Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Sep 2000.> Search Strategy (You Saved Citations 1-300 From Set 55): ----------------------------------------------------------------------------- 1 Toothbrushing/ 3349 2 toothbrush:.mp. 3757 3 ((tooth or teeth) adj5 brush:).mp. 744 4 ((tooth or teeth) adj5 unbrush:).mp. 1 5 (brush: adj5 (week: or day: or frequenc:)).mp. 588 6 Toothpaste/ 1206 7 ((tooth or teeth) adj3 (paste: or powder:)).mp. 200 8 toothpaste:.mp. 1667 9 or/1-8 5692 10 exp Tooth demineralization/ 22604 11 demineralization.mp. 1614 12 caries.mp. 15267 13 caires.mp. 1 14 craies.mp. 0 15 careis.mp. 4 16 carise.mp. 0 17 (teeth adj3 cavit:).mp. 422 18 (tooth adj3 cavit:).mp. 217 19 (dental adj3 cavit:).mp. 276 20 (dentin adj3 cavit:).mp. 254 21 (enamel adj3 cavit:).mp. 182 22 (teeth adj3 decay:).mp. 374 23 (tooth adj3 decay:).mp. 321 24 (dental adj3 decay:).mp. 249 25 (dentin adj3 decay:).mp. 12 26 (enamel adj3 decay:).mp. 20 27 (active adj decay).mp. 9 28 (rampant adj3 decay:).mp. 14 29 (recurrent adj3 decay:).mp. 30 30 (white adj spot:).mp. 507 31 carious.mp. 2073 32 cariology.ti,ab. 56 33 (non-cavitated adj3 lesion:).mp. 15 34 (noncavitated adj3 lesion:).mp. 2 35 Tooth remineralization/ 472 36 (dental adj3 fissure:).mp. 98 37 (tooth adj3 fissure:).mp. 50 38 (teeth adj3 fissure:).mp. 97 39 caries-free.mp. 602 40 cariesfree.mp. 17 41 Cariogenic agents/ 728 42 precavit:.mp. 8 43 (filled adj3 teeth).mp. 510 44 (filled adj3 tooth).mp. 116 45 (oral adj fissure:).mp. 6 46 (tooth adj3 remineraliz:).mp. 28 47 (teeth adj3 remineraliz:).mp. 24 48 dft.mp. 411 49 dfs.mp. 1246 50 dmf:.mp. 6389 51 cariogeni:.mp. 1783 52 or/10-51 32194 53 9 and 52 1450 54 limit 53 to (human and english language and yr=1975-2000) 844 55 limit 54 to (infant < 1 to 23 months > or preschool child < 563 2 to 5 years > or child < 6 to 12 years > or adolescence < 13 to 18 years >) 56 from 55 keep 1-300 300 *************************** <1> UI - 20321848 AU - Retnakumari N IN - Dept. of Pedodontics and Preventive Dentistry, Govt. Dental College, Thiruvananthapuram. TI - Prevalence of dental caries and risk assessment among primary school children of 6-12 years in the Varkala municipal area of Kerala. SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1999 Dec;17(4):135-42 AB - This epidemiological survey attempted to establish the prevalence and severity of dental caries among primary school children of Varkala municipal area. The prevalence of dental caries was 68.5% with a standard error (SE) of 1.64% and 95%, confidence interval (CI) 65.18, 71.82. The highest caries prevalence was found among 10 year age group (75.9%) and lowest in the 8 year age group (63%). The highest dmft score was found in 9 year age group 2.73 +/- 0.443 and highest DMFT score was found in 12 year age group 2.06 +/- 0.3824. Statistically significant association was found with dental caries and oral hygiene status (Odds Ratio (OR) 3.59, 95% CI, 2.53, 5.06 and oral cleanliness OR 2.73, 95% CI 2.96, 3.82). Statistically significant association was found between low socioeconomic status and prevalence of caries (O.R. 1.89, 95% CI--1.28, 2.8). <2> UI - 20321838 AU - Kuriakose S AU - Joseph E IN - Department of Pedodontics, Government Dental College, Trivandrum. TI - Caries prevalence and its relation to socio-economic status and oral hygiene practices in 600 pre-school children of Kerala-India. SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1999 Sep;17(3):97-100 AB - This Study was undertaken to determine the caries status of pre-school children in Ulloor Panchayat of Trivandrum, Kerala and to determine the relation if any, between their caries and socio-economic status and oral practices. 200 children each from the low, middle arid higher socio-economic group were visually examined for caries by the same examiner in natural daylight. Caries was recorded according to the WHO criteria. Information regarding the childrens' oral hygiene practices were obtained through structured questionnaires to the care takers of the children. Computer analysis of the data collected showed that 43% of the study sample were caries free. Socio-economic level was found to have a negative association with caries status. The mode of tooth brushing was found to be significantly related to caries severity while the frequency of tooth brushing was found to have no association with caries prevalence and severity. <3> UI - 20321821 AU - Gopinath VK AU - Barathi VK AU - Kannan A IN - Dept. of Pedodontics, Meenakshi Ammal Dental College, Chennai. TI - Assessment and treatment of dental caries in semi-urban school children of Tamilnadu (India). SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1999 Mar;17(1):9-12 AB - The study was carried out with the purpose of evaluating the prevalence of dental caries, in semi urban school children. The sample comprised of 415 school going children. DMFT/dmft scores were recorded as per WHO 1987 criteria. Mean DMFT was found to be 0.17, 0.06 in male and female children at 3 to 6 age group which increased to 1.21 & 1.10 in males and female in 9 to 12 year age group. Mean dmft at 3 to 6 years was 1.36, 1.17 in male and female children which further increased at 6 to 9 years in both sexes but in the 9 to 12 year age group the value decreased to 1.48, 0.87 in male and female children respectively. The entire sample showed a dental caries prevalence of 58.1. It was noted that the children brushed once a day with toothpaste and toothbrush. Complete oral rehabilitation was undertaken through an incremental school health care programme. <4> UI - 20316562 AU - Petersen PE AU - Razanamihaja N IN - University of Copenhagen, Faculty of Health Sciences, Department of Community Dentistry, Denmark. TI - Carbamide-containing polyol chewing gum and prevention of dental caries in schoolchildren in Madagascar. SO - International Dental Journal 1999 Aug;49(4):226-30 AB - The objective of this investigation was to evaluate the effect on dental caries experience of using carbamide polyol chewing gum as a supplement to standard oral hygiene procedures for schoolchildren in a developing country (Madagascar). In 1994, grades 1 and 4 children of demonstration schools were allocated to experimental and control groups; all children participated in a school-based oral health education programme, including daily toothbrushing supervised by the classroom teacher. At grade 1, the test group (n = 125) also used chewing gum (V6: 55.5 per cent sorbitol, 4.3 per cent xylitol, 2 per cent carbamide) three times a day. At grade 4, one test group (n = 177) had chewing gum three times a day and an additional test group (n = 74) had chewing gum five times a day. The control groups included 117 children at grade 1 and 209 at grade 4. Dental caries was registered in 1994 and 1997 according to the Recording System for the Danish Child Dental Services. In grade 1 children, the preventive effect of the total DMFS was not statistically significant except for occlusal caries (-0.65 DMFS, P < 0.01). In the grade 4 test groups, non-significant reductions of dental caries experience were found when compared with controls. The present community trial indicates that the use of polyol chewing gum may be considered a supplement to the control of occlusal dental caries in young primary schoolchildren, particularly in developing countries with limited resources for dental care. <5> 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. <6> UI - 20316546 AU - Mikami Y AU - Croucher R AU - Hector M IN - Tokyo Medical and Dental University, Japan. TI - Knowledge and reported behaviour concerning the prevention of caries in children: a questionnaire survey of Japanese parents resident in London, UK. SO - International Dental Journal 1999 Apr;49(2):115-21 AB - The objective of this study was to assess the knowledge and self-reported behaviours of a sample of Japanese parents resident in London, UK with respect to the prevention of caries in their children. Japanese parents were asked to complete a structured questionnaire which was distributed through the school authorities to seventeen primary schools. Data was collected on: socio-demographics, dental service use in their children, knowledge and reported behaviours with respect to the prevention of dental caries in their children. After one reminder the questionnaire response rate was 69 per cent (n = 111). The mean age of the children was 6.75 years (range 3-12 years) and 73 per cent had been born in Japan. Those respondents with children born in the UK were more likely to take their children to the dentist regularly and more likely to correctly identify the cause and prevention of dental caries. Whilst a majority of respondents reported that their children brushed their teeth twice daily, toothpaste was not used by one quarter of the children. Barriers to dental attendance were identified. Whilst there were some similarities in levels of knowledge and reported behaviours, the parents of Japanese born children were disadvantaged with respect to knowledge about the causes and prevention of dental caries and the use of UK primary dental care services. These parents should be offered information about these issues. <7> UI - 20237496 AU - Birkeland JM AU - Haugejorden O AU - von der Fehr FR IN - Department of Odontology-Cariology, University of Bergen, Norway. jan.birkeland@odont.uib.no TI - Some factors associated with the caries decline among Norwegian children and adolescents: age-specific and cohort analyses. SO - Caries Research 2000 Mar-Apr;34(2):109-16 AB - The purpose of this study was to evaluate factors related to the caries decline in children between 1966 and 1983. The decline started in the late sixties for the 8- to 11- and the 17-year-olds, and after 1971 for the remaining age groups. Regression analyses confirmed a significantly different start of the decline. Fluorides in school-based programmes, lozenges, and toothpaste, as well as education and sale of antibiotics were significantly (p< or =0.01) related to the caries decline in partial correlation analyses. Fluoride toothpaste was only significantly related to the decline in the last part of the period of observation. Supervised fluoride rinsing and brushing programmes at school may explain most of the decline before 1971. The later decline may be related to all fluoride agents and to education. Use of fluorides and other preventive efforts aimed at pre-school children may have contributed to the continual decline in the number of fillings in the permanent teeth of the youngest cohorts. <8> UI - 20274720 AU - Hamilton FA AU - Davis KE AU - Blinkhorn AS IN - Salford Community Health Care NHS Trust, UK. TI - An oral health promotion programme for nursing caries. SO - International Journal of Paediatric Dentistry 1999 Sep;9(3):195-200 AB - AIM: To evaluate an oral health promotion programme involving health visitors and mothers of 8-month-old babies in order to address some of the risk factors associated with nursing caries. DESIGN: Two cross-sectional studies using postal questionnaires. SAMPLE: A random sample of 250 mothers who had not received the oral health promotion programme and 250 mothers who had received the programme. SETTING: The City of Salford. RESULTS: The oral health promotion programme significantly improved mothers recall of advice given by health visitors encouraging the use of a feeder cup, brushing their babies' teeth with fluoride toothpaste and restricting sugary foods and drinks. Significant improvements were also found in recall of advice regarding the use of sugar-free medicine and registering babies with a dentist. The programme encouraged a higher proportion of the mothers to bring their children to clinics for a hearing check. CONCLUSION: A simple oral health promotion programme facilitated by health visitors improved recall of advice and clinic visiting behaviour. <9> UI - 20200898 AU - Peretz B AU - Faibis S AU - Ever-Hadani P AU - Eidelman E IN - Department of Pediatric Dentistry, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel. TI - Dental health behavior of children with BBTD treated using general anesthesia or sedation, and of their parents in a recall examination. SO - ASDC Journal of Dentistry for Children 2000 Jan-Feb;67(1):50-4, 9 AB - The aim of the study was to assess the dental status and dental health behavior of children with Baby Bottle tooth Decay treated using general anesthesia or sedation, and the dental health behavior of their parents in a recall examination. The study population consisted of sixty-five children, among whom thirty-four were treated using general anesthesia and thirty-one using sedation. The recall examination included a full dental examination from which the children's dif index could be drawn. Loe's plaque index was used to assess the amount of plaque on the teeth. Sociodemographic information and the dental health behavior of the parents and children were obtained. Plaque index was similar in the general anesthesia and sedation groups. The parents of the general anesthesia group were younger than the parents of the sedation group (35.0 +/- 6.7 and 38.8 +/- 6.2 for the fathers, and 32.4 +/- 5.9 and 34.9 +/- 5.3 for the mother, respectively). More firstborn children were treated using general anesthesia than using sedation. Significantly more siblings were treated in the sedation group. Children treated using sedation had significantly more siblings treated in the same mode. Parents of the children in the general anesthesia group were significantly more involved in brushing their children's teeth than the other group. In the sedation group, more children brush their teeth without parental help. Significantly more children in the general anesthesia group reduced their sweet consumption than in the sedation group. We conclude that preventive behaviors were more frequently adopted among the families of children treated using general anesthesia. <10> 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. <11> UI - 20236897 AU - Forss H IN - Oral and Maxillofacial Department, Kuopio University Hospital, Finland. helena.forss@kuh.fi TI - Efficiency of fluoride programs in the light of reduced caries levels in young populations. SO - Acta Odontologica Scandinavica 1999 Dec;57(6):348-51 AB - Since the late 1930s, when the efficacy of fluoride in caries prevention was first detected, various efficient methods for fluoride delivery have been developed. Nowadays, fluoride is used for caries prevention on a global scale, the most widely used methods being fluoridated toothpaste and water fluoridation. The latter is a typical community-based prevention method, whereas the former method relies on individual motivation. The goal of an efficient community-based fluoride program is to maintain a constant low level of fluoride in as many mouths as possible at as low a cost as possible. Initially, water fluoridation and other community-based programs were highly efficient, but nowadays in societies in which the major part of the population is using fluoride toothpaste and caries levels are low, population-based programs show a low efficiency. As an example, even though water fluoridation was withdrawn in Kuopio, there have been no dramatic effects on the dental health of children and youths. In societies with well-attended, community-based, free dental health care for children and youths, the dental motivation of individuals is, in general, very high and the use of fluoride for caries prevention may be taken care of at the individual level. <12> UI - 20236896 AU - Wang NJ IN - Public Dental Services, Oslo, Norway. ninaw@odont.uio.no TI - Government policies on fluoride utilization in the Nordic countries. SO - Acta Odontologica Scandinavica 1999 Dec;57(6):342-7 AB - In most but not all the Nordic countries, the National Boards of Health have issued guidelines governing the utilization of fluoride. The purpose of this paper is to outline the process of policy formation, describe the current fluoride guidelines in the Nordic countries, and discuss compliance with and appropriateness of the guidelines. The fluoride guidelines summarize current knowledge and make recommendations on choice of fluoride preparations (supplements, toothpaste, and varnish) and doses. Fluoride policies in the Nordic countries in the late 1990s state that use of fluoride toothpaste twice a day is the preferred and sufficient source of fluoride for the majority of the population. The policies of the Nordic countries are similar, but there are differences, some of them self-explanatory others not so obvious. In the case of supplements, for example, there are differences in the recommended dosage schedules. In the case of toothpaste, it is unclear what concentrations of fluoride are recommended both for children and for adults. Starting time for the use of fluoride, whether toothpaste or supplements, varies between countries. The clinicians' compliance with fluoride guidelines has not been systematically evaluated. Comparing the advice and treatments offered by dentists in the Nordic countries with current guidelines suggests that national policies influence the practice of clinicians. For government policy to be appropriate, it is imperative that the guidelines are based on sound scientific evidence. It is thus concluded that if nonevidence-based elements are included in national guidelines, this should be clearly stated to prevent confusion and enhance compliance from professionals and the public. <13> UI - 20236890 AU - Honkala S AU - Honkala E AU - Tynjala J AU - Kannas L IN - Department of Health Sciences, University of Jyvaskyla, Finland. TI - Use of xylitol chewing gum among Finnish schoolchildren. SO - Acta Odontologica Scandinavica 1999 Dec;57(6):306-9 AB - The preventive, and partly the remineralizing, effect of xylitol was shown in Finland in the Turku Sugar Studies in 1971-73. Since then, several clinical trials in many countries have confirmed these results. In Finland, oral health personnel have recommended daily use of xylitol chewing gum in their dental health education. Moreover, commercial companies have advertised xylitol, emphasizing in particular its caries preventive effects. All Nordic dental associations have given their recommendations for xylitol use. The aim of this study was to describe how this health habit has been adopted by Finnish schoolchildren. The study was part of the comprehensive cross-national survey on Health Behavior in School-aged Children (HBSC Study)--a WHO Collaborative Study. The data were collected using standardized questionnaires to which pupils in grades 5 (11 years), 7 (13 years) and 9 (15 years) responded anonymously in school classrooms during the spring term 1998. The response rate varied between 87% (15-year-old boys) and 94% (11- and 13-year-old girls). Among boys, the percentages of daily users of xylitol chewing gum were 47% (11 years), 46% (13 years), and 44% (15 years), and among girls, 57% (11 years), 65% (13 years), and 69% (15 years), respectively. Use of sugar-sweetened chewing gum was very rare (1%), as also was use of chewing gum with other artificial sweeteners (1%). It may be concluded that since 1991 the use of xylitol chewing gum has further increased in Finland and currently more than a half of all schoolchildren benefit from it. <14> UI - 20228676 AU - Vrbic V IN - Department of Cariology and Endodontics, Medical Faculty, University of Ljubljana, Slovenia. TI - Retention of a fluoride-containing sealant on primary and permanent teeth 3 years after placement. SO - Quintessence International 1999 Dec;30(12):825-8 AB - OBJECTIVE: The aim of this study, conducted in 132 randomly selected children, was to evaluate the retention of a fluoride-containing sealant on primary and permanent teeth. METHOD AND MATERIALS: In autumn 1995, a total of 195 primary molars in 36 children aged 4.5 years on average and 391 permanent premolars and molars in 96 children aged 10.5 years on average were sealed with Helioseal-F. The manufacturer's instructions were followed closely. The teeth were cleaned with a slurry of pumice and a rotating brush, isolated with cotton rolls, dried with air, etched for 60 seconds with an etching gel (37% phosphoric acid), rinsed with an air-water combination spray, and dried. Sealant was applied with a cannula and polymerized for 60 seconds. A saliva ejector was used throughout the procedure. Sealant retention was checked 3 years after placement. RESULTS: In the primary molars, full retention was found in 95.04%, partial retention in 3.12%, and loss of the sealant in 1.84% of the treated teeth. In the permanent molars, the corresponding rates were 95.81%, 2.83%, and 1.36%, respectively. CONCLUSION: Very good sealant retention was found 3 years after placement. The observed difference in retention between primary and permanent molars was not statistically significant. <15> UI - 20227030 AU - Mattila ML AU - Rautava P AU - Sillanpaa M AU - Paunio P IN - Dept. of Child Neurology, University of Turku, Public Health Center, Finland. TI - Caries in five-year-old children and associations with family-related factors. SO - Journal of Dental Research 2000 Mar;79(3):875-81 AB - It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful. <16> UI - 20205076 AU - Kowash MB AU - Pinfield A AU - Smith J AU - Curzon ME IN - Department of Paediatric Dentistry, Leeds Dental Institute, University of Leeds. TI - Effectiveness on oral health of a long-term health education programme for mothers with young children. SO - British Dental Journal 2000 Feb 26;188(4):201-5 AB - AIM: To determine the effect of dental health education (DHE) on caries incidence in infants, through regular home visits by trained DH Educators over a period of 3 years. METHOD: A randomly selected cohort of 228 children born between 1st January and 30th September 1995, in a low socioeconomic/high caries suburb of Leeds (UK) were divided into the following groups: A) DHE focused on diet; B) DHE focused on oral hygiene instruction (OHI) using fluoride toothpaste; and C) DHE by a combined diet and OHI message. DHE was given using an interview and counselling for at least 15 minutes at home every 3 months for the first 2 years and twice a year in the third year of the study. A fourth group D was given diet and OHI, at home, once a year only. All children and mothers were examined for caries and oral hygiene. A fifth group E (control) received no DHE and were never visited but examined at 3 years of age only. RESULTS: In the groups of children visited regularly only two developed caries and three had gingivitis (all in group A). In group E, however, 33% of children had caries and nine (16%) had gingivitis. The differences in caries levels and caries risk factors between study and control groups were statistically significant (P < 0.001). Mothers of the study groups also showed an improvement in their own levels of gingivitis, debris and calculus scores by the second and third examinations (P < 0.001). CONCLUSION: Regular home visits to mothers with infants, commencing at or soon after the time of the eruption of the first deciduous teeth, was shown to be effective in preventing the occurrence of nursing caries. <17> 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. <18> UI - 20162073 AU - Frame PS AU - Sawai R AU - Bowen WH AU - Meyerowitz C IN - Tri-County Family Medicine, Cohocton, New York 14826, USA. TI - Preventive dentistry: practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines. [Review] [16 refs] SO - American Journal of Preventive Medicine 2000 Feb;18(2):159-62 AB - INTRODUCTION: The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. METHODS: Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. RESULTS: The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. CONCLUSIONS: Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling and polishing to prevent periodontal disease in low-risk persons. There is no scientific evidence that dental examinations, including scaling and polishing, at 6 month intervals, as recommended by the dentists surveyed in this study, is superior to annual or less frequent examinations for low-risk populations. There is also no evidence that in-office fluoride applications offer incremental benefit over less costly methods of delivering fluoride for low-risk populations. [References: 16] <19> UI - 20162455 AU - Kwan SY AU - Williams SA IN - Oral Health and Ethnicity Unit, Leeds Dental Institute, United Kingdom. TI - Dental beliefs, knowledge and behaviour of Chinese people in the United Kingdom. SO - Community Dental Health 1999 Mar;16(1):33-9 AB - OBJECTIVE: This study explored oral health beliefs, knowledge and behaviour among a sample of United Kingdom Chinese. DESIGN: A quota sample of Chinese people, stratified by age and gender, were interviewed by trained and standardised Chinese interviewers using a piloted, validated semi-structured questionnaire. SUBJECTS: One hundred and fifty-six Chinese people--with similar number of teenagers, younger adults and older people--resident in the North East of England. SETTING: Chinese communities. OUTCOME MEASURE: Reported dental knowledge, beliefs and behaviours. RESULTS: Regardless of gender and age, the majority of respondents believed that it was natural for people to lose all their teeth in old age. Less than half were convinced that they would be able to keep their own teeth for life. The majority of the sample considered that they were susceptible to dental diseases, the consequences of which were thought to be serious. Approximately half presumed that dental diseases were preventable, although the aetiology of dental caries, periodontal disease and tooth loss was poorly understood. While 94% claimed to brush their teeth as part of routine dental care, dental visiting and dietary restriction of sugar intake were reported only in 61% and 30% of the sample respectively. Inter-generational differences were marked; older people tended to have a fatalistic attitude and were least likely to attend the dentist. CONCLUSIONS: A low level of dental awareness was found among the UK Chinese. In order to facilitate effective health promotion and treatment services, the extent of Chinese people's traditional oral health beliefs and behaviour must be taken into account. <20> UI - 20162452 AU - Downer MC IN - Eastman Dental Institute, University of London, UK. TI - Caries experience and sucrose availability: an analysis of the relationship in the United Kingdom over fifty years. SO - Community Dental Health 1999 Mar;16(1):18-21 AB - OBJECTIVE: A previous study suggested that the most likely explanation for the rise and subsequent fall in caries in children in England and Wales during the last 50 years was the concurrent increase and then reduction in the sugar challenge to the population, mitigated after the early 1970s by the preventive effect of fluoride toothpaste. The current objective was to quantify the relationship between sucrose available for consumption annually since 1948 and caries experience at 5 and 12 years. METHOD: In a retrospective, longitudinal ecological study, cross-sectional mean dmft values at 5 years and DMFT values at 12 years in England from 1948 to 1968 and England and Wales from 1973 to 1996/97, from three series of standardised surveys, were regressed on data for the relevant years on sucrose available for consumption in the UK. RESULTS: For sucrose consumption and 5-year-old dmft, Spearman's rho was +0.62 (P < 0.05) while for 12-year-old DMFT the value was +0.84 (P < 0.001). For the 12 year age group, Pearson's coefficient could also be calculated (r = +0.87; P < 0.001). CONCLUSION: For several reasons caution should be used in interpreting these findings. Nevertheless they do suggest a strong positive correlation over time between dmft/DMFT and sucrose availability nationally. <21> UI - 20146916 AU - Burt BA IN - Program in Dental Public Health, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. bburt@umich.edu TI - The case for eliminating the use of dietary fluoride supplements for young children. [Review] [72 refs] SO - Journal of Public Health Dentistry 1999 Fall;59(4):269-74 AB - Fluoride supplements have been used for years to prevent dental caries; nevertheless, there are three reasons why their use is inappropriate today among infants and young children in the United States. Evidence for the efficacy of fluoride supplements when used from birth or soon after is weak, supplements are a risk factor for dental fluorosis, and fluoride has little preeruptive effect in caries prevention. While there are many reports on the caries-preventive efficacy of supplements, few meet standards for acceptability as clinical trials, and those that do have tested chewable tablets or lozenges under supervision in school-aged children. North American children today are exposed to fluoride from many sources--drinking water, toothpaste, gels, rinses, and in processed foods and beverages. The additional cariostatic benefits that accrue from using supplements are marginal at best, while there is strong risk of fluorosis when young children use supplements. Available evidence suggests that the public is more aware of the milder forms of fluorosis than was previously thought; thus, it is prudent for caries-preventive policies to aim to maximizing caries reductions while minimizing the risk of fluorosis. It is therefore concluded that the risks of using supplements in infants and young children outweigh the benefits. Because alternative forms of fluoride for high-risk individuals exist, fluoride supplements should no longer be used for young children in North America. [References: 72] <22> UI - 20128564 AU - Irigoyen ME AU - Maupome G AU - Mejia AM IN - Departamento de Ciencias de la Salud, Universidad Autonoma Metropolitana Unidad Xochimilco, Mexico D.F., Mexico. meirigo@cueyatl.uam.mx TI - Caries experience and treatment needs in a 6- to 12-year-old urban population in relation to socio-economic status. SO - Community Dental Health 1999 Dec;16(4):245-9 AB - OBJECTIVE: To report caries experience in the permanent dentition among Mexico City elementary school children and undertakes a comparative analysis of dental caries experience and treatment needs of children of different socio-economic status (SES). RESEARCH DESIGN: SES was established according to an official measure of economic well-being, that of the family income being high enough to allow the child to attend school in a private institution as opposed to a public school. PARTICIPANTS: A probabilistic sample of 4,048 6- to 12-year-old children (47.2% females) was examined using the 1987 WHO caries criteria (546 attended private schools and 3,502 were public school children). RESULTS: The proportion of caries-free 12-year-old children was 28.6% and 9.5% in the private and public schools, respectively (P < 0.01). In 12-year-old children, DMFT was 2.78 (SD 2.9) and 4.64 (SD 3.2) in the private and public school groups, respectively (P < 0.001). Higher treatment needs were found among public schoolchildren (TN = 83.0%) compared with private schoolchildren (TN = 27.6%) (P < 0.001). CONCLUSIONS: Dental caries and treatment needs were considerably higher in children of lower SES. Differences in dietary patterns and toothpaste use could be the more likely explanations for these findings, indicating markedly unequal burdens of disease according to socio-economic status. Special efforts should be developed to improve the oral health status in Mexico City children by implementing preventive health promotion and treatment programmes. <23> UI - 20151476 AU - Kleber CJ AU - Milleman JL AU - Davidson KR AU - Putt MS AU - Triol CW AU - Winston AE IN - Health Science Research Center, Indiana University-Purdue University, Ft. Wayne, USA. kleber@ipfw@edu TI - Treatment of orthodontic white spot lesions with a remineralizing dentifrice applied by toothbrushing or mouth trays. SO - Journal of Clinical Dentistry 1999;10(1 Spec No):44-9 AB - This pilot study investigated the effect of a remineralizing fluoride dentifrice (Enamelon) on newly formed incipient carious lesions using two methods of application. Teenage orthodontic patients with obvious white spot lesions on their teeth were selected to begin treatment within 30 days after debanding. At baseline, the surface enamel of the test teeth was cleaned by air etching with 50 microns alumina at 150 psi. Lesion size (mm2) was measured using a calibrated periodontal probe and surface appearance was quantified as shiny (0), dull (1), or chalky (2). Twice daily for 3 months, one group with a total of 27 lesions brushed with the remineralizing dentifrice, while a second group with 41 total lesions brushed and used a mouth tray to apply the paste directly to the lesions for 5 min. In order to promote treatment compliance, test group assignment was based on subject and parental preference. After 1, 2, and 3 months, lesion size was reduced by 5% (ns), 10% (p < 0.05) and 22% (p < 0.01), respectively, for the brushing group, and 16% (p < 0.05), 37% (p < 0.01) and 30% (p < 0.01) for the combined brushing and tray group, respectively. The dull appearance of the lesions treated by brushing improved slightly over 3 months. However, the lesions receiving combined brushing and tray applications became significantly (p < 0.01) less dull by 28%, 44% and 61% after 1, 2, and 3 months, respectively, indicating the formation of a shiny, intact surface layer. In conclusion, brushing with a remineralizing dentifrice significantly reduced the size of new orthodontic white spots within 2 months, while brushing combined with topical tray applications reduced lesion size within 1 month with concomitant formation of a shiny enamel surface layer. Thus, the combined brushing and mouth tray treatment significantly accelerated the remineralization process. <24> UI - 99381492 AU - Watt R AU - Sheiham A IN - Department of Epidemiology and Public Health, University College London Medical School. TI - Inequalities in oral health: a review of the evidence and recommendations for action [see comments]. [Review] [69 refs] CM - Comment in: Br Dent J 1999 Sep 11;187(5):237-8 SO - British Dental Journal 1999 Jul 10;187(1):6-12 AB - Reducing inequalities in health has become one of the main health policy issues in the late 1990s. The Labour Government set up an independent inquiry into inequalities in health under Sir Donald Acheson to make recommendations on approaches to reducing health inequalities. This paper reviews the evidence on inequalities in oral health in Britain. Dramatic improvements in dental health in children and young adults have taken place in the past 30 years. The levels of caries in permanent teeth of children is low. Widening inequalities in oral health however exist between social classes, regions of England, and among certain minority ethnic groups in pre-school children. The main social class and minority ethnic differences in dental caries is in pre-school children. Wide district and regional differences also exist in prevalence of caries in young children. The area differences relate very strongly to deprivation. In adults the differences in decay experience is less unequal than in children but there are marked social class inequalities in edentulousness. Dental caries decreased in all social classes in the United Kingdom. The main causes of the inequalities are differences in patterns of consumption of non milk extrinsic sugars and fluoridated toothpaste. Improvements in oral health that have occurred over the last 30 years have been largely a result of fluoride toothpaste and social, economic and environmental factors. Oral health inequalities will only be reduced through the implementation of effective and appropriate oral health promotion policy. Treatment services will never successfully tackle the underlying cause of oral diseases. [References: 69] <25> UI - 20011596 AU - Yehieli M AU - Koch SB TI - "Bright smiles, shining futures" response [letter; comment]. CM - Comment on: J Sch Health 1999 Apr;69(4):162-4 SO - Journal of School Health 1999 Oct;69(8):299-300 <26> UI - 20011595 AU - Sheikh A AU - Horowitz AM TI - Benefits of fluoride toothpaste [letter; comment]. CM - Comment on: J Sch Health 1999 Apr;69(4):162-4 SO - Journal of School Health 1999 Oct;69(8):299 <27> UI - 20110279 AU - Whittle JG AU - Whittle KW IN - South and East Lancashire Health Authorities, UK. TI - Household income in relation to dental health and dental health behaviours: the use of Super Profiles. SO - Community Dental Health 1998 Sep;15(3):150-4 AB - OBJECTIVE: To investigate the relationship between household income defined by Super Profiles, a socio-economic indicator, and dental health and dental health behaviours. BASIC RESEARCH DESIGN: Analytical survey involving a clinical examination and a questionnaire to parents. SETTING: Primary schools in Salford, UK. PARTICIPANTS: Two thousand five hundred and seventy eight 5-year-old children were examined; 1938 (75%) returned questionnaires. MAIN OUTCOME MEASURES: Mean caries experience and ages at first visit to dentist and when toothbrushing commenced. RESULTS: Children in the highest income group had a mean dmft of 1.83 compared with 2.56 in the middle group and 3.43 in the lowest income group. The proportions who had visited a dentist by their second birthday were 71%, 64% and 62% respectively. The corresponding proportions having their teeth brushed by their first birthday were 69%, 58% and 57%. CONCLUSIONS: The study showed a relationship between Super Profiles, and the dental health and dental health behaviours of 5-year-old children. <28> UI - 20110277 AU - Kay E AU - Locker D IN - University Dental School of Manchester, UK. TI - A systematic review of the effectiveness of health promotion aimed at improving oral health. SO - Community Dental Health 1998 Sep;15(3):132-44 AB - OBJECTIVE: To examine the quality of oral health promotion research evidence and to assess the effectiveness of health promotion, aimed at improving oral health using a systematic and scientifically defensible methodology. BASIC RESEARCH DESIGN: Systematic review of oral health promotion research evidence using electronic searching, iterative hand-searching, critical appraisal and data synthesis. CLINICAL SETTING: The settings of the primary research reviewed were clinical, community, schools or other institutions. The participants were children, the elderly, adults and people with handicaps and disabilities. INTERVENTIONS: Only studies which reported an evaluative component were included. Theoretical and purely descriptive papers were excluded. MAIN OUTCOME MEASURES: The review examined the evidence of effectiveness of oral health promotion on caries, oral hygiene, oral health related knowledge, attitudes and behaviours. RESULTS: Very few definitive conclusions about the effectiveness of oral health promotion can be drawn from the currently available evidence. Caries and periodontal disease can be controlled by regular toothbrushing with a fluoride toothpaste but a cost-effective method for reliably promoting such behaviour has not yet been established. Knowledge levels can almost always be improved by oral health promotion initiatives but whether these shifts in knowledge and attitudes can be causally related to changes in behaviour or clinical indices of disease has also not been established. CONCLUSIONS: Oral health promotion which brings about the use of fluoride is effective for reducing caries. Chairside oral health promotion has been shown to be effective more consistently than other methods of health promotion. Mass media programmes have not been shown to be effective. The quality of oral health promotion evaluation research needs to be improved. <29> UI - 20105829 AU - Flinck A AU - Kallestal C AU - Holm AK AU - Allebeck P AU - Wall S IN - Department of Epidemiology and Public Health, Umea University, Sweden. TI - Distribution of caries in 12-year-old children in Sweden. Social and oral health-related behavioural patterns. SO - Community Dental Health 1999 Sep;16(3):160-5 AB - OBJECTIVE: To describe the distribution of caries in 12-year-old children in Sweden according to socio-demographic and oral health related behaviour. PARTICIPANTS: The study group consisted of 3,373 12-year-old children residing in catchments of 26 different public dental health clinics in Sweden, geographically well represented. METHOD: The clinical examination for dental caries was performed by 28 calibrated dentists. A questionnaire on lifestyle was distributed to the children with questions on ethnicity, socio-economic level and oral health as well as overall health attitudes. RESULTS: The proportion of 12-year-old children with no experience of dentine caries was 47% and 35% were completely free from all caries. Intraoral distribution of caries showed most lesions on the first molar mesial surface, with 80% enamel and 20% dentine caries. Almost all children brushed their teeth twice a day and a third of the children had an extra intake of fluoride. Decayed surfaces including enamel caries (DeS) was chosen as a measure of ongoing caries and used when dividing children into three caries groups; caries free (50%), 1-3 lesions (40%) and the high caries group (10%) with more than 3 lesions. These groups showed distribution differences. More non-Swedish children, children from workers' homes, and children who brushed their teeth less than twice a day were found in the high caries group. More children from workers' homes living in big cities and snacking more than once a week were also found in the high caries group. This could not be shown for other social groups. Also children who had an extra intake of fluoride were classified in the high caries group. <30> UI - 20105820 AU - Mascarenhas AK IN - Ohio State University, Columbus, USA. TI - Determinants of caries prevalence and severity in higher SES Indian children. SO - Community Dental Health 1999 Jun;16(2):107-13 AB - OBJECTIVES: Recent epidemiological studies in the economically developing countries show that the prevalence and severity of dental caries has increased with industrialization and exposure of these populations to western diets. The aim of this study was to quantify the caries experience, and identify determinants associated with caries, in a population which has a higher socio-economic status (SES), and is the most westernized in India. BASIC RESEARCH DESIGN: The study site was Goa, a former Portuguese colony, which became part of India in 1961. Data came from a cross-sectional survey of 1,189 seventh grade children in private schools, consisting of a clinical dental examination and a self-administered questionnaire to their parents. MAIN OUTCOME MEASURES: The study used the cavitated/non-cavitated criteria to score for caries, the TF index for fluorosis, and the Silness and Loe index for plaque. RESULTS: The mean age of the children was 12.2 years. The proportion of children caries-free in the permanent dentition was 22.2%. The mean DMFT and DMFS in the study group were 2.78 and 4.20, respectively. The decayed component accounted for over 87% of the DMFT, DMFS, dft, and dfs. Results of the crude, stratified, and multivariate regression analyses showed that poor oral hygiene, mother's highest level of education, use of fluoride toothpaste before the age of six years, and higher frequency of tooth brushing were risk indicators of caries prevalence and severity. CONCLUSION: The findings suggest that risk indicators of caries in this study population were similar to those in developed countries. <31> UI - 20105819 AU - Vigild M AU - Skougaard M AU - Hadi R AU - Halling C IN - School of Dentistry, University of Copenhagen, Denmark. TI - An oral health programme for schoolchildren in Kuwait 1986-97. SO - Community Dental Health 1999 Jun;16(2):102-6 AB - OBJECTIVES: To assess whether it was possible to implement an oral health programme in Kuwait which followed guidelines underlying the public Danish Child Oral Health Service, and thereby improve the oral health of Kuwaiti children. DESIGN: Successive cross-sectional surveys were carried out in one governorate in Kuwait (Al-Ahmadi) during the period 1986-97 interrupted by the Gulf War. Data were collected by clinical examinations. SETTING: The programme was initiated by the Ministry of Health in Kuwait in order to improve the community services through a school-based oral health care programme. PARTICIPANTS: The study population comprised incrementally all children in the four primary school classes in the governorate. INTERVENTIONS: The children received bi-weekly tooth brushing instructions with fluoridated toothpaste and fluoride rinsing, fissure sealing, oral health education, and restorative treatment of dental caries. OUTCOME MEASURES: The children were clinically examined each year before the start of the treatment. Dental caries was scored at surface level in accordance with the Danish registration system, using the WHO criteria for dental caries. RESULTS: The average participation rate was 94%. The percentage of caries-free children, exemplified by second class, increased from 64% in 1987 to 78% in 1990, dropped to 71% in 1992 and increased again to 79% in 1997. CONCLUSION: It is concluded that it has been possible to adapt the principles from the Danish Child Oral Health Service programme to Kuwait, that parents and teachers accepted the principle of treating the children during school hours, and that the oral health of the children improved. Whether the improvement in the oral health is due to the programme or to changes in the society is discussed. <32> UI - 20103524 AU - Petti S AU - Bossa MC AU - Tarsitani G AU - Falcolini G AU - Lumbau A AU - Campus G IN - G. Sanarelli Hygiene Institute, La Sapienza University, Rome. TI - Variables affecting salivary Streptococcus mutans counts in a cohort of 12-year-old subjects. [Review] [31 refs] SO - Minerva Stomatologica 1999 Sep;48(9):361-6 AB - BACKGROUND: Several factors such as toothbrushing, diet, acidogenic potential of the mutans streptococci strain and site of the carious lesion can modify the salivary Streptococcus mutans (Sm) counts. In the present investigation the effect of some behavioural, clinical and microbiological variables on Sm salivary counts was evaluated in a cohort of 12-year-olds. METHODS: Forty subjects were examined by two calibrated examiners (GC, AL). The number of surfaces either decayed occlusal, decayed smooth or filled and the number of bleeding sextants, (clinical index for oral hygiene) were reported. Saliva was collected using a tongue depressor and was plated onto mitis salivarius agar with bacitracin and 20% sucrose. The presumptive Sm colonies were counted and the concentrations were logarithmically transformed. One Sm strain per subject was identified and the cariogenic potential evaluated as the minimum pH value recorded, during 5 hrs of incubation in 5% sucrose solution. The children's parents or guardians completed a questionnaire concerning the frequency of toothbrushing, the consumption of sweet foods and soft drinks and at what age the children started brushing their teeth. The effect of the explanatory variables on Sm count logarithms was evaluated by stepwise multiple regression. RESULTS: The regressors with significant additional explanatory power were cariogenic potential (b = -1.335, p = 0.00001, R2 increment = 0.312), decayed smooth surfaces (b = -0.456, p = 0.009, R2 increment = 0.114) and bleeding sextants (b = -0.113, p = 0.004, R2 increment = 0.062), whereas the power of filled surfaces was marginally significant (p = 0.08). CONCLUSIONS: On the basis of these results, it is suggested that acidogenicity is not only a cariogenic factor, but also a factor promoting colonization of oral sites by Sm, especially in subjects with a high frequency of sugar consumption. [References: 31] <33> UI - 20069257 AU - Ekstrand KR AU - Kuzmina IN AU - Kuzmina E AU - Christiansen ME IN - Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark. KIM.EKSTRAND@ODONT.KU.DK TI - Two and a half-year outcome of caries-preventive programs offered to groups of children in the Solntsevsky district of Moscow. SO - Caries Research 2000 Jan-Feb;34(1):8-19 AB - This study examined the 2.5-year outcome of preventive programs - based on the Nexo method - offered to three groups of children from Solntsevsky, a district of Moscow. Study group A consisted of 45 3-year-olds, study group B of 50 6-year-olds, and study group C of 50 11-year-olds. A similar number of children were selected as control groups and they followed the normal dental service provided by the local Health Service System in the district. The caries-preventive programs offered to the study groups were based on: (1) education of the child, parents and teachers in the caries disease, (2) training in toothbrushing. In addition, the children in study groups B and C were offered professional plaque removal, applications of sodium fluoride (2%) and sealant applications according to individual needs. The children in groups B and C were clinically examined in March 1994 (baseline) after 1 and 2.5 years, respectively. Because of the age of the children in group A, these children were only examined once, after the study had been completed. After 2.5 years the children in all three study groups had improved their oral health status significantly compared to the children in the control group. The caries experience among the children in study group A was about half of that observed among children in the control group (4.91 def-s versus 8.60 def-s). The program was highly effective in controlling dental caries in the permanent dentition among the children in the study groups, who finished with a mean DMF-S of 0.28 (group B) and 3.12 (group C) compared to 2.24 and 6.35 among the children in the corresponding control groups. Nearly all the children used fluoridated toothpaste. The mean number of visits to the clinic decreased from year 1 to year 2 (5 versus 3.4 in study group B and 4.5 versus 3.3 in study group C). In conclusion, the preventive programs were highly effective with regard to improving the level of oral hygiene, and thereby reducing or even controlling the plaque-induced disease activity. <34> UI - 20106769 AU - Sanchez OM AU - Childers NK IN - University of Alabama School of Dentistry, Birmingham 35294-0007, USA. TI - Anticipatory guidance in infant oral health: rationale and recommendations. [Review] [31 refs] SO - American Family Physician 2000 Jan 1;61(1):115-20, 123-4 AB - If appropriate measures are applied early enough, it may be possible to totally prevent oral disease. The American Academy of Pediatric Dentistry recommends that infants be scheduled for an initial oral evaluation within six months of the eruption of the first primary tooth but by no later than 12 months of age. The rationale for this recommendation is provided, although the recommendation itself is not universally accepted. Specific recommendations include elimination of bottles in bed, early use of soft-bristled toothbrushes (with parental supervision) and limitation of high-carbohydrate food intake after teeth have been brushed. [References: 31] <35> UI - 20039828 AU - Lin YT AU - Tsai CL IN - Department of Dentistry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan. TI - Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan. SO - Cleft Palate-Craniofacial Journal 1999 Nov;36(6):522-6 AB - OBJECTIVE: The purposes of this study were to investigate the caries prevalence in cleft lip, cleft palate, or both in children under the age of 2 years and to evaluate parental attitudes toward bottle-feeding, dental care, and their relationship to baby bottle tooth decay (BBTD) in Taiwan. DESIGN: Randomized and prospective study. SETTING: Institutional setting. PATIENTS AND METHODS: One hundred twenty-three 2-year-old children (68 boys and 55 girls) with cleft lip, cleft palate, or both were selected for this study. A questionnaire that asked questions about knowledge of oral health, knowledge and beliefs about BBTD, children's feeding habits, children's dental care, and parenting attitudes toward children with clefts was completed by the parents or caretakers. Children were divided into bottle-feeding and non-bottle-feeding groups according to the questionnaire responses of parents or caretakers. Each child was examined with a dental mirror and explorer under focused flashlight using defs index to determine the presence of BBTD. RESULTS: Thirty-nine percent (48) subjects reported a bottle-feeding habit; the overall prevalence of BBTD was 15.4%. The habit of bottle-feeding was significantly related to BBTD (p = .019). The defs score for children who were bottle-fed was significantly higher than children who were not bottle-fed (p = .045). Parents or caretakers of both bottle-feeding and non-bottle-feeding children showed no significant differences in their attitudes toward bottle-feeding and feeding habits (p > .05). However, parents of non-bottle-fed children had significantly better dental care than parents of bottle-fed children in brushing frequency (p < .001) and brushing before bed (p < .001). CONCLUSIONS: Children with clefts who took a bottle to bed showed an increased risk of developing BBTD. The parents or caretakers of bottle-fed children also showed a lack of motivation to perform regular preventive dental home care for their children. This suggests that oral health promotion programs should begin in infancy for children with clefts and their parents. <36> UI - 20065043 AU - Loh T AU - Chan J AU - Low CN IN - Dental Division, Ministry of Health, Singapore. TI - Oral health of Singapore adults. SO - Singapore Dental Journal 1996 Jul;21(1):6-10 AB - In a study conducted by the Dental Division of the Ministry of Health in 1992, 3157 Singapore adults aged 20 to 65 years and over were interviewed on their knowledge, attitude and practice of dental care and given an examination. About 66% indicated they required dental treatment. Utilisation of dental services was low with 39% visiting the dentist at least once in 2 years. About 72% brushed their teeth morning and night. The dental examination showed that 79.2% had calculus, 92% needed prophylaxis and oral hygiene instruction and only 0.2% needed complex periodontal treatment. A large proportion (96.6%) of the sample was dentate. The mean DMFT was 10.7 and the mean number of decayed root for the dentate population was 0.2. The age-group 65 years and over had the highest percentage (63.6%) of persons wearing dentures and the age group 50-54 years had the highest percentage (54.2%) requiring dentures. This study has shown that oral health promotion for home and professional care should be stressed to the adult population, particularly the older age groups. <37> UI - 20065017 AU - Tonacao LG AU - Orata FM AU - Carino BH AU - Bautista LF TI - A study on how military dependents at Philippine Navy Officers Wives Association (PNOWA) Child Learning Center brush their teeth. SO - Journal of the Philippine Dental Association 1998 Sep-Nov;50(2):43-62 <38> UI - 99408154 AU - Kneckt MC AU - Syrjala AM AU - Knuuttila ML IN - Institute of Dentistry, University of Oulu, Finland. mkneckt@hotmail.com TI - Locus of control beliefs predicting oral and diabetes health behavior and health status. SO - Acta Odontologica Scandinavica 1999 Jun;57(3):127-31 AB - Our study evaluates the correlation between dental and diabetes locus of control beliefs and the potentiality of locus of control beliefs in predicting oral health behavior, dental status, diabetes compliance, and HbA1c level by using situation-specific locus of control scales and considering the value dimension. Data were collected by means of a quantitative questionnaire, a clinical oral examination and patient records. The research population comprised 149 insulin-dependent diabetics who had teeth of their own. Variables were the frequencies of tooth brushing and dental visiting, oral indexes, diabetes adherence, and HbA1c level. Dental and diabetes locus of control beliefs correlated with each other. Dental locus of control associated with frequency of dental visiting, plaque index, decayed surfaces, and with root caries, but diabetes locus of control associated only weakly with adherence with diabetes self-care regimens and not at all with HbA1c level. Correlations between dental locus of control and oral indexes were stronger among those having high value for dental care. Although there were correlations between dental and diabetes locus of control beliefs, only dental locus of control beliefs are practicable for determining health behavior and health status. It is therefore concluded that locus of control beliefs are health behavior specific. <39> UI - 99391690 AU - Ashley PF AU - Attrill DC AU - Ellwood RP AU - Worthington HV AU - Davies RM IN - Eastman Dental Institute, London, UK. p.ashley@eastman.ucl.ac.uk TI - Toothbrushing habits and caries experience. SO - Caries Research 1999 Sep-Oct;33(5):401-2 <40> UI - 99360011 AU - Holst A AU - Braune K AU - Kjellberg-Larsson M IN - Public Dental Service, County of Blekinge, Sweden. TI - Occurrence and distribution of caries in 6-year-old children in Blekinge, Sweden. SO - Swedish Dental Journal 1999;23(2-3):71-6 AB - Community dentistry in Blekinge aims at age-specific levels of dental health. For 6-year-old children the goal is that > 65 percent will have dmft = 0 in the year 2000. At present there is no study on dental health in 6-year-olds in Blekinge. The aims of the present study are to establish baseline epidemiological data on dental caries in the county of Blekinge, expressed as dentin lesions and enamel lesions, to analyse these data and to formulate program oriented planning of dental care for pre-school children to achieve the dental health goal for the year 2000. The material comprised a random sample of 213 children. The sample was drawn from the population register for children living in the county of Blekinge. A clinical investigation was performed by one of the authors and was completed with bite-wing radiographs whenever the proximal surface could not be inspected clinically. In addition the parents were asked questions about tooth-brushing and use of fluoride tablets. Fifty-six percent of the children had filled lesions and manifest lesions (dfs), 65 percent had enamel caries lesions (dsi) and 42 percent had manifest lesions (ds). Fifty-three percent had dmft > 0. The finding of initial lesions in 65 percent of the children indicates that caries prevalence is greatly underestimated. Together with poor oral hygiene, this means an increase in the risk of caries progression. The pattern of dental health was very skewed among the children; 23 percent had between 5 and fourteen decayed or filled teeth and 11 percent had from 5 to 23 manifest lesions. Clinics in Blekinge have had different strategies for preventive dental care. In 1997, however, all the public dental service clinics in Blekinge, adopted a uniform program for child dental care, focusing on primary prevention and risk assessment for each individual. <41> 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. <42> UI - 99285277 AU - Kodaka T AU - Kobori M AU - Hirayama A AU - Abe M IN - Department of Oral Anatomy, Showa University School of Dentistry, Tokyo, Japan. TI - Abrasion of human enamel by brushing with a commercial dentifrice containing hydroxyapatite crystals in vitro. SO - Journal of Electron Microscopy 1999;48(2):167-72 AB - Automatic toothbrushing with a commercial dentifrice containing hydroxyapatite (HAP) crystals was performed on the tangential polished surfaces of sound human enamel, mainly consisting of biological apatite similar to HAP, for 10 min in vitro. The X-ray diffraction peaks of HAP, brushite (DCPD), and monetite (DCP) crystals were detected from the dentifrice. After brushing, the enamel surfaces were observed with a scanning electron and a confocal scanning laser microscope. The brushing caused larger abrasive loss and more remarkable roughness of the enamel surfaces following the broad traces of brush bristles and the exposure of prism structures than brushing with a dentifrice containing only DCPD, which we previously reported. We claim that the fine granular-shaped HAP crystals of the dentifrice indicated as an active ingredient for preventing enamel caries possess stronger abrasivity of sound enamel than the DCPD and DCP as abrasives on account of their Mohs hardness values rather than sizes and shapes. The HAP crystals of dentifrices may not occlude the small defects of early caries enamel, but erode them more strongly as an abrasive than the other abrasives. <43> UI - 99283432 AU - Tinanoff N AU - Daley NS AU - O'Sullivan DM AU - Douglass JM IN - Department of Pediatric Dentistry, University of Connecticut Health Center, USA. TI - Failure of intense preventive efforts to arrest early childhood and rampant caries: three case reports. SO - Pediatric Dentistry 1999 May-Jun;21(3):160-3 AB - This report presents the first three children who developed dental caries despite being enrolled in a randomized, control trial to test methods to prevent early childhood caries. The children's caretakers received education on decreasing frequent and prolonged feeding with a nursing bottle and other sugar containing foods, as well as brushing the children's teeth daily with 0.4% SnF2 gel. One of the child's caretaker additionally received training sessions to improve confidence in eliminating the child's nursing bottle habit and in performing daily tooth brushing. The two other children received monthly topical fluoride treatments with 2% NaF. Despite these intensive preventive efforts, these three children developed dental caries. Two of the children had mutans streptococci colonization at the time of initial visit, (12 and 14 months of age, respectively). All had high mutans streptococci levels at the time that caries was detected. Incorrigible, high-frequency sugar consumption from a bottle or from solid foods was suggested in all three cases. In one case, dental caries was associated with defects of the tooth enamel. Conceivably, the cariogenic challenge and harmful behaviors in certain children may be so extreme that they can overwhelm even extraordinary preventive efforts. <44> UI - 99247416 AU - Kneckt MC AU - Syrjala AM AU - Laukkanen P AU - Knuuttila ML IN - Institute of Dentistry, University of Oulu, Finland. mkneckt@hotmail.com TI - Self-efficacy as a common variable in oral health behavior and diabetes adherence. SO - European Journal of Oral Sciences 1999 Apr;107(2):89-96 AB - Successful treatment of dental caries, periodontal diseases and diabetes requires persistent daily self-care. The aim of this study was to evaluate the perception of self-efficacy as a common behavioral factor determining oral health behavior, diabetes self-care, and actual health status. Cross-sectional data relating to 149 insulin-dependent diabetes mellitus (IDDM) patients were collected from patient records, and by clinical oral examination and a quantitative questionnaire. The study population was recruited from different locations, and the participation percentage was 80%. Self-efficacy scales associated with corresponding behaviors, and a dental self-efficacy scale also correlated with dental caries. Dental self-efficacy correlated with diabetes self-efficacy, diabetes adherence, and with HbA1c. Also, logistic regression analysis revealed that dental self-efficacy was related to diabetes adherence. Further, those diabetics reporting a high frequency of dental visiting had higher diabetes self-efficacy. As a conclusion, good dental self-efficacy has a positive influence on diabetes adherence. The results suggest that the perception of self-efficacy may be a common behavioral factor determining diabetes self-care and oral health behavior. <45> UI - 99243308 AU - Wang NJ AU - Riordan PJ IN - Faculty of Dentistry, University of Oslo, Norway. ninaw@odont.uio.no TI - Fluoride supplements and caries in a non-fluoridated child population. SO - Community Dentistry & Oral Epidemiology 1999 Apr;27(2):117-23 AB - In Norway, there is no water fluoridation and little naturally occurring fluoride in drinking water. Fluoride toothpaste is used by 95% of the population and there is a long tradition of use of fluoride supplements. The purpose of this study was to analyse whether children who used fluoride toothpaste regularly and complied with the recommendations for use of fluoride supplements had less caries than other children at the age of 8 years. Most fluoride supplements sold in Norway are lozenge-type tablets, which allow for extended enamel exposure to fluoride. All children (n = 551) born in 1988 living in a suburban community in Norway were invited to participate. In those who participated (n = 470), caries was registered clinically and radiographically and parents provided data on use of supplements. Thirty-eight percent of the children had used fluoride supplements regularly during the period 0.5 to 4.0 years of age and 66% used supplements regularly at the age of 6 to 8 years. Multivariate analyses showed that the children complying with the recommendations for use of fluoride supplements during the period 0.5 to 4.0 years of age had lower caries experience (dmfs) and fewer decayed surfaces (ds) in primary teeth than other children. No significant associations were found between supplement use in childhood and caries prevalence (DMFS) or number of decayed surfaces (DS) in permanent teeth at the age of 8 years. Supplement use from 6 to 8 years of age was not associated with caries occurrence either in primary or in permanent teeth. Both mother's education and the quality of dental hygiene were inversely associated with caries occurrence. <46> UI - 99243312 AU - Kallestal C AU - Wang NJ AU - Petersen PE AU - Arnadottir IB IN - Department of Epidemiology and Public Health, Umea University, Sweden. carina.kallestal@epiph.umu.se TI - Caries-preventive methods used for children and adolescents in Denmark, Iceland, Norway and Sweden. SO - Community Dentistry & Oral Epidemiology 1999 Apr;27(2):144-51 AB - Denmark, Iceland, Norway, and Sweden have all had a similar decline in dental caries during the last 20 years, although the decline has come later in Iceland. The purpose of this study was to compare the caries-preventive methods used for children and adolescents in these four countries. Questionnaires were sent to random samples of dentists, dental hygienists, and dental nurses working with children during 1995 and 1996. The results showed that the use of preventive methods was generally consistent between the countries. Nevertheless there were differences between the countries concerning the choice of preventive strategy for risk patients and also in how prevention was implemented. Danish dental care providers chose oral hygiene education as the priority, which they put into practice. Apart from fluoride varnish for some patients, most of them did not use or recommend fluoride except fluoride toothpaste. The Norwegian and Icelandic dental care providers chose both oral hygiene education and the use of fluoride as priorities, while most Swedish dental care providers preferred to provide dietary advice and oral hygiene education, and additional fluoride for risk patients. The differences could not be explained by other variables than nationality, implying that there are differences between the dental cultures in the four countries. The informational basis of decisions on preventive strategies varied between the different dental professionals in each country as well as between the countries, indicating that national professional cultures are being shaped differently. Despite the differences in choice of preventive methods, the dental health of children varies little across the frontiers. This raises the question of the significance of the choice of preventive methods to the decline of dental caries and points towards an urgent need to develop evidence-based preventive strategies. <47> UI - 99184725 AU - Watson MR AU - Horowitz AM AU - Garcia I AU - Canto MT IN - Baltimore College of Dental Surgery Dental School, University of Maryland, 21201-1586, USA. mwatson@umaryland.edu TI - Caries conditions among 2-5-year-old immigrant Latino children related to parents' oral health knowledge, opinions and practices. SO - Community Dentistry & Oral Epidemiology 1999 Feb;27(1):8-15 AB - OBJECTIVES: To collect baseline data prior to initiating a community-based, oral health promotion program in an inner city Latino community in Washington DC, populated by Central American immigrants. METHODS: In 1995, an oral survey of a convenience sample of children 2-5 years of age (n = 142) and a survey of the knowledge, opinions and practices (KOP) of their parents (n = 121) were completed. Clinical data of children were matched with parent respondents of the KOP survey. Data were analyzed for statistical associations using univariate odds ratios, Fisher's exact tests, and multiple logistic regression. RESULTS: Only 53% of the children were caries free. Eighteen percent of all children were in need of immediate dental care and 26% were in need of early or non-urgent dental care. Only 7% of the parents knew the purpose of sealants and 52% knew the purpose of fluorides. Further, only 9% thought that brushing with toothpaste can prevent tooth decay The strongest predictors of dental caries in this population, after adjusting for child's age and mother's education, were recency of mother's residence in the United States and report of an uncooperative child when attempting toothbrushing. CONCLUSIONS: Regimens of caries prevention have been successful in reducing dental decay for a large segment of the US population, yet this disease remains prevalent especially among low socioeconomic groups. The oral health status of the children and the oral health KOP of the parents in this community are disturbingly deficient. <48> UI - 99184733 AU - Riordan PJ IN - Perth Dental Hospital and Community Dental Services, Australia. riordan@q-net.net.au TI - Fluoride supplements for young children: an analysis of the literature focusing on benefits and risks. [Review] [71 refs] SO - Community Dentistry & Oral Epidemiology 1999 Feb;27(1):72-83 AB - The use of fluoride supplements to prevent caries has been advised for more than 100 years, but serious promotion of this strategy occurred only after the effectiveness of water fluoridation was established, in the late 1950s and 1960s. Although the effectiveness of fluoride supplements was apparently endorsed by many small clinical studies, closer examination of the experimental conditions of these, their methods and the analysis of their results undermined confidence in their findings. It is likely that confounding resulted in spurious conclusions in many of them. More modern, well-conducted clinical trials of supplements suggest that today, in children also exposed to fluoride from other sources such as toothpaste, the marginal effect of fluoride supplements is very small. There is evidence that fluoride lozenges, designed to maximise any local effect, may have a small caries preventive effect, particularly in deciduous teeth. Overall, poor compliance makes fluoride supplements a poor public health measure. Supplement use by young children is associated with a substantial risk of dental fluorosis. Fluorosis is an issue about which the public is becoming concerned in several countries and this concern, if translated into opposition to all fluoride use, could jeopardise the most successful caries preventive aid we have. The potential for dental fluorosis, concern about the public's reaction to this, the poor effectiveness of supplements and the public's poor compliance with their use are persuasive arguments for a radical reduction in the use of supplements by young children. Recent changes in fluoride dosage schedules and deferment of the age of commencing the use of supplements, implemented in many countries, have followed from these concerns. Supplements formulated as lozenges maximise topical exposure of enamel to fluoride and such products may offer older children and some adults a way of maintaining an elevated fluoride level in saliva at times when toothbrushing is not practical. [References: 71] <49> UI - 99185487 AU - Tvinnereim HM AU - Eide R AU - Riise T AU - Fosse G AU - Wesenberg GR IN - Department of Anatomy and Cell Biology, University of Bergen, Norway. helene.tvinnereim@odont.uib.no TI - Zinc in primary teeth from children in Norway. SO - Science of the Total Environment 1999 Feb 9;226(2-3):201-12 AB - Human primary teeth have been used as indicators of exposure to several heavy metals both in Norway and elsewhere. Local dentists in all 19 counties of Norway collected 2747 primary teeth during 1990-1994. Samples of tooth powder from whole, ground teeth were analyzed for zinc concentration by flame atomic absorption spectrophotometry. The overall geometrical mean was 144.5 micrograms of Zn/g of tooth substance (S.D. = 1.6). The result represents a small increase (5.2%) compared with a similar investigation in the 1970s. However, the mean zinc concentrations in the geographically matching parts of the two materials did not differ significantly. The variation in tooth zinc concentrations between the different counties declined from the 1970s to the 1990s. We found no correlation between the tooth zinc concentration and available environmental data on zinc in drinking-water, discharge of zinc from industrial point sources or population density in the same geographical areas. The zinc concentrations varied significantly with caries status, tooth type and root length. Few samples had a zinc concentration below 90 micrograms/g, indicating that most children consume sufficient zinc. Some very high values could not immediately be explained, but may be caused by contamination from zinc-containing dental restorations. <50> UI - 99110705 AU - Angelillo IF AU - Torre I AU - Nobile CG AU - Villari P IN - Medical School, University of Catanzaro, Italy. TI - Caries and fluorosis prevalence in communities with different concentrations of fluoride in the water. SO - Caries Research 1999;33(2):114-22 AB - The need to defluoridate and fluoridate the water supplies in areas with drinking water naturally containing above-optimal (>/=2.5 mg/l) and suboptimal ( UI - 99110704 AU - Gibson S AU - Williams S IN - Nutrition Consultant Guildford, Surrey, UK. sigrid.gibson@compuserve.com TI - Dental caries in pre-school children: associations with social class, toothbrushing habit and consumption of sugars and sugar-containing foods. Further analysis of data from the National Diet and Nutrition Survey of children aged 1.5-4.5 years. SO - Caries Research 1999;33(2):101-13 AB - This project examined the relative significance of dietary sugars, toothbrushing frequency and social class as predictors of caries experience (caries vs. no caries) among 1,450 British pre-school children who took part in the National Diet and Nutrition Survey. This cross-sectional survey was based on a representative sample of children aged 1.5-4.5 years studied in 1992/3. Children were classified into four groups according to social class and toothbrushing habit. Diet/caries associations were examined for biscuits and cakes, sugar confectionery, chocolate confectionery and soft drinks, and the percentage of energy from non-milk extrinsic sugars, using data on amount and frequency of consumption from 4-day weighed dietary records. In stepwise logistic regressions, the strength of the association between social class and caries experience was twice that between toothbrushing and caries, and nearly three times that between sugar confectionery and caries (other dietary variables were not significant). The association of caries with sugar confectionery (both in amount and frequency) was only present among children whose teeth were brushed less than twice a day. Toothbrushing frequency appeared to have a stronger impact on caries prevention in non-manual compared with manual children. Household expenditure on confectionery was associated with caries only among children from the manual group. The findings suggest the hypothesis that regular brushing (twice a day) with a fluoride toothpaste may have greater impact on caries in young children than restricting sugary foods. <52> UI - 20002311 AU - Stecksen-Blicks C AU - Borssen E IN - Department of Paedodontics, Umea University, Umea, Sweden. TI - Dental caries, sugar-eating habits and toothbrushing in groups of 4-year-old children 1967-1997 in the city of Umea, Sweden. SO - Caries Research 1999 Nov-Dec;33(6):409-14 AB - Four-year-old children in the city of Umea, northern Sweden, have been the subjects for studies of dental caries at regular intervals between 1967 and 1997. Similar methods and criteria were used in all studies and the children were selected from the same catchment areas. The results of this study signified a shift in the trend towards a declining caries prevalence among 4-year-old children. There was a slight non-significant increase in the number of children with caries as well as in the mean dmft and dmfs values between 1992 and 1997. The mean dmfs value was 7.8 in 1967 and declined to 4.5 in 1971. It was 2.9 in 1976 and 2.0 in 1980 and 1987, 1.8 in 1992 and increased to 2.0 in 1997. Ten percent of the children were immigrant or refugee children in 1997 compared to 6% in 1992 and they had a significantly higher caries prevalence than children with a Swedish background (p<0.001). In 1997, 58% of the children had one or more daily intakes of sugary snacks such as buns, cakes sweets, soft drinks, etc. There was an increasing consumption of sweets and soft drinks between 1987 and 1997. <53> UI - 20002314 AU - Dong YM AU - Pearce EI AU - Yue L AU - Larsen MJ AU - Gao XJ AU - Wang JD IN - School of Stomatology, Beijing Medical University, Beijing, People's Republic of China. TI - Plaque pH and associated parameters in relation to caries. SO - Caries Research 1999 Nov-Dec;33(6):428-36 AB - Intensified plaque acidogenicity in caries-prone subjects was reported many years ago, but emerging evidence has suggested that the relationship may not be as strong as once thought. We have now determined a range of acidogenicity variables in subjects having both caries prevalence and incidence data, and have included plaque mineral data in the analysis. pH measurements were made in 20 randomly selected subjects from a high-caries group (mean DMFS = 8. 95) and 20 from a caries-free group of Beijing children aged 12 years participating in a caries prediction study. Subgroups with a 12-month DMFS increment >/=2 or = 0 were also formed from the two groups, respectively. Measurements were made with an iridium oxide electrode inserted between teeth 13/14, 23/24, 34/35 and 44/45, before and every 5 min for 30 min after rinsing with 10% sucrose, and the 4 resulting 'Stephan curves' averaged using a plaque pH analysis program. Supragingival plaque was collected from buccal and lingual smooth surfaces of posterior and upper anterior teeth and its acid extract analysed for Ca, P and F. Caries-free subjects (based on past experience) had a significantly higher maximum plaque pH and pH value after 30 min (reflecting a faster return to resting pH), a lower minimum enamel dissolution capacity of plaque and recorded less time below pH 7.0 than did high-caries subjects. No other differences were significant, including those of the principal acidogenic parameters 'minimum pH attained after a sugar rinse', 'curve area below the critical pH of 5.5' and 'time below the critical pH'. Selection of the caries groups on the basis of both experience and incidence did not reveal significant differences in more parameters. Upper arch plaque was significantly more acidogenic than lower arch plaque, and there was a consistently strong association between upper and lower arch values in individuals. Ca, P and F in the subjects' plaque had little or no influence on the principal acidogenic parameters. Our failure to find a relationship between caries prevalence or activity and these principal acidogenicity parameters may be related to differences between fissure and smooth surface plaque, temporal variations in acidogenicity and/or to use of F toothpaste during the 1-year observation period. These results support the view that factors such as the frequency of acidogenic episodes may be more important in caries progression than the degree of acidogenicity during any one episode. <54> UI - 20020821 AU - Warren JJ AU - Levy SM IN - Department of Preventive and Community Dentistry, University of Iowa, College of Dentistry, Iowa City, USA. john-warren@uiowa.edu TI - Systemic fluoride. Sources, amounts, and effects of ingestion. [Review] [106 refs] SO - Dental Clinics of North America 1999 Oct;43(4):695-711 AB - Fluoride may be ingested from a variety of sources, including many foods and beverages. Fluoride intake varies greatly among individuals and is dependent on dietary constituents and use of fluoride products. Although ingestion of toxic amounts of fluoride is rare, the prevalence of dental fluorosis has increased in North America, suggesting that the levels of fluoride ingestion need to be closely monitored. Care should be taken to avoid excessive ingestion of fluoride dentifrice by preschool-aged children by placement of a small, pea-sized quantity on the tooth-brush. Dietary fluoride supplements should be considered a targeted, preventive procedure only for those at elevated caries risk, and before prescribing them, careful consideration should be given to other fluoride sources, including home and child-care water supplies, foods, and beverages. [References: 106] <55> UI - 99319181 AU - Mattila ML AU - Paunio P AU - Rautava P AU - Ojanlatva A AU - Sillanpaa M IN - Department of Public Health, University of Turku, Finland. TI - Changes in dental health and dental health habits from 3 to 5 years of age. SO - Journal of Public Health Dentistry 1998 Fall;58(4):270-4 AB - OBJECTIVES: This study sought to determine how dental health and dental health habits change from 3 to 5 years of age and to consider whether preventive dental health care helped in preventing or halting caries in children. METHODS: The study included 67 maternity health care clinics, 72 well-baby clinics, and 69 dental health care clinics. Of the 1,292 newborn children, 1,003 (90.8%) were included in this study. RESULTS: Preventive dental health care contributed to dental caries being halted in only 13.2 percent of those children who had enamel caries at 3 years of age. The dmft index did not increase in 22.6 percent of those children who had dentinal caries at 3 years of age. For all others, the disease became more severe. Toothbrushing habits of 3-year-old children were very consistent over the two years studied. Children were at a risk for caries when their mothers had nine years of basic education, when they already had plaque and caries at 3 years of age, and when the frequency of eating sweets increased the most during the two-year study period. CONCLUSIONS: Among 3-year-old children, plaque is an indicator of caries risk and therefore should be a key element in health education. Those children who already have evidence of caries at 3 years of age should be the target of preventive dental services because of their increased risk. <56> 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. <57> UI - 99139130 AU - Petersen PE AU - Mzee MO IN - Department of Community Dentistry and Graduate Studies, Faculty of Health Sciences, University of Copenhagen, Denmark. TI - Oral health profile of schoolchildren, mothers and schoolteachers in Zanzibar. SO - Community Dental Health 1998 Dec;15(4):256-62 AB - OBJECTIVE: To analyse oral health status and oral health practices of schoolchildren in Zanzibar, to assess oral health knowledge, attitudes and practices of the mothers, and to describe knowledge and attitudes of schoolteachers in relation to oral health education of children. DESIGN: Cross-sectional surveys of standards 1 and 5 children and their mothers were carried out based on the WHO pathfinder principle. The children were clinically examined and the mothers responded to personal interviews. Self-administered questionnaires were used to collect information on a convenience sample of schoolteachers. SETTING: The surveys were conducted to aid the planning and evaluation of school-based oral health promotion in Zanzibar. SUBJECTS: Two hundred and fifty-nine standard 1 and 226 standard 5 children participated in the survey; the sample was balanced by gender and degree of urbanisation. A total of 455 mothers (92% of original sample) and 123 schoolteachers (100% of sample) were included. OUTCOME MEASURES: For children, dental caries experience (dmft/DMFT) and CPI were recorded. For mothers, knowledge about causes and prevention of dental disease, dental attitudes and oral health behaviour were ascertained. For teachers, dental knowledge and attitudes to health education were investigated. RESULTS AND CONCLUSIONS: The mean caries experiences were 2.1 dmft (standard 1) and 0.7 DMFT (standard 5) and the prevalence was higher in urban than in rural areas. Daily toothcleaning was reported for 59% of the children and 67% of the mothers. The use of traditional Miswaki was frequent in rural areas whereas toothbrushes were common in urban areas. The level of knowledge was similar for mothers and teachers. Training in oral health topics is needed for schoolteachers to provide for school-based health education of children. <58> UI - 99086087 AU - Chestnutt IG AU - Schafer F AU - Jacobson AP AU - Stephen KW IN - Lanarkshire Health Board, Hamilton, Scotland. TI - The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. SO - Community Dentistry & Oral Epidemiology 1998 Dec;26(6):406-11 AB - OBJECTIVE: To examine the effect of reported toothbrushing frequency and method of rinsing after brushing on caries experience and increment. METHODS: Data are presented from 2621 adolescents (mean age 12.5 years at outset) participating in a 3-year double-blind caries clinical trial. At baseline, examiners questioned each participant about their toothbrushing habits, and at subsequent examinations, this information was obtained using a self-administered computer-based questionnaire. Participants used a fluoride-containing dentifrice throughout and clinical examinations were conducted using a mirror, CPITN probe and fibre-optic transillumination. RESULTS: The reported brushing frequency increased throughout the trial. Caries experience at baseline was inversely related to toothbrushing frequency with mean DMFS=9.66, 8.12 and 7.63 respectively for <1/day, 1/day and >1/day brushers (P<0.001). Mean 3-year DMFS increments of 8.90, 6.63 and 5.48 (P<0.01) were observed in those reporting to brush <1/day, 1/day or >1/day, on not less than two of the three clinical examinations during the trial. Caries increment was also significantly related to the claimed method used to rinse post-brushing. Overall frequency of brushing and rinsing method accounted for over 50% of the explained variance in the ANOVA model used to analyse the DMFS increments. CONCLUSIONS: Stated toothbrushing frequency and rinsing method after brushing were found to be strongly correlated with caries experience and caries increment. These factors should be reflected in the design of oral health education material and taken into account in the design and analysis of caries clinical trials. <59> UI - 99126887 AU - Lo EC AU - Schwarz E AU - Wong MC IN - Faculty of Dentistry, University of Hong Kong. TI - Arresting dentine caries in Chinese preschool children. SO - International Journal of Paediatric Dentistry 1998 Dec;8(4):253-60 AB - OBJECTIVES: To investigate the incidence of rehardening of caries lesions in children in Southern China taking part in a preventive programme. DESIGN: Longitudinal study. SAMPLE AND METHODS: A prevention programme was established for 168 3-6-year-old children in a kindergarten (KG1), which included regular oral health education sessions and a daily toothbrushing exercise using fluoridated toothpaste (1000 ppm F). A group of 121 children studying in two other kindergartens without a preventive programme formed the controls. Due to lack of resources and dental personnel, restorative and other curative treatments were not provided. RESULTS: Rehardening of dentine caries (arrested caries) was found in children in both test and control groups. At the third annual examination, 45% of the caries lesions on the proximal surfaces of primary anterior teeth in KG1 children found at the baseline and previous annual examinations had become arrested. A multiple linear regression analysis indicated that baseline ds score and its interactions with the prevention programme, gender and the child's oral hygiene all had significant effect on the number of tooth surfaces with arrested caries at the third annual examination. CONCLUSION: Results from this study support the use of simple prevention programmes to stabilize the caries situation in communities where intensive use of trained dental personnel is not feasible. <60> UI - 99035981 AU - Winston AE AU - Bhaskar SN IN - Technology and Clinical Research, Enamelon Inc., Brunswick, N.J. 08816, USA. TI - Caries prevention in the 21st century [see comments]. [Review] [87 refs] CM - Comment in: J Am Dent Assoc 1999 Feb;130(2):160, 162 SO - Journal of the American Dental Association 1998 Nov;129(11):1579-87 AB - While the incidence of caries has decreased during the past 50 years because of the introduction of water fluoridation and fluoride toothpastes, it is still widespread. Improved therapies, using topical treatments to replace lost calcium and phosphate minerals from early carious lesions, will reduce the need for surgical intervention in the future. Early caries detection techniques currently being developed will allow dentists to maximize the usefulness of these treatments. [References: 87] <61> UI - 99006586 AU - Villa AE AU - Guerrero S AU - Icaza G AU - Villalobos J AU - Anabalon M IN - Institute of Nutrition and Food Technology, INTA, University of Chile, Santiago. avilla@uec.inta.uchile.cl TI - Dental fluorosis in Chilean children: evaluation of risk factors. SO - Community Dentistry & Oral Epidemiology 1998 Oct;26(5):310-5 AB - The purpose of this case-control study was to determine the association between very-mild-to-moderate enamel fluorosis and exposure during early childhood to fluoridated water, mainly through ingestion of powdered milk. Analysis was performed on 136 residents of the optimally fluoridated community of San Felipe in the Chilean Fifth Region, who were categorised into one of three groups according to their age when water fluoridation was introduced in 1986: Group I was born after 1986; Group II was 16-24 months old in 1986; and Group III was >24 months of age. The case and control subjects were selected on the basis of a clinical examination given in July 1996. Dean's scoring system was used to determine fluorosis status. Risk factor exposure was ascertained by a questionnaire used in interviews with mothers of participating children. Logistic regression analysis, after adjustment for confounding variables, revealed that very-mild-to-moderate enamel fluorosis of permanent central maxillary incisors (CMI) was strongly associated both with the age of the subjects when water fluoridation began and with breast-feeding duration for children belonging to Group I. Subjects in Group I were 20.44 times more likely (95% CI: 5.00-93.48) to develop CMI fluorosis than children who were older than 24 months (Group III) when fluoridation began. Subjects who were between 16 and 24 months old when water fluoridation began were 4.15 times more likely (95% CI: 1.05-16.43) to have CMI fluorosis than children older than 24 months. An inverse association was found with breastfeeding duration (OR=0.86, 95% CI: 0.75-0.98) among Group I subjects but not in Groups II and III. Results obtained suggest that the current fluoride concentration in drinking water may be contributing to fluorosis. Further studies will be necessary to determine the relative competing risks of dental fluorosis and dental caries in Chilean children in order to establish the most appropriate water fluoridation level in Chile. <62> UI - 99006588 AU - Arrow P IN - Dental Services, Health Department of Western Australia, Perth, Australia. denserwa@alphawest.net.au TI - Oral hygiene in the control of occlusal caries. SO - Community Dentistry & Oral Epidemiology 1998 Oct;26(5):324-30 AB - Occlusal pit and fissure caries accounts for a high proportion of the total caries burden among children. Studies from Denmark suggested that oral hygiene measures may be effective in the control of occlusal caries in permanent teeth. This study reports on the findings after 24 months of a controlled field trial comparing the caries-preventive effects of a professional tooth-cleaning and dental health education programme (test) with a standard preventive programme (control), comprising selective fissure sealing and application of topical fluorides. School Dental Service clinics of the Health Department of Western Australia, in Perth, were assigned to four test or four control clinics. Schoolchildren, mean age 6 years, with sound newly erupted first permanent molars were included in the study (207 test, 197 control). After 24 months, 179 test and 156 control children were examined by a calibrated examiner who was 'blind' to the test or control status of the child. Thirty-two test and 31 control children developed occlusal caries on the first permanent molars; the estimated risk ratio was 0.90 (95% CI 0.58-1.41). Children in both groups had an average DMFT score of 0.30. The 24-month results suggest that the two preventive programmes did not differ with respect to the control of occlusal caries in newly erupted molars. <63> UI - 99006589 AU - Mascarenhas AK IN - Section of Health Services Research, College of Dentistry, The Ohio State University, Columbus, USA. mascarenhas.1@osu.edu TI - Oral hygiene as a risk indicator of enamel and dentin caries. SO - Community Dentistry & Oral Epidemiology 1998 Oct;26(5):331-9 AB - Dental researchers have postulated that the risk factors for enamel and dentin caries may not be the same. A review of the literature ascertained that data to support this theory are lacking. OBJECTIVES: To evaluate the risk indicators of enamel and dentin caries of the permanent dentition in a study group who had limited access to fluorides and made limited use of dental services. METHODS: The study was conducted in Goa, India. Data came from a cross-sectional survey of 1189 seventh grade children, which consisted of a clinical dental examination and a self-administered questionnaire to their parents. The cavitated and non-cavitated criteria were used to score for caries, and the Silness-Loe index for plaque. RESULTS: The mean age of the children was 12.2 years. The percentage of children caries free in the permanent dentition was 22.2%, the mean+/-s for dmfs, enamel and dentin lesions were 4.20+/-5.10, 2.59+/-2.89 and 1.61+/-3.30 respectively, and the mean plaque score was 1.00+/-0.48. Results of regression analyses showed that the risk indicators of prevalence and severity of caries differed depending on lesion type. The only variable that was consistently a risk indicator of presence and severity of both dentin and enamel caries was poor oral hygiene. Mother's highest level of education and presence of fluorosis were also risk indicators of enamel and dentin caries. The presence of decayed primary teeth was a risk indicator of enamel caries; and fluorosis severity, use of fluoride toothpaste at the time of the survey, and toothbrushing frequency were risk indicators of dentin caries. The observed caries-oral hygiene association seen is explored further. <64> UI - 98452123 AU - Petersen PE AU - Esheng Z IN - University of Copenhagen, Faculty of Health Sciences, Department for Community Dentistry, Denmark. TI - Dental caries and oral health behaviour situation of children, mothers and schoolteachers in Wuhan, People's Republic of China. SO - International Dental Journal 1998 Jun;48(3):210-6 AB - This study was undertaken in order to describe the occurrence of dental caries in Chinese schoolchildren and to highlight the oral health behaviour situation. Clinical examinations of grade 1 children (age 6, n = 381) and grade 6 children (age 12, n = 413) were performed. At age 6, 86 per cent of the children were affected by dental caries and at age 12 the mean DMFT index was 1.0. Personal interviews with the mothers (n = 691) showed that dental care habits of children were poor; 22 per cent of all children brushed their teeth twice a day and 20 per cent had seen the dentist within the past 12 months. Very few children (4 per cent) had practical support from their parents in daily toothcleaning. Self-administered questionnaires for schoolteachers (n = 138) revealed that most (85 per cent) are positive towards oral health education of children. Systematic school-based programmes should be implemented to promote oral health. <65> UI - 98429393 AU - Seppa L AU - Karkkainen S AU - Hausen H IN - Institute of Dentistry, University of Oulu, Finland. liisa.seppa@oulu.fi TI - Caries frequency in permanent teeth before and after discontinuation of water fluoridation in Kuopio, Finland. SO - Community Dentistry & Oral Epidemiology 1998 Aug;26(4):256-62 AB - The piped water of Kuopio, Finland, was fluoridated in 1959. Owing to strong opposition by different civic groups, water fluoridation was stopped at the end of 1992. OBJECTIVES: The aim of this study was to examine the consequences of the discontinuation on dental health. METHODS: In 1992 and 1995, independent random samples of all children aged 6, 9, 12 and 15 years were drawn from Kuopio and Jyvaskyla, a nearby low fluoride town whose distribution of demographic and socio-economic characteristics was fairly similar to Kuopio's. The total number of subjects examined was 550 in 1992 and 1198 in 1995. Caries was registered clinically and radiographically by the same two calibrated dentists in both towns. RESULTS: In 1992, the mean DMFS values were lower in the fluoridated town for the two older age groups, the percentage differences for 12- and 15-year-olds being 37% and 29%, respectively. For the two younger age groups no meaningful differences could be found. In 1995, the only difference with possible clinical significance was found in the 15-year-olds in favor of the fluoridated town (18%). In 1995, a decline in caries was seen in the two older age groups in the nonfluoridated town. In spite of discontinued water fluoridation, no indication of an increasing trend of caries could be found in Kuopio. The mean numbers of fluoride varnish and sealant applications decreased sharply in both towns between 1992 and 1995. In spite of that caries declined. CONCLUSIONS: These findings suggest that the decline of caries has little to do with professional preventive measures performed in dental clinics. <66> UI - 99009623 AU - Brugman E AU - Verrips GH AU - Danz MJ AU - Kalsbeek H IN - TNO Prevention and Health, Leiden, The Netherlands. TI - Dental prevention among Turkish and Moroccan parents in The Hague. SO - Community Dental Health 1998 Jun;15(2):109-14 AB - OBJECTIVE: The aim of this study was to determine the extent to which dental prevention among Turkish parents differs from that among Moroccan parents in one of the large cities in the Netherlands. DESIGN: Turkish and Moroccan mothers with a child of approximately six months old, who visited the well baby clinics in the Schilderswijk area of The Hague, were asked to participate in a dental care project. As part of the initial data collection in this project, 170 Turkish and 153 Moroccan mothers were interviewed at home by a woman who spoke their native languages. The interview contained questions about dental prevention, such as fluoride use, feeding bottle use, visits to the dentist, brushing, information about oral care, and about relevant background characteristics. RESULTS: More Moroccan than Turkish mother reported that they did not use a feeding bottle for the baby, went to the dentist twice a year, brushed their own teeth at least twice a day and started to brush their children's teeth at an early age. The Moroccan mothers were more committed to dental prevention than Turkish mothers, even after correction for background characteristics such as education, language skills and the number of years spent in the Netherlands. CONCLUSIONS: Ethnic groups should not be seen as a single group for dental prevention. It is recommended that Turkish parents in particular be encouraged to go to the dentist twice a year, to start brushing their children's teeth at an early age and to wean their children off use of a feeding bottle in bed. <67> UI - 99025051 AU - Foster LV IN - Department of Oral and Dental Science, University of Bristol Dental School. TI - Three year in vivo investigation to determine the progression of approximal primary carious lesions extending into dentine. SO - British Dental Journal 1998 Oct 10;185(7):353-7 AB - OBJECTIVE: To investigate the proportion of a sample of approximal carious lesions extending up to 1 mm into dentine which progressed over a 3-year period and to examine factors which influenced that progression. DESIGN: Prospective, single centre, clinical study. SETTING: Restorative Clinic at Bristol Dental School, UK. SUBJECTS AND METHODS: Sixty-five adult patients were identified who each had an approximal carious lesion which extended up to 1 mm into the dentine and which were assessed at intervals of up to 36 months. All patients were given appropriate preventive advice. MAIN OUTCOME MEASURES: Progression of the lesions was determined by assessment of sequential bitewing radiographs. RESULTS: 29% of the lesions progressed within 8 months, 56% by 20 months and 69% by 36 months. After 36 months, lesions which extended over 0.5 mm and up to 1 mm into the dentine were significantly more likely to have progressed (92%) compared with shallower lesions which extended up to only 0.5 mm into dentine (50%). CONCLUSIONS: The depth of an approximal dentine lesion was the main clinical marker which related to its progression. It is recommended that operative intervention is considered for approximal lesions which extend deeper than 0.5 mm into the dentine, while preventive treatment and re-assessment may be considered for shallower lesions. <68> UI - 98351516 AU - Burt BA IN - Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. TI - Prevention policies in the light of the changed distribution of dental caries. SO - Acta Odontologica Scandinavica 1998 Jun;56(3):179-86 AB - Changes in the distribution of caries in economically developed nations over the last 15-20 years include 1) an overall decline in prevalence and severity in child populations; 2) an increasingly skewed distribution, with most disease now found in a small number of children; and 3) concentration of caries in