Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Sep 2000.> Search Strategy (You Saved Citations 1-258 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 adolescence < 13 to 18 years > 257 75 ("93099748" or "94086857" or "96176352").ui. 3 76 75 or 74 258 77 from 76 keep 1-258 258 *************************** <1> UI - 20316555 AU - Kawamura M AU - Iwamoto Y IN - Department of Preventive Dentistry, Hiroshima University School of Dentistry, Japan. TI - Present state of dental health knowledge, attitudes/behaviour and perceived oral health of Japanese employees. SO - International Dental Journal 1999 Jun;49(3):173-81 AB - The aim of this survey was to assess the present state of dental health knowledge, attitudes/behaviour and perceived oral health of Japanese employees. A 60-item questionnaire was used in a dental health project in the work place. The subjects comprised 77,845 employees, 76 per cent of whom reported delaying a dental visit until they had toothache, with about 60 per cent delaying even when they discovered a decayed tooth. The majority did not regard decayed teeth as a disease and only a minority reported regular dental visits. About three quarters reported bleeding gums on brushing, although more than half had never been taught professionally how to clean their teeth and less than 5 per cent flossed daily. More than half believed that false teeth were inevitable in old age, and that their teeth were getting worse despite daily brushing. About 70 per cent of the employees thought that it was impossible to prevent gum disease with toothbrushing alone, and nearly half believed a toothpaste with fluoride was effective in preventing periodontal disease. Reorientation of oral health care in Japan, therefore, is urgently needed and dental services have to be provided for the implementation of systematic oral health promotion for employees in the workplace. <2> UI - 20317625 AU - Chikte U AU - Brand AA IN - Department of Community Dentistry, University of Stellenbosch. TI - Attitudes to water fluoridation in South Africa 1998. Part I. Analysis by age, sex, population and province. SO - SADJ 1999 Nov;54(11):537-43 AB - The successful implementation of water fluoridation (WF) depends upon support from the public. A survey was conducted in 1998 by the Human Sciences Research Council to assess attitudes of the South African population towards WF. A representative sample of 2,220 persons over the age of 18 years was interviewed. Questions relating to current knowledge, sources of information, the purpose of water fluoridation and its desirability as a public health measure were put to respondents. Only 25% of the population had heard or read of WF. The major sources of information were the electronic and printed media (40% and 27% respectively), while 2.5% heard about it from dentists. Just over a third of the sample (35.5%) identified the purpose of WF as protecting teeth from decay; 28% said it was to purify water and 28.5% were uncertain of, or did not know its purpose. Nearly two-thirds (61.9%) indicated that fluoride should be added to drinking water if it can reduce tooth decay, while 9% were not in favour and 29% were uncertain. The results suggest that most people do not know what WF is or does, though most were in agreement that it should be implemented to reduce tooth decay. <3> UI - 20305626 AU - Brennan DS AU - Spencer AJ AU - Slade GD IN - Australian Institute of Health and Welfare Dental Statistics and Research Unit, University of Adelaide. TI - Caries experience among publicly-funded dental patients in Australia, 1995-96: type of care and geographic location. SO - Australian Dental Journal 2000 Mar;45(1):37-45 AB - Health card holders are a financially disadvantaged group and are the target population eligible for publicly-funded dental care. While their health status is generally worse compared with other Australians, there is also considerable variation among card holders. The aims of this study were to describe the oral health status of publicly-funded dental patients by type of care, geographic location and age, and to compare trends over time against other Australian studies. Patients were sampled randomly, based on date of birth, by State/Territory dental services in 1995-96. Dentists recorded oral health measures at the initial visit of a course of care using written instructions, but there was no formal calibration. The 6109 patients sampled were weighted in proportion to the numbers of publicly-funded dental patients for each State/Territory. Multiple linear regression analysis indicated that caries experience measured by the DMFT index increased across older age groups (p < 0.05). For rural compared with urban patients, mean numbers of decayed and filled teeth tended to be higher. For emergency compared with non-emergency care, mean numbers of decayed and missing teeth were higher, and filled teeth lower. The findings of this monitoring survey document high levels of previous disease and treatment and indicate variation between subgroups of users of publicly-funded dental care. This included an uneven geographic distribution of oral health and disease, and variation in unmet treatment needs by type of course of care. Temporal comparisons indicate publicly-funded patients have experienced the population trend towards lower levels of tooth loss over time but have higher levels of untreated decayed teeth compared with the general population. <4> 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] <5> UI - 20291695 AU - Shahabuddin AK AU - Talukder K AU - Talukder MK AU - Hassan M AU - Seal A AU - Rahman Q AU - Mannan A AU - Tomkins A AU - Costello A IN - Institute of Child and Mother Health, Matuail, PO Tushar Dhara, Bangladesh. icmh@bangla.net TI - Adolescent nutrition in a rural community in Bangladesh. SO - Indian Journal of Pediatrics 2000 Feb;67(2):93-8 AB - The objective of this study was to assess the nutritional status of adolescent boys and girls in a rural community in Bangladesh. Between December 1996 and January 1997, a cross-sectional survey was carried out in 803 households, each containing at least one adolescent, sampled consecutively from four purposely-selected villages in Rupganj Thana, Narayanganj district. Initially, the guardians of 1483 healthy and unmarried 10-17 year old adolescents (51% boys and 49% girls) were interviewed about family structure and socio-economic status. Out of these children, 906 (47% boys and 53% girls) from 597 households were weighed, had their height and MUAC measured and were clinically examined. Blood was then collected from 861 adolescents for haemoglobin estimation. The median monthly income per person in these 597 families was approximately Taka 554 (US $12). Twenty seven per cent of the household heads were labourers, 21% were solvent farmers, 14% ran small scale businesses and 6% were unemployed. Sixty seven per cent of adolescents were thin (defined as BMI < 5th centile of WHO recommended reference) with 75% boys and 59% girls being affected. The percentage of thin adolescents fell from 95% at age 10 years to 12% at age 17 years. The prevalence of stunting (height for age < 3rd centile NCHS/WHO) was 48% for both boys and girls and rose from 34% at age 10 to 65% at age 17. On clinical examination angular stomatitis was present in 46%, 27% had glossitis, 38% had pallor, 11% had dental caries, 3.2% had an conspicuously enlarged thyroid and 2.1% had eye changes of vitamin A deficiency. According to INACG (International Nutritional Anaemia Consultative Group, 1985) cut-off values, 94% of the boys and 98% of the girls were anaemic. We conclude that rural Bangladesh adolescents suffer from high rates of malnutrition and almost universal anaemia. Nutritional interventions to target this population are urgently required. <6> 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. <7> 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. <8> 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 <9> 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. <10> UI - 20192961 AU - Holst D AU - Schuller AA IN - Institute of Community Dentistry, Blindern, Oslo, Norway. dholst@odont.uio.no TI - Oral health changes in an adult Norwegian population: a cohort analytical approach. SO - Community Dentistry & Oral Epidemiology 2000 Apr;28(2):102-11 AB - OBJECTIVES: The purpose of this analysis was to study temporal variation in oral health in an adult population. The cohort analysis comprised 1) estimation of longitudinal, cross-sectional, and time-lag differences in caries and treatment experience of the adult population in Trondelag from 1973 to 1983 and to 1994; 2) assessment of which of the effects of age, period and cohort was the most plausible explanation for the observed differences and 3) discussion of causal and other factors underlying the effects of age, period and cohort. METHODS: Cohort analysis was used to study changes in oral health over time. Study participants were selected by random sampling in 1973, 1983, and 1994 (n = 1959, n = 3195, n = 2341 respectively). The methods of data collection comprised standardised clinical measurements and a self-administered questionnaire. Cohort tables were established to analyse changes in DFT from 1973 to 1983 and DFT and DFS from 1983 to 1994. RESULTS: Four patterns of changes in oral health were identified from adolescence to older adulthood. They point in different directions which indicate that complex processes are present. There were two and three significant changes in the subsets of analysis. Assumptions and conditions that allow identification of separate cohort, period, and age effects appeared not to be present. The pattern of changes was consistent with main effects of both age, period, and cohort. The effects were discussed from the perspective of the chosen frame of explanatory factors. CONCLUSIONS: The changes in oral health between populations in 1973, 1983 and 1994 were the combined consequences of simultaneously occurring factors that account for both age, period and cohort effects. <11> 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. <12> 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. <13> 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. <14> 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. <15> 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. <16> 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. <17> UI - 20105815 AU - Antoft P AU - Rambusch E AU - Antoft B AU - Christensen HW IN - Herlev Municipal Dental Service, Denmark. TI - Caries experience, dental health behaviour and social status--three comparative surveys among Danish military recruits in 1972, 1982 and 1993. SO - Community Dental Health 1999 Jun;16(2):80-4 AB - OBJECTIVE: To compare caries experience among young Danish men in 1972, 1982 and 1993; and on the same occasions to describe relationship between their utilisation of regular dental care and social status, as well as the relationship between their caries experience, utilisation of dental services and social status. DESIGN: During their routine health examinations in 1972, 1982 and 1993 all recruits enlisted in the Danish Air Force were subjected to an additional oral examination combined with a structured socio-dental questionnaire. Identical methods were applied in each of the three surveys. SETTING: Dental clinics at air bases in Denmark. SUBJECTS: 4,103 male military recruits, aged 18 to 25 years. OUTCOME MEASURES: Caries was registered in accordance with the WHO Basic Methods 1971. The questionnaire provided information on age, place of residence during childhood, social origin, and patterns of utilisation of dental services. RESULTS: The findings indicated a considerable decrease in average caries experience from 16.6 DMFT in 1972 to 11.8 in 1982 and 6.2 in 1993. The results further documented markedly increased availability of public school dental health services, the coverage rising from 33% in 1972 to 65% in 1982 and 100% in 1993, as well as moderately increased utilisation of regular dental care with private practitioners, rising from 71% in 1972 to 86% in 1982 and 84% in 1993. In 1993 as in 1982 and 1972, recruits who used the public school dental health services and also received regular dental care after their school leaving age showed the lowest average caries experience. CONCLUSIONS: The findings indicate a marked decrease in average caries experience and an increased utilisation of dental services among Danish young men from 1972 to 1993. However, in 1993 the least privileged social group continued to maintain the highest average caries experience and the lowest rate of utilisation of regular dental care. <18> 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. <19> 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. <20> 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. <21> 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. <22> 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. <23> 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. <24> 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. <25> 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. <26> UI - 99223940 AU - Swedberg Y AU - Noren JG IN - Department of Pedodontics, Faculty of Odontology, Goteborg University, Sweden. TI - A time-series analysis of caries status among adolescents in relation to socioeconomic variables in Goteborg, Sweden. SO - Acta Odontologica Scandinavica 1999 Feb;57(1):28-34 AB - The aim of this study was to detect, using time-series analysis methods, whether measurable socioeconomic adjustments for the time period 1986-96, as presented by caries index values, could be related to a new trend in caries status development for specific age groups leaving the free state-organized dental care system. In the study, Goteborg was divided into four districts. The study showed a favorable development in dental health for the 15-19 age group. However, the caries incidence index DSa (decayed approximal surfaces) values showed no or only negligible signs of lower mean values. During the study period, the study showed an unfavorable trend concerning the socioeconomic variables related to health care. However, the incongruity for the different districts between the trend results of the caries index values and the contemporaneous socioeconomic variable development indicated few signs of relationship. In relation to general discussions of environmental questions, the idea of sustainable development was discussed when applied to the field of dental care. The results of this study indicate that dental health, in times of major economic adjustments and lack of resources for health care for the 15-19 age group in Goteborg--as interpreted by the caries indices used is an example of sustainable dental health development. <27> UI - 99448351 AU - Frencken JE AU - Sithole WD IN - Department of Preventive and Community Dentistry, University of Nijmegen, The Netherlands. TI - National oral health survey Zimbabwe 1995: quality of restorations. SO - SADJ 1998 Sep;53(8):435-8 AB - In 1995, a second national oral health survey was carried out, ten years after the first. Application of a multi-stage sampling procedure resulted in 3709 persons being examined. The restorations were assessed using the criteria described by Kroeze et al (1990). Only ditches on the tooth/restoration margins that were wider than 0.4 mm were considered to be carious. The background variables studied were age, gender, type of location, socioeconomic status (SES) and level of education. The prevalence of restorations in all persons examined was 3.4 per cent. Restorations were found much more often among urban (95.5 per cent) than rural people (4.5 per cent) and also among those living in high (75 per cent) compared to low SES suburbs (25 per cent). Amalgam was more often used (89 per cent) than composite resin (10 per cent). The most frequently observed type of restoration was Class I (45 per cent) followed by Class II (39 per cent) and Class III (7 per cent). The prevalence of satisfactory restorations was 83.9 per cent. Failures were due to 'fractured restorations' (6.3 per cent), 'caries at the margin' and 'breakdown of restoration margin', both 4 per cent. Amongst adults, multiple-surface amalgam restorations failed more often than single-surface ones. It is concluded that the prevalence of restorations found was very low. There is a need to extend the provision of preventive and restorative oral health care by a more equitable distribution of oral health personnel and by making more finance available to rural and low-SES suburban areas. <28> 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. <29> 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 <30> 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. <31> 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. <32> 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. <33> 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. <34> 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] <35> UI - 99122128 AU - Kmietowicz Z TI - Decline and fill. SO - Nursing Times 1998 Nov 18-24;94(46):28-9 <36> 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. <37> UI - 99000274 AU - Elvery MW AU - Savage NW AU - Wood WB IN - Department of Dentistry, The University of Queensland, St. Lucia, Australia. TI - Radiographic study of the broadbeach aboriginal dentition. SO - American Journal of Physical Anthropology 1998 Oct;107(2):211-9 AB - This study forms part of a larger anthropological investigation of the Ngaraangbal Aboriginal Tribe's ancestral burial ground at Broadbeach, Australia. It examines the dentition, records the associated pathology in a noninvasive manner, and relates this to the likely subsistence diet of the tribe. The Broadbeach osteological collection was returned for reburial in 1985; however, radiographic and photographic records of 36 adult males were available. These form the basis of our study. The pathology noted in the study sample was compared with a representative sample (n = 38) of pre-European Aboriginal remains from throughout Queensland for verification purposes only. Rates of dental pathology and injury were calculated from the radiographic and photographic records. There was a significant rate of tooth-wear related intra-bony pathology (4.0%), moderate to severe alveolar bone loss, and heavy dental attrition, of which the mandibular posterior teeth were the most severely affected. Caries prevalence (0.8%) was low for hunter-gatherer populations. A large number of molar pulp chambers had a distinctive "cruciate" morphology resulting from the formation of secondary dentine and pulp stones. Injuries and abnormalities included upper central incisor avulsion (58.3%) and taurodontism. These results support the proposal that the Ngaraangbal tribe was a hunter-gatherer population subsisting on an abrasive diet that included marine foods. <38> 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. <39> 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. <40> UI - 99025052 AU - Mandall NA AU - McCord JF AU - Blinkhorn AS AU - Worthington HV AU - O'Brien KD IN - Department of Dental Medicine and Surgery, University of Manchester. TI - Does the ethnicity of teenage children influence oral self perception and prevalence of dental disease?. SO - British Dental Journal 1998 Oct 10;185(7):358-62 AB - AIM: The primary aim was to evaluate the effect of ethnicity, social deprivation and oral health on oral self perceptions of 14-15-year-old Asians and Whites. A secondary aim was to assess the influence of ethnicity and social deprivation on oral treatment need in the same sample. DESIGN: A cross-sectional epidemiological study. DATA SOURCE: A stratified, random sample of 408 14-15-year-old Asian and White children from schools in Manchester. METHOD: Information was collected on oral self perceptions using a questionnaire and on oral treatment need with a clinical examination. RESULTS: Multivariate data analysis revealed that oral treatment need, but not ethnicity or social deprivation, was an important predictive variable with respect to oral self perceptions. Ethnicity was the only variable to influence periodontal treatment need. Social deprivation influenced the level of untreated caries. CONCLUSIONS: 1. Socially deprived children have higher caries levels than their more affluent counterparts and this is evident regardless of ethnic background. 2. Although Asian 14-15-year-old children have a higher periodontal treatment need than Whites, there was no ethnic influence on how they perceive their oral health. 3. Oral treatment need is an important factor with respect to oral self perceptions. <41> 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. <42> UI - 98399457 AU - Moore PA AU - Weyant RJ AU - Mongelluzzo MB AU - Myers DE AU - Rossie K AU - Guggenheimer J AU - Hubar H AU - Block HM AU - Orchard T IN - University of Pittsburgh, School of Dental Medicine, PA 15261, USA. PAM7@pitt.edu TI - Type 1 diabetes mellitus and oral health: assessment of tooth loss and edentulism. SO - Journal of Public Health Dentistry 1998 Spring;58(2):135-42 AB - OBJECTIVE: The oral health of an adult population previously diagnosed with juvenile onset insulin dependent-diabetes was comprehensively assessed. The goal of this exploratory cross-sectional evaluation was to described the characteristics related to partial tooth loss edentulism in subjects with Type 1 diabetes mellitus. METHODS: An adult population of 406 Type 1 diabetes mellitus subjects, who had been monitored for 6-8 years as part of a University of Pittsburgh longitudinal study of medical complications associated with diabetes, received an oral health examination for missing teeth, edentulism, coronal and root caries, periodontal status, and oral health behaviors. RESULTS: Of the 406 subjects evaluated, 204 had no missing teeth, 186 had partial tooth loss (1-27 missing teeth), and 16 were edentulous. Patients who had partial tooth loss or who were edentulous were generally older; had lower incomes and levels of education; and had higher rates of nephropathy, neuropathy, retinopathy, and peripheral vascular disease. A logistic regression model found partial tooth loss to be significantly associated with extensive periodontal disease in remaining teeth (OR = 7.35), a duration of diabetes longer than 24 years (OR = 5.32), not using dental floss (OR = 2.37), diabetic neuropathy (OR = 2.29), household income less than $20,000 (OR = 2.21), multiple coronal caries and fillings (OR = 1.98), and bleeding on probing (OR = 1.82). CONCLUSIONS: Although the majority of these adult Type 1 diabetes patients had serious medical complications associated with their diabetes, the possible impact of diabetes mellitus on oral health should be included in their overall management. <43> 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. <44> 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. <45> 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. <46> 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. <47> UI - 98222820 AU - Breistein B AU - Burden DJ IN - School of Clinical Dentistry, The Queen's University of Belfast, Northern Ireland, UK. TI - Equity and orthodontic treatment: a study among adolescents in Northern Ireland. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1998 Apr;113(4):408-13 AB - This epidemiological study investigated the reasons why children in Northern Ireland who need orthodontic treatment do not receive treatment even when it is provided free by the state. A total of 1584 15- and 16-year-olds were examined in 23 high schools with the Index of Orthodontic Treatment Need. The characteristics of the adolescents who had received orthodontic treatment were compared with those who had a definite need for treatment and yet did not receive treatment or advice. One in 10 of the adolescents examined had an unmet need for orthodontic treatment. Logistic regression analysis was used to assess the influence of 11 variables including socioeconomic status, religion, and standard of dental health on the uptake of orthodontic care. This analysis revealed that the only significant predictors of whether an adolescent received orthodontic treatment was the dental attendance pattern of the adolescent, the adolescent's dental health, and the dental attendance pattern of the adolescent's mother. Those adolescents who had good dental health, who regularly attended a dentist, and whose mother regularly attended a dentist were more likely to receive orthodontic treatment. <48> UI - 98170784 AU - Kinirons MJ AU - Stewart C IN - Division of Paediatric and Preventive Dentistry, School of Clinical Dentistry, Belfast, Northern Ireland. TI - Factors affecting levels of untreated caries in a sample of 14-15-year-old adolescents in Northern Ireland. SO - Community Dentistry & Oral Epidemiology 1998 Feb;26(1):7-11 AB - Dental caries experience in children in Northern Ireland is the highest in the United Kingdom. OBJECTIVE: The aims were to examine the levels of untreated decay in a sample of 14-15-year-old children from an area known to have high dental needs and to relate them to factors which affect dental attendance. METHOD: A sample of 470 pupils aged 14-15 years who attended the 4th form of second level schools in North and West Belfast was obtained and closed questionnaires were distributed 2 weeks prior to the dental examination. RESULTS: 417 pupils were included in the analysis (inclusion rate 88.7%). The mean D value was 1.52 and the D/DMFT mean was 0.31. Individual factors which had significant associations with untreated decay were social class, time since the last dental visit, dental anxiety ratings and the type of dentist attended (mean D of 2.78 for those attending community service dentists and 1.24 for those attending general dental practitioners). Stepwise multiple regression models were constructed with dependent variables of D and the D/DMFT ratio, and the above independent variables remained significantly related to the outcome variables, with the exception of the type of dentist attended. Those attending the community service had higher social needs and longer intervals since dental treatment. CONCLUSION: Factors related to dental attendance are important in relation to the level of untreated decay but exclusive analysis of the type of dental service attended can be misleading. An active approach is required in order to improve the status of pupils with the highest needs. <49> 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. <50> UI - 98064356 AU - Yewe-Dyer M TI - Tooth fairies [letter]. SO - British Dental Journal 1997 Nov 8;183(9):317 <51> 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. <52> 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. <53> 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. <54> UI - 98219321 AU - Lang WP AU - Borgnakke WS AU - Taylor GW AU - Woolfolk MW AU - Ronis DL AU - Nyquist LV IN - Department of Periodontics/Prevention/Geriatrics, University of Michigan, School of Dentistry, Ann Arbor 48109-1078, USA. wplang@umich.edu TI - Evaluation and use of an index of oral health status. SO - Journal of Public Health Dentistry 1997 Fall;57(4):233-42 AB - OBJECTIVES: The goals of this investigation were (1) to evaluate the Oral Health Status Index in relation to demographic characteristics, socioeconomic status, and preventive behaviors of an adult population; and (2) to understand how individual index components performed as indicators of oral health status compared to the composite index. METHODS: The Oral Health Status Index (OHSI) was used on a probability sample of adults, aged 18-93 years, living in the Detroit tricounty area. Data were collected on 509 subjects via in-home dental examinations. Bivariate and multivariate analyses were used to compare the OHSI and its components, including decayed, missing, and replaced teeth, free ends, and moderate and severe periodontal disease measures. RESULTS: The mean OHSI score for subjects was 77.3 (SE = 1.83) with a range of -8.0 to 100.0. In regression analyses, OHSI scores were positively correlated with subjects' education level, self-rated oral health scores, and frequency of dental checkups and negatively correlated with age, nonwhite race, and smoking. Of the index components, missing teeth performed well as an indicator of oral health status. Missing teeth were positively correlated with age, nonwhite race, and smoking and negatively correlated with education level, self-rated oral health, and use of Medicaid. About 53 percent of variance in OHSI scores was explained by the multivariate models, compared to 46 percent for missing teeth. CONCLUSIONS: Choosing an indicator of oral health status likely will depend upon the characteristics of the population to be studied. As a composite measure of oral health status, the OHSI performed acceptably; however, missing teeth, an index component, also worked well. Continued evaluation of the OHSI is warranted. <55> UI - 98132733 AU - Kallestal C AU - Oscarson N AU - Holm AK IN - Department of Oral Biology, Umea University, Sweden. TI - Costs for prevention of dental caries in a group of Swedish teenagers. SO - Swedish Dental Journal 1997;21(5):193-7 AB - The aim of this study was to analyse the costs for 4 years of prevention of dental caries in 92 Swedish adolescents. Using records, the total time allocated to prevention between 1987 and 1991 was calculated. Costs for prevention was assessed from the total cost for dental service at the clinic. The cost for one hour of dental service was SEK 860, 80 pounds. The total cost for prevention in the study group during 4 years was SEK 40,162, 3,744 pounds. The amount spent on prevention in the low or average caries active group of adolescents during 4 years was less than half the sum spent in the high caries active group. <56> 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 <57> 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] <58> 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. <59> UI - 98110244 AU - Taani DQ IN - Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan. TI - Caries prevalence and periodontal treatment needs in public and private school pupils in Jordan. SO - International Dental Journal 1997 Apr;47(2):100-4 AB - A total of 886 pupils aged 15-16 years selected from 20 public and 10 private schools in northern Jordan were investigated for frequency of toothbrushing and sweet consumption, dental caries and periodontal treatment needs. A questionnaire and clinical examination were used utilising decayed-missing-filled teeth (DMFT) code and the Community Periodontal Index of Treatment Needs (CPITN), respectively. Results revealed that 35.5 per cent of public and 57.1 per cent of private school pupils reported to brush their teeth regularly while the majority of them frequently consumed sweets. There were slight differences in caries experience amongst public and private school pupils, as measured by DMFT (4.74: 4.95). While bleeding and calculus scores were prevalent in pupils of both types of schools, they were slightly higher in pupils of public schools than those in private schools. Both shallow and deep pathological pockets were found in fewer numbers (6.09 per cent) in pupils in public schools only. Oral hygiene instruction and scaling were the predominant periodontal treatment needs in both types of schools. However, the treatment needed by pupils in public schools was higher than those in private schools. Complex treatment was rarely needed by public school pupils only. <60> UI - 98081698 AU - Bagedahl-Strindlund M AU - Ilie M AU - Furhoff AK AU - Tomson Y AU - Larsson KS AU - Sandborgh-Englund G AU - Torstenson B AU - Wretlind K IN - Division of Psychiatry, Huddinge University Hospital, Sweden. TI - A multidisciplinary clinical study of patients suffering from illness associated with mercury release from dental restorations: psychiatric aspects. SO - Acta Psychiatrica Scandinavica 1997 Dec;96(6):475-82 AB - The aim of this study was to map the psychological/psychiatric, odontological and medical aspects of patients with symptoms allegedly related to the side-effects of mercury in dental fillings. A total of 67 consecutive patients and 64 controls matched for age, sex and residential area were included in the study. The most striking result was the high prevalence of psychiatric disorders in the patients (89%) compared to the controls (6%), predominantly somatoform disorders. The personality traits differentiating the patients according to the Karolinska Scales of Personality (KSP) were somatic anxiety, muscular tension, psychasthenia and low socialization. More patients than controls showed alexithymic traits. The prevalence of diagnosed somatic diseases was higher, but not sufficiently so to explain the large difference in perceived health. The multiple symptoms and signs of distress displayed by the patients could not be explained either by the odontological data or by the medical examination. Our data indicate that the patients show sociodemographic and clinical patterns similar to those of somatizing patients. The medicalization of the suffering of these patients and the neglect of psychiatric problems prevent the use of appropriate psychotherapeutic approaches. <61> UI - 98030656 AU - Edwards DM AU - Watt RG IN - Department of Public Health, Bedfordshire Health, Luton. TI - Oral health care in the lives of Gypsy Travellers in east Hertfordshire. SO - British Dental Journal 1997 Oct 11;183(7):252-7 AB - OBJECTIVE: To explore Gypsy Travellers' perceptions of dental health and dental service use within the context of culture, environment and the use of other services. SETTING: The author was a community dental officer and the study formed part of a MSc dissertation in dental public health. SUBJECTS AND METHODS: Information was obtained from semi-structured interviews with 43 Gypsy Travellers supplemented by a questionnaire and clinical screening of 72 Travellers. MAIN OUTCOME MEASURES: Place of residence, registration with GMP and GDP, school attendance, caries, normative and perceived barriers to care. RESULTS: The Travellers in the study had a high level of unmet need, low dental registration and very little use of preventive services. Travellers have no cultural barriers to dental care. Control of their travelling was the major factor determining access to education and health services. CONCLUSIONS: There is inequity of dental health and dental service use with more disadvantage being experienced by Travellers on unauthorized and transit sites. <62> UI - 97463608 AU - Main PA AU - Lewis DW AU - Hawkins RJ IN - Department of Community Dentistry, Faculty of Dentistry, University of Toronto. TI - A survey of general dentists in Ontario, Part II: Knowledge and use of topical fluoride and dental prophylaxis practices. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1997 Sep;63(8):607, 610-7 AB - A mail questionnaire was used to assess variations in the knowledge and practices of Ontario dentists with respect to topical fluoride and prophylaxis procedures. The questionnaire was answered by 1,276 general dentists. A high percentage (72 to 83 per cent) of respondents identified six months as the optimal time interval at which both procedures should be repeated for all patients under 19 years of age. Relatively few dentists (< 10 per cent) indicated that there should be no specific time interval for re-treatment (i.e. that it should be individually selected). The respondents' preventive knowledge was found to be deficient in two areas: few dentists (16 per cent) knew that it is not necessary to provide a prophylaxis prior to topical fluoride application to achieve maximum caries protection; and most dentists overestimated the speed of caries progress from outer enamel to the dentinoenamel junction (DEJ) in both primary (83 per cent) and permanent (82 per cent) approximal tooth surfaces. In bivariate analysis, three variables were found to be consistently and significantly related to optimal time intervals selected for both topical fluoride application and prophylaxis procedures: year of graduation from dental school; level of hygienist employment; and percentage of patients with private insurance. Multivariate analysis also identified three significant variables: year of graduation from dental school; level of dental hygienist employment; and practice business. Continuing education courses are suggested as a means of updating dentists' knowledge regarding preventive services. Studies are needed to determine the extent to which recent recommendations regarding the professional application of topical fluorides have been followed. <63> UI - 98050846 AU - Robison VA AU - Rozier RG AU - Weintraub JA AU - Koch GG IN - Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland 21205, USA. TI - The relationship between clinical tooth status and receipt of sealants among child Medicaid recipients. SO - Journal of Dental Research 1997 Dec;76(12):1862-8 AB - This study investigated the association between caries status and sealant need at a prior survey and subsequent sealant use in a Medicaid program. Clinical data from a 1986-87 statewide epidemiological survey (N = 8026) representative of North Carolina (NC) schoolchildren (grades K-12) were linked with all NC Medicaid dental claims submitted during 1987-92, yielding 570 children in the survey who had at least one dental visit during 1987-1992. From the 570, 390 children were included: 71 who received sealants (S) and 319 who received non-sealant care (NS). Children were excluded based on age, having preexisting sealants, or having no sealant-eligible molars or premolars. S and NS were compared on baseline dfs, DMFS, and sealant need, controlling for the patient's age, number of visits, and the provider's propensity to seal. At all ages, NS was twice as likely to have had prior dfs or DMFS (OR = 2.04, 95% CI = 1.15, 3.70). The association between sealant receipt and prior sealant need varied by age. At 6 to 11 years, S and NS had equal likelihood of sealant need (OR = 1.41, 95% CI = 0.62, 3.18). At 12 to 15 years, NS had a greater likelihood of sealant need (OR = 6.82, 95% CI = 1.60, 29.08). Caries-free status was associated with subsequent sealant receipt. Prior sealant need caused variability in dentists' decisions, depending on the child's age and past caries experience. Sealants were used infrequently by most providers and for a minority of patients. These findings are important for the Medicaid program and for future non-randomized studies of sealant effectiveness. <64> UI - 98045013 AU - Robison VA AU - Rozier RG AU - Weintraub JA IN - Johns Hopkins School of Hygiene and Public Health, Department of Epidemiology, Baltimore, MD 21205, USA. vrobison@loxinfo.co.th TI - Dental caries and treatment need in schoolchildren related to Medicaid enrollment. SO - Journal of Public Health Dentistry 1997 Summer;57(3):163-70 AB - OBJECTIVES: This study compared dental caries status and treatment need in four groups of children: those not enrolled in Medicaid, those enrolled in Medicaid who used dental services prior to a dental survey, those enrolled in Medicaid who used services after the survey, and those enrolled in Medicaid who did not use dental services. METHODS: This study used data on 6,620 children 5 to 18 years of age, who were representative of North Carolina schoolchildren and who participated in a statewide oral health survey in 1986-87. Clinical results from the survey were linked with a separate data base of Medicaid claims and enrollment files from 1984 to 1992. With this link, the surveyed children were classified into the four study groups and dental status compared. RESULTS: Medicaid-enrolled children who used services prior to the survey had the highest caries prevalence of all groups (DMFS = 1.74 at ages 6 to 11 years), and had fewer treatment needs (D/DMFS = 19%) than children outside of Medicaid (DMFS = 0.95, D/DMFS = 33%). Enrolled children who never used dental services had a caries prevalence (DMFS = 0.83) similar to children outside of Medicaid, yet had greater unmet treatment need (D/DMFS = 62%). CONCLUSIONS: Caries prevalence did not differ substantially among groups; however, the level of unmet treatment did very. Some Medicaid-enrolled children had a significant portion of their restorative treatment needs met. <65> UI - 98043100 AU - Anonymous TI - The public side of DSSNY. SO - New York State Dental Journal 1997 Oct;63(8):44-5 <66> UI - 97473277 AU - Albandar JM AU - Brown LJ AU - Loe H IN - Dental Faculty, University of Bergen, Norway. TI - Clinical features of early-onset periodontitis. SO - Journal of the American Dental Association 1997 Oct;128(10):1393-9 AB - The authors estimate the prevalence of early-onset periodontitis, or EOP, in U.S. adolescents and describe the clinical features that occur at an early stage in those who have EOP. In 1986 and 1987, about 10.0 percent of African-American, 5.0 percent of Hispanic and 1.3 percent of white U.S. adolescents had EOP. Clinical features that may be useful in the early detection of EOP include overt gingival inflammation, dental calculus and a high rate of caries, restorations and tooth loss. <67> UI - 97473965 AU - van Palenstein Helderman WH AU - Munck L AU - Mushendwa S AU - van't Hof MA AU - Mrema FG IN - WHO Collaborating Centre, Dentistry, University of Nijmegen, The Netherlands. TI - Effect evaluation of an oral health education programme in primary schools in Tanzania. SO - Community Dentistry & Oral Epidemiology 1997 Aug;25(4):296-300 AB - This study aimed to assess the clinical oral health outcome effects among schoolchildren participating in a school-based oral health education (OHE) programme. Local social, cultural and environmental conditions were determinants of the school-based OHE programme, which was compiled on the basis of prevailing beliefs and on what teachers and educational authorities considered to be important for the oral health of schoolchildren. Consequently, the practical aspects of oral hygiene and information on the cause and prevention of caries and gingivitis were the components of oral health education. The teachers were prepared to carry out weekly supervised toothbrushing sessions and monthly lessons on aspects of oral health for the school year in grade 4. Eight participating schools were selected for the clinical effect evaluation and four non-participating schools served as the control. In total, 309 children from the participating schools and 122 children from the non-participating schools were available for the evaluation. Their ages varied between 9 and 14 years. The mean plaque score, calculus score and gingival bleeding score at baseline and at follow-up examinations 3, 8, 15 and 36 months later were not significantly different for participating schools and controls. The mean DMFT value at baseline was 0.4 and 3 years later 0.9 in both the participating and control schools. In conclusion, the present study shows that the implemented school-based OHE programme did not result in significant reductions of the clinical parameters measured. <68> UI - 97459142 AU - Ben-Bassat Y AU - Harari D AU - Brin I IN - Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel. TI - Occlusal traits in a group of school children in an isolated society in Jerusalem. SO - British Journal of Orthodontics 1997 Aug;24(3):229-35 AB - The prevalence of occlusal features in 939 children, aged 6-13 years, belonging to an ultra-orthodox community of Jewish Ashkenazi descent living in Jerusalem was studied clinically. Sexual dimorphism was found for overjet, overbite, and habit practising. About one-quarter of the sample exhibited some degree of occlusal mutilation due to caries, thus creating a 'caries-affected' subgroup, the rest forming the 'caries-free' subgroup. In the latter set, normocclusion was scarce (7.4 per cent), Class I being the most frequent malocclusion (49.1 per cent). Caries had a significant effect on the symmetry of bilateral occlusal relationships, lower dental midline deviation, and on crowding/spacing conditions in the mixed dentition stage (except for the maxilla in late mixed dentition). The low prevalence of normocclusion can be attributed to genetic background, environmental influences and the definition attached to normal occlusion. <69> UI - 98019359 AU - Garcia-Closas R AU - Garcia-Closas M AU - Serra-Majem L IN - Institute of Public Health, University of Barcelona, Spain. rclosas@huc.rcanaria.es TI - A cross-sectional study of dental caries, intake of confectionery and foods rich in starch and sugars, and salivary counts of Streptococcus mutans in children in Spain. SO - American Journal of Clinical Nutrition 1997 Nov;66(5):1257-63 AB - In this cross-sectional study of 236 schoolchildren living in Manresa, Spain, we evaluated the association between prevalence of dental caries and frequency of consumption of various food groups, including sweetened baked goods and similar foods (rich in starch and sugars) and confectionery (rich in sugars but not starch), using a food-frequency questionnaire. Because Streptococcus mutans is associated with the cariogenicity of carbohydrates, we also evaluated the modification of these associations by salivary counts of this microorganism. Odds ratios (ORs) were used to measure the association between caries and tertiles of consumption. Sex, age, use of fluorides, tooth-brushing frequency, frequency of dental visits, socioeconomic status, and intake of other potentially cariogenic food groups were considered as potential confounders. We did not find a significant association between any of the food groups evaluated and caries prevalence. Failure to detect an association could have been due to the low prevalence of caries in our population (decayed, missing, or filled permanent teeth = 1.3 at age 10.6 y) or to underestimation of the association due to diet misclassification. In this population, the association between consumption of sweetened baked goods and caries appeared to be modified by the numbers of S. mutans [OR = 6.1 (95% CI: 1.6, 23.0) for low compared with high intake in children with moderate-to-high S. mutans counts and OR = 0.3 (95% CI: 0.1, 1.6) for low compared with high intake in children with low S. mutans counts]. These results suggest that a high intake of sweetened baked goods may be a determinant of caries prevalence in children with moderate-to-high salivary counts of S. mutans. <70> UI - 97406845 AU - Saemundsson SR AU - Slade GD AU - Spencer AJ AU - Davies MJ IN - Department of Dental Ecology, School of Dentistry, University of North Carolina-Chapel Hill, USA. TI - The basis for clinicians' caries risk grouping in children. SO - Pediatric Dentistry 1997 Jul-Aug;19(5):331-8 AB - Despite the growing emphasis on targeting care to high-risk groups, little is known about the factors used by clinicians to designate risk. This study investigates the degree to which factors measured in a typical dental health survey are used by clinicians in assigning children to dental disease risk groups. A random sample of 9690 children aged 5-15 years was selected from the South Australian School Dental Service. Dentists or dental therapists judged each child as low-, medium-, or high-risk for dental disease. Clinicians recorded caries experience (DMFS/dmfs), and children's parents completed a questionnaire on dental behaviors and socioeconomic status (SES). Two binary logistic models were fitted using the risk grouping as the outcome variable, one comparing low- with moderate-risk and the other comparing moderate- with high-risk. Sixty percent of children were judged as moderate-risk, 27% as low-risk, and only 13% as high-risk. In the logistic models, proximal DMFS/dmfs were stronger predictors of assignment to the higher-risk groups than were factors indicating past occlusal caries, while factors describing caries on buccal or lingual surfaces appeared unimportant. Untreated lesions on permanent and primary teeth were among the strongest predictors of assignment to the higher-risk groups. Other significant factors (P < 0.05) were: exposure to professionally applied fluoride and sealants, country of birth, frequency of toothbrushing, and exposure to fluoridated water. No SES factors reached significance. The models explained nearly one-half the variation in the risk predictions. Clinical markers of past caries experience explained the greatest variation in the judgments, showing that clinicians base their risk predictions largely on children's past disease. The three types of surfaces contribute unevenly to the judgments and unrestored caries was the largest contributor to the decision. <71> UI - 97422941 AU - Davies MJ AU - Spencer AJ AU - Westwater A AU - Simmons B IN - Australian Institute of Health and Welfare Dental Statistics, University of Adelaide, Australia. TI - Dental caries among Australian Aboriginal, non-Aboriginal Australian-born, and overseas-born children. SO - Bulletin of the World Health Organization 1997;75(3):197-203 AB - Few studies have specifically compared the prevalence of dental caries among contemporary Australian Aboriginal and non-Aboriginal children. Historically, Aboriginal groups have had substantially fewer dental caries than non-Aboriginal peoples. More recently, however, this trend appears to have been reversed, with improvements in the oral health of non-Aboriginal children and a deterioration in that of Aboriginal children; this tendency has important implications for dental health services. This study compared the caries experience among a weighted sample of Community Dental Service patients aged 4-13 years for the period January-December 1992 among 4138 Aboriginal children, 9674 non-Aboriginal Australian-born children, and 957 overseas-born children resident in Northern Territory, Australia. The outcomes considered included the aggregate numbers of decayed, missing and filled deciduous (dmft) and permanent (DMFT) teeth. Oral disease experience and prevalence of untreated oral disease were higher among Aboriginal and overseas-born children. An analysis of variance using planned comparisons indicated that there were significantly more decayed teeth and higher aggregate caries experience in the deciduous and permanent dentition of Aboriginal and overseas-born children than of non-Aboriginal Australian-born children, while overseas-born children also had more fillings and fissure sealants than the non-Aboriginal Australian-born children. <72> UI - 97409890 AU - Main PA AU - Lewis DW AU - Hawkins RJ IN - Community Dental Services, North York Public Health Department, Faculty of Dentistry, University of Toronto, ON. TI - A survey of general dentists in Ontario, Part I: Sealant use and knowledge. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1997 Jul-Aug;63(7):542, 545-53 AB - This study assessed the use of pit and fissure sealants by Ontario dentists, as well as variations in the knowledge and practices of this population with respect to certain aspects of the preventive technique. A mail questionnaire on dental practices and knowledge was answered by 1,276 general dentists in Ontario. Most dentists (90 per cent) provided sealants to their patients, and reported using sealants on an average of 45 per cent of their patients between the ages of six and 16 years. While most dentists knew that sealants have been proven effective in preventing caries (90 per cent), many incorrectly believed that sealants are cost-effective to apply to both primary molars and permanent premolars (40 per cent and 68 per cent respectively). Bivariate analyses showed that many of the reported characteristics are statistically significant. The variables that were consistently associated with sealant use include: knowledge of the effectiveness and cost-effectiveness of sealants; year of graduation from dental school; level of dental hygienist employment; and continuing education participation. Although multivariate analyses identified many of these variables as statistically significant, only a moderate amount of the variation in sealant use for patients aged six to 16 was explained (R2 = 0.22). Due to misinformation about the cost-effectiveness of sealants, some dentists may overuse them in certain instances. Conversely, misinformation about the effectiveness of sealants and the risk of further decay after sealant placement has resulted in some dentists under-utilizing them. Continuing education courses are needed to update dentists' knowledge and beliefs regarding dental sealants. In addition, dentistry's professional bodies should develop clinical practice guidelines to aid dentists in their treatment planning decisions. <73> UI - 97251137 AU - Siener K AU - Rothman D AU - Farrar J IN - Department of Pediatric Dentistry, University of the Pacific, USA. TI - Soft drink logos on baby bottles: do they influence what is fed to children?. SO - ASDC Journal of Dentistry for Children 1997 Jan-Feb;64(1):55-60 AB - Baby bottle with popular soda pop and soft drink logos are on marked shelves. A descriptive study was conducted to determine their prevalence among families and to determine whether the logos could be influencing what families put in baby bottles. A convenience sample of 314 mothers (and grandmothers if they were primary caregivers) with children using baby bottles was interviewed in three California counties. The results were analyzed for significance, using the chi-square test for independence. The ethnicities and educational levels of the sample population matched the distribution of the State. Overall, 31 percent of the children drank either soda pop or Kool-Aid from baby bottles. Forty-six percent of the respondents owned a baby bottle with a soda pop logo and 17 percent owned a bottle with a Kool-Aid logo. Families who owned bottles with popular beverage logos were four times more likely to give children the respective beverage in bottles than families with "logo bottles." Populations most likely to drink these beverages were those in the black and Hispanic ethnic groups, in the youngest age-group (15-20 years of age), and those without a high school diploma. Health professionals are concerned that the logos could cause an increase in children's consumption of sweetened beverages in baby bottles and consequently an increase in Baby Bottle Tooth Decay and nutritional problems. <74> UI - 97200480 AU - Kanellis MJ AU - Logan HL AU - Jakobsen J IN - Department of Pediatric Dentistry, University of Iowa, Iowa City, USA. TI - Changes in maternal attitudes toward baby bottle tooth decay. SO - Pediatric Dentistry 1997 Jan-Feb;19(1):56-60 AB - Several studies have shown that a significant number of parents whose children have baby bottle tooth decay (BBTD) admit prior knowledge regarding the harmful effects of putting their children to bed with a bottle. The Elaboration Likelihood Model of Persuasion (ELM) offers a theoretical framework for better understanding why knowledge and attitude are often not predictive of behavior. The goal of this study was to use the ELM to analyze the manner in which information about BBTD is evaluated. One hundred twenty low-income women (either pregnant or with a child younger than 7 months of age) at a WIC clinic were randomly assigned to three groups: 1) 5-min audiotaped persuasive message about BBTD; 2) same audiotaped message with overheard audience response affirming the message; and 3) no intervention control group. Knowledge and attitudes about BBTD were measured before and after the experimental intervention. Participants he