carious primary teeth among children has declined. Since the 1970s, the absolute difference in untreated caries between disadvantaged children in the United States and the rest of the U.S. child population has narrowed, although not to the same extent as in permanent teeth. PRACTICE IMPLICATIONS: On average, children of preschool and elementary-school age have less untreated caries than in the past. More often, dentists do not need to treat on a first visit. This provides more opportunity to introduce these children to preventive dentistry at an early age. <20> UI - 20105829 AU - Flinck A AU - Kallestal C AU - Holm AK AU - Allebeck P AU - Wall S IN - Department of Epidemiology and Public Health, Umea University, Sweden. TI - Distribution of caries in 12-year-old children in Sweden. Social and oral health-related behavioural patterns. SO - Community Dental Health 1999 Sep;16(3):160-5 AB - OBJECTIVE: To describe the distribution of caries in 12-year-old children in Sweden according to socio-demographic and oral health related behaviour. PARTICIPANTS: The study group consisted of 3,373 12-year-old children residing in catchments of 26 different public dental health clinics in Sweden, geographically well represented. METHOD: The clinical examination for dental caries was performed by 28 calibrated dentists. A questionnaire on lifestyle was distributed to the children with questions on ethnicity, socio-economic level and oral health as well as overall health attitudes. RESULTS: The proportion of 12-year-old children with no experience of dentine caries was 47% and 35% were completely free from all caries. Intraoral distribution of caries showed most lesions on the first molar mesial surface, with 80% enamel and 20% dentine caries. Almost all children brushed their teeth twice a day and a third of the children had an extra intake of fluoride. Decayed surfaces including enamel caries (DeS) was chosen as a measure of ongoing caries and used when dividing children into three caries groups; caries free (50%), 1-3 lesions (40%) and the high caries group (10%) with more than 3 lesions. These groups showed distribution differences. More non-Swedish children, children from workers' homes, and children who brushed their teeth less than twice a day were found in the high caries group. More children from workers' homes living in big cities and snacking more than once a week were also found in the high caries group. This could not be shown for other social groups. Also children who had an extra intake of fluoride were classified in the high caries group. <21> UI - 20105824 AU - Evans DJ AU - Howe D AU - Maguire A AU - Rugg-Gunn AJ IN - Newcastle and North Tyneside Health Authority, Newcastle upon Tyne, UK. TI - Development and evaluation of a sugar-free medicines campaign in north east England: analysis of findings from questionnaires. SO - Community Dental Health 1999 Sep;16(3):131-7 AB - OBJECTIVE: To develop a strategy for a campaign aimed at general medical practitioners (GPs) and pharmacists and to evaluate the effectiveness of the campaign on (a) awareness of the role of liquid oral medicines containing sugar in dental disease and (b) changing prescribing and dispensing of sugar-containing medicines. DESIGN: Pre- and post-campaign questionnaires were sent to community pharmacists and GPs and following a series of qualitative interviews with them, a campaign was developed. Following post campaign questionnaires, changes due to the effects of the campaign were evaluated. SETTING: The test area was Newcastle and North Tyneside Health Authority area with Sunderland and South Tyneside Health Authority areas as control. INTERVENTIONS: An information pack followed up by a personal contact was the main form of intervention. The pack comprised a Smile for Sugar-Free Medicines leaflet used in the north west campaign, abstracts from professional journals illustrating the benefits of sugar-free medicines, local dental health information and computing information which could be used to adapt computer terminals in surgeries to display sugar-free options more prominently. MAIN OUTCOME MEASURES: Changes in the knowledge and awareness of both pharmacists and GPs to liquid oral medicines containing sugar as assessed by questionnaires. RESULTS: Increased knowledge and awareness of both pharmacists and GPs to the role of liquid oral medicines containing sugar and the use of sugar-free medicines had taken place but these were not statistically significant. CONCLUSION: The campaign created awareness amongst GPs and pharmacists about dental issues and it is hoped that this awareness can be built upon in future oral health promotion campaigns. However, it is likely that facilitation of sugar-free medicines use will occur only if sustained and constant reinforcement is available. The methodology used presented several difficulties in evaluating change. <22> UI - 20105820 AU - Mascarenhas AK IN - Ohio State University, Columbus, USA. TI - Determinants of caries prevalence and severity in higher SES Indian children. SO - Community Dental Health 1999 Jun;16(2):107-13 AB - OBJECTIVES: Recent epidemiological studies in the economically developing countries show that the prevalence and severity of dental caries has increased with industrialization and exposure of these populations to western diets. The aim of this study was to quantify the caries experience, and identify determinants associated with caries, in a population which has a higher socio-economic status (SES), and is the most westernized in India. BASIC RESEARCH DESIGN: The study site was Goa, a former Portuguese colony, which became part of India in 1961. Data came from a cross-sectional survey of 1,189 seventh grade children in private schools, consisting of a clinical dental examination and a self-administered questionnaire to their parents. MAIN OUTCOME MEASURES: The study used the cavitated/non-cavitated criteria to score for caries, the TF index for fluorosis, and the Silness and Loe index for plaque. RESULTS: The mean age of the children was 12.2 years. The proportion of children caries-free in the permanent dentition was 22.2%. The mean DMFT and DMFS in the study group were 2.78 and 4.20, respectively. The decayed component accounted for over 87% of the DMFT, DMFS, dft, and dfs. Results of the crude, stratified, and multivariate regression analyses showed that poor oral hygiene, mother's highest level of education, use of fluoride toothpaste before the age of six years, and higher frequency of tooth brushing were risk indicators of caries prevalence and severity. CONCLUSION: The findings suggest that risk indicators of caries in this study population were similar to those in developed countries. <23> UI - 20088438 AU - Skaret E AU - Raadal M AU - Berg E AU - Kvale G IN - Center for Odontophobia, Faculty of Odontology, University of Bergen, Norway. erik.skaret@odont.uib.no TI - Dental anxiety and dental avoidance among 12 to 18 year olds in Norway. SO - European Journal of Oral Sciences 1999 Dec;107(6):422-8 AB - The aim of this study was to explore the prevalence and possible explanatory factors of dental avoidance due to dental anxiety among 12 to 18 year olds treated within the Norwegian Public Dental Service. A total of 754 20-yr-olds completed a questionnaire and three psychometric scales, the Dental Fear Scale (DFS), the Dental Beliefs Survey (DBS) and the Geer Fear Scale (GFS), and gave their consent to collect data from their dental records. A total of 169 subjects (22.4%) had high dental anxiety (DFS>59 or DBS>47 at age 20 yr), and 124 subjects (16.4%) had high frequency of missed/cancelled appointments (20% or more) during the period 12-18 yr. Forty-seven subjects (6.2%) fulfilling both of the above criteria constituted the dental avoidance group. An analysis using a stepwise regression model indicated that having had more than one painful or unpleasant treatment experience increased the risk of being included in the avoidance group by a factor of 10.9. Equally, adolescents who were not attending school (working or without specified occupation) increased the risk by a factor of 6.9, having a high caries experience by a factor of 5.0, and not having their dental treatment completed at the age of 18 yr by a factor of 4.4. <24> UI - 20041242 AU - Brown LJ AU - Wall TP AU - Lazar V IN - American Dental Association, Health Policy Resources Center, Chicago, Ill. 60611, USA. TI - Trends in untreated caries in permanent teeth of children 6 to 18 years old. SO - Journal of the American Dental Association 1999 Nov;130(11):1637-44 contd AB - BACKGROUND: This article is the first in a series of three that focus on recent changes in the caries status of children and adolescents in the United States. METHODS: This study is based on analyses of data regarding untreated carious permanent teeth among children 6 to 18 years of age from the first and third National Health and Nutrition Examination Surveys, or NHANES I and NHANES III. The NHANES is periodically conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. RESULTS: Overall, the number of carious permanent teeth among children 6 to 18 years old decreased from 1.43, as measured in NHANES I, to 0.33, as measured in NHANES III. The number of carious permanent teeth in children 6 to 18 years old also decreased across four demographic variables: age, sex, race and poverty level. CONCLUSIONS: The number of untreated carious permanent teeth among children has declined dramatically. Since the 1970s, the absolute difference in untreated caries between disadvantaged children and the rest of the child population has narrowed substantially. PRACTICE IMPLICATIONS: The reduction in untreated caries, the major oral disease among children, has been dramatic in all subgroups of children. This may reinforce the already apparent shift from restorative to preventive dental services. <25> UI - 99448361 AU - Westaway MS AU - Viljoen E AU - Rudolph MJ IN - Medical Research Council, University of the Witwatersrand, Johannesburg. TI - Utilisation of oral health services, oral health needs and oral health status in a peri-urban informal settlement. SO - SADJ 1999 Apr;54(4):149-52 AB - Interviews were conducted with 294 black residents (155 females and 138 males) of a peri-urban informal settlement in Gauteng to ascertain utilisation of oral health services, oral health needs and oral health status. Only 37 per cent of the sample had consulted a dentist or medical practitioner, usually for extractions. Teenagers and employed persons were significantly less likely to utilise dentists than the older age groups and unemployed persons. Forty per cent were currently experiencing oral health problems such as a sore mouth, tooth decay and bleeding/painful gums. Two hundred and twelve (73 per cent) interviewees wanted dental treatment or advice. Residents who rated their oral health status as fair or poor appeared to have the greatest need for oral health services. The use of interviews appears to be a cost-effective method of determining oral morbidity. <26> UI - 99317465 AU - Swedberg Y IN - Department of Health and Environment, Faculty of Health Sciences, Linkoping, Sweden. TI - On the reporting of dental health, time for dental care, and the treatment panorama. SO - Swedish Dental Journal - Supplement 1999;133:1-65 AB - The thesis included five methodological studies and one caries epidemiological investigation, the general aim being to study how to measure and report dental health, time for dental care, treatment panorama, and dental care outcomes, within a Public Dental Service organization. The specific aims were to monitor dental clinic activities using a time study method, to apply time study results of a dental health-related patient group system for the 3-19 year age groups, and to compare time study results with corresponding results from computerized systems used for reporting dental care. Other specific aims were to compare longitudinal caries index data results between cohort and cross-sectional samples, to analyse caries index for extreme caries groups among adolescents leaving organized dental care, and--using time series methods--to analyse dental health development of the 15-19 year age groups. Results from the time studies portrayed the dental clinic as a working unit, showed that reported values can represent dental care only for intervention procedures, and indicated that clinic patterns were not adapted to the health situation of the patient groups. Longitudinal cohort attempts gave different values from those of the cross-sectional year classes, which should be the primary focus when presenting caries index mean values in dental health reviews. Caries-free groups from 15 to 19 years of age seem to be stable in their caries development in about 60%-80% of cases; while the 20% groups with the highest index values accounted for about 80% of all approximal lesions. In times of major economic adjustment, dental health for adolescents in Goteborg was an example of sustainable dental health development. A model system for monitoring, analysing, and reporting dental health and dental care outcomes within a dental care-giving organization calls for several conditions, for example, a dental health-related patient group system, and a rationale for the choice of dental team models. These areas could be gathered into a system where contemporary socio-economic factors and dental research results interact with performed dental care, and also with different methods for reporting and evaluating dental health, dental care costs, and the demand for dental care competence. <27> UI - 99312080 AU - Kumar JV AU - Swango PA IN - Bureau of Dental Health, New York State Department of Health, Albany 12237-0619, USA. jvk01@health.state.ny.us TI - Fluoride exposure and dental fluorosis in Newburgh and Kingston, New York: policy implications. SO - Community Dentistry & Oral Epidemiology 1999 Jun;27(3):171-80 AB - 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. <28> UI - 99243306 AU - Zimmer S AU - Robke FJ AU - Roulet JF IN - Charite, Humboldt-University Berlin, School of Dentistry, Dept. of Operative and Preventive Dentistry, Germany. stefan.zimmer@t-online.de TI - Caries prevention with fluoride varnish in a socially deprived community. SO - Community Dentistry & Oral Epidemiology 1999 Apr;27(2):103-8 AB - It has been suggested that specific preventive programs be developed for children with high caries risk. One possibility is to consider whole classes in socially deprived schools as caries-risk groups and perform an intensified preventive program for the entire class. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of such a program which includes the application of a fluoride varnish (Duraphat). METHODS: The application of the varnish was offered three to four times a year in a community with low socio-economic status and a generally high caries level. Two hundred and sixty-nine children in six primary schools of Linden/Limmer, a district in Hannover, Germany, were allocated to a test or a control group. The test group received the fluoride varnish for 4 years whereas the control group received no professional fluoride application. DMFT was recorded at the beginning of the study and after 4 years. RESULTS: At the end of the study, children who had received a minimum of two fluoride applications per year showed a significantly lower caries increment in comparison with the control group (0.88 DMFT vs 1.39 DMFT, P < 0.05). CONCLUSIONS: It can be concluded that a minimum of two applications of the fluoride varnish Duraphat per year may be an effective measure in preventing caries in socially deprived children with high caries activity. <29> UI - 99243305 AU - Gaughwin A AU - Spencer AJ AU - Brennan DS AU - Moss J IN - South Australian Dental Service, University of Adelaide, Australia. aihw.dsru@dentistry.adelaide.edu.au TI - Oral health of children in South Australia by socio-demographic characteristics and choice of provider. SO - Community Dentistry & Oral Epidemiology 1999 Apr;27(2):93-102 AB - Australia has a highly developed school dental program for providing dental care to schoolchildren which operates alongside well-established private practice delivery of dental care. While free school-based dental care has high utilisation where offered, little is known about the oral health outcomes of groups of children across different providers of dental care, or patterns of service use. This paper investigates the effects of socio-demographic characteristics and choice of dental provider on oral health amongst a random sample of secondary school students residing in Adelaide, South Australia. OBJECTIVES: To describe the oral health of children by different dental provider groups, to describe the association of socio-demographic characteristics with oral health outcomes; and to describe the differences in oral health that remained after controlling for socio-demographic confounding, by dental provider group. METHODS: The study included metropolitan Adelaide schoolchildren from Year 9 and 10 school grades (n = 373). RESULTS: Children who received care from the School Dental Service (SDS) and from both the SDS and private dentists (Mixed) had significantly lower caries experience (DMFS) than children who received care from private dentists (Private) or who had not received any care for at least 2 years (No Recent Care). There were differences in the socio-demographic characteristics between children who used different dental providers, and these socio-demographic characteristics were significantly associated with levels of decayed, missing and filled surfaces and surfaces which had been fissure sealed. After controlling for socio-demographic characteristics using multiple regression, significant differences were seen in mean caries experience (DMFS) and mean numbers of decayed surfaces and filled surfaces. CONCLUSION: Although from less advantaged backgrounds, children seen through the SDS had more favourable oral health outcomes than children seen by a private dentist. <30> UI - 99230647 AU - Albert DA IN - Division of Community Health, Columbia University School of Dental and Oral Surgery, USA. TI - Sealant use in public and private insurance programs [see comments]. CM - Comment in: N Y State Dent J 1999 Feb;65(2):24-5 SO - New York State Dental Journal 1999 Feb;65(2):30-3 AB - Dental sealants are a safe and efficacious method for preventing caries in pits and fissures. An increase in sealant use has been observed in the NHANES III survey. However this increase still accounts for less than one fifth of children aged 5-17 having sealants on their teeth. Reimbursement and coverage of sealants by public and private insurance programs have lagged behind the widespread acceptance of this methodology by the profession. Medicaid preventive services are poorly used by patients and the profession: and the inclusion of sealants in traditional, indemnity, fee-for-service commercial plans has been inconsistent. Managed care programs include dental sealants, but lack financial incentives to increase their use. <31> UI - 99241534 AU - Pine CM IN - University of Dundee, Scotland, UK. TI - Deprivation and inequalities in women's health: smoking, an oral cancer, and child dental health. SO - Journal of Dental Education 1999 Mar;63(3):276-80 <32> UI - 99213083 AU - Hughes T AU - Bawden JW IN - Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, USA. TI - A survey of private pediatric dental practices in North Carolina. SO - Pediatric Dentistry 1999 Mar-Apr;21(2):104-8 AB - PURPOSE: In response to concerns about current and future demands for specialized pediatric dental care in North Carolina, a survey of private pediatric dental practices was conducted. METHODS: Data were collected on the demographics and other practice variables. Information was also collected on the ages, caries activity, Medicaid status, estimated treatment needs, fluoridation status, and location of residence (urban/rural) of all new patients seen in each practice during three designated, consecutive days in November 1996. RESULTS: The survey response rate was 76%. The data indicated that most pediatric dentists in North Carolina are quite busy. A total of 519 new patients were seen during the three-day survey period. The mean age was 4.7 years and 22% had advanced caries. Forty seven percent were caries free. Most of the disease was found in the primary dentitions of young children. CONCLUSIONS: The findings indicate that the specialized pediatric dental care system in North Carolina is operating close to its capacity and is overtaxed in many areas of the state. <33> UI - 99110705 AU - Angelillo IF AU - Torre I AU - Nobile CG AU - Villari P IN - Medical School, University of Catanzaro, Italy. TI - Caries and fluorosis prevalence in communities with different concentrations of fluoride in the water. SO - Caries Research 1999;33(2):114-22 AB - The need to defluoridate and fluoridate the water supplies in areas with drinking water naturally containing above-optimal (>/=2.5 mg/l) and suboptimal ( UI - 99193228 AU - Thompson GW AU - Schuller PD AU - Lewis DW IN - University of Alberta, Edmonton, Canada. TI - Dental caries knowledge in a group of Northwest Territories children. SO - International Journal of Circumpolar Health 1998;57 Suppl 1:169-73 AB - A total of 953 children in schools in communities in the Northwest Territories was surveyed to determine their attitudes and knowledge about dental decay. A questionnaire was answered by these Native and non-Native children in the Northwest Territories. The median age of the children was 12.5 years. The girls tended to brush their teeth more frequently and consumed less sugared sweets between meals. More of the girls and in particular the Native girls knew about "nursing" caries. The Native students more often than not went for dental treatment when it was necessary. The Native students brushed their teeth less frequently and often learned to brush their teeth on their own. The consumption of sugared sweets between meals was greater in the Native sample. The knowledge level of the factors that affect dental decay rates was lower in the Native group, but was not extremely high in either group. These children should receive more information on oral health practices and be given an opportunity to improve their oral health knowledge. <35> UI - 99218799 AU - Parajas IL AU - Palacios CG TI - Community participation in dental health. SO - Journal of the Philippine Dental Association 1998 Mar-May;49(4):22-8 <36> UI - 99099778 AU - Waldman HB AU - Perlman SP AU - Swerdloff M IN - Department of General Dentistry, State University of New York at Stony Brook 11794-8706, USA. TI - Dental care for children with mental retardation: thoughts about the Americans with Disabilities Act. SO - ASDC Journal of Dentistry for Children 1998 Nov-Dec;65(6):487-91, 439 AB - The Americans with Disabilities Act bars discrimination in public accommodations, housing, employment and health care for people with disabilities. Efforts to "mainstream" (in housing and education) many of the individuals with mental retardation have altered the setting for dental services and place demands for services by dental practitioners in the community. These developments should be considered within the jurisdiction of this new legislation. Demographic characteristics and dental needs of children with mental retardation are reviewed to provide a background for this discussion. <37> UI - 99139136 AU - Marshall N TI - What has general dental practice got to offer?. SO - Community Dental Health 1998 Dec;15 Suppl 1:301-3 <38> UI - 99139135 AU - Pitts NB IN - Dental Health Services Research Unit, University of Dundee, UK. TI - Inequalities in children's caries experience: the nature and size of the UK problem. SO - Community Dental Health 1998 Dec;15 Suppl 1:296-300 AB - OBJECTIVE: To discuss, as part of a symposium on 'Dental Care for the Disadvantaged Child', the inequalities in caries experience between a minority of children who demonstrate substantial dental disease and have, as a consequence, a considerable need for dental care and the majority who have little disease. METHOD: 1) Analysing data from regular NHS surveys of the dental health of British children in a number of defined age groups and examining socio-economic factors which operate and influence levels of dental caries to answer questions such as "Do we understand which children need and get appropriate dental care?". 2) Considering how appropriate future needs may be identified and addressed, and the gap between academic acceptance of new methodology and use by dental professionals may be narrowed. CONCLUSIONS: Integrated approaches to prevention should be focused on those children who have the greatest need in addition to the provision of appropriate, clinically effective, preventive and operative care for all children. <39> UI - 99139133 AU - al Shammery A AU - el Backly M AU - Guile EE IN - Department of Restorative Dental Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia. TI - Permanent tooth loss among adults and children in Saudi Arabia. SO - Community Dental Health 1998 Dec;15(4):277-80 AB - OBJECTIVE: The objective of this study was to assess tooth loss among various age-groups in Saudi Arabia as a part of a national epidemiological study on oral conditions. DESIGN: Methodology was based on the WHO International Collaborative Study II. The sampling strategy covered Kingdom-wide sites in 10 regions with stratified cluster random samples. Data collection was confined to age-groups 6 to 7, 12 to 13, 15 to 19, 20 to 29, 35 to 44 and 65 to 74 years. SETTING: Children and adults from the schools and households of the ten provinces of Saudi Arabia. Clinical examinations were performed in daylight to determine oral clinical status and the prevalence of tooth loss. SUBJECTS: A total of 7,377 children and adults in the specified age-groups. OUTCOME MEASURES: Loss of permanent teeth assumed due to caries, assessed on clinical examination. Examiners reliability was calibrated using the kappa statistic. RESULTS: Tooth loss due to caries was 0.03 in the 6 to 7-year age-group; 0.12 at 12 to 13 years; 0.29 at 15 to 19 years; 1.24 at 20 to 29 years; 4.15 at 35 to 44 years; and 15.79 in the 65 to 74-year age-group. When compared by gender, a statistically significant difference was found between males and females for those aged 6 to 7, 15 to 19, 20 to 29, and 35 to 44 years. CONCLUSIONS: This study indicated that tooth loss increases with age and differs for gender and socio-economic status. No differences found based on city or rural lifestyles. <40> UI - 99094521 AU - Skaret E AU - Raadal M AU - Kvale G AU - Berg E IN - Center for Odontophobia, Faculty of Odontology, University of Bergen, Norway. erik.skaret@odont.uib.no TI - Missed and cancelled appointments among 12-18-year-olds in the Norwegian Public Dental Service. SO - European Journal of Oral Sciences 1998 Dec;106(6):1006-12 AB - The aims of this study were to evaluate the prevalence and distribution of missed and cancelled dental appointments in the Norwegian Public Dental Service during the age period from 12 to 18 yr, and to explore possible relationships with demographics and individual caries experience (DMFT). A total of 968 patients (86.5% of the sample) gave their consent to collect data from their dental records. Forty-seven % of the group had missed and 26% had cancelled one or more dental appointments. A total of 13.6% had missed more than 20% of their appointments. Missed and cancelled appointments were to a great extent related to different individuals. The frequency of individuals with missed and cancelled appointments showed an almost linear increase from age 12 to 18 yr, and the mean individual frequency increased from 1.1 to 11.8% for missed appointments and from 0.7 to 4.8% for cancelled appointments. Subjects with missed appointments had a significantly higher mean DMFT at the age of 18 compared with the rest of the group. Individuals with missed and cancelled appointments may represent a risk group for future dropout from dental care which should be further analyzed. <41> UI - 99086082 AU - Powell LV IN - Restorative Dentistry, University of Washington, Seattle 98126, USA. lvpowell@u.washington.edu TI - Caries prediction: a review of the literature. [Review] [48 refs] SO - Community Dentistry & Oral Epidemiology 1998 Dec;26(6):361-71 AB - For over a decade researchers have been looking for the formula that will allow caries prediction. The purpose of this summary is to review recent multifactorial prediction models for adults and children with the aim of identifying the most successful and consistent methods. Conclusions from this review include the following: Clinical variables, especially past caries experience, are confirmed as the most significant predictors of future caries development. The status of the most recently erupted/exposed surface is the most successful measure of past caries experience. Bacterial levels are included in the most accurate prediction models. Sociodemographic variables are most important to caries prediction models for young children and older adults. [References: 48] <42> UI - 99122128 AU - Kmietowicz Z TI - Decline and fill. SO - Nursing Times 1998 Nov 18-24;94(46):28-9 <43> UI - 99126900 AU - Gugushe TS AU - du Plessis JB IN - Department of Community Dentistry, Medical University of Southern Africa, Medunsa. TI - Regional urban-rural distribution of dental caries experience in Swaziland. SO - SADJ 1998 Aug;53(8):409-12 AB - Understanding the regional and countrywide urban-rural distribution of dental caries in Swaziland was considered important for the formulation of a National Oral Health Policy based on the Primary Health Care Approach. A National Oral Health survey was undertaken in Swaziland at the request of the ministry of health. Part of the objective of this study was to establish the regional urban-rural distribution of dental caries in Swaziland. For the 6-18 year olds a cluster sampling technique by schools was used to get a representative sample. For the 35-44 year age group a simple random sampling technique was used in areas of employment influenced by regional and urban-rural distribution. All examinations were carried out using the WHO 1987 criteria. More than 90 per cent of the mean dmft of 6 and 12 year olds was comprised of the decayed component of the dmft/DMFT. The level of restorative care (ft/dmft, FT/DMFT) was low for all age groups. For the 6 and 12 year olds in the Lubombo region there was a significant difference (p < 0.05) in the urban-rural caries experience. When regional data for 6 and 12 year olds were pooled, the difference in urban-rural caries experience is also significant (p < 0.05). For the older age groups there was no significant difference (p > 0.05) in the regional urban-rural caries experience. This study indicates that the oral health care system in Swaziland with its limited resources, should focus its attention on the younger age groups especially in urban areas as far as dental caries treatment needs and preventive programmes are concerned. <44> UI - 99006589 AU - Mascarenhas AK IN - Section of Health Services Research, College of Dentistry, The Ohio State University, Columbus, USA. mascarenhas.1@osu.edu TI - Oral hygiene as a risk indicator of enamel and dentin caries. SO - Community Dentistry & Oral Epidemiology 1998 Oct;26(5):331-9 AB - Dental researchers have postulated that the risk factors for enamel and dentin caries may not be the same. A review of the literature ascertained that data to support this theory are lacking. OBJECTIVES: To evaluate the risk indicators of enamel and dentin caries of the permanent dentition in a study group who had limited access to fluorides and made limited use of dental services. METHODS: The study was conducted in Goa, India. Data came from a cross-sectional survey of 1189 seventh grade children, which consisted of a clinical dental examination and a self-administered questionnaire to their parents. The cavitated and non-cavitated criteria were used to score for caries, and the Silness-Loe index for plaque. RESULTS: The mean age of the children was 12.2 years. The percentage of children caries free in the permanent dentition was 22.2%, the mean+/-s for dmfs, enamel and dentin lesions were 4.20+/-5.10, 2.59+/-2.89 and 1.61+/-3.30 respectively, and the mean plaque score was 1.00+/-0.48. Results of regression analyses showed that the risk indicators of prevalence and severity of caries differed depending on lesion type. The only variable that was consistently a risk indicator of presence and severity of both dentin and enamel caries was poor oral hygiene. Mother's highest level of education and presence of fluorosis were also risk indicators of enamel and dentin caries. The presence of decayed primary teeth was a risk indicator of enamel caries; and fluorosis severity, use of fluoride toothpaste at the time of the survey, and toothbrushing frequency were risk indicators of dentin caries. The observed caries-oral hygiene association seen is explored further. <45> UI - 99035979 AU - Eklund SA AU - Pittman JL AU - Smith RC IN - University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor, Mich. 48109-2029, USA. TI - Trends in per-patient gross income to dental practices from insured patients, 1980-1995. SO - Journal of the American Dental Association 1998 Nov;129(11):1559-65 AB - The authors discuss changes that occurred in per-patient gross income to dental practices from insured patients between 1980 and 1995. The current young-adult cohort appears to provide lower per-patient practice incomes compared with earlier young-adult cohorts. These changes may be the result of differences in the need for restorative care among young adults who benefited from the childhood caries decline of the 1970s and 1980s. If this reduced use of restorative services pattern persists as this young-adult cohort and succeeding cohorts age, the effect on dental practices could be substantial. <46> UI - 99058531 AU - Kumar JV AU - Swango PA AU - Lininger LL AU - Leske GS AU - Green EL AU - Haley VB IN - New York State Department of Health, Albany 12237-0619, USA. TI - Changes in dental fluorosis and dental caries in Newburgh and Kingston, New York. SO - American Journal of Public Health 1998 Dec;88(12):1866-70 AB - OBJECTIVES: This study sought to determine whether the prevalence of dental fluorosis and dental caries had changed in a fluoridated community and a nonfluoridated community since an earlier study conducted in 1986. METHODS: Dental fluorosis and dental caries data were collected on 7- to 14-year-old lifelong residents (n = 1493) of Newburgh and Kingston, NY. RESULTS: Estimated dental fluorosis prevalence rates were 19.6% in Newburgh and 11.7% in Kingston. The greatest disparity in caries scores was observed between poor and nonpoor children in nonfluoridated Kingston. CONCLUSIONS: The prevalence of dental fluorosis has not declined in Newburgh and Kingston, whereas the prevalence of dental caries has continued to decline. <47> UI - 98456640 AU - McDerra EJ AU - Pollard MA AU - Curzon ME IN - Department of Pediatric Dentistry, Leeds Dental Institute, England. TI - The dental status of asthmatic British school children. SO - Pediatric Dentistry 1998 Jul-Aug;20(4):281-7 AB - PURPOSE: This study was performed to determine the prevalence of dental disease in British school children with asthma. METHODS: A convenience sample of 100 asthmatic children (aged 4-16 years) was examined for dental caries, periodontal condition, and tooth surface loss. School children, equated for age, sex, race, and socioeconomic status were chosen for comparison. Children were divided into two age ranges; 4-10 and 11-16 years. A significant difference was found in DMFT (0.96 vs. 0.31) and DMFS (1.37 vs. 0.37) between the 4-10-year-old asthmatic children compared with healthy control children. RESULTS: In the 11-16-year age range, the asthmatic children had a DMFT and DMFS of 2.48 and 3.39 compared with the control children who had a DMFT and DMFS of 1.11 and 1.97 respectively. Asthmatic children had significantly more plaque, gingivitis, and calculus compared with the control group. There was a significant difference in the severity and number of teeth affected by tooth surface loss affecting labial surfaces of the anterior teeth and occlusal surfaces of the posterior teeth of asthmatic children. CONCLUSIONS: It was concluded that asthmatic children have more decay affecting their permanent teeth, poorer periodontal status, and more tooth surface loss than healthy controls. <48> UI - 98362871 AU - Lipetz J IN - Ealing, Hammersmith and Hounslow Health Authority. TI - The use of fluoride in the UK's water supply has been shown to improve the health of children's teeth. SO - Nursing Times 1998 Mar 18-24;94(11):45 <49> UI - 98452105 AU - el-Nadeef MA AU - Adegbembo AO AU - Honkala E IN - Division of Dental Infectious Diseases, University of Helsinki, Finland. TI - The association of urbanisation with the prevalence of dental caries among schoolchildren in Nigeria new capital territory. SO - International Dental Journal 1998 Feb;48(1):44-9 AB - The aim of this study was to examine the association of urbanisation and social class with dental caries. A multi-stage stratified cluster sampling technique was used to select schoolchildren (n = 915). Clinical examination was carried out in daylight according to WHO criteria. The distribution of the subjects between strata was: 315 (urban); 303 (semi-urban) and 297 (rural). The mean age of subjects in each strata was 11.4 years. The mean number of decayed teeth (DT) in the respective strata were 27 per cent; 24 per cent; and 12 per cent. Urban children and semi-urban had higher risk for caries than their rural reference group. Urbanisation had no significant effect on the caries prevalence when social class was controlled except among subjects from the low social class in semi-urban areas. The development of satellite towns around big cities do have implications for planning oral health services. <50> UI - 99009620 AU - Waplington JA AU - White DA AU - Clarke JR IN - University of Birmingham, School of Dentistry, UK. TI - A comparison of the social backgrounds and dental health of patients attending the Community Dental Service, the General Dental Service and non registered patients. SO - Community Dental Health 1998 Jun;15(2):93-6 AB - OBJECTIVE: To compare the dental health and social backgrounds of children in Southern Birmingham registered with the General Dental Service (GDS), the Community Dental Service (CDS) and those who were not registered with a dentist. DESIGN: Data characterising children as either registered with the GDS or not registered, which had been collected for a study in 1993/4 were analysed to distinguish those children attending the CDS within Southern Birmingham. The children were divided into three groups; those registered with the GDS, those attending the CDS and those not registered with a dentist. SUBJECTS: Three thousand two hundred and five eight-year-old children who attended schools in Southern Birmingham. RESULTS: Of the children attending the CDS 74% were in the lowest ACORN category compared with 44% of those registered with GDS. Only 10% of the children registered with the GDS were of Asian ethnic origin compared with 54% of those attending the CDS. The dmft of children from the same ethnic background and ACORN category was found to be higher in those children registered with the GDS (3.15 +/- 2.75) than those who were not registered (2.17 +/- 2.58), due to more filled and missing teeth. CONCLUSIONS: A higher proportion of children attending the CDS in Southern Birmingham come from a deprived social background and are of Asian ethnic origin than those registered with the GDS. The dental health of these children differs between those who have attended a dentist (GDS or CDS) and those who are non-registered (P < 0.05). <51> UI - 98413383 AU - Maupome G IN - Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada. TI - An introspective qualitative report on dietary patterns and elevated levels of dental decay in a deprived urban population in northern Mexico [published erratum appears in ASDC J Dent Child 1998 Nov-Dec;65(6):437]. SO - ASDC Journal of Dentistry for Children 1998 Jul-Aug;65(4):276-85, 230 AB - Disorganized urbanization in Latin America has led to masses of impoverished people to become squatters in the larger urban areas. Using a community development network in the outskirts of Tijuana, in Northern Mexico, this investigation assessed the dental health situation, aiming to establish the underlying behavioral causes of poor oral health in these slums. Using quantitative and qualitative tools, fifty-six mothers (mean age 30.1 +/- 7.2) with their accompanying children (n = 56; mean age 6.1 +/- 3.3; 46.4 percent female) were interviewed and examined. Dental health was poor and characterized by vast unmet treatment needs in adults and children. 22.2 percent of children under three years of age suffered from Early Childhood Caries, strongly linked to inappropriate patterns of bottle use. Dietary patterns for the overall child population included many cariogenic snacks and beverages. A straightforward model to explain behavioral structures incorporates these findings against the background of living in a highly-deprived environment, whereby the allure of more affordable gratifications for self and family is often translated in the form of tokens such as junk food. <52> UI - 98410985 AU - Norhayati binti Moktar M AU - Noor Hayati MI AU - Nor Fariza N AU - Rohani AK AU - Halimah AS AU - Sharom MY AU - Zainal Abidin AH IN - Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur. hayati@medic.ukm.my TI - Health status of Orang Asli (aborigine) community in Pos Piah, Sungai Siput, Perak, Malaysia. SO - Southeast Asian Journal of Tropical Medicine & Public Health 1998 Mar;29(1):58-61 AB - A study of health status of Orang Asli population (based on physical examination findings) was conducted in 4 villages in Pos Piah, Sungai Siput Perak, Malaysia. In all 356 individuals between 4 months-72 years old (178 males and 178 females) participated in this study. Poor general health status, physical and mental handicaps were seen in 7.8%, 0.3% and 0.3% of the population, respectively. About one-fifth of the population had dental caries. Splenomegaly, hepatomegaly and hepatosplenomegaly were among the commonest abnormalities with the occurrence rates of 19.8%, 13.7% and 6.7%, respectively, being detected in the population. About one-fifth of the population showed signs suggestive of protein-energy deficiency; whilst less than 5% showed signs indicative of riboflavin, iodine and iron deficiencies. Vitamin A deficiency was the commonest nutritional deficiency identified in this community with almost 38.4% of them showing signs of the deficiency. The commonest skin infection was scabies. <53> UI - 98353063 AU - Angelillo IF AU - Anfosso R AU - Nobile CG AU - Pavia M IN - Medical School, University of Reggio Calabria, Catanzaro, Italy. TI - Prevalence of dental caries in schoolchildren in Italy [published erratum appears in Eur J Epidemiol 1998 Oct;14(7):733]. SO - European Journal of Epidemiology 1998 Jun;14(4):351-7 AB - The caries experience and its potential risk indicators such as socioeconomic status, sweets consumption, toothbrushing habits, dental visit attendance pattern and salivary mutans streptococci (in 12 year old only), were assessed in schoolchildren raised and living in low fluoridated areas (Catanzaro, Italy). Caries-free prevalence in the 6-year-old was 52.9% in their primary dentition; the dmft and dmfs were 2.1 and 5.1, and both DMFT and DMFS were 0.1. Almost 91% of the dmft was attributable to active decay. The proportion of children with a dmft+DMFT > or = 1 and the dmft and dmfs were significantly higher in those with low socio-economic status. In the 12-year-old, 52.7% had a history of caries and the DMFT and DMFS were 1.5 and 2.6; the filled component was the dominant proportion. The more likely they visited a dentist for routine checkup, the higher socio-economic status (it was not associated with DMFT), the less frequently they had sweets, and the low level of Streptococcus mutans, the more likely they were caries-free and the less likely they were to have a high DMFT, DMFS, and DT. In the 15-year-old, 68.8% had a history of caries and the DMFT and DMFS were 2.8 and 4.8, with a higher prevalence of the F component. The children who visited a dentist for routine checkup had a significantly lower caries experience, DMFT, DMFS, and DT than the irregular attenders, and those with low socio-economic background were more likely to have a high DMFS. <54> UI - 98439241 AU - Vargas CM AU - Crall JJ AU - Schneider DA IN - National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md. 20782, USA. TI - Sociodemographic distribution of pediatric dental caries: NHANES III, 1988-1994 [see comments]. CM - Comment in: J Am Dent Assoc 1998 Nov;129(11):1526 SO - Journal of the American Dental Association 1998 Sep;129(9):1229-38 AB - This article examines the extent to which caries prevalence and untreated caries vary in children by ethnicity and household income level. Data from the Third National Health and Nutrition Examination Survey, 1988-1994, for 10,332 children 2 to 18 years of age indicate that lower-income children and Mexican-American and African-American children are more likely to have a higher prevalence of caries and more unmet treatment needs than their higher-income and non-Hispanic white counterparts. <55> UI - 98334277 AU - Horowitz HS TI - Research issues in early childhood caries [see comments]. [Review] [89 refs] CM - Comment in: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):82-3 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):67-81 AB - Research is needed to establish what nomenclature and case definition for early childhood caries (ECC) are most relevant to health care professionals and to the public. Profiles or indexes for predicting the prevalence of ECC in communities should be developed on the basis of the socioeconomic factors, immigrant status and ethnic/racial backgrounds of populations. Future research should target risk factors of ECC, particularly prenatal and perinatal histories, nutritional status and microbiologic factors. Determining the relation of malnutrition of infants and young children, low birthweight, complicated pregnancies and traumatic births with the development of enamel linear hypoplasia deserves research attention. Factors that affect how and when infants and young children are colonized by mutans streptococci also need further study. The evaluation of chemotherapeutic preventive agents will likely yield more fruitful interventions for prevention than trying to change behaviors. Research in young children to prevent ECC, however, has particular ethical considerations. Withholding treatments or administering placebos to vulnerable subjects is not acceptable. Consequently, future clinical research likely will determine the relative rather than the absolute effectiveness of preventive regimens; the former requires large sample sizes and may necessitate multi-center studies. Human studies may be hampered by problems of recruitment, compliance and transiency of subjects. Because federal support for research on dental caries has declined in recent years, a special initiative that focuses specifically on ECC may be necessary to obtain adequate funding for research on the disease. [References: 89] <56> UI - 98334284 AU - Tinanoff N AU - Kaste LM AU - Corbin SB IN - Department of Pediatric Dentistry, School of Dental Medicine, University of Connecticut Health Center, Farmington 06030-1610, USA. tinanoff@idx.uchc.edu TI - Early childhood caries: a positive beginning. SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):117-9 AB - Early childhood caries (ECC) is among the most prevalent health problems of low-income infants and toddlers, yet little attention and few resources have been allocated to understanding this disease. Since dental caries in infants and toddlers cannot be exclusively ascribed to feeding practices, other concepts regarding its etiology and prevention need to be examined. Furthermore, the establishment of evidence-based policies regarding this basic health problem is critical for the dissemination of consistent standards of care to health care providers and government agencies. To accomplish these objectives, the scientific community, organizations concerned with children's health and the political process need to be energized to find resources and energy to solve this public health challenge. <57> UI - 98334282 AU - Lopez GM IN - grantomate@aol.com TI - Response to Edelstein: policy issues in early childhood caries [comment]. CM - Comment on: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):96-103 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):104-5 AB - This paper is a response to Dr Edelstein's paper on policy related to early childhood caries (ECC) and makes specific recommendations for policy that would have impact on ECC. The review by Dr Edelstein shows that currently there is little policy addressing the problems of ECC. The following specific policy suggestions are made: 1) Health Care Finance Administration should require the same accountability for well child dental checkups as they do for well child medical checkups; 2) The Special Supplemental Nutrition Program for Women, Infants and Children should include an oral health component in the physical evaluation visit; 3) The Centers for Disease Control and Prevention should set up a surveillance system for ECC; 4) continuing education courses should offer classes to health care workers in infant oral health; and 5) research must be aimed at practical preventive and treatment modalities. <58> UI - 98334279 AU - Weinstein P IN - Dental Public Health Sciences, University of Washington, Seattle 98195-7475, USA. philw@u.washington.edu TI - Public health issues in early childhood caries [see comments]. [Review] [61 refs] CM - Comment in: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):91-5 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):84-90 AB - Early childhood caries (ECC) is primarily a disease of poor, minority population children who generally have limited access to dental services. Public health dental clinics have not made the prevention and control of ECC a priority, and the services provided have not controlled ECC. New training and early screening are recommended. Additionally, repeated accessing of mothers and children through prenatal and postnatal medical visits is recommended. At such visits behavioral and chemotherapeutic strategies need to be utilized. Examples from a demonstration project in the Commonwealth of Northern Marianas are presented. [References: 61] <59> UI - 98334275 AU - Ismail AI IN - Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, The University of Michigan, Ann Arbor 48109-1078, USA. ismailai@umich.edu TI - Prevention of early childhood caries. [Review] [96 refs] SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):49-61 AB - This paper reviews the methods used for the prevention of early childhood caries (ECC). The education of mothers or caregivers to promote healthy dietary habits in infants has been the main strategy used for the prevention of ECC. This review found that education has a modest impact on the development of ECC. While education should be promoted especially in high risk communities and population groups (low-income families and native populations), it should not be the only preventive strategy of ECC. Early screening for signs of caries development, starting from the first year of life, could identify infants and toddlers who are at risk of developing ECC and assist in providing information to parents about how to promote oral health and prevent the development of tooth decay. High risk children include those with early signs of ECC, poor oral hygiene, limited exposure to fluorides, and frequent exposure to sugary snacks and drinks. These children should be targeted with a professional preventive program that includes fluoride varnish application, fluoridated dentifrices, fluoride supplements, sealants, diet counseling, and chlorhexidine. Prevention of ECC also requires addressing the social and economic factors that face many families where ECC is endemic. [References: 96] <60> UI - 98334273 AU - Reisine S AU - Douglass JM IN - Department of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, Farmington 06030-3910, USA. reisine@nsol.uchc.edu TI - Psychosocial and behavioral issues in early childhood caries [see comments]. [Review] [130 refs] CM - Comment in: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):45-8 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):32-44 AB - Rampant caries in infants and young children has long been recognized as a clinical syndrome referred to by various names, including nursing caries, nursing bottle syndrome, night bottle mouth, and baby bottle tooth decay. The common theme among these terms is the perceived central role of inappropriate use of the baby bottle in the etiology and progression of carious lesions. Use of the baby bottle is not the only, and may not be the most important, factor in caries development. Because of questions about the role of the baby bottle in caries among young children, the Centers for Disease Control and Prevention recently suggested that the term for this clinical syndrome be replaced with early childhood caries (ECC). The purpose of this paper is to evaluate the literature on the influence of psychosocial and behavioral factors in early childhood caries. Prevalence of caries and maxillary anterior decay varies greatly in developed and undeveloped countries and among socioeconomic groups in developed countries. However, relatively little is known about the onset and progression of the disease or the antecedents of ECC, such as high risk behaviors, cultural norms, health beliefs and attitudes, or health care delivery factors. Furthermore, studies that do exist are limited by small and possibly biased samples and a lack of clear case definition. Future research should aim to develop a clear case definition of ECC, differentiate patterns of caries and conduct community-based epidemiological studies in order to obtain accurate estimates of the etiology and epidemiology of ECC in the general population, as well as in high risk groups. [References: 130] <61> UI - 98331801 AU - Rupp RP TI - Conditions to be considered in the differential diagnosis of child abuse and neglect. [Review] [65 refs] SO - General Dentistry 1998 Jan-Feb;46(1):96-100 AB - Dentists and dental personnel have an obligation to report occurrences of child abuse and neglect (CAN). The general types of abuse and neglect are defined, as is dental neglect. Dental neglect is the "willful failure of parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection." Dentists and dental staff should be trained in recognizing and reporting abuse and neglect. In this training, consideration should be given to dental and medical conditions which mimic CAN. These include tooth fractures, nursing caries syndrome, rampant dental decay, skeletal injuries, dermatologic conditions, and genetic and certain congenital defects. The article reviews literature on the subject and includes photographs of conditions which could be mistaken for CAN. [References: 65] <62> UI - 98219844 AU - Nurko C AU - Aponte-Merced L AU - Bradley EL AU - Fox L IN - University of Alabama at Birmingham, USA. TI - Dental caries prevalence and dental health care of Mexican-American workers' children. SO - ASDC Journal of Dentistry for Children 1998 Jan-Feb;65(1):65-72 AB - The purpose of this study was to determine the prevalence of dental caries and the use of dental services in a pediatric population of Mexican-American migrant workers. The results were compared with the Mexican-American child population from the Hispanic Health and Nutrition Examination Survey (HHANES). One hundred thirty three-to-sixteen-year-old children participated in the study. The children who were born in Mexico and those who spoke Spanish had seen the dentist less often and had a higher incidence of decayed teeth than those who were born in the US and than those who spoke English (p < 0.05). The children from low-income families had visited the dentist less frequently and did so at an older age than those from high income families (p < 0.05). When compared with HHANES, the children in this study visited the dentist at an older age, had been to the dentist less often, were less likely to have dental insurance, and had a higher incidence of dental caries than the children from HHANES (p > 0.05). This study demonstrated a general lack of dental health knowledge, a disproportionate prevalence of decayed teeth and unmet dental need in the Mexican-American migrant workers' children. <63> UI - 98285379 AU - Vanderas AP AU - Kavvadia K AU - Papagiannoulis L IN - Department of Pediatric Dentistry, School of Dental Medicine, University of Athens, Greece. TI - Urinary catecholamine levels and gingivitis in children. SO - Journal of Periodontology 1998 May;69(5):554-60 AB - This study investigated the relationship between gingivitis and emotionally stressful states measured by the urinary catecholamines in children. Three-hundred and fourteen (314) children, boys and girls, aged 6 to 8 years were included in the study. Gingivitis was recorded by the gingival bleeding index and dental plaque by the plaque control record index. Proximal decayed surfaces, faulty restorations, and stainless steel crowns were diagnosed clinically and radiographically. Information concerning systemic and socioeconomic factors was collected by a questionnaire. A 24-hour urine sample was collected for each subject and analyzed by the HPLC technique to assay the catecholamine content. The multiple-regression analysis was carried out to test whether gingivitis was affected by the studied variables. The 95% probability was used. The results showed that epinephrine, norepinephrine, and dopamine did not have a significant association with gingival index. Dental plaque and proximal decayed surfaces significantly affected gingivitis. Of the socioeconomic factors, mother's education had a significant association with gingivitis when all factors were included in the analysis. The data suggest that emotionally stressful states may not increase the probability of developing gingivitis in children of this age. <64> UI - 98225612 AU - Chintakanon K AU - Boonpinon P IN - Department of Dentistry, University of Adelaide, Australia. kchintakanon@dentistry.adelaide.edu.au TI - Ectopic eruption of the first permanent molars: prevalence and etiologic factors. SO - Angle Orthodontist 1998 Apr;68(2):153-60 AB - The purpose of this research was to study the prevalence of ectopic eruption of the first permanent molars and possible etiologic factors. A group of 4,232 Thai students, from 6 to 9 years old, was examined. The prevalence of ectopic eruption of the first permanent molars in the subjects was 0.75%. Both the severity of the ectopic eruption and the amount of root resorption on the second primary molars were more pronounced in the maxilla than in the mandible. The important etiologic factors were the eruption path of the first permanent molars relative to reference lines and the size of the mandibular second primary molars. The amount of proximal caries did not seem to affect the prevalence of ectopic eruption. <65> UI - 98193620 AU - Drum MA AU - Chen DW AU - Duffy RE IN - Division of Science, Education, and Analysis, Maternal and Child Health Bureau, Rockville, MD, USA. TI - Filling the gap: equity and access to oral health services for minorities and the underserved. SO - Family Medicine 1998 Mar;30(3):206-9 AB - BACKGROUND AND OBJECTIVES: Family physicians and other primary care providers play a pivotal role in preventing oral disease, especially among minority and underserved populations who have limited access to dental services and poorer oral health status. Oral diseases/conditions, such as caries, baby bottle tooth decay, gingivitis, periodontitis, oral pharyngeal malignancies, and orofacial trauma, are prevalent and costly, yet largely preventable. Given their role in promoting and protecting overall health and their historical role in serving minority and underserved families, family physicians occupy a unique position to assure equity, access, and improvement in oral health for all Americans. <66> UI - 98170559 AU - Ismail AI AU - Messer JG AU - Hornett PJ IN - School of Dentistry, University of Michigan, Ann Arbor 48109-1078, USA. TI - Prevalence of dental caries and fluorosis in seven- to 12-year-old children in northern Newfoundland and Forteau, Labrador. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1998 Feb;64(2):118-24 AB - In 1993, a cross-sectional oral health survey of 739 randomly selected seven- to 12-year-old Canadian school children was conducted in Forteau (Labrador), Roddickton (northern Newfoundland), and Flower's Cove (northern Newfoundland) to determine the prevalence of dental caries and fluorosis. Children in grades two through six (n = 838) were selected to participate in the survey, which achieved a response rate of 88.2 per cent. Caries prevalence was estimated using modified World Health Organization (WHO) criteria (non-cavitated carious pits and fissures were coded separately from cavitated carious lesions). Fluorosis was measured using the Tooth Surface Index of Fluorosis (TSIF). In-school examinations were carried out by three dentists using portable equipment. There was a significantly higher percentage of caries-free children in Forteau (17.6 per cent) than in Roddickton (7.1 per cent) or Flower's Cove (8.3 per cent). Less than 20 per cent of the children surveyed in all regions had fluorosis. When fluorosis was present, it was mostly of the "very mild" type. Children from Forteau had a significantly lower mean number of decayed permanent teeth than children from the two other regions (1.6 in Forteau, versus 2.7 in Roddickton and 3.4 in Flower's Cove). The mean number of sealed teeth was significantly higher in Forteau children (mean = 1.1) compared with children from Roddickton (mean = 0.3) and Flower's Cove (mean = 0.03). In Forteau children, the F/DMFS2 (non-cavitated carious lesions excluded) ratio was 57 per cent, compared to a ratio of 29 per cent in children from Roddickton and 25 per cent in children from Flower's Cove. Similarly, the mean number of non-cavitated carious pits and fissures were higher than cavitated tooth surfaces by a ratio of 1.5 to 1. The risk markers significantly associated with lower DMFS scores were the number of sealants, lower grade level, college or university education of parents, and residence in Forteau. However, dental caries is endemic in the region and there is a clear need for an accessible school- and community-based oral health promotion and treatment program. In conclusion, this survey found that sealants are effective in preventing dental caries. <67> UI - 98099401 AU - Truin GJ AU - Konig KG AU - Bronkhorst EM AU - Frankenmolen F AU - Mulder J AU - van't Hof MA IN - Department of Preventive and Community Dentistry and Pedodontics, College of Dental Science, University of Nijmegen, The Netherlands. TI - Time trends in caries experience of 6- and 12-year-old children of different socioeconomic status in The Hague. SO - Caries Research 1998;32(1):1-4 AB - The caries experience among 6- and 12-year-old children in the The Netherlands from the mid seventies showed a continued decreasing trend. A halt in the decline of caries experience of the primary dentition of 6-year-olds occurred after 1983, whereas among 12-year-old children the decrease in mean DMFS values continued in the period 1980-1989. The 1996 survey in The Hague showed that the decline in caries in 12-year-old native children of low socioeconomic status (SES) has come to an end (average DMFT of 1.1). However, in medium- and high-SES groups, the percentages of caries-free children have continued to rise. Of the medium-SES 6- and 12-year-old children, 79 and 89% were caries-free, respectively; in the high-SES children the respective figures were 84 and 86%. A DMFT of 0.3 in 12-year-olds of medium and high SES was found, the general value was 0.7 and 74% with zero caries experience. <68> UI - 98118345 AU - Takayama JI AU - Wolfe E AU - Coulter KP IN - Department of Pediatrics, University of California San Francisco 94143-0374, USA. TI - Relationship between reason for placement and medical findings among children in foster care. SO - Pediatrics 1998 Feb;101(2):201-7 AB - OBJECTIVE: To determine the reasons for placement of children in foster care, the prevalence of medical findings during initial placement, and the relationship between reason for placement and medical findings. The association between placement reasons and parental substance abuse also was explored. METHODS: Population-based analysis of medical records of 749 children examined at the Child Protection Center in San Francisco from October 1, 1991, to December 31, 1992. Health evaluations consisted of a clearance examination of children during entry into foster care and a comprehensive examination 3 weeks later. Reasons for foster placement included abandonment, neglect, no available caretaker, physical abuse, sexual abuse, and failed placement. RESULTS: Nearly 50% of children in our study were < 6 years of age. Neglect (30%), physical abuse (25%), and no available caretaker (24%) were the most frequent placement reasons, followed by abandonment (9%), failed placement (7%), and sexual abuse (5%). Substance abuse was documented in 30% of parents, 51% when the placement reason was neglect. Medical findings were identified in 60% of children. Among 0 to 6-year-olds, 27% had upper respiratory illnesses, 23% had developmental delay, and 21% had skin conditions; for children 7 to 12 years of age, 32% failed vision screening, 12% had dental caries, and 11% had upper respiratory illnesses; and among 13- to 18-year-olds, 31% failed vision screening and 12% had positive tuberculin skin tests. For younger children, skin conditions were associated with neglect, no available care taker, and failed placement, and developmental delay with neglect and abandonment. For adolescents, history of psychiatric illness was associated with neglect and failed placement. Marks of abuse for all age groups were limited to children who had been physically abused. Three or more diagnoses were identified for approximately 20% of children who had been neglected or abandoned or had failed placement, compared with 10% of children who had been either physically or sexually abused. CONCLUSIONS: Specific medical findings associated with reasons for placement provide health professionals with additional information to assess more accurately the health care needs of children entering foster care. As important, screening tests revealed high rates of vision problems and exposures to tuberculosis, warranting earlier and more comprehensive screening. Finally, children who have endured variations of neglect or failed placement may have more health problems than anticipated previously. <69> UI - 99459753 AU - Hofling JF AU - Spolidori DM AU - Rosa EA AU - Pereira CV AU - Moreira D IN - Department of Oral Diagnosis, School of Dentistry, University of Campinas, Sao Paulo, Brazil. hofling@fop.unicamp.br TI - Salivary counts of mutans streptococci and lactobacilli in children ageing 6-8 year old having a socioeconomic background in Brazil. SO - Indian Journal of Dental Research 1998 Jul-Sep;9(3):91-7 AB - Saliva samples from students aged 6 to 8 year-old were analysed in order to determine the incidence of Streptococcus group mutans and Lactobacillus. Two hundred children were examined, distributed in five socioeconomic categories (A to E). Stimulated saliva samples were collected and inoculated into the SB20 and Rogsa agar culture medium for the Streptococcus and Lactobacillus cultivation. After growth, the number of these microorganisms (CUF/mL) was determined after identification of the representative colonies by biochemical methods on the basis of carbohydrate fermentation. A significative part of the population, particularly among the lower socioeconomic categories (D/E) was considered a high risk group in developing dental caries because of the high number of Streptococcus group mutans and Lactobacillus. <70> UI - 98064356 AU - Yewe-Dyer M TI - Tooth fairies [letter]. SO - British Dental Journal 1997 Nov 8;183(9):317 <71> UI - 99143524 AU - Chakraborty M AU - Saha JB AU - Bhattacharya RN AU - Roy A AU - Ram R IN - Deptt. of Community Medicine, North Bengal Medical College, Dist. Darjeeling. TI - Epidemiological correlates of dental caries in an urban slum of West Bengal. SO - Indian Journal of Public Health 1997 Apr-Jun;41(2):56-60, 67 AB - The overall prevalence of dental caries was found to be 57.47 percent in an urban slum irrespective of sex, with a maximum of 75.88 percent in the age group of 5-9 years. Habit of taking hard and sticky food, bad oral hygiene were some of the important epidemiological correlates. Fluoride content of drinking water did not show any significant role. <72> UI - 98231303 AU - Eronat N AU - Koparal E IN - Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkiye. eronatn@dishekimligi.ege.edu.tr TI - Dental caries prevalence, dietary habits, tooth-brushing, and mother's education in 500 urban Turkish children. SO - Journal of Marmara University Dental Faculty 1997 Sep;2(4):599-604 AB - 500 children with ages ranging between 2 and 13 years and their families joined the study. A detailed questionnaire and a 3-day food intake diary were evaluated to find the relationship between dental caries and dietary habits. It is concluded that the prevalence of caries increases by frequent and high sugar consumption. With lower age and lower caries experience followed a more balanced diet. There was an inverse relationship between caries prevalence and the mothers' educational level. The percentage of children who never or irregularly brushed their teeth was highest in the caries active group. <73> UI - 98219317 AU - Kuthy RA AU - Siegal MD AU - Wulf CA IN - Health Services Research, Ohio State University College of Dentistry, Columbus 43210-1241, USA. kuthy.1@osu.edu TI - Establishing maternal and child health data collection priorities for state and local oral health programs. SO - Journal of Public Health Dentistry 1997 Fall;57(4):197-205 AB - OBJECTIVE: This paper identifies specific data items for use by state and local agencies in a maternal and child oral health needs assessment model. METHODS: A modified Delphi approach was used to develop consensus on items for inclusion in the data set and their relative importance. Initially, 31 data items were chosen from several national sources. All state dental directors, along with other selected administrators and advisory committee members for this process, were asked to categorize each of the data items as core (essential), important but optional, or of lesser importance. Short comments about each data item were accepted, as were additions to the list of data items. Two rounds of comments were held. RESULTS: Eleven data items/types of information were selected as core items to be included in all needs assessments. All but one of these items were determined by the scores of the respondents. The advisory committee strongly recommended that at least one core item relate to the public's perception of oral health. Some differences in perceived importance of several items existed among the state dental directors, local dental directors, and the advisory committee. Twenty-one items were identified as being important, but optional, and seven were considered less than important and not included in the model data set. CONCLUSIONS: A modified Delphi approach facilitated the development of core and optional data items for a model oral health needs assessment. This model has potential for a common reporting mechanism so that states and local dental programs can share data. <74> UI - 98127163 AU - Warren JJ AU - Hand JS AU - Yao JH IN - Department of Preventive and Community Dentistry, University of Iowa, College of Dentistry, Iowa City, USA. TI - First-molar caries experience among Taiwanese first-grade children. SO - ASDC Journal of Dentistry for Children 1997 Nov-Dec;64(6):425-8 AB - Evidence suggests that dental caries levels may have risen dramatically among Taiwanese children during the past twenty years. Accurate and consistent methods of assessing the dental caries in Taiwanese children, however, have not been widely employed. This project assessed, in detail, the caries status of 333 first grade children attending four schools in Taiwan. Mean DMFS and DMFT computed solely from first-molar data for these children were 1.46 and 1.19, respectively. Mean DMFS for females was 1.57, while for males it was 1.35. Overall, 48 percent of the children were caries-free in their permanent first molars. Nearly 90 percent of DMF was "decayed," while the remainder was "filled." Children from families in lower socioeconomic status (SES) categories had significantly higher mean DMFS than did higher SES children. Results suggest that caries prevention and dental treatment programs should be developed or enhanced to reduce the caries problem among Taiwanese children, particularly those at high risk. <75> UI - 98143041 AU - Sgan-Cohen HD AU - Rafalovitz G AU - Ron H AU - Mann J IN - Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University-Hadassah, Jerusalem, Israel. TI - Changing caries prevalence in primary and permanent teeth of children in a Jerusalem neighbourhood. SO - International Journal of Paediatric Dentistry 1997 Sep;7(3):167-70 AB - The objective of the present study was to conduct cross-sectional surveys of caries prevalence in Jerusalem schoolchildren from one geographic region over time (9 years for 6-year-old first graders and 6 years for 9-year-old fourth graders), and to examine possible changes in caries levels. Dental caries was assessed among school children in one Jerusalem neighbourhood, employing the DMFS and dmfs indices, for permanent and primary teeth respectively. One epidemiologist in the team of examiners participated in all stages of the surveys and served as the calibrator. Data indicated a decline among 6-year-old children of mean DMFS scores from 1.64 in 1983, to 0.32 in 1992, and of mean dmfs values from 13.95 to 8.09. Among 9-year-old children, mean DMFS scores declined from 3.50 in 1986 to 2.50 in 1992. The water supply of Jerusalem was optimally fluoridated to 0.9 ppm in 1988, and this is suggested as a contributor to the decline in caries prevalence. <76> UI - 98157280 AU - Platt MJ IN - Department of Public Health, University of Liverpool. TI - Child health statistical review, 1997. SO - Archives of Disease in Childhood 1997 Dec;77(6):542-8 <77> UI - 98123538 AU - du Plessis JB IN - Department of Stomatological Studies, Faculty of Dentistry, Medunsa. TI - The effect of socio-economic status on dental caries experience in 6, 12 and 15 year-old school children in Port Elizabeth and Despatch. [Review] [12 refs] SO - Journal of the Dental Association of South Africa 1997 Jul;52(7):483-6 AB - The socio-economic status of urbanised families throughout the world influences the caries experience of children. The higher the socio-economic status the lower the caries experience. Therefore, in surveys undertaken to determine caries experience of large communities it is necessary to take the above mentioned factor into consideration during the sampling process. It is, however, difficult and time consuming to classify individual children in terms of their socio-economic status. During a recent large scale survey in Port Elizabeth and Despatch, the whole area was divided into three socio-economic sub-sections decided on the basis of residential property values. All children attending school in a particular area was regarded as being from that particular socio-economic group. The results of the survey show that this method of classification into socio-economic groups yields similar results to those of more accurate methods of classification. The influence of the intervention by dental personnel on the caries experience, as expressed in the dmft and DMFT counts in 6-, 12- and 15-year-old children, is a matter of concern and needs further investigation. [References: 12] <78> UI - 98121866 AU - Watt ME AU - Lunt DA AU - Gilmour WH IN - University of Glasgow, Dental School, U.K. TI - Caries prevalence in the deciduous dentition of a mediaeval population from the south-west of Scotland. SO - Archives of Oral Biology 1997 Dec;42(12):811-20 AB - The prevalence, distribution and location of dental caries were studied in the deciduous dentition of 185 skeletons aged between 6 months and 13 years from a large, mostly mediaeval, cemetery, where successive phases of use could be distinguished. The main phases dated from 1240 to 1440 AD. During this period, no consistent trend or pattern of caries was identified, but there was a significantly higher caries prevalence in the age band 6-12.9 years than in the age band 0.1-5.9 years. The caries prevalence in the juveniles from the earlier Northumbrian, or Anglo-Saxon, phase of the cemetery was higher than in any mediaeval phase group, with mostly approximal surfaces affected. In the mediaeval population, first deciduous molars generally showed lower caries prevalence than second deciduous molars, significantly lower for the older age band, and maxillary molars consistently showed lower levels than mandibular molars. The highest caries rate, shown by mandibular second molars in the older age band, was 7.9%. In deciduous molars, the occlusal surface was most frequently affected by caries, whereas in the permanent molars of the same population the approximal surfaces had shown the highest level of attack. The overall caries prevalence in deciduous teeth in the mediaeval population of Whithorn was 2.3% of the teeth present, lower than the levels found in previous Scottish and English population groups, including a small assemblage of children from the Scottish sites of Elcho, Southwick and Kirkhill. <79> UI - 98073449 AU - Jago JD IN - University of Melbourne, School of Dental Science, Victoria. TI - Elsdon Storey Memorial Lecture. Dentistry and the world of children [see comments]. CM - Comment in: Aust Dent J 1998 Apr;43(2):133 SO - Australian Dental Journal 1997 Oct;42(5):348-53 <80> UI - 98110238 AU - Pollard MA AU - Cleaton-Jones P AU - Smit A AU - Sam C IN - Child Dental Health, Leeds Dental Institute, UK. TI - The plaque acidogenic response to carbohydrates of children from three ethnic groups in South Africa. SO - International Dental Journal 1997 Feb;47(1):39-44 AB - The plaque acidogenic response of children from three ethnic groups in South Africa to four different carbohydrates was investigated using the plaque sampling method. A total of 30, 12-year-old children, ten black, ten 'coloured' and ten white, completed this study. The foods tested were 10 per cent sucrose solution, maize porridge, strawberry flavoured yoghurt and banana. The blacks produced an