Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Oct 2000.> Search Strategy (You Saved Citations 1-300 From Set 118): ----------------------------------------------------------------------------- 1 exp Tooth demineralization/ 22628 2 demineralization.mp. 1620 3 caries.mp. 15295 4 caires.mp. 1 5 craies.mp. 0 6 careis.mp. 4 7 carise.mp. 0 8 (teeth adj3 cavit:).mp. 422 9 (tooth adj3 cavit:).mp. 217 10 (dental adj3 cavit:).mp. 276 11 (dentin adj3 cavit:).mp. 254 12 (enamel adj3 cavit:).mp. 182 13 (teeth adj3 decay:).mp. 374 14 (tooth adj3 decay:).mp. 321 15 (dental adj3 decay:).mp. 250 16 (dentin adj3 decay:).mp. 12 17 (enamel adj3 decay:).mp. 20 18 (active adj decay).mp. 9 19 (rampant adj3 decay:).mp. 14 20 (recurrent adj3 decay:).mp. 30 21 (white adj spot:).mp. 509 22 carious.mp. 2077 23 cariology.ti,ab. 56 24 (non-cavitated adj3 lesion:).mp. 15 25 (noncavitated adj3 lesion:).mp. 2 26 Tooth remineralization/ 478 27 (dental adj3 fissure:).mp. 99 28 (tooth adj3 fissure:).mp. 50 29 (teeth adj3 fissure:).mp. 98 30 caries-free.mp. 603 31 cariesfree.mp. 17 32 Cariogenic agents/ 728 33 precavit:.mp. 8 34 (filled adj3 teeth).mp. 510 35 (filled adj3 tooth).mp. 117 36 (oral adj fissure:).mp. 6 37 (tooth adj3 remineraliz:).mp. 28 38 (teeth adj3 remineraliz:).mp. 24 39 dft.mp. 413 40 dfs.mp. 1258 41 dmf:.mp. 6397 42 cariogeni:.mp. 1787 43 or/1-42 32256 44 (pc or th).fs. 1011356 45 43 and 44 11962 46 exp Dental bonding/ 10476 47 exp Dental care/ 14573 48 Dental devices, home care/ 905 49 Dental implantation/ 2906 50 exp Dental restoration, permanent/ 21229 51 exp Dental restoration, temporary/ 9612 52 Dental restoration failure/ 796 53 Dental pulp capping/ 1277 54 Pulpectomy/ 769 55 Pulpotomy/ 831 56 exp Root canal therapy/ 9857 57 Enamel microabrasion/ 42 58 Mouth rehabilitation/ 997 59 Tooth extraction/ 8995 60 exp Preventive dentistry/ 18127 61 exp Tooth preparation/ 5601 62 (dental adj3 bond:).mp. 290 63 ((acid adj etch:) and (dent: or tooth or teeth)).mp. 1161 64 cementation.mp. 2032 65 ((dent: or tooth or teeth) adj3 (care or hygien: or 13394 prevent: or intervent:)).mp. 66 ((dent: or tooth or teeth) adj3 (implant: or restor:)).mp. 11268 67 (pulp adj4 cap:).mp. 551 68 pulpectomy.mp. 809 69 pulpotomy.mp. 858 70 ('root' adj canal adj3 (therap: or treat: or interven: or 1148 prepar: or prevent:)).mp. 71 (enamel adj3 microabrasion).mp. 34 72 ((tooth or teeth or dent:) adj3 (extract: or pull:)).mp. 5441 73 ((dent: or tooth or teeth) adj3 (prophylaxis or clean:)).mp. 1693 74 or/46-73 97112 75 Home care services/ 12282 76 exp Dentistry/ 207747 77 75 and 76 99 78 74 or 77 97122 79 Chlorhexidine/ 2890 80 chlorhexidine.mp. 3507 81 sebidin.mp. 3 82 tubulicid.mp. 21 83 or/79-82 3517 84 exp Cariostatic agents/ 19795 85 fluoride:.mp. 26332 86 ((sulfur or sulphur) adj3 hexafluoride:).mp. 520 87 difluoride:.mp. 458 88 tetrafluoride:.mp. 82 89 ossin.mp. 7 90 zymafluor.mp. 3 91 or/84-90 27713 92 78 or 91 119866 93 exp Decision support techniques/ 19211 94 exp Decision making/ 28700 95 exp Decision making, computer-assisted/ 16758 96 ((decision: or consensus) adj (making or make$1 or support 14407 or theory or trees or technique:)).mp. 97 exp "Sensitivity and specificity"/ 89544 98 Computer simulation/ 19925 99 Computer systems/ 3947 100 Computers/ 40006 101 (computer: adj5 (simulation: or system: or decision: or 23667 predict: or forecast:)).mp. 102 Forecasting/ 28594 103 Models, biological/ 101335 104 Likelihood functions/ 3382 105 exp risk/ 227197 106 risk:.mp. 414044 107 exp "Outcome assessment (health care)"/ 103983 108 or/93-107 824928 109 45 and 92 and 108 798 110 ("96119848" or "20020823" or "97180014" or "20098169" or 5 "92083572").ui. 111 109 or 110 799 112 limit 111 to (human and english language) 689 113 limit 112 to (infant < 1 to 23 months > or preschool child 391 < 2 to 5 years > or child < 6 to 12 years > or adolescence < 13 to 18 years >) 114 110 or 113 392 115 43 and 92 and 108 1625 116 limit 115 to (human and english language) 1419 117 limit 116 to (infant < 1 to 23 months > or preschool child 719 < 2 to 5 years > or child < 6 to 12 years > or adolescence < 13 to 18 years >) 118 110 or 117 721 119 from 118 keep 1-300 300 120 from 118 keep 301-600 300 *************************** <1> UI - 96230308 AU - Caliskan MK IN - Department of Endodontics, Ege University Dental Faculty, Bornova, Izmir, Turkey. TI - Pulpotomy of carious vital teeth with periapical involvement. SO - International Endodontic Journal 1995 May;28(3):172-6 AB - Twenty-six permanent vital molars with carious pulp exposures and periapical involvement presenting as radiolucencies or radiopacities on radiographic examination, in patients aged between 10-24 years, were treated using an atraumatic surgical technique with calcium hydroxide alone. The healing was evaluated using clinical and radiographic criteria: absence of clinical symptoms, sensitivity of the radicular pulp, formation of a hard tissue barrier in the exposed area, resolution of periapical involvement and no intraradicular pathosis radiographically. Assessed by these criteria, successful results were achieved in 24 teeth. The observation period following pulpotomy treatment was 16-72 months. The favourable results of this study demonstrate that pulpotomy treatment in teeth with cariously exposed vital pulps and with periapical involvement may be an alternative treatment to root canal therapy. <2> UI - 96193283 AU - Bolin AK AU - Bolin A AU - Koch G AU - Alfredsson L IN - Department of Medicine, Karolinska Institutet, Stockholm, Sweden. TI - Children's dental health in Europe. Clinical calibration of dental examiners in eight EU countries. SO - Swedish Dental Journal 1995;19(5):183-93 AB - An epidemiological investigation has been initiated from Sweden with the aim to study and compare dental health, dental treatment needs and attitudes to dental care in two well-defined age-groups, children of 5 and 12 years of age, in eight EU countries. To ensure comparability of the clinical registrations, data collection was preceded by clinical calibrations of the examiners from the participating countries. All the examiners participated in a workshop with initial calibration exercises. Agreement, expressed as sensitivity, was measured between the Swedish examiner acting as the reference examiner and each of the other examiners in turn, and assessed separately for the two age-groups. For DMFS/dmfs, agreement ranged from 44.3% to 82.2%. These results were discussed and where necessary the criteria were modified and/or made more stringent, so that they were clearcut and could be adhered to consistently. In a second calibration between the Swedish and the national examiner undertaken in each of the seven countries, the inter-examiner agreement (sensitivity) varied between 85.4% and 100%. The mean sensitivity for DMFS/dmfs after the total calibration procedures was 89.5% for the 12-year olds and 91.7 for the 5-year olds. The mean sensitivity for both age-groups together was 90.6% and the corresponding value for specificity was 98.9%. <3> UI - 96191993 AU - Kielbassa AM AU - Attin T AU - Schaller HG AU - Hellwig E IN - Department of Operative Dentistry, University of Freiburg, School of Dentistry, Germany. TI - Endodontic therapy in a postirradiated child: review of the literature and report of a case. [Review] [30 refs] SO - Quintessence International 1995 Jun;26(6):405-11 AB - Exodontia of extremely carious teeth leads to a significant risk of osteoradionecrosis in patients who have undergone radiotherapy. In these patients, endodontic treatment could be an alternative. Successful root canal therapy in a girl who had been irradiated for head and neck neoplasms is reported. The results indicated that use of calcium hydroxide to obturate the root canals is a viable method of postirradiation endodontics in primary teeth. [References: 30] <4> UI - 96159396 AU - Holland TJ AU - Whelton H AU - O'Mullane DM AU - Creedon P IN - Oral Health Services Research Centre, University Dental School, Wilton, Cork, Ireland. TI - Evaluation of a fortnightly school-based sodium fluoride mouthrinse 4 years following its cessation. SO - Caries Research 1995;29(6):431-4 AB - The aim of this study was to investigate the effectiveness of a school-based fortnightly 0.2% sodium fluoride mouthrinse programme after children ceased to participate. The programme, which commenced at age 6 and ceased at age 12, was investigated 4 years following its cessation. Three groups of 12-year-olds and three groups of 16-year-olds were examined, i.e. children who had participated in the mouthrinse, those attending non-participating nearby schools and life-time residents of a fluoridated community. Significant differences in mean DMFT in the 12-year-olds between the mouthrinse and the control group were not found in the 16-year-old group. Mean DMFT for the mouthrinse group and those in a fluoridated community (which were the same in 12-year-olds) showed a statistically significant difference in those aged 16. Most caries found, both in 12-year-olds and in 16-year-olds, occurred on molar teeth and was found on pit and fissure surfaces. The cessation of these programmes at age 12 should be reappraised and the combination of school-based fluoride mouthrinse programmes with a fissure sealing programme is recommended. <5> UI - 96159399 AU - Grindefjord M AU - Dahllof G AU - Modeer T IN - Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Karolinska Institutet, Stockholm, Sweden. TI - Caries development in children from 2.5 to 3.5 years of age: a longitudinal study. SO - Caries Research 1995;29(6):449-54 AB - The development of dental caries from the age of 2.5 to 3.5 years was studied longitudinally in 692 children living in the southern suburbs of Stockholm. The parents answered a structured questionnaire concerning the family's social and immigrant background as well as the dietary habits, oral hygiene and fluoride exposure of their children. Furthermore, the occurrence of mutans streptococci and lactobacilli was determined in samples taken from the tongue of the children, and the buffer capacity of the saliva was measured. At baseline examination, 11.3% of the children exhibited dental caries. At follow-up, 1 year later, decayed and/or filled surfaces were registered in 36.7% of the subjects. The majority of the new lesions were located on the occlusal surfaces of the second molar. Ninety-two percent of the children with caries at baseline developed new carious lesions during the 1-year period, compared to 29% of the children who were caries-free at baseline (p < 0.001). Of the lesions diagnosed at baseline as initial caries, 64% progressed to manifest lesions during the 1-year period. The study indicates that children with early caries development exhibit high caries progression as well as a high risk for further development of an extensive number of new carious lesions. <6> UI - 96113472 AU - Arrow P AU - Riordan PJ IN - Dental Service, Health Department of Western Australia, Perth, Australia. TI - Retention and caries preventive effects of a GIC and a resin-based fissure sealant. SO - Community Dentistry & Oral Epidemiology 1995 Oct;23(5):282-5 <7> UI - 96118045 AU - Hunter JM AU - Arbona SI IN - Department of Geography, Michigan State University, East Lansing 48824, USA. TI - The tooth as a marker of developing world quality of life: a field study in Guatemala. SO - Social Science & Medicine 1995 Nov;41(9):1217-40 AB - A geographical sample in a rural area of eastern Guatemala revealed widespread, premature and heavy losses of permanent teeth. Social and environmental influences that affect tooth loss include inadequate diet, refined sugar, poor oral hygiene, absence of fluoride, lack of preventive education and insufficiency of dental care services. Land hunger and family poverty are of paramount importance. Gender-based cultural differences are apparent in tooth extraction rates, and use of dentures. No one escapes visitations of severe orofacial pain that cast a blight upon the quality of rural life. Periodontal disease drives the poorest of the poor to spend disproportionately large sums on pharmaceutical pain-killers and destructive traditional medicines. Lay 'tooth-pullers' visit remote rural homes to extract teeth. Only full edentulism can bring patients permanent somatic and financial relief. Community dental health is conspicuously neglected in official policies and plans for rural development. <8> UI - 96106334 AU - Vanderas AP AU - Manetas C AU - Papagiannoulis L IN - Department of Pediatric Dentistry, School of Dental Medicine, University of Athens, Greece. TI - Urinary catecholamine levels in children with and without dental caries. SO - Journal of Dental Research 1995 Oct;74(10):1671-8 AB - Urinary catecholamines have been used to measure emotionally stressful states which may affect the development of dental caries. This study investigates the hypothesis that children with and without dental caries do not differ significantly in the mean values of urinary catecholamines such as epinephrine, norepinephrine, and dopamine. As a test of this hypothesis, 314 children, males and females, aged from 6 to 8 years, were included in the study. Dental caries were recorded clinically and radiographically, and oral hygiene was evaluated by the recording of dental plaque. A 24-hour urine sample was collected for each subject, and a representative sample (25 mL) was analyzed by the HPLC technique to assay the catecholamine content. Socioeconomic factors such as parental age, education, and profession were recorded by a questionnaire distributed to the parents. Of the examined children, 38 (14 males and 24 females) were free of dental caries and constituted the case group. Two control groups, A and B, of 38 children each (14 males and 24 females) with dental caries were matched by age and gender. Differences in the quantitative and qualitative data were tested by the paired t test and the X2-test, respectively, while a regression analysis was applied to measure the effects of norepinephrine and dopamine on epinephrine. The logistic multiple-regression analysis was used to test, in the entire population, the impact of catecholamines and other related factors on the probability of subjects' developing dental caries. The 95% probability was used. The results showed statistically significant differences in epinephrine values between the case group and control groups A and B. The data suggest, therefore, that children with emotionally stressful states have higher probability of developing dental caries. <9> UI - 96095091 AU - Tinanoff N IN - Department of Pediatric Dentistry, School of Dental Medicine, University of Connecticut Health Center, Farmington 06030-1610, USA. TI - Critique of evolving methods for caries risk assessment. SO - Journal of Dental Education 1995 Oct;59(10):980-5 <10> UI - 96095087 AU - Dodds MW AU - Suddick RP IN - Department of Community Dentistry, University of Texas Health Science Center at San Antonio 78284-7917, USA. TI - Caries risk assessment for determination of focus and intensity of prevention in a dental school clinic. SO - Journal of Dental Education 1995 Oct;59(10):945-56 <11> UI - 96095086 AU - Imfeld TN AU - Steiner M AU - Menghini GD AU - Marthaler TM IN - Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland. TI - Prediction of future high caries increments for children in a school dental service and in private practice. SO - Journal of Dental Education 1995 Oct;59(10):941-4 <12> UI - 96106547 AU - Johnston DW AU - Lewis DW IN - Division of Community Dentistry, University of Western Ontario, London, Canada. TI - Three-year randomized trial of professionally applied topical fluoride gel comparing annual and biannual applications with/without prior prophylaxis. SO - Caries Research 1995;29(5):331-6 AB - The twice yearly application to children's teeth of acidulated phosphate fluoride (APF) gel in dental trays preceded by a professionally rendered 'dental prophylaxis' has become the standard and most commonly used dental chairside procedure for prevention of dental caries. This study was a randomized, 3-year, community-based clinical trial of professionally applied APF gel involving the use and non-use of a prior dental prophylaxis and annual and biannual APF applications for children in age groups 6-7 (n = 176) and 10-11 (n = 153) years initially, who are likely at high risk of future dental caries. The 3-year results of this study show no significant effect on dental caries reduction of either a prior prophylaxis or annual versus biannual APF gel applications. A significant reduction in the frequency of provision of these dental services, limited to high caries risk patients only, is recommended. <13> UI - 96106549 AU - Grindefjord M AU - Dahllof G AU - Nilsson B AU - Modeer T IN - Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Karolinska Institutet, Stockholm, Sweden. TI - Prediction of dental caries development in 1-year-old children. SO - Caries Research 1995;29(5):343-8 AB - Dietary habits, oral hygiene, fluoride exposure and occurrence of mutans streptococci were studied in 1-year-old children (n = 786) as well as the socio-economic and immigrant background of their parents. The purpose was to evaluate the predictive ability of variables studied in 1-year-old children that could be used to identify children at risk for early caries development. In a multivariate logistic regression analysis, the variables significantly associated with caries at 3.5 years of age were immigrant background (p < 0.001), mother's education (p < 0.001), consumption of sugar-containing beverages (p < 0.001), mutans streptococci (p < 0.05) and candy (p < 0.05). The probability of caries development was 87% when all the variables associated with caries were present at 1 year of age. The relative risk (odds ratio) of those children to develop manifest caries at 3.5 years of age was estimated to be 32 times higher than in the children where corresponding risk factors were not present. The results indicate that prediction at 1 year of age, built on risk factors associated with dental caries, can provide an indication of possible preventive interventions. <14> UI - 96119847 AU - Tinanoff N IN - Department of Pediatric Dentistry, School of Dental Medicine, University of Connecticut Health Center, Farmington, USA. TI - Dental caries risk assessment and prevention. [Review] [36 refs] SO - Dental Clinics of North America 1995 Oct;39(4):709-19 AB - Although dental caries in preschool children has declined in the past 20 years, the decrease is not observed equally across all populations. Considerable benefit could be achieved if the children at high risk could be identified before lesions develop. The best predictors of dental caries in preschool children are previous caries history, especially nursing bottle caries, and the salivary mutans streptococci levels. Other caries risk factors include inadequate oral hygiene practices, deficient fluoride exposure, low socioeconomic status, and familial caries patterns. Children at high caries risk should be considered for more intensive home fluoride programs, such as brushing the child's teeth with a pea-size amount of either 0.4% SnF2 or 1.1% NaF gels. Frequent professional fluoride treatments can be substituted if there is poor compliance with home programs. There is little documentation that dietary modification and plaque control and sealant programs are cost-effective measures for preventing caries in preschool children. [References: 36] <15> UI - 96119848 AU - Edelstein BL IN - Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA. TI - Case planning and management according to caries risk assessment. SO - Dental Clinics of North America 1995 Oct;39(4):721-36 AB - Ultimately, the dentist's role is to guide children through their growth and development free of disease. The dentist must recognize each child's unique susceptibility to caries and each parent's interest, competency, and accomplishment in controlling this disease. With this recognition, it is possible to tailor the frequency and content of dental visits necessary to maintain a child caries-free. Similarly, the frequency of examinations, office topical fluoride treatments, radiographs, and other diagnostic or preventive interventions depends upon the dentist's assessment of how intense professional efforts need to be to help parents maintain their children in health. Goldman and Burket summarized the relationship between science and practice and detailed the responsibilities of clinicians with the following words: "The practice of dentistry is an art in which the teachings of dental science are put to their practical application. A patient visits the dentist for consultation on the state of health of the dentition, with the expectation that everything possible will be done not only to repair or help heal by therapeutic correction any disease present but also to prevent disease from occurring, if possible." Treating caries at the level of the disease process to prevent its expression, progression, and ultimate dental destruction is the highest calling and deepest challenge facing dentists who care for young children. Techniques including risk assessment, triage, tailored care, and thoughtful treatment grounded in dental and behavioral science have put that goal within reach of dentists and parents to the great benefit of children. <16> UI - 96119857 AU - Waldman HB IN - Department of Dental Health, School of Dental Medicine, State University of New York at Stony Brook, USA. TI - Preschool children. Need and use of dental services. [Review] [33 refs] SO - Dental Clinics of North America 1995 Oct;39(4):887-96 AB - There have been major decreases in dental diseases, but many youngsters are still in need of care, especially low-income and medically compromised children. Additionally, family structure and economic changes are placing children at increased risk for dental diseases. Although there is a progressive increase in the use of services, many children don't have insurance coverage and do not receive preventive and restorative dental care. The preschool years are a foundation period for children, but many continue to receive an uncertain start. [References: 33] <17> UI - 96116625 AU - Pendrys DG IN - Department of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut Health Center, Farmington 06030, USA. TI - Risk of fluorosis in a fluoridated population. Implications for the dentist and hygienist. SO - Journal of the American Dental Association 1995 Dec;126(12):1617-24 AB - The prevalence of enamel fluorosis has increased in optimally fluoridated areas in recent years. This has led to efforts to identify the cause or causes and to make recommendations that seek to maintain the caries-preventive effectiveness of fluoride use while minimizing the risk of fluorosis. In this study, the author estimated the potential direct impact that dental practitioners could have on reducing the amount of enamel fluorosis in U.S. children. The findings suggest that dental practitioners could have an important impact on reducing the prevalence of enamel fluorosis by guiding the public toward the most appropriate use of fluoride products. <18> UI - 96045875 AU - Provart SJ AU - Carmichael CL IN - Department of Dental Public Health, County Durham Health Commission, UK. TI - The use of an index of material deprivation to identify groups of children at risk to dental caries in County Durham. SO - Community Dental Health 1995 Sep;12(3):138-42 AB - An investigation of the potential for an index of material deprivation to indicate groups of young children at risk to dental caries and to assess caries experience in their age group at three levels of deprivation, measured by the Townsend Index, was undertaken in County Durham. Electoral wards were ranked on an index of material deprivation derived from 1991 Census data. Dental caries data for the upper quartile, inter-quartile range and lower quartile of material deprivation in the County were obtained from a dental survey of 6052 five-year-old children in 1991-92. The number of children in each group ranged from 1145 to 3058. Significant differences in dental caries experience between high, middle and low ranges of material deprivation existed. The index of material deprivation can indicate groups of children in the community at high and low risk of dental caries. <19> UI - 96037069 AU - Larsson B AU - Johansson I AU - Hallmans G AU - Ericson T IN - Department of Cariology, Research University of Umea, Sweden. TI - Relationship between dental caries and risk factors for atherosclerosis in Swedish adolescents?. SO - Community Dentistry & Oral Epidemiology 1995 Aug;23(4):205-10 AB - In an earlier study on a selected group of adolescents with high caries prevalence we found dietary habits that resembled those considered to promote the development of atherosclerosis. In the present study we have compared DMF-score with factors traditionally associated with the risk for development cardiovascular diseases (CVD). All 15-yr-olds living in an urban community in Northern Sweden 1987-1989 were included. Medical variables related to the risk of developing CVD were evaluated in groups of adolescents with various levels of manifest caries expressed as decayed and filled surfaces (DFS). The proportion of individuals with no medical risk factor at an unfavorable level was significantly higher in a caries free than in a high-caries (DFS > or = 9) group. Adolescents with two or more medical factors reaching unfavorable levels had a significantly higher caries score than the group with no factor at unfavorable level. A significant positive correlation was found for the whole group between DFS-score and relative body weight (body mass index) in an univariate correlation test as well as multiple linear regression analysis. The hypothesis that high caries score can be an indicator for unfavorable levels of traditional risk factors for CVD is not contradicted by the results in the present study but supported by the observed covariation with BMI. We therefore suggest that dietary counseling to adolescents with a high caries score in combination with a moderate obesity can be of advantage in reducing the caries risk as well as the risk for development of CVD at higher ages. <20> UI - 96063835 AU - Tsubouchi J AU - Tsubouchi M AU - Maynard RJ AU - Domoto PK AU - Weinstein P IN - Department of Pediatric Dentistry, University of Washington, USA. TI - A study of dental caries and risk factors among Native American infants. SO - ASDC Journal of Dentistry for Children 1995 Jul-Aug;62(4):283-7 AB - Seventy-seven infants, ages twelve to thirty-six months, were examined in a Women Infant Children (WIC) program at the Tulalip Health Center, Marysville, Washington. All parents/caregivers completed questionnaires, which consisted of twenty-nine questions regarding children's feeding, general care, and dental health behavior. After completing questionnaires, dental examinations were conducted with mouth mirror and explorer by one dentist. Results indicated overall caries prevalence of 46.8 percent (26 percent for twelve to eighteen months, 56 percent for eighteen to twenty-four months and 56 percent for twenty-four to thirty-six months groups). The overall average number of carious teeth per child (deft) was 2.09 (0.83, 2.17 and 2.86, in order). Caries in children was significantly associated with following factors; bottle fed now (63.9 percent vs 29.3 percent, p = .00), giving bottle as baby falls sleep (82.4 percent vs 61.0 percent, p = .03), and 3 times or more snacks between meals (73.5 percent vs 40.0 percent, p = .01). Similarly, brushing behavior was related to caries. These results suggest that the present population was at risk for caries and that feeding patterns beyond bottle use appear to be behavioral risk factors in the prevalence of infant caries in this population. <21> UI - 96045998 AU - Loe H IN - Department of Periodontology, School of Dental Medicine, University of Connecticut Health Center, Farmington 06030-1710, USA. TI - Changing paradigms in restorative dentistry. [Review] [37 refs] SO - Journal of the American College of Dentists 1995 Fall;62(3):31-6 AB - Dramatic improvements in oral health have occurred during the last twenty years. Success is most noticeable in children and young adults, but also extends to the general population. The impact from declining disease rates, improved restorative materials and techniques, new diagnostics and treatments, a broad array of preventives, and better ways to deliver products and services to the public are demonstrated in the decline in the number of restorative procedures performed each year, including a 40% decline in the use of amalgam over the last eleven years. The new paradigm for restorative dentistry calls for an increasingly conservative approach to treatment. The question now is not primarily whether amalgam, composite, or any other material will fill a cavity. The real issue is to make the distinction between caries as a disease and caries as a lesion. Treating caries as a disease requires a new approach to patient management. A diagnosis of caries requires that a patient risk profile be established. We can no longer be limited in our efforts to merely restore the individual tooth surface. This paper discusses the need to cure disease and restore the total integrity of our patients' oral health. [References: 37] <22> UI - 96039478 AU - Miyazaki H AU - Sakao S AU - Katoh Y AU - Takehara T IN - Department of Preventive Dentistry, Kyushu Dental College, Kitakyushu, Japan. TI - Correlation between volatile sulphur compounds and certain oral health measurements in the general population. SO - Journal of Periodontology 1995 Aug;66(8):679-84 AB - Oral malodor was measured using a portable sulphide monitor in 2,672 individuals aged 18 to 64 years. In addition, dental (DMFT) and periodontal conditions (CPITN and attachment loss), dental plaque, and tongue coating status were assessed. Before clinical examination, subjects were interviewed about their oral health habits, smoking habits, and medical history. Data on volatile sulphur compounds (VSC) were analyzed by gender, age group, and time of measurement. There were no significant differences observed in the VSC between males and females in any age group. In each age group, the measured values of oral malodor were highest in the late morning group (58.6 ppb in average), followed by the late afternoon group (52.1 ppb), while lowest values were shown in the early afternoon group (39.4 ppb). Significant correlation was observed only between the VSC value and periodontal conditions and tongue coating status. The results also suggest that oral malodor might be caused mainly by tongue coating in the younger generation and by periodontal diseases together with tongue coating in older cohorts in the general population. Age was not a risk factor for increasing VSC. <23> UI - 96073585 AU - Litt MD AU - Reisine S AU - Tinanoff N IN - University of Connecticut School of Dental Medicine, Farmington, USA. TI - Multidimensional causal model of dental caries development in low-income preschool children. SO - Public Health Reports 1995 Sep-Oct;110(5):607-17 AB - Despite the decline in the incidence of dental caries in the United States over the past several years, the condition remains a significant problem for the nation's poor children. Efforts to identify the factors responsible for caries development in samples of children of low socioeconomic status have primarily focused on a limited number of variables, and those have been predominantly biological (mutans streptococci, for example). Resulting models of caries development have usually shown good sensitivity but poor specificity. They have had limited implications for treatment. In an effort to produce a comprehensive model of caries development, 184 low-income preschool children were clinically assessed for mutans streptococci and for decayed, missing, or filled surfaces of deciduous teeth twice, first at age 4 years (baseline) and again a year later (year 1 assessment). As the clinical assessments were being done, caretakers were being interviewed to obtain data from five domains: demographics, social status, dental health behaviors, cognitive factors such as self-efficacy (self-confidence) and controllability, and perceived life stress. Data were analyzed using a structural equations modeling approach in which variables from all domains, plus baseline decayed missing and filled surfaces and baseline mutants, were used together to create a model of caries development in the year 1 assessment. Results confirmed earlier work that suggested that caries development at a 1-year followup was strongly dependent on earlier caries development. Early caries development in this sample was determined in part by mutans levels and by dental health behaviors. These behaviors themselves were accounted for partly by a cognitive factor.(ABSTRACT TRUNCATED AT 250 WORDS) <24> UI - 96052346 AU - Ismail AI AU - Gagnon P IN - Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada. TI - A longitudinal evaluation of fissure sealants applied in dental practices. SO - Journal of Dental Research 1995 Sep;74(9):1583-90 AB - Sealants are highly effective in preventing dental caries in the pits and fissures of teeth when applied by trained operators in clinical trials and public health programs. The effectiveness of fissure sealants when applied in dental practices is still not known. The purpose of this longitudinal study was to evaluate the effectiveness of fissure sealants applied in dental practices in preventing dental caries on occlusal surfaces of first permanent molars. In 1990, on the Island of Montreal, 911 randomly selected children, from 6 to 9 years of age, were examined; out of those, 816 and 733 were re-examined in 1991 and 1992, respectively. Only the 733 children with complete examination records were included in this evaluation. Sealant applications were either personally paid for or were paid for by private dental insurers. All children were covered for diagnosis and restorative care by a publicly financed and universal insurance program. Dental treatment records were provided by Quebec's health insurance board. In the epidemiological examination, the occlusal surfaces of first permanent molars, which are the only surfaces included in this analysis, were classified into: sound, non-cavitated and cavitated status, restored, and sealed. Sealants were evaluated for full or partial coverage of the occlusal surface and presence of dental caries. During the first and second years, 11.6% and 17.5% of the students had new sealants. The number of new sealants placed during the two years was 507. Children with caries-free status and whose parents had high school education or higher were significantly more likely to receive sealants during the study.(ABSTRACT TRUNCATED AT 250 WORDS) <25> UI - 96036258 AU - O'Mullane D IN - WHO Collaborating Centre for Oral Health Services Research, University Dental School, Ireland. TI - Can prevention eliminate caries?. [Review] [24 refs] SO - Advances in Dental Research 1995 Jul;9(2):106-9 AB - There are four main factors involved in the carious process: at-risk tooth structure, plaque flora, fermentable carbohydrates, and time. Based on our knowledge of the carious process, four main preventive strategies have been developed over the years, namely, fluorides, fissure sealing, dietary choice, and plaque control. Fluorides are having a major impact on smooth-surface caries; hence, strategies combining fluorides and fissure sealing are very effective. However, use of fissure sealing is still problematic. Changing dietary practices with a view to reducing dental caries seems to be having little impact on a global scale. Plaque control, as practiced routinely by the majority of people, is not sufficient to result in caries reductions. Deprivation and poverty are strongly associated with high caries levels. Although the preventive strategies currently available are likely to result in lower caries levels for many, for logistical reasons and because of factors associated with deprivation and poverty, caries is likely to remain a major public health problem in most communities for the foreseeable future. [References: 24] <26> UI - 96036270 AU - Bergmann KE AU - Bergmann RL IN - Department of Pediatrics, Virchow-Klinikum Humboldt University, Berlin, Germany. TI - Salt fluoridation and general health. [Review] [42 refs] SO - Advances in Dental Research 1995 Jul;9(2):138-43 AB - Salt fluoridation is a systemic form of fluoride supplementation, leaving it to the consumer whether he wants fluoride supplements or not, but thereafter not requiring special dependability for daily compliance. Most German drinking water has low fluoride concentrations. The estimated fluoride intake in German children is between 100 and 300 micrograms/day, and in adults, between 400 and 600 micrograms/day. Male subjects have higher mean intakes than females. From 70 to 90% of the salt intake of 10 to 13.5 g/day in German adults comes from commercially prepared foods. This leaves about 1 to 4 g of salt to be added as table salt at the individual level and to become the source of supplementary fluoride. To increase fluoride intake by at least 500 micrograms/d, and to prevent an additional intake of more than 3000 micrograms/day, it may be necessary to have salt at a fluoride level of around 500 micrograms/g or to include one commercial food to be prepared with fluoridated salt, e.g., bread. A salt fluoride concentration of 250 micrograms/g does not present a risk of dental fluorosis. However, clear recommendations about systemic fluoride supplementation must be given as long as there are fluoride tablets, fluoride-rich mineral waters, and fluoridated table salt available simultaneously. Persons at risk for hypertension from salt consumption require different means of fluoride supplementation. By and large, in areas of low drinking water fluoride, fluoridated table salt has the potential to become a means of systemic supplementation comparable with drinking water fluoridation. [References: 42] <27> UI - 96036253 AU - Fejerskov O IN - Department of Dental Pathology, Royal Dental College, Faculty of Health Sciences, Aarhus University, Denmark. TI - Strategies in the design of preventive programs. [Review] [35 refs] SO - Advances in Dental Research 1995 Jul;9(2):82-8 AB - Dental caries is mostly recorded at the cavity level only. A reduced mean number of cavities in new age cohorts is often thought of as a result of prevention of the disease, dental caries. However, what is measured is rather our success in controlling the disease in such a way that prevalence of its more severe manifestations (cavities) can be reduced in children. Caries lesions and periodontal breakdown are cumulative with age and progress steadily in all populations. Thus, caries is the predominant reason for tooth loss in almost all age groups. The low prevalence and skewed distribution of dental caries make several fluoride programs less (if at all) cost-effective. Rather than considering a "whole population strategy" as opposed to a "high-risk strategy", it is argued that they should go hand in hand. However, the high-risk strategy may appear to have an unfavorable ratio of benefits to costs. So far the available literature shows no evidence that we have tests which, with sufficient predictive power, can identify groups or individuals of "high risk". It is therefore concluded that a population strategy should be maintained and further developed with emphasis on oral hygiene, because it influences norms and behavior. More knowledge about the pathogenesis of oral disease is needed before we can develop truly cost-effective strategies for the prevention of caries and periodontal breakdown. [References: 35] <28> UI - 96017041 AU - Wilson NH AU - Wilson MA IN - Department of Restorative Dentistry, University Dental Hospital, United Kingdom. TI - The outcome of a clinical trial of a dentin bonding system. Justice or injustice?. SO - American Journal of Dentistry 1995 Apr;8(2):99-102 AB - PURPOSE: To review the findings and to question the outcome of a clinical evaluation of a dentin bonding system. MATERIALS AND METHODS: The study was a split mouth, single blind (to patient), randomised within patient, clinical trial of Tripton used in conjunction with Opalux and the ultrafine compact-filled, experimental visible light cured resin composite M221784 (ICI Dental) in the restoration of mixed (enamel/dentin), caries free buccal-surface cervical lesions in vital, permanent canine and premolar teeth. The design of the trial was based on the then current American Dental Association (ADA) Clinical Protocol Guidelines for Dentin and Enamel Adhesive Materials. Restorations were placed as dictated by a predetermined randomised number scheme with each patient recruited to the study receiving at least one pair of matched restorations, comprising one restoration of each resin composite. RESULTS: The study reported was discontinued at 1 year subsequent to a 17% loss rate between 6 and 12 months after placement, with most of the restorations lost having been placed in what has subsequently become shown to be relatively unfavorable situations. It is suggested that the outcome of clinical trials of the type considered may warrant review in the light of new knowledge and understanding, and that regulatory bodies setting clinical protocol guidelines must give careful consideration as to whether the criteria for this type of trial should be more restrictive or required to include a representative range of clinically relevant situations. <29> UI - 96019453 AU - Kilpatrick NM AU - Murray JJ AU - McCabe JF IN - Department of Child Dental Health, Dental School, Newcastle upon Tyne. TI - The use of a reinforced glass-ionomer cermet for the restoration of primary molars: a clinical trial [see comments]. CM - Comment in: Br Dent J 1996 Feb 24;180(4):129, Comment in: Br Dent J 1996 Apr 6;180(7):246 SO - British Dental Journal 1995 Sep 9;179(5):175-9 AB - The development of adhesive restorative materials has led to more conservative cavity design with greater reliance being placed upon the bond of a material with tooth tissue for retention of the restoration. Glass-ionomer cements may offer particular advantages but have yet to achieve the durability reported for amalgam. This study reports on the results of a 2.5-year prospective clinical trial comparing the durability of two glass-ionomer cements, a conventional material (Ketac Fil) and a metal reinforced cermet (Ketac Silver) in the restoration of Class II lesions in primary molars. Forty-six pairs of restorations were assessed in 37 children. The failure rate of Ketac Fil, 23%, was significantly lower than that of Ketac Silver, 41% (P < 0.05). The median survival time of the Ketac Fil restorations was significantly greater, 25.3 months, than that of the Ketac Silver restorations, 20.3 months (P < 0.05). These values may be an underestimate of the true longevity of both restoration types as many of the restorations survived intact at the censor date. Neither the age of the child nor the tooth restored influenced the durability of the restoration. The deterioration in both marginal integrity and anatomic form of the Ketac Silver restorations was significantly greater than the Ketac Fil restorations (P < 0.05). The durability of Ketac Silver was such that it cannot be recommended for use in restoring carious primary molars. <30> UI - 96036304 AU - Aranda M AU - Garcia-Godoy F IN - Department of Pediatric Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA. TI - Clinical evaluation of the retention and wear of a light-cured pit and fissure glass ionomer sealant. SO - Journal of Clinical Pediatric Dentistry 1995 Summer;19(4):273-7 AB - The purpose of this study was to evaluate the 12-month retention and wear of an experimental light-cured glass ionomer for pit and fissure sealing. A total of 25 patients 7-14 years-old were selected from the Pediatric Dentistry Clinic at the University of Texas Health Science Center at San Antonio. The patients resided in areas without fluoridated water. Each tooth was isolated with cotton rolls, dried with oil-free compressed air and GC Dentin Conditioner applied with a small disposable brush to the pits and fissures for 20 seconds. The teeth were rinsed with water and gently air dried using an air/water syringe. The teeth were not desiccated. GC experimental glass ionomer for pit and fissures was used. The powder/liquid ratio was dispensed at 1.4 gm/1.0 gm (one level spoonful of powder to one drop of liquid). The powder was mixed for 15-20 seconds. An explorer was used to apply the mixed sealant to the tooth and teased into all pits and fissures. The sealant was then cured for 20 seconds. Occlusion was corrected after the sealant was light-cured. Immediately, a color slide and a vinyl polysiloxane impressions were taken. The impressions were poured in epoxy resin. Color slides, impressions and epoxy models were also made at 3, 6, 9 and 12-month recalls. A total of 95 sealants were placed and follow-up for 12 months. The results showed that with the clinical visual inspection all sealants were present at 3 and 6 months postoperatively. At 12 months, only 20% of the sealants were clinically evident.(ABSTRACT TRUNCATED AT 250 WORDS) <31> UI - 95388212 AU - Greene P AU - Chisick MC IN - Pediatric Dentistry, Fort Stewart, GA 31314, USA. TI - Child abuse/neglect and the oral health of children's primary dentition. SO - Military Medicine 1995 Jun;160(6):290-3 AB - This paper compares oral health status and presence of untreated, decayed primary teeth in 42 confirmed cases of child abuse with 822 non-abused controls. The 864 children (ages 3-11) came from military families at one Army installation. We assessed oral health status using the dfs (decayed and filled surfaces) index and derived presence of untreated, decayed teeth from the decayed and unfilled component of each child's dfs score. Using logistic regression, we determined the influence of abuse status and other sociodemographic characteristics on both outcome measures. Results show that abuse status does not contribute to differences in oral health status, but it does contribute to differences in presence of untreated, decayed primary teeth. Abused children with sponsors assigned to noncombat units are 5.2 times more likely to have untreated, decayed primary teeth than other children. These results suggest that military child abuse intervention efforts should include referral for dental care plus the need to target younger children from families with non-combatant sponsors. <32> UI - 95385060 AU - Raitio M AU - Mottonen M AU - Uhari M IN - Oulu Municipal Health Center, University of Oulu, Finland. TI - Toothbrushing and the occurrence of salivary mutans streptococci children at day care centers. SO - Caries Research 1995;29(4):280-4 AB - Risk factors for the occurrence of salivary mutans streptococci (MS) were surveyed in 677 children aged 1-8 years (4.9 +/- 1.2; mean +/- SD) at 20 municipal day care centers in Oulu. As a part of an intervention program to reduce the spread of infectious diseases, toothbrushing was discontinued in 10 centers, the other 10 serving as controls. The test for MS was performed on 506 children before the 8-month intervention, on 358 at the end and on 345 on both occasions. Past caries experience was recorded from the children's dental health cards (dmf). Dental health habits were evaluated by means of questionnaires filled in by the parents. The occurrence of MS varied from 43.4 to 48.0%. Although those children who cleaned their teeth regularly at home carried less MS than those who did so irregularly (46.4 vs. 64.9%, p < 0.001), the withdrawal of toothbrushing at the day care center did not increase the incidence of MS. The occurrence of MS was increased by consumption of sweets containing sucrose (p < 0.01) and reduced by the regular use of fluoride tablets (p < 0.02). Logistic modeling showed a positive MS test to be associated significantly with older age (p < 0.01) and female sex (p < 0.05) in addition to toothbrushing at home (p < 0.001). The children with positive tests had significantly higher mean (+/- SD) dmf than those with negative ones (1.6 +/- 2.7 vs. 0.3 +/- 1.2, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) <33> UI - 95376483 AU - Holt RD IN - Department of Children's Dentistry, Eastman Dental Institute for Oral and Dental Health Care Sciences, London, UK. TI - The pattern of caries in a group of 5-year-old children and in the same cohort at 9 years of age. SO - Community Dental Health 1995 Jun;12(2):93-9 AB - A group of 1,006 children examined at 5 years of age was followed up after a further four year period. Thirty seven per cent of the group had some caries experience at the age of 5 years. Four years later this proportion had increased to 52 per cent. There was little caries in incisor teeth at the age of 5 with the disease affecting mainly primary molars, (especially second primary molars) and occlusal surfaces. Primary molars continued to experience new attack in the subsequent four years, with lesions affecting more first primary molars and more approximal than occlusal surfaces during this period. New caries was seen most often in children with previous disease experience but children with a lower dmfs of between 1 and 5 at 5 years experienced a similar increment to those with more extensive caries (dmfs > or = 6). In contrast, few lesions were seen in the children who had been caries free at 5 years. Children in the study had taken part in a trial of a lower fluoride toothpaste (550ppmF) especially formulated for young children. There was no difference in relative pattern of disease in test and control groups but the trend seen at the end of the trial for children who had used the test paste to have slightly higher levels of disease than those who had used a standard control paste (1,055ppmF) was seen again four years later. <34> UI - 95406831 AU - Swedberg Y IN - Department of Pedodontics, Faculty of Odontology, Goteborg, Sweden. TI - Dental time study results in relation to a model for a dental health related patient group system. SO - Swedish Dental Journal 1995;19(3):109-18 AB - Using a time study method, dental care treatment resources were studied concerning different caries groups of children and adolescents 3-19 years of age. The results were applied to a model for a dental health related patient group system as a tool for presenting the dental care situation. Quality assurance aspects of a dental health related patient group system, adapted for use in general dental care, had led to a suggested model system: "Dental Visiting Groups" (DVG). The DVG system takes into consideration the fact that dental care was performed by three dental care-giving personnel groups--dentists, dental hygienists and dental assistants--giving dental care in three main areas of dental procedures: diagnostic, prevention and intervention. The DVG system implied a model of Swedish dentistry in change, and presented the relationships among the dental health related patient groups, the three main areas of dental procedures, and the tasks of the dental care-givers. Applied over time, the DVG system illustrated the efficiency of the dental care model used. <35> UI - 95406830 AU - Twetman S AU - Petersson LG IN - Department of Pediatric Dentistry, Medical and Dental Center, Halmstad, Sweden. TI - Influence of xylitol in dentifrice on salivary microflora of preschool children at caries risk. SO - Swedish Dental Journal 1995;19(3):103-8 AB - The aim was to study whether the use of a xylitol-containing dentifrice could affect the number of mutans streptococci and lactobacilli in preschool children with medium and high initial salivary counts. After screening 147 healthy preschool children, 3-6 years of age, 70 were selected and randomly assigned into two groups for 3-month's use of either a xylitol (9.7%) or a non-xylitol-containing fluoride dentifrice. The parents were trained to brush the teeth of their children twice daily in a standardized manner and the study was carried out double blind. Bacterial levels at screening and after 3 months were enumerated with aid of chair-side methods. No significant differences in mutans streptococci levels or lactobacilli counts after 3 months were obtained, either in comparison to baseline or between the groups. About 50% of all children exhibited unchanged bacterial scores at the end of the test period but more children in the xylitol group disclosed reduced scores of salivary mutans streptococci compared with the non-xylitol group (38% vs 16%). The results suggest that the dose level achieved by using this xylitol-containing dentifrice in preschool children, did not provide sufficient antibacterial action to suppress caries associated microorganisms in the saliva of those with high initial counts. <36> UI - 95361472 AU - Mackeown JM AU - Cleaton-Jones PE AU - Hargreaves JA IN - MRC/University of the Witwatersrand Dental Research Institute, Johannesburg, South Africa. TI - Energy intake, dental caries and periodontal disease in 11-year-old black children in two regions of Southern Africa: KwaZulu and Namibia. SO - Community Dentistry & Oral Epidemiology 1995 Jun;23(3):182-6 AB - The study examined energy intake in relation to dental caries and periodontal disease in 11-yr-old rural and urban black children in low fluoride areas of KwaZulu and Namibia (0.15 ppm F) and one higher fluoride area of Namibia (1.56 ppm F). Twenty-four hour dietary recalls were conducted by trained interviewers and daily energy intake estimated using the MRC dietary analysis programme. DMFS was recorded according to WHO criteria: periodontal disease was measured using CPITN and SAS was used for statistical analysis. The prevalence of dental caries and periodontal disease (using CPITN), were compared within three energy groupings; < or = 850 kcal/day; > 850, < 1400 kcal/day and > or = 1400 kcal/day. The rural low fluoride Namibian children had the lowest mean energy intake (616 kcal/day), which also was the grouping with highest healthy periodontal prevalence (65%). The urban groups had higher energy intakes than the rural communities. Statistically significant effects on caries prevalence were seen for country and fluoride grouping; for periodontal disease, significant effects were noted for country, fluoride group and environment. Energy intake had no statistically significant effect, so this is not a risk marker for the disease. <37> UI - 95357757 AU - Wendt LK IN - Department of Cariology, Faculty of Odontology, Goteborg University, Sweden. TI - On oral health in infants and toddlers. [Review] [115 refs] SO - Swedish Dental Journal - Supplement 1995;106:1-62 <38> UI - 95361462 AU - Amstutz RD AU - Rozier RG IN - Directorate of Health Care Studies and Clinical Investigation, AMEDD Center & School, Ft. Sam Houston, Texas 78234-6060, USA. TI - Community risk indicators for dental caries in school children: an ecologic study. SO - Community Dentistry & Oral Epidemiology 1995 Jun;23(3):129-37 AB - A statewide survey of NC schoolchildren found wide variation in dental caries prevalence among sampled classrooms. This study examined factors associated with this variation using classrooms as a surrogate for the larger community, in order to identify community risk indicators (CRI). In all, 172 classrooms (3400 students) in Grades K-6 were available for analysis. Initially, 56 sociodemographic, environmental, health system, and clinical factors were evaluated for their association with caries prevalence (K-3: average dfs + DMFS; 4-6: average DMFS) using univariate and bivariate analyses. Of these, 21 factors met our criteria for evaluation using WLS multivariate regression. For Grades K-3 (n = 108), population density, parental education, and coastal residence were negatively associated with caries scores, while age, and medical and dental, Medicaid expenditures were positive. For Grades 4--6 (n = 64), age and fs:dfs ratio were positively associated with caries scores while population density, population:dentist ratio, and years of natural fluoride exposure were negative. CRIs for both models, when compared to individual models, explained a substantial portion of the variation in caries prevalence, 31% for Grades K-3 and 51% for Grades 4-6. Results suggest that a risk assessment model based on community rather than individual variables is feasible and further refinement may reveal factors useful in identifying high risk communities. <39> UI - 95361464 AU - Szpunar SM AU - Eklund SA AU - Burt BA IN - Program in Dental Public Health, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. TI - Sugar consumption and caries risk in schoolchildren with low caries experience. SO - Community Dentistry & Oral Epidemiology 1995 Jun;23(3):142-6 AB - This paper assesses the risk from sugar consumption in a population of school children with low caries experience. It relates eight different measures of sugar consumption to the occurrence of any DMFS increment, and, separately, to approximal and pit-and-fissure DMFS. The data are from a 3-yr longitudinal study of 429 children, initially aged 11-15, residing in non-fluoridated rural communities in Michigan, USA. All children completed at least three dietary interviews, were present for baseline and final dental examinations, and had a parent or guardian provide questionnaire information on residence history, use of fluoride and dental services, and family history. Results indicated that a higher proportion of total energy intake from sugars increased the probability of caries on all surfaces, and a higher total intake of sugars was also associated with total caries increment. No relationship, however, was found between DMFS increment and the frequency of eating high sugar foods. Each additional 5 g of daily sugars intake was associated with a 1% increase in the probability of developing caries, and those whose energy intake from sugars was 1 SD above the mean had 2.0 times the risk of developing approximal caries than did children whose energy intake from sugars was 1 SD below the mean. <40> UI - 95361465 AU - Weissenbach M AU - Chau N AU - Benamghar L AU - Lion C AU - Schwartz F AU - Vadot J IN - Faculte de Chirurgie Dentaire, Nancy, France. TI - Oral health in adolescents from a small French town. SO - Community Dentistry & Oral Epidemiology 1995 Jun;23(3):147-54 AB - In France, caries are more prevalent in rural areas than in large cities. This study analyzed the relationship between number of oral health indices and some known risk factors (toothbrushing, sugar consumption, saliva components) and sociodemographic factors in adolescents from a small town. The sample included 112 children aged 12-14 in the north-east of France. School marks was found to be better linked with dental caries indices than the socio-occupational category of parents: gingival index (GI), DMFS, DMFT and caries severity (CS) significantly increased with decreasing school marks; oral plaque was related to socio-occupational of parents. The analysis using the regression method showed that the variance explained by the various factors studied was modest (between 23 and 30%) for GI, initial caries sites (IS), DS, DMFS, DMFT and CS, and was small for plaque (5%) and calculus (3%). This would be due in part to the wide dispersion of these indices. The sex had a non-significant regression coefficient for all oral health indices investigated. For GI, only mutans streptococci (MS) and plaque had a significant regression coefficient. Calculus was explained by any factor considered. Only MS had a significant part in plaque. IS was explained by MS, toothbrushing and age. For DS, only toothbrushing, MS and sweet drinks during meals had a significant part. DMFS and DMFT were explained only by MS and age. CS was explained by MS, age, salivary buffer pH, salivary flow rate, and toothbrushing. <41> UI - 95369178 AU - Rimondini L AU - Baroni C IN - School of Dentistry, University of Bologna, Italy. TI - Morphologic criteria for root canal treatment of primary molars undergoing resorption. SO - Endodontics & Dental Traumatology 1995 Jun;11(3):136-41 AB - The endodontic anatomy of primary molars is difficult to predict because of the balance of resorption and hard tissue deposition. In particular, the resorption causes perforating lacunae across the wall of the root, even at the furcation level, and modifies shape, dimension and position of endodontic apex. The phenomenon can be so deep as to compromise endodontic therapy. The first aim of the study was to verify if reliable criteria can be found for treatability in primary molars undergoing resorption, i.e. if it is possible to predict if perforating lacunae are present or not. The second aim of the study was to verify if other informations needed for endodontic treatment, as shape, dimension and location of the apex, and curvature of the root canal can be predicted. For the study, 80 extracted primary molars, 75 of which pulpally involved by caries, were selected. The treatability was evaluated in term of root length, root shape, dimension and shape of endodontic apex, age of the patient and X-ray index of resorption. The association between variables was performed by multiple correspondence analysis. The results suggested that root length was the most reliable criterion of the integrity of the root. The borderline of treatability was at the length of 4 mm. The position of endodontic apex related to anatomical apex, and the lingual related to the buccal root length were analyzed by linear regression analysis. The canal length was often similar to the root length (i.e. the endo and anatomical apices were very close) in lower and upper molars. However, in lower molars, if two or more canals were present in the same root, a discrepancy was observed between buccal and lingual root length. This finding was constant in first lower molars. In addition regression analysis provided a linear function between the lengths of the buccal and lingual side of the same root in lower molars. Its coefficient b was 0.73. <42> UI - 95331875 AU - Makinen KK AU - Makinen PL AU - Pape HR Jr AU - Allen P AU - Bennett CA AU - Isokangas PJ AU - Isotupa KP IN - School of Dentistry, University of Michigan, Ann Arbor 48109, USA. TI - Stabilisation of rampant caries: polyol gums and arrest of dentine caries in two long-term cohort studies in young subjects. SO - International Dental Journal 1995 Feb;45(1 Suppl 1):93-107 AB - The purpose of this paper is to report clinical observations on the stabilisation of dentine caries in two chewing gum studies carried out in young subjects. One study focused on the permanent dentition of 1,277 initially 10-year old subjects, while the other study was carried out on 510 initially 6-year old subjects and focused on the primary dentition. In both trials, several chewing gum formulas containing dietary polyols (xylitol and sorbitol, or their combinations) were used for up to 40 months (10-year olds) or up to 24 months (6-year olds). The daily consumption level of both polyols was up to 10.7 g per subject, used normally in 5-minute chewing episodes 3 to 5 times per day. Supervised chewing in schools lasted 5 min per episode, and for variable times during non-school days. Rehardening of dentine caries lesions was observed clinically by experienced, blinded examiners using sharp dental explorers and fibre optic light. After 40 months (permanent dentition) or after 18 months (primary dentition), rehardening (caries arrest) generally occurred more frequently in subjects who used polyol gums than in subjects who did not receive gum as part of the programmes, or who received sucrose gum. Arrest or non-progression of dentine caries was most frequently observed in subjects who used 100 per cent xylitol gums or mixtures of xylitol and sorbitol, but the differences between gums were not consistently significant. However, the usage of 100 per cent xylitol pellet-shaped gum was more frequently associated with arrest of dentine caries than other treatments. These results and previous studies suggest that high-xylitol chewing gum usage can retard or arrest even rampant dentine caries in conditions where effective restoration and prevention programmes have not been instituted, and can also provide additional protection against further caries development during full implementation of restorative procedures by holding the lesion in a non-progressive condition. <43> UI - 95332537 AU - Mertz-Fairhurst EJ AU - Adair SM AU - Sams DR AU - Curtis JW Jr AU - Ergle JW AU - Hawkins KI AU - Mackert JR Jr AU - O'Dell NL AU - Richards EE AU - Rueggeberg F AU - et al IN - Department of Oral Rehabilitation, School of Dentistry, The Medical College of Georgia, Augusta 30912, USA. TI - Cariostatic and ultraconservative sealed restorations: nine-year results among children and adults. SO - ASDC Journal of Dentistry for Children 1995 Mar-Apr;62(2):97-107 AB - The objective of this clinical study was to evaluate the long-term efficacy of placing sealed posterior composite restorations for arresting active caries. The tooth preparation for this bonded and sealed restoration was limited to placing a bevel in the enamel only, without the removal of the carious lesion. The radiographic and clinical performance of these ultraconservative sealed composite restorations placed over caries (CompS/C) was compared over a period of nine years with: 1) ultraconservative, localized sealed amalgam (AGS) restorations with no extension for prevention, and 2) traditional, unsealed amalgam restorations (AGU) with the usual extension for prevention outline form. Sealant retention with > 50 percent to 100 percent of the margins occurred in 64 percent of CompS/C and 82.5 percent of AGS restorations. After nine years the cumulative failure rates were 16 percent for CompS/C, 2.5 percent for AGS, and 17.1 percent for AGU restorations. Thus, the clinical performance of CompS/C restorations was slightly superior to that of the traditional AGU restorations. The AGS restorations were definitely superior to the traditional AGU restorations and to the CompS/C restorations in both children and adults alike. Complete sealant retention over CompS/C and AGS restorations was equivalent between children and adults (P = 0.14 and 0.74, respectively). A higher percentage of open margins in CompS/C restorations was seen, however, in children (17.4 percent) than adults (1.94 percent). This study has shown that Class I caries can be arrested by the CompS/C restoration. <44> UI - 95323629 AU - Pienihakkinen K AU - Jokela J IN - Institute of Dentistry, University of Turku, Finland. TI - A simple method for monitoring mutans streptococci in young children. SO - European Journal of Oral Sciences 1995 Feb;103(1):61-2 AB - The study assessed the practicability of the Dentocult-SM STRIP MUTANS test in children, using dental floss to transfer the dental plaque to the strip. The subjects were children of 2-3 yr (n = 365) and 5-6 yr (n = 398). The mutans streptococci count on the strip was found to be a good indicator of infection and was surprisingly accurate in the prediction of the 3-yr caries increment. <45> UI - 95318336 AU - Anusavice KJ TI - Treatment regimens in preventive and restorative dentistry. [Review] [70 refs] SO - Journal of the American Dental Association 1995 Jun;126(6):727-43 AB - Due in part to a lack of appropriate training and the incentive of adequate compensation, preventive dentistry in the United States has focused on prophylaxis and fluoride application. Dentistry must shift its attention to developing standardized protocols for "preservative dentistry"--diagnosing caries, assessing and monitoring caries risk, arresting active caries and remineralizing non-cavitated lesions. This article addresses shortcomings in preventive dentistry and proposes a plan for treatment standardization that can ensure optimum treatment and, ideally, lead to adequate compensation. [References: 70] <46> UI - 95294913 AU - Rozier RG TI - A new era for community water fluoridation? Achievements after one-half century and challenges ahead [editorial]. SO - Journal of Public Health Dentistry 1995 Winter;55(1):3-5 <47> UI - 95294918 AU - Horowitz HS TI - Commentary on and recommendations for the proper uses of fluoride. SO - Journal of Public Health Dentistry 1995 Winter;55(1):57-62 AB - Fluorosis has been associated with the fluoride concentration of drinking water, use of dietary fluoride supplements, early use of dentifrices, and prolonged use of infant formula. The literature, however, does not show associations between fluorosis and use of fluoride mouthrinses, professionally applied fluorides, bottled waters, carbonated beverages, and juices. It is unwise to issue laundry lists of items that may be implicated as problem-causing when, in fact, they may not be. Although usually classified without fluorosis, children in Dean's "questionable" category would be classified with the condition if the TFI or TSIF were used. Accordingly, Dean, in 1942, really reported only 52.8 percent of children without fluorosis in Kewanee, a community with 0.9 ppm fluoride in drinking water. Because the morbidity and sequelae of dental caries have declined, undue emphasis has been placed recently on the risks of using fluoride rather than on its profound beneficial effects. Although of paramount importance, conclusions cannot be drawn on whether fluoride protects against, contributes to, or has no effect on bone fractures or is valuable in treating osteoporosis. Careful thought is required before making recommendations that may reduce health benefits because of unfounded concerns about perceived risks. There should be greater regulation of extraneous fluoride sources, rather than reliance on educational efforts or recommendations to eliminate use of highly effective preventive regimens. <48> UI - 95302260 AU - Albandar JM AU - Buischi YA AU - Oliveira LB AU - Axelsson P IN - Department of Periodontology, University of Oslo, Norway. TI - Lack of effect of oral hygiene training on periodontal disease progression over 3 years in adolescents. SO - Journal of Periodontology 1995 Apr;66(4):255-60 AB - A comprehensive new oral hygiene training program has lately been described and found effective in controlling dental plaque formation and in significantly reducing the incidence of approximal dental caries and gingivitis in adolescents. This study investigated the long-term effect of plaque control on the progression of periodontal diseases in adolescents. A group of 227 Brazilian schoolchildren were followed up over a period of 3 years. The children were divided randomly into 3 groups. The first group was given a needs-related intensive program which combined detailed information to parents and children pertaining to the etiology and prevention of dental diseases, instructions in self-diagnosis of plaque and gingivitis, and a detailed oral hygiene training based on individual needs, together with continued feedback and motivation during the entire 3 years. The second group was given a similar program, but through shorter sessions and with no motivation and feedback and no training in self-diagnosis. A control group received no motivation sessions or oral hygiene training. The 3 groups were examined radiographically at baseline and annually at 3 subsequent occasions. The data were analyzed with a multi-level variance analysis. The frequency of subjects showing sites with alveolar bone loss increased steadily during the entire period in all groups. Neither of the training programs had a significant effect on the alveolar bone level during 3 years compared to the control group. Generally, girls demonstrated higher proportions of approximal tooth surfaces showing radiographic bone loss, though not statistically significant. In this population the supragingival plaque control lacked any significant effect on periodontal disease progression.(ABSTRACT TRUNCATED AT 250 WORDS) <49> UI - 95292512 AU - Wang NJ AU - Holst D IN - Institute of Community Dentistry, Dental Faculty of Oslo, Norway. TI - Individualizing recall intervals in child dental care. SO - Community Dentistry & Oral Epidemiology 1995 Feb;23(1):1-7 AB - Individualizing and extending recall intervals for children have been recommended in Norway to target resources efficiently. Recall intervals were changed for children aged 3-18 years in Drammen from 1991. Clinical time spent by dentists and dental hygienists, dental health status and length of recall intervals were registered from 1990 to 1993. For the child population, the mean recall interval changed from 12.5 to 13.7 months and the annual time spent per child was reduced by 14% from 1990-91 to 1992-93. Adjusted for the decline in number of new decayed teeth, the reduction in time spent was 11%. Children with intervals of 17 to 20 months had fewer new decayed teeth and their care required less personnel time than other children. For children with new decayed teeth, time spent for dental care was not associated with recall interval, while for children without new decayed teeth, longer recall intervals were associated with shorter time for dental care. The variation in number of decayed teeth and time spent for dental care was substantial at all intervals. Individualizing and extending recall intervals to some extent targeted resources at children with more dental disease. However, in the short run, inequality in dental health persisted. Limited extension of recall intervals did not interrupt the long-term trend toward better dental health in the children and substantial resources were saved in the dental services. <50> UI - 95292518 AU - Hede B IN - Department for Community Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark. TI - Oral health in Danish hospitalized psychiatric patients. SO - Community Dentistry & Oral Epidemiology 1995 Feb;23(1):44-8 AB - The purpose of the present study was to describe oral health status in a group of hospitalized mental patients, and to study the association between dental caries and mental illness. A total of 278 psychiatric patients admitted to a regional Danish hospital were described with respect to the number of teeth present, DMFS, gingival and periodontal status and presence of removable dentures. The oral health status of the hospitalized mental patients was relatively poor compared with the general population of the area. For instance, actual decayed surfaces were found among 55% of the participants compared to the reference figure of 23% in the general population. A multiple regression analysis demonstrated that DMFS was related to duration of mental illness and to psychiatric diagnosis. Furthermore, a multiple logistic regression analysis revealed that the presence of actual decayed surfaces was associated with neglect of toothbrushing, subjective symptoms of xerostomia and participation in the hospital dental program. To conclude, variables of mental illness and psychiatric treatment and care were demonstrated to influence oral health. This underlines the need of special preventive programs aimed at hospitalized psychiatric patients. <51> UI - 95292523 AU - Wang NJ AU - Riordan PJ IN - Institute of Community Dentistry, Dental Faculty of Oslo, Norway. TI - Recall intervals, dental hygienists and quality in child dental care. SO - Community Dentistry & Oral Epidemiology 1995 Feb;23(1):8-14 AB - Decline in dental disease and the need to provide dental care efficiently suggest changes in clinical and administrative routines in public dental care provision for children. A field project in Norway demonstrated productivity gains after the introduction of individualized recall intervals and using dental hygienists to conduct recall examinations. The purpose of the present study was to assess changes in the quality of dental health outcome and changes in the quality of the process of dental care provision. Recall intervals were increased from a target of 12 months to 16 and 18 months in two districts. Dental hygienists undertook all recall examinations and referred to dentists those patients who required operative care. Bitewing radiographs were inspected for all 18-yr-olds who were examined in 1989, 1990 and 1991 (n = 956) and for those who were examined before the changes were implemented in 1987 (n = 300). For each child, approximal caries on 24 surfaces was scored according to a 4-point severity scale. Clinical records were examined to determine what treatment had been provided. For each year after the changes were implemented, the quality of health outcome was assessed by comparing the radiographic caries prevalence and the number of sound surfaces with 1987 data. Quality in the process of care provision was indicated by the treatment decisions for approximal caries and by the proportion of uninterpretable surfaces on radiographs for each study year. The mean number of sound surfaces increased over time. A declining proportion of sound surfaces was restored over the study period, and almost all caries lesions extending deep into dentine were restored. Radiographic quality improved during the project period.(ABSTRACT TRUNCATED AT 250 WORDS) <52> UI - 95294916 AU - Levy SM AU - Kiritsy MC AU - Warren JJ IN - Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City 52242, USA. TI - Sources of fluoride intake in children. [Review] [111 refs] SO - Journal of Public Health Dentistry 1995 Winter;55(1):39-52 AB - Wide variations in fluoride intake among children make estimating fluoride intake difficult. This paper discusses the various sources of fluoride intake among children, beginning with a review of the fluoride concentrations of water and other beverages, foods, and therapeutic fluoride products. A review of previous studies' estimates of fluoride intake from diet, dentifrice, fluoride supplements, fluoride mouthrinses, and gels, as well as total fluoride intake also is presented. Then, estimates of fluoride intake among young children of different age groups are summarized, and examples demonstrating the high level of variability of fluoride intake, both from individual sources and in total, are presented. Lastly, this paper discusses the implications of our current level of knowledge of children's fluoride intake, and presents recommendations for the use of fluoride for children in light of this current knowledge. The major recommendations are that: (1) the fluoride content of foods and beverages, particularly infant formulas and water used in their reconstitution, should continue to be monitored closely in an effort to limit excessive fluoride intake; (2) ingestion of fluoride from dentifrice by young children should be controlled, and the use of only small quantities of dentifrice by young children should be emphasized; and (3) dietary fluoride supplements should be considered a targeted preventive regimen only for those children at higher risk for dental caries and with low levels of ingested fluoride from other sources. [References: 111] <53> UI - 95302259 AU - Albandar JM AU - Buischi YA AU - Axelsson P IN - Department of Periodontology, University of Oslo, Norway. TI - Caries lesions and dental restorations as predisposing factors in the progression of periodontal diseases in adolescents. A 3-year longitudinal study. SO - Journal of Periodontology 1995 Apr;66(4):249-54 AB - The present study used a novel approach to assess the relationship between untreated caries lesions and defective and non-defective dental restorations and the incidence of gingival inflammation and the progression of chronic inflammatory periodontal diseases at the approximal surfaces of posterior teeth and at the adjacent surface of the neighboring tooth in adolescents over a period of 3 years. Two hundred-twenty-seven (227) 13-year-old schoolchildren were examined clinically and radiographically at baseline and annually at three subsequent occasions. At each site the alveolar bone height and presence of gingival bleeding were assessed. Incipient caries lesions, manifest caries, and defective and non-defective restorations were identified at the same site and also at the adjacent approximal tooth surface at all examinations, both clinically and radiographically. The data were analyzed by the multi-level logistic regression and variance components analyses. On average, 32, 8.5, 7, and 10% of the sites, respectively, were diagnosed as having incipient caries, manifest caries, and defective and non-defective restorations. There was a significant association between the presence of untreated manifest caries lesions, non-defective and defective dental restorations, and the progression of periodontal support loss. Also there was an association between presence of defective restorations and manifest caries and the incidence of gingival inflammation. Consistently, factors detected at the involved site and at the adjacent site had significant effects. The present study indicates that untreated cavities and dental restorations are predisposing factors with a significant negative effect on periodontal health in adolescents.(ABSTRACT TRUNCATED AT 250 WORDS) <54> UI - 95310690 AU - Anonymous TI - Caries diagnosis and risk assessment. A review of preventive strategies and management. [Review] [72 refs] SO - Journal of the American Dental Association 1995 Jun;126 Suppl:1S-24S AB - The scientific basis for caries risk assessment, prevention and treatment on an individual patient basis requires further development, specification and continuing validation. Still, current technologies and techniques, taken together, can provide enhanced capabilities over those that have been employed traditionally. Undoubtedly, the clinical tools for carrying out these responsibilities will be refined and expanded in the future in response to the changing clinical profile of caries in the population. For example, bacteriologic testing methods have become easier and more reliable, and will become more widely used. Other effective methods to detect the early, pre-cavitation stage of caries also should become more available in the future. Practitioners will be continually challenged and responsible for evaluating the effectiveness and value of emerging technologies in their practices and in light of their patients' needs. But how can this be accomplished best? Effectiveness claims will be made for new drugs and devices that come onto the market. There are several sources of information to assist the practitioner in making such decisions. The American Dental Association acceptance programs (voluntary) and the U.S. Food and Drug Administration compliance programs (law) provide standards and guidance as to product safety and effectiveness. Without such determinations, the practitioner must judge independently product claims and clinical studies. Marketing materials by themselves (advertisements, videos, pamphlets) may not be sufficient evidence of effectiveness particularly when scientific references supporting claims either are not provided or are inadequate. Peer-reviewed scientific literature in publications of the major scientific and professional associations can be viewed as generally reliable. Changing the way dental caries is managed in clinical practice will require integrating new scientific information and technology into workable clinical procedures. Dental education and third-party reimbursement issues must be addressed also but are beyond the scope of this document. Given that disease patterns are always changing in the population, dentists need to modify practice decisions using risk assessment. Ultimately, the goal for dentistry is that adult patients also will enjoy the same low level of caries experience that many children enjoy today. [References: 72] <55> UI - 95258947 AU - Klingberg G IN - Department of Pedodontics, Faculty of Odontology, Goteborg University, and Public Dental Service, Sweden. TI - Dental fear and behavior management problems in children. A study of measurement, prevalence, concomitant factors, and clinical effects. [Review] [112 refs] SO - Swedish Dental Journal - Supplement 1995;103:1-78 AB - A Swedish parental version of the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) was administered twice to the parents of 52 children aged 4-14 yr, and CFSS-DS was compared with child behavior during treatment. CFSS-DS reached high values for validity and reliability, and scores of 38 or more were found to be related to dental fear. The prevalences, concomitant factors, and clinical effects of dental fear and behavior management problems (BMP) were studied in a representative study population of 4,505 children aged 4-6 and 9-11 yr. Parents of 3,204 of the children (71%) answered a questionnaire containing CFSS-DS, a Short Form of Children's Fear Survey Schedule (CFSS-SF) measuring general emotional status, Corah Dental Anxiety Scale (DAS) to measure maternal and paternal dental fear. The dental records were retrieved from the Public Dental Service, and 4,061 complete dental records provided information regarding behavior management problems, caries, fillings, dental treatments and number of missed appointments. The study population had a mean score of 23.1 on CFSS-DS (sd 8.1; range 15-71). Dental fear (CFSS-DS scores > or = 38) was found in 6.7%, and BMP in 10.5% of the children. Both dental fear and BMP decreased with age. Age, general emotional status, and maternal dental anxiety were identified as concomitant factors in the development of dental fear. Experiences of pain during dental treatment increased the risk of developing dental fear and BMP. Dental fear and BMP were associated with missing of dental appointments and deterioration of dental health. A new method using projective techniques to measure child dental fear, the Children's Dental Fear Picture test (CDFP), was developed. Data regarding reliability and validity of CDFP was established in a group of 146 children selected from the questionnaire survey. The testings with CDFP were performed by two trained dentists. CDFP proved to have high interexaminer reliability (88.9%), and to be a valid test. Sensitivity was calculated to 98.5%. [References: 112] <56> UI - 95216948 AU - Dens F AU - Boute P AU - Otten J AU - Vinckier F AU - Declerck D IN - Department of Dentistry, Free University of Brussels, Belgium. TI - Dental caries, gingival health, and oral hygiene of long term survivors of paediatric malignant diseases. SO - Archives of Disease in Childhood 1995 Feb;72(2):129-32 AB - Fifty two children who had had cancer and been treated with chemotherapy, and who were long term event free, were examined for caries prevalence, gingival health, and oral hygiene and compared with a control group. A higher dental caries prevalence for the 14-17 year age group was noted. The restorative index was significantly lower in the age group 10-13. There were no significant differences in gingival index, plaque index, or toothbrushing frequency. It is concluded that these patients should be considered as at high risk for caries after cancer treatment. Professional dental follow up should be integrated in the medical follow up. <57> UI - 95217584 AU - Nadanovsky P TI - Sugar consumption and dental caries [letter; comment]. CM - Comment on: Br Dent J 1995 Jan 7;178(1):10 SO - British Dental Journal 1995 Mar 11;178(5):169 <58> UI - 95239641 AU - Miller TE IN - Department of Restorative Dentistry, Dental School, University of Maryland, Baltimore, USA. TI - Implications of congenitally missing teeth: orthodontic and restorative procedures in the adult patient. SO - Journal of Prosthetic Dentistry 1995 Feb;73(2):115-22 AB - Missing teeth are a concern to the patient and restorative dentist, and this social liability can be a multifactorial problem that involves esthetics, phonetics, disease, function, and stabilization. Dental caries, trauma, and periodontal disease are usually identified by pain, food impaction, discomfort, and lack of esthetics or poor phonetics. Restorative dentists are concerned with all aspects of the general health and appearance of the stomatognathic system and not only have the responsibility for immediate correction of an extant problem, but also for ensuring long-term "outcomes." The perceptive integration of interspecialty orthodontic treatment before restorative dentistry can obviate deleterious circumstances that threaten successful completion of the treatment plan. The prerestorative repositioning of malposed adjacent teeth in spaces created by congenitally missing teeth is illustrated with clinical treatment of three patients. <59> UI - 95238732 AU - Brown LJ AU - Caldwell SB AU - Eklund SA IN - Division of Epidemiology and Oral Disease Prevention Program, National Institute of Dental Research, Bethesda, Md. 20892-6401, USA. TI - How fee and insurance changes could affect dentistry: results from a microsimulation model [see comments]. CM - Comment in: J Am Dent Assoc 1995 Jul;126(7):824 SO - Journal of the American Dental Association 1995 Apr;126(4):449-59 AB - Dentists have become concerned about the possible impact of reductions in dental insurance coverage. The authors used a microsimulation model of the dental sector to assess the potential impact of reductions in the percentage of Americans with dental insurance, in universal dental insurance coverage for children and in fees paid to dentists for their services. The model predicted that reductions in dental insurance coverage would reduce per capita dental expenditures, but that the impact would not be large. Fee reductions had the greatest impact on dental expenditures of any change simulated by the model. <60> UI - 95143075 AU - Ricketts DN AU - Kidd EA AU - Wilson RF IN - Department of Conservative Dental Surgery, UMDS Guy's Hospital, London. TI - A re-evaluation of electrical resistance measurements for the diagnosis of occlusal caries [see comments]. CM - Comment in: Br Dent J 1995 Mar 25;178(6):205 SO - British Dental Journal 1995 Jan 7;178(1):11-7 AB - Clinical and radiographic diagnosis of occlusal caries is difficult. Resistance measurements in pits and fissures have shown better sensitivity compared with the more conventional methods of diagnosis. Two machines have been manufactured for this purpose: the Vanguard and the Caries Meter L. The aims of this study were to calibrate the readouts of these machines against a variable standard resistance box and use the Vanguard to compare readings taken in vivo and in vitro after extraction of the teeth. The diagnostic accuracy of clinical, radiographic, Vanguard and Caries Meter L diagnoses were also assessed. One hundred occlusal sites in 40 teeth of 20 patients were investigated in vivo with the Vanguard, noting clinical and radiographic appearances. The teeth were then extracted and the Vanguard readings repeated in vitro, together with Caries Meter L readings. The in vivo/in vitro comparison between Vanguard readings showed excellent reproducibility (Cohen's Kappa = 0.80). The sensitivity and specificity for the different examination techniques at the enamel level of diagnosis were 27% and 89% for visual, 6% and 100% for radiographic, 81% and 78% for the Vanguard and 74% and 74% for the Caries Meter L. In conclusion, this study supports the renewed interest in resistance measurements as a diagnostic technique and indicates that the in vitro model used gives results comparable to those in vivo. <61> UI - 97180014 AU - Pink FE AU - Minden NJ AU - Simmonds S IN - University of Detroit Mercy School of Dentistry, MI 48207-4282, USA. TI - Decisions of practitioners regarding placement of amalgam and composite restorations in general practice settings. SO - Operative Dentistry 1994 Jul-Aug;19(4):127-32 AB - This study was undertaken to analyze the current reasons practitioners in general practice settings choose to place amalgam and composite restorations. Data were gathered on individual restorations in the clinical setting to provide information on reasons practitioners state that restorations are placed, the type of material most often placed in different restoration classifications, and the age of restorations at the time of replacement. The results of this study indicate that approximately one-half of all restorations, both amalgam and composite, were placed to treat primary caries. One-half of the remaining restorations placed, i.e., not including those with primary caries, were placed to treat recurrent caries. With respect to restorative materials, amalgam was most often placed in class 1 and class 2 situations (88.9% of the amalgam restorations reported), while composite was most often placed in class 3, 4, or 5 situations (77.4% of the composite restorations reported). From the total data set returned for replaced restorations, only 20% of the data forms reported on verified longevity of the restoration being replaced. Analysis of these data gave a calculated median longevity for amalgam and composite restorations of 10 years and 5 years respectively. <62> UI - 96197703 AU - Attwood D AU - Reid JS AU - Evans D IN - Department of Child Dental Health, Glasgow Dental Hospital and School, UK. TI - Assessment of glass polyalkenoate restorations in primary molar teeth. SO - European Journal of Prosthodontics & Restorative Dentistry 1994 Jun;2(4):183-5 AB - This study assess the suitability of glass polyalkenoate cement as a restorative material in primary molars, when placed by community dental officers in their own clinics. Nine officers placed the restorations and two assessors examined the restorations after one and three years, recording details of the success or failure of each restoration. A total of 635 glass polyalkenoate restorations were placed and, after one year, 149 (23.4%) of these had failed. Of the 359 available for examination after three years, a further 142 (22.4%) had failed, leaving 217 (42.7%) intact. This study shows that the major factor in the successful use of glass polyalkenoate cements as a restorative material in deciduous molars is the classification type of cavity. A significant number of Class II restorations failed within the first year. The study confirms that glass polyalkenoate cements provide a satisfactory means of restoring Class I cavities in primary teeth. <63> UI - 96013537 AU - Liebenberg WH TI - The fissure sealant impasse [editorial]. [Review] [25 refs] SO - Quintessence International 1994 Nov;25(11):741-5 <64> UI - 95267752 AU - Ansai T AU - Yamashita Y AU - Shibata Y AU - Katoh Y AU - Sakao S AU - Takamatsu N AU - Miyazaki H AU - Takehara T IN - Department of Preventive Dentistry, Kyushu Dental College, Japan. TI - Relationship between dental caries experience of a group of Japanese kindergarten children and the results of two caries activity tests conducted on their saliva and dental plaque. SO - International Journal of Paediatric Dentistry 1994 Mar;4(1):13-7 AB - To establish a dental caries preventive programme in 4- and 5-year-old children, caries activity tests were used to assess salivary levels of mutans streptococci (using the Mucount test, Showa Yakuhin, Japan) and the acidogenic ability of dental plaque bacteria (using the Cariostat test, Sankin, Japan) in 260 kindergarten children. The relationships between the results of these two tests and the dental caries experience (dfs) of the children was evaluated. There was a significant positive correlation between the results of the Mucount and Cariostat tests in the total group of subjects. However, 91 subjects (35%) gave conflicting results with the two tests. These subjects were divided into two groups: one group (group B) included Mucount-negative and Cariostat-positive subjects, and the other group (group C) included Mucount-positive and Cariostat-negative subjects. Group B had a significantly higher mean dfs score than a group that was negative on both tests (group A). On the other hand, no significant difference in mean dfs score was observed between group C and group A. These findings suggested that mutans streptococci levels alone are an insufficient indicator for assessing dental caries activity of children at these ages and that the role of lactobacilli and other aciduric bacteria should be considered. It was concluded that assessment of caries activity using both Mucount and Cariostat tests is useful for a dental caries preventive programme for children of these ages. <65> UI - 95267305 AU - Cordioli G AU - Castagna S AU - Consolati E IN - Department of Periodontology, Dental School, University of Padova, Italy. TI - Single-tooth implant rehabilitation: a retrospective study of 67 implants. SO - International Journal of Prosthodontics 1994 Nov-Dec;7(6):525-31 AB - The use of osseointegrated implants is an accepted procedure for the treatment of total and partial edentulism and offers good predictability of long-term success. For the last several years, this procedure has also been used for single-tooth replacement following loss of teeth for traumatic, periodontal, and carious lesions. This paper reports the clinical experience of 47 patients treated for a single-tooth replacement. Sixty-seven screw-type standard, self-tapping implants and mini-implants were placed. The results were similar to those for complete and partial osseointegrated prostheses. The total implant survival rate was 94.4%. Two implants were lost as a result of suppuration caused by membrane exposure, while another was lost after loading. The results suggest that single-tooth replacement using osseointegrated implants provides predictable success. <66> UI - 95242237 AU - Holst A AU - Braune K IN - Department of Pedodontics, Blekinge County Council, Karlskrona, Sweden. TI - Dental assistants' ability to select caries risk-children and to prevent caries. SO - Swedish Dental Journal 1994;18(6):243-9 AB - A new model for dental care in children has been used since 1987 in a small-town clinic in the county of Blekinge in southern Sweden. The model is based on early screening of caries risk, performed by dental assistants. The purpose is to obtain an individual assessment of the need of preventive dental care among pre-school children, in order to prevent dental caries and gingivitis. The aim was to 1) evaluate the dental assistants' selection of caries risk children up to the age of three by comparing dental health variables in 4 yr olds in the test clinic with those for the whole county and 2) compare the time spent by the dentists and the dental assistants in the test clinic and in the whole county per child up to the age of four. 102 children participated. Specially trained dental assistants screened children likely to develop caries lesions using background factors combined with clinical examinations at ages 1, 2 and 3. A systematized form for questioning the parents was used. Individual caries prevention was given. Dental health and time spent were analyzed. The proportion of children with caries lesions at four years and a caries risk assessment up to the age of three was 11/19 = 0.58 (sensitivity). The proportion of children with no caries lesions at four years and no caries risk assessment up to the age of three was 82/83 = 0.99 (specificity). The proportion of children with no caries lesions at 4 yr of age in the test clinic was 81.4% compared to a county mean of 77.2%.(ABSTRACT TRUNCATED AT 250 WORDS) <67> UI - 95204693 AU - Weinstein P AU - Domoto P AU - Koday M AU - Leroux B IN - Dental Public Health Sciences, University of Washington, Seattle. TI - Results of a promising open trial to prevent baby bottle tooth decay: a fluoride varnish study. SO - ASDC Journal of Dentistry for Children 1994 Sep-Dec;61(5-6):338-41 AB - One hundred thirty-three farm worker children with an average age of 17 months participated in a study of a fluoride varnish in WIC programs in the Yakima Valley of Central Washington. After parents were interviewed, the child was examined and a fluoride varnish applied to the maxillary incisors. At the six-month recall 62 children and their parents returned. Results indicated a significant decrease in decalcification from 35 percent to 21 percent and an increase in decay from 3 percent to 16 percent. The rate of decay was lower than the 30 percent found in this age-group in this population. Of 130 sound teeth at baseline, 13 percent were decayed or decalcified in six months; of 73 decalcified teeth at baseline, 51 percent were found to be sound in six months. Additional experimentation with fluoride varnish is warranted. <68> UI - 95169603 AU - Lygidakis NA AU - Oulis KI AU - Christodoulidis A IN - Paediatric Dentistry Centre IKA, Athens, Greece. TI - Evaluation of fissure sealants retention following four different isolation and surface preparation techniques: four years clinical trial. SO - Journal of Clinical Pediatric Dentistry 1994 Fall;19(1):23-5 AB - The purpose of this study was to evaluate the retention of fissure sealants, applied with 4 different combinations of isolation and preparation of occlusal surface. In 95 children aged 7-8 years, having all four first permanent molars fully erupted and caries free, a chemically initiated tinted fissure sealant was placed with the following 4 different methods in every child. 1) Tooth 16: Cotton rolls isolation and cleaning of occlusal surface using a bristle brush and non-fluoridated paste. 2) Tooth 26: Rubber dam isolation and mechanical preparation of pits and fissures using a round bur No. 0 in a slow hand-piece. 3) Tooth 36: Rubber dam isolation and cleaning of occlusal surface using a bristle brush and non-fluoridated paste. 4) Tooth 46: Isolation with cotton rolls and mechanical preparation of pits and fissures using a round bur No. 0 in a slow hand-piece. Eighty children were available for re-examination 4 years later (320 teeth). The 4 methods of application showed the following success rates of full retention: 1) 81% 2) 88% 3) 91% 4) 93%. Although statistical analysis of the results revealed only marginal statistically significant difference among the four different methods of application (p = 0.091), there was statistical significant difference (p = 0.031) between methods 1 and 4. No differences were detected among the remaining methods. The present trial revealed best sealant retention using a combination of cotton rolls isolation and mechanical preparation of the occlusal surface.(ABSTRACT TRUNCATED AT 250 WORDS) <69> UI - 95153514 AU - Verrips GH AU - Kalsbeek H AU - Van Woerkum CM AU - Koelen M AU - Kok-Weimar TL IN - TNO Institute of Preventive Health Care, Department of Community Dental Health and Epidemiology, Leiden, The Netherlands. TI - Correlates of toothbrushing in preschool children by their parents in four ethnic groups in The Netherlands. SO - Community Dental Health 1994 Dec;11(4):233-9 AB - A previous study among Amsterdam 5-year-old children showed that on average, the older the child at the onset of toothbrushing and the less frequent the toothbrushing, the more life time caries experience it had. The aim of the present study was to assess correlates of these two caries risk factors, in four ethnic groups. A further aim was to evaluate the putative role of correlates as intervening variables between ethnicity and caries risk factors. Questionnaire data were available from the Amsterdam study, in which a stratified sample of 103 Turkish, 258 Moroccan, 59 Dutch and 56 Surinamese parents were interviewed at home in their mother tongue. Results showed 69 per cent of the Turkish, 45 per cent of the Moroccan, 17 per cent of the Dutch and 11 per cent of the Surinamese parents had commenced brushing their child's teeth only after its second birthday or even never at all. Moreover, many parents had not brushed their child's teeth every day. Almost all potential correlates in six domains, namely parental habits, attitudes, evaluative beliefs, behavioural beliefs, perceived role of the child and that of the partner, were found to be related crudely to the risk factors. Large differences in score patterns on the correlates were observed between ethnic groups. Multiple logistic regression analyses showed substantial parts of the differences in risk factor scores between the Turkish group and a combined Dutch and Surinamese reference group could be attributed to the intervening role of the correlates, as could only minor parts of the difference in risk factor scores between the Moroccan group and the reference group.(ABSTRACT TRUNCATED AT 250 WORDS) <70> UI - 95158185 AU - Reisine S AU - Litt M AU - Tinanoff N IN - Department of Behavioral Sciences, University of Connecticut School of Dental Medicine, Farmington. TI - A biopsychosocial model to predict caries in preschool children. SO - Pediatric Dentistry 1994 Nov-Dec;16(6):413-8 AB - The purpose of the study is to assess a multidisciplinary caries-prediction model. Enrolled in the study were 184 low-income children ages 3-5 years old in two Head Start programs in Connecticut. Children were examined by a dentist at baseline and at 1 year for dental caries. Each child also provided a saliva sample to obtain a measure of S. mutans. The children's caregivers completed an interview that assessed oral health behaviors, and cognitive and socioeconomic factors. The prevalence of decay (1 dmfs) increased from 40 to 58% and the number of dmfs increased significantly from 2.5 (7.1) dmfs to 4.5 (8.8) dmfs (P < 0.001) in 1 year. S. mutans did not change significantly. Discriminant function analysis predicting change in caries in the second year from data obtained in the first year showed that S. mutans, dmfs, and toothbrushing significantly predicted caries risk (canonical correlation = 0.5571; x2 = 51; df = 3; P < 0.001). Children with higher dmfs, higher S. mutans, and whose parents reported more frequent brushing had more decay in the second year. None of the other behavioral, cognitive, or demographic factors was significant. The results emphasize the importance of early intervention in preventing dental caries in an underserved population. <71> UI - 95113534 AU - Frencken JE AU - Songpaisan Y AU - Phantumvanit P AU - Pilot T IN - Ministry of Health and Child Welfare, Dental Department, Harare, Zimbabwe. TI - An atraumatic restorative treatment (ART) technique: evaluation after one year. SO - International Dental Journal 1994 Oct;44(5):460-4 AB - Extraction is the most common dental treatment provided for people in rural and suburban areas in many less-industrialised countries. By comparison, restorative care is rarely provided. In order to improve such situations, a treatment technique has been developed based only on hand excavation of carious lesions and using glass-ionomer cement as a filling material and a sealant. This Atraumatic Restorative Treatment (ART) technique follows the concept of minimal intervention and does not require electrically driven equipment. This paper reports on the longevity of fillings and sealants placed using the technique under field conditions in rural Thailand. Dental caries was treated using the ART technique in one village, whilst the population in a second village received restorative care (amalgam fillings) through mobile dental units. A third village was the control. After one year, 79 per cent of single surface ART fillings and 55 per cent of ART fillings of greater than one surface placed in deciduous teeth were judged successful. The success rate of ART fillings in the permanent dentition (mainly single surface fillings) was 93 per cent and the retention rate for sealants was 78 per cent. Children were pleased at having received treatment by this technique and showed little fear. The ART technique is a promising caries treatment procedure for use in rural and sub-urban areas in less-industrialised countries. <72> UI - 95113529 AU - Rear SB IN - Faculty of General Dental Practitioners (UK), Royal College of Surgeons of England, London. TI - The effect of changes in caries prevalence on general dental practice. SO - International Dental Journal 1994 Aug;44(4 Suppl 1):435-8 AB - There have been many changes in the organisation and structure of general dental practice in the UK in recent years. Some of these have been due to the changes in caries prevalence. Other changes have been caused by shifts in the system of remuneration under the National Health Service (NHS), which may themselves have been influenced by falling caries levels. It is also pertinent to consider the ways in which dental practice has affected caries rates, since, arguably some of the changes in caries prevalence have been due to developments in dental practice. <73> UI - 95113527 AU - Spencer AJ AU - Davies M AU - Slade G AU - Brennan D IN - Department of Dentistry, University of Adelaide, Australia. TI - Caries prevalence in Australasia. SO - International Dental Journal 1994 Aug;44(4 Suppl 1):415-23 AB - The prevalence of caries in Australian children has decreased markedly since its peak in the 1950s. More than half the child population has no experience of caries. However, a small minority, approximately one in sixteen, may be considered still at high risk with an unacceptably large number of teeth with caries experience. This is leading to the addition of high risk strategies to programmes for caries prevention and management. While the prevalence of caries in children has decreased, caries experience in adults has remained widespread and extensive. The majority of teeth in dentate adults have experienced caries. Comparisons over time indicate little change in caries experience in middle-aged adults, but an increase in filled teeth and decrease in missing teeth. The prevalence of caries has not changed substantially, but the management of the disease has moved towards maintenance and repair of teeth. Tooth retention has increased over recent decades. Edentulism has decreased markedly and dentate adults are retaining more teeth. Sizeable increases in the pool of teeth at risk of caries give emphasis to the continued need for preventive measures to reduce caries activity in adults. <74> UI - 95113525 AU - Marthaler TM AU - Steiner M AU - Menghini G AU - Bandi A IN - Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland. TI - Caries prevalence in Switzerland. SO - International Dental Journal 1994 Aug;44(4 Suppl 1):393-401 AB - The first Swiss studies of DMFT counts were undertaken in the late 1950s and showed values of 7.7-11.3 for children of 12 years of age and 12.6-18.6 for children of 15 years of age. Although these studies did not use current statistical sampling methods, and so are not directly comparable, the results of the most recent surveys do present a startling contrast. In 1992, DMFT figures had fallen to an average of 1.12 and 2.22 DMFT in 12- and 15-year-olds respectively. Reasons for these sharp declines are discussed, as are the available figures for adults over the same period of time. Predictions are made for DMFT levels for the year 2008 and their likely impact on dental services. <75> UI - 95113521 AU - Downer MC IN - Department of Dental Health Policy, Eastman Dental Institute, London, UK. TI - Caries prevalence in the United Kingdom. SO - International Dental Journal 1994 Aug;44(4 Suppl 1):365-70 AB - Since 1973, national surveys of dental caries in children, one series directed decennially by the Office of Population Censuses and Surveys and another, using analogous methods, coordinated regionally on a regular basis by the British Association for the Study of Community Dentistry, have produced a comprehensive record of trends in caries experience of children in England and Wales. Betwe