Tooth loss and periodontal bone level in individuals of J?nk?ping County. A comparison between two adult populations living in the city and in the surrounding area

Cross-sectional and longitudinal studies were performed in the community (in this paper changed to city) of J?nk?ping, Sweden, over a period of 20 years to follow changes in oral health and oral health behaviour. To widen our knowledge about dental health and dental care among the adult population, we expanded the study in 1993 to cover the whole county. The specific aim of the present study was to describe tooth loss (excluding third molars) and periodontal bone level in adult residents of J?nk?ping County and to compare these two parameters in adults living in the city of J?nk?ping with the same in adults living in the rest of the county. Random samples of individuals 30, 40, 50, 60, and 70 years old were selected. A total of 484 persons from the city and 1219 subjects from the rest of the county were examined. A total of 32 (7%) and 27 (2%) persons were completely edentulous in the examined populations from the city and from the rest of the county, respectively. A majority belonged to the older age groups, 60 and 70 years, with 17% of the subjects in the city being edentulous compared with 13% in the rest of the county. The mean number of missing teeth in subjects in the city versus subjects in the rest of the county was 0.75/0.95, 1.37/1.60, 3.34/2.43, 6.34/7.40, and 9.95/10.26 in 30-, 40-, 50-, 60-, and 70-year-olds, respectively. Of all the different tooth types, the average number of molars per person decreased the most with increasing age from an average of 7.79/7.83 (city/county) to 3.06/3.09 (city/county) for 30- and 70-year-olds, respectively. The proportion of subjects without molars was higher in the older age groups in both the city and the rest of the county with 4.8/10.7% and 15.6/22.0% of the 60- and 70-year-olds, respectively, lacking molars. In both populations, the mean periodontal bone level decreased with age. It was concluded that no important differences in tooth loss and periodontal health could be seen between the two populations. When organising dental care, dental health administrators could apply the findings from the population in the city to the entire county.     

Traumatic dental injuries in a cohort of 16-year-olds in northern Sweden

The prevalence and yearly incidence of traumatic tooth injury between 1 and 16 years of age were studied in a cohort of 16-year-olds, born in 1975, and residing in the County of V?sterbotten, northern Sweden. The study comprised 3007 dental records from the public dental health service. The general distribution was 50.3% girls and 49.7% boys. The records showed that 35% of the children on one or more occasions had sustained injury to their primary or permanent dentition. The frequency was nearly twice as high for boys (64%) as for girls (36%). Twenty-five percent of the 16-year-olds had met with tooth injury more than once and this group consisted predominantly of boys. The incidence of injury episodes to primary and permanent teeth was 28 per 1000 per year. The boys had sustained trauma to their teeth most frequently when they were 4 years of age and between the ages of 8 and 11. This was also true for girls at 4 and at 9 years of age, although less evidently so. In the primary dentition, the majority of dental injuries had affected the supporting tissue of the maxillary incisors. In the permanent dentition, 75% of the traumatised teeth were upper incisors. Fractures of varying severity constituted 60% of all registered diagnoses in this dentition, followed by subluxation (19%) and concussion (11%).     

Self-assessed quality of mastication in relation to remaining teeth and self-assessed health status in elderly persons

To explore factors related to quality of mastication, information about teeth status and self-assessed health status were obtained by a self-administered questionnaire from participants in a dental screening program. Invitation letters for participation in the program were distributed by members of the neighborhood association to 1.275 residents of a town in Gifu prefecture aged 65 years or older. Participation rate in the dental screening program was 40.5%. A total of 513 participants (245 males and 268 females) completed the program and the questionnaire. The results were as follows. 1. Overall, 32% had 20 teeth or more and 88.4% had bridge(s) and/or denture(s). 2. The mean number of remaining teeth were 12.9 for males and 12.5 for females. There was no statistical difference in the number of remaining teeth between males and females. The mean numbers of remaining teeth among those aged 65-69 years was 15.7 and two thirds of them had lost the Lower First Molar. 3. Those who reported to be satisfied with their present mastication were 83.3% of men and 86.3% of women. The proportions were not influenced by age or sex. 4. Quality of mastication was related to self-reported "good physical condition' and "not easily tired'. 5. The proportion of those satisfied with their mastication was large in the groups with remaining teeth index 0-8 and > or = 17, and small in the group with remaining teeth index 9-16, showing a U-shaped curve for satisfaction rate against remaining teeth index. These results suggest a relationship of quality of mastication on health status. The importance of primary dental care for the elderly persons is underlined.     

Regulation of gene expression for lipogenic enzymes in the liver and adipose tissue of hereditary hypertriglyceridemic, insulin-resistant rats: effect of dietary sucrose and marine fish oil

The aim of this study was to investigate to what extent declining odour perception can be ascribed to dental status and oral hygiene habits, taking into account gender and age. Apparently healthy adults (n = 182), ranging from 53 to 93 years (mean age = 68.4) were tested. Information about oral hygiene habits (brushing teeth and cleaning dentures) and dental status was obtained by questionnaires. A validated objective procedure was used to measure sensory detection thresholds for isoamylacetate by an ascending method of limits. A significant negative correlation of odour perception with age was shown by the edentulous subjects which might reflect their wider age spread with many subjects over age 75. The evaluation of odour perception as a function of dental status shows no significant difference in odour perception between persons partial denture wearers, with natural teeth only or complete dentures. However, a tendency for lower odour perception was observed among male partial denture wearers, especially those reporting less frequent oral hygiene, which justifies further more detailed study.     

Serum follistatin concentrations are increased in patients with septicaemia

Reviewed in this article are epidemiological studies included in the WHO Global Oral Data Bank for noninstitutionalized European adults aged 65-74 years for the period 1986-96. Edentulous percentages, decayed, missing, filled teeth (DMFT) index, and data on the mean number of teeth are presented. At least one representative study had been carried out in 48% of the countries, with the quantity of information from countries with developed market economies being similar to that from countries with economies in transition. The proportion of 65-74-year-olds who were edentulous varied from 12.8% to 69.6%, the mean number of teeth ranged from 15.1 to 3.8, and the DMFT index from 22.2 to 30.2. The observed disparities in the oral health status among older European adults suggest that it may be possible to develop and implement oral health policies that take into account geographical and socioeconomic differences in populations.     

Translation, adaptation and validation process for the DINA instrument. Derdiarian Information Needs Assessment

The 5-year incidence of dental caries in a random sample of 60-, 70- and 80-year-old inhabitants of Goteborg was related to salivary and microbial conditions. Of the 208 persons examined at baseline, 148 (71%) participated in the follow-up examination; 69, 51 and 28, respectively, in the different age groups. The study revealed that 27% of the participants had not developed any carious lesions during the 5-year period and that the incidence of coronal and root caries increased with age. In the 60-year-olds, 2.5% of the susceptible coronal and root surfaces, respectively, had decayed, while the corresponding figures for the 80-year-olds were 8.8% for coronal surfaces and 9.8% for root surfaces. In all, 18% had an unstimulated saliva secretion rate of below 0.1 ml/min and 14% had a stimulated secretion rate of <0.7 ml/min, with a mean rate which decreased with increasing age from 2.0 to 1.6 and 1.3 ml/min (p = 0.02). The overall salivary counts of lactobacilli and mutans streptococci, particularly the subspecies of Streptococcus sobrinus, had increased during the period. In the respective age groups of 60, 70 and 80 years, 15, 39 and 39% had a mutans streptococci count of > or = 10(6) CFU/ml in saliva and the corresponding figures for > or = 10(5) lactobacilli counts were 22, 31 and 43%. In the stepwise regression analysis, it was found that age, salivary levels of mutans streptococci and lactobacilli and number of teeth were the best predictors of the incidence of root caries. In conclusion, these observations indicate that there is an increased risk of dental caries with age owing to unfavourable microbial and salivary conditions.     

Biosynthetic retrovectoring systems for gene therapy

The 5-year incidence of caries was studied in a random sample of 60-, 70- and 80-year-old inhabitants of G?teborg, with 69, 51 and 28 individuals in the different age groups. One aim of the study was to introduce a root caries index (DMFRS%) in which the missing root surfaces are taken into account. This study, as well as other recent studies, has shown that dental caries is the main reason for tooth extraction. The study also revealed that coronal and root caries occurred more frequently in elderly than younger people and the incidence of root caries was positively correlated with coronal caries (r = 0.3, p < 0.001) and negatively correlated with the number of remaining teeth (r = 0.4, p < 0.0001). The 5-year DMFRS% increment values increased with advancing age from 2.7 involved root surfaces per 100 susceptible ones in the 60-year-olds to 4.8 in the 70-year-olds and 10.7 in the 80-year-olds. It should be mentioned, however, that only people able to come to the clinic were enrolled in the study and an analysis of the attrition bias indicated that oral health may be worse in those who are too ill to participate. The frequent utilization of dental care among the participants was reflected in the finding of several new fillings and prosthetic crowns. Most of the very elderly people with carious lesions at baseline, however, had developed new lesions at the margins of the newly made restorations.     

Absorption and elimination kinetics of zidovudine in the cerebrospinal fluid in HIV-1-infected patients

The first two surveys of the dental health of young Finnish men were conducted in 1919 and 1965. The objective of four subsequent surveys (1976, 1981, 1986, and 1991) was to collect both interview and clinical examination data for the monitoring of changes in the oral health status of the recruits. A significant reduction in self-reported toothache, gingival bleeding, and number of decayed teeth was observed from 1976 to 1991. At examination, the numbers of decayed teeth, teeth indicated for extraction, teeth in need of fillings, and missing teeth decreased substantially, as did the teeth with visible plaque, subgingival calculus, and teeth with 4-mm or deeper periodontal pockets. This comprehensive series of successive cross-sectional oral health surveys clearly shows that since 1976 a significant decrease in oral disease and treatment needs has taken place among the Finnish population of young men.     

Social inequality in the use and comprehensiveness of dental services

Fair access is a value enshrined through universal insurance for health care in Australia. However, dentistry is not included in this system. As a consequence, there is a strong likelihood of inequalities in access to dental services among adults. Data from the 1989-90 National Health Survey were analysed to determine sociodemographic factors related to use and comprehensiveness of dental services. Age, income, age of leaving school and occupation were independently associated with the use of dental services, and occupation was associated with an indicator of comprehensiveness of care: self-reported extraction at the last visit. In different adult age groups these sociodemographic factors had different effects, with the disparities in use of dental services greater in older age groups. Planning of dental services in the 1990s and beyond should include not only the removal of financial barriers to dental services among adults but also attention to the specific barriers experienced by the elderly.     

Oral disease and physical disability in community-dwelling older persons

OBJECTIVE: The aim of this epidemiologic investigation was to determine whether poor oral health in older persons was associated with physical disability. DESIGN: The study was a cross-sectional survey involving in-home interviews and dental examinations of older persons. SETTING: A random sample of 68 cities and towns was selected from the six New England states, with stratification according to population size. PARTICIPANTS: The study sample consisted of 1,156 community-dwelling (non-institutionalized) individuals aged 70 and over, randomly selected from the Medicare beneficiary lists for each city and town. MEASUREMENTS: Oral health was assessed by three dichotomous indices: edentulism (no teeth); current caries, including either coronal or root decay; and periodontal disease, as measured by gingival pocket depth. Physical disability was indicated by the subject's self-report of difficulty in the areas of personal care (eating, bathing, dressing, and using the toilet) and mobility (walking, bed transfer, getting outside). Additional independent variables included age, sex, number of teeth, education, living alone, oral hygiene practices, and time since last dental visit. RESULTS: We found a direct association between specific areas of physical disability and current caries and edentulism. The risk of poor oral health did not increase with advancing age once the related risk factors were controlled for. Those subjects with mobility disabilities were at increased risk of tooth loss; those with personal care limitations were at increased risk of current caries. CONCLUSIONS: Physical disability should be added to the list of known risk factors for oral disease among the older population. Our findings call attention to the need for health care providers to screen for oral health problems among disabled older persons. Further gerontologic research is needed to identify the mechanisms linking physical disability with oral disease in older persons.     

Dental knowledge, attitudes towards oral health care and utilization of dental services among male industrial workers with or without an employer-provided dental benefit scheme

In industrialized countries various dental benefit schemes have been implemented to improve the utilization of dental services, though few studies have demonstrated that effect. Prior to a comprehensive clinical study in southern Finland, a postal questionnaire survey of male industrial workers (age 38-65 yrs) was conducted to investigate knowledge and attitudes concerning oral health care and whether access to an employer-provided dental benefit scheme was associated with the utilization of dental services. The response rate was 81% (n = 325) in the subsidized group and 69% (n = 174) in the control group. In both groups, 60% of the subjects had had their last dental visit within a year but 91% of the subsidized workers compared to 79% of the controls had visited a dentist in the past two years (P < 0.001). The subjects had similar attitudes towards the importance of regular dental care and its implications for dental and general health. Subsidization explained the disparity in the current dental visiting pattern between the groups better than the possibility of using working hours for dental visits. Backward stepwise logistic regression revealed that the probability of a dental visit within the past two years was positively associated with access to an employer-provided dental benefit scheme, tooth brushing to maintain dental health, and number of teeth, and negatively associated with number of carious teeth. Our results demonstrate a positive impact of subsidization on the utilization of dental services.     

Dental health attitudes among dentate black and white adults

OBJECTIVES: Blacks and poor persons share a greater burden of oral disease and are less likely to seek dental care on a regular basis. The role of dental attitudes and knowledge of services on this circumstance is unclear. The authors quantified group differences in dental attitudes and knowledge of services and related them to regularity of dental care use. METHODS: As part of the baseline phase of The Florida Dental Care Study, a longitudinal study of oral health, 873 respondents who had at least one tooth and who were 45 years or older participated for an interview and a clinical dental examination. Dental care use, seven dental attitudinal constructs, and knowledge of dental services were queried. RESULTS: Forty-five percent of respondents reported going to a dentist only when they have a problem, and 17% of respondents had not seen a dentist in more than 5 years. Ten percent of respondents reported that they had at least one permanent tooth removed by someone other than a dentist (typically, the respondent himself). Blacks and poor persons had more negative attitudes toward dental care and dental health and were less knowledgeable of dental services. Multivariate analyses suggested that dental attitudes were important to understanding the use of dental care services for this diverse group of adults, and that race and poverty contributed independently to dental care use even with dental attitudes taken into account. CONCLUSIONS: Dental attitudes contribute to race and poverty differences in dental care use among adults. The persistence of race and poverty effects with attitudes taken into account suggests that additional explanatory factors contribute as well. These differences may contribute to more prevalent and severe oral health decrements among the same adults who also are more likely to suffer from other health decrements.     

Evidence for an antemortem injury of a burned head dissected from a burned body

This paper describes risk factors for dental caries identified among 491 2-year-olds in the city of Ume?, Sweden. The study was performed as a risk screening for dental caries according to a method developed for use by dental assistants. The sugar consumption was high, 80% of the 2-year-olds had sweets once a week or more and 25% had sweet beverages once a day or more frequently. In addition, 14% of the children had a meal at night and most common were formula, bovine milk or breastmilk. The majority of the parents brushed the child's teeth at least daily using fluoride toothpaste. Among the children 6% had a chronic somatic disorder and 6% had an intolerance towards specific foods, milk being the most common. The high level of sugar consumption indicates that improved dental health education focusing on the importance of limiting sugar consumption is needed among parents with young children.     

Teaching tools. A simulated clinical problem-solving experience

The author analyzes statistical data of examinations of the oral cavity and teeth and of sociological interviews of 739 schoolchildren of a Moscow school, carried out in March, 1997. Loss of teeth has been recorded; the data characterize the maxillodental status and dental health. Relationship between dental loss and such factors as sex, age, place of lost teeth (functional orientation in the maxilla and mandible), etc., has been established. The author emphasizes the need in regular check-ups of the oral cavity and teeth in various age groups of children and adolescents both in girls and boys and considers that both dentists and endocrinologists should take part in these check-ups.     

The reasons for tooth extractions in adults and their validation

OBJECTIVES: To investigate the primary reasons for the extraction of permanent teeth in adults and to validate the dentists' reasons for extraction. METHODS: Twenty-one dentists in the Greater Manchester area took part in the study. These dentists provided extracted teeth stored in 10% buffered formal saline together with details of the patient's age, sex, dental attendance pattern and the reason for extraction. In order to validate the reasons for extraction, teeth were examined for the presence or absence of coronal and root caries. A subgroup of 80 teeth, half of which were extracted primarily for caries and half for periodontal reasons were selected, stained and attachment loss measured at six sites per tooth to validate periodontal reasons for extraction. RESULTS: Three hundred and eighty-nine teeth were collected of which 37% were extracted primarily due to caries and 29% due to periodontal disease. Caries was the main reason for extraction in patients under 50 years, whereas periodontal disease was the commonest reason in the over-50 age group. Irregular attenders had more extractions for caries than regular attenders but attendance pattern did not affect the proportion of teeth extracted for periodontal reasons. The mean greatest loss of attachment on teeth extracted for periodontal reasons was 12 mm compared with 6.5 mm for caries. CONCLUSION: In this group of patients caries was the most common reason for extraction of teeth but periodontal disease became a more important reason for extraction after 50 years of age. The study validated the dentists' given reason for extraction.     

Multidimensionality of oral health in dentate adults

OBJECTIVES: An understanding of the validity and usefulness of self-reported measures (as distinct from clinically determined measures) of oral health is emerging. These self-reported measures include self-rated oral health (SROH). Three objectives were to: (1) describe self-rated oral health in dentate adults, (2) quantify associations between self-rated oral health and other measures of oral health (oral disease and tissue damage, pain and discomfort, functional limitation, and disadvantage), and (3) assess the construct validity of a model of oral health proposed herein. METHODS: The Florida Dental Care Study is a longitudinal study of oral health, which included at baseline 873 subjects who had at least one tooth, were 45 years or older, and who participated for an interview and clinical examination. RESULTS: The prevalence of self-rated oral health decrements was substantial; approximately one fourth of subjects reported their oral health as only fair or poor. Bivariate and multivariate results provided consistent evidence of the construct validity of the proposed model of oral health. Additionally, the salience of one measure of dental appearance suggests that persons may use esthetic cues when rating their oral health. CONCLUSIONS: The proposed multidimensional model of oral health has construct validity. Self-rated oral health is affected by oral disease and tissue damage, oral pain and discomfort, oral functional limitation, and oral disadvantage. These self-reported measures and the proposed model should provide useful information for dental care effectiveness research. General health status has been disaggregated into the "physical" and the "mental;" an additional separation into the "oral" aspects of health seems warranted.     

Children's use of triadic eye gaze information for "mind reading."

Five experiments examined children's use of eye gaze information for "mind-reading" purposes, specifically, for inferring another person's desire. When presented with static displays in the first 3 experiments, only by 4 years of age did children use another person's eye direction to infer desires, although younger children could identify the person's focus of attention. Further, 3-year-olds were capable of inferring desire from other nonverbal cues, such as pointing (Experiment 3). When eye gaze was presented dynamically with several other scaffolding cues (Experiment 4), 2- and 3-year-olds successfully used eye gaze for desire inference. Scaffolding cues were removed in Experiment 5, and 2- and 3-year-olds still performed above chance in using eye gaze. Results suggest that 2-year-olds are capable of using eye gaze alone to infer about another's desire. The authors propose that the acquisition of the ability to use attentional cues to infer another's mental state may involve both an association process and a differentiation process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prosthodontic considerations for the older patient

The elderly have both the greatest level of need for prosthodontic services of any age group, and the greatest degree of complicating dental, medical, and behavioral factors. Issues arise in daily practice of whether or not to replace a missing tooth or teeth for a patient of advanced age and a wide variety of challenges-dental/oral and others-face the dentist who is considering replacing some or all of an older person's teeth. This article focuses on clinical approaches and techniques that have proven particularly important and useful for providing prosthodontic care to the older adult.     

Idiopathic dental root replacement resorption in old dogs

The roots of the teeth of 33 large dogs aged 10 years or older were radiographed. These dogs were euthanized for reasons other than oral diseases; dogs with obvious dental or periodontal diseases were excluded. The dogs had shown no clinical signs related to the teeth and the teeth were macroscopically normal. Of the 33 dogs, six had one or more teeth that had abnormally shaped and partially resorbed roots, with replacement of root structure by radiographically normal trabecular bone. Histological examination of radiographically abnormal roots revealed mid-root resorption, without signs of inflammation or hypercementosis. These findings are similar to the condition known as idiopathic dental root replacement resorption in the human dental literature. Possible etiologies of root resorption are discussed.     

The diabetic heart is more sensitive to ischemic injury

A review of the literature on the impact of dental care on the incidence of dental caries in children and adults suggests that the effect is small. Dental services were relatively unimportant in explaining the recent decline in caries in 5- and 12-year-olds. An important contribution of the dental services to the decline in caries was a change in the diagnostic and treatment criteria. The role of dentistry in reducing dental caries may lie mainly in the non-personal health services. Knowledge of the life history and patterns of caries attack rates within populations and individuals could be used as a benchmark against which interventions can be assessed. Different teeth and tooth sites are affected differentially at different levels of dental caries. This truism may appear obvious but it is not used to evaluate the effectiveness and quality of dental treatment. A working rule is that "As caries prevalence falls, the least susceptible sites (proximal and smooth surfaces) reduce by the greatest proportion, while the most susceptible sites (occlusal) reduce by the smallest proportion." There is a specific relationship between the mean DMFT and mean DMFS, and the percentage of caries-free subjects and the frequency distribution of subjects with different levels of caries. Further more, the best predictor of caries at older ages is DMFT at a younger age. Caries levels follow trend lines for each level of caries. As the mean DMFT declines so post-eruptive time increases for initiation of caries and the progression rates of caries through enamel decreases. This is true regardless of the presence of fluoride.