The value of extended-setting-time amalgam in pre-clinical practice in undergraduate dental training

This is a single-blind controlled study investigating the advantages of extended-setting time dental amalgam compared to a standard amalgam in the training of undergraduate dental students. 50 dental students were randomly assigned 1 of the 2 alloys for each restoration placed in the study. Each student placed class I and class II restorations in extracted human teeth mounted in typodont arches. 449 completed restorations were available for assessment, 228 restorations in the experimental group and 221 restorations in the control group. The test restorations were overall marginally inferior to those of the control group. There appears to be no advantage in using extended-setting time dental amalgam in undergraduate training.     

Relationships between fluoride in enamel, DMFT Index and fluorosis in high- and low-fluoride areas in South Africa

The DMFT Index, degree of fluorosis (DEGF), and enamel fluoride concentration (F) were determined in 88 children living in a high- and 79 children living in a low-fluoride area in South Africa. The following interrelationships between these parameters were found: in both areas there was a significant negative correlation between log F and age; in the high-fluoride area there was a significant positive correlation between log F and DEGF; and in the combined data from the two areas there were significant correlations between log F and area, log F and age, and log F and DEGF, and a significant association between DEGF and area. There were no significant correlations between DMFT and log F and between DMFT and DEGF.     

Results of a dental fear survey in Japan: implications for dental public health in Asia

The purpose of this investigation was to initiate the study of dental fear in Japan. 415 college students, aged 18-22 yr were surveyed. A standardized questionnaire which has been used in the United States was translated into Japanese and was administered to the students. More than 80% of those surveyed reported some dental fear. Six to 14% of the students reported extreme fear of the dentist. The majority of the subjects admitted that they delayed making dental appointments due to fear. Muscle tension was the most common physiological symptom reported. The dental drill and needle were the most fear-provoking stimuli.     

Dental hygienists as a new element in the oral health service in Poland

A comparison of the number, employment, utilization and activities of dental hygienists in Poland between 1977 and 1982 is described. In spite of a distinct increase in number and better distribution in the country, the employment of hygienists in the oral health service is still low. However, the majority of dental hygienists are employed in the oral health service for children, working mostly as dental assistants doing fluoride prophylaxis and dental health education in addition. The percentage of operating dental hygienists is also low. The need for their preventive activity is great, as the dental caries rate in Polish children is generally high.     

Dental behavior management problems in Swedish children

Abstract – 4505 Swedish children aged 4-11 yr were surveyed regarding dental behavior management problems (BMP) and dental health. Dental charts were retrieved from clinics in the Public Dental Service in Göteborg. and data were then compiled regarding BMP, action against BMP, caries, fillings, use of local anesthetics, and number of missed appointments. Behavior management problems were found in 10.5% of the children, and were more common in the younger children, among children who missed appointments, and in children who received restorative treatment without local anesthetics. The BMP children had more carious and fewer filled surfaces. In 43.4% of the cases with BMP the strategy chosen was postponement of dental treatment or no measure taken.     

Posteruptive development of isolated and confluent pits in fluorosed enamel in a 6-year-old girl

Abstract – A 6-yr-old Danish girl born and reared in a high fluoride area in Kenya was examined for a period of 11/2 yr during which a permanent maxillary central incisor erupted. Present primary and permanent teeth showed obvious dental fluorosis with isolated pits on primary molars. At the time of eruption the crown of the permanent central incisor had its normal anatomical shape. Isolated and confluent pits began to develop about the time of complete eruption. The observations thus confirm previous theories suggesting that pits in fluorosed enamel are secondarily produced defects of traumatic orign.     

Structure of experimental in vitro and in vivo lesions around composite (Addent XV®) fillings

abstract — In the in vitro experiments of the present study Class V Addent XV® fillings were inserted on buccal surfaces of 32 permanent human teeth. Lesions were produced by placing acidified gelatin around the fillings. In the corresponding in vivo experiments, caries was produced around similar fillings in 17 permanent teeth. In both series, sections of the teeth with the fillings in situ were studied by polarized light microscopy and microradiography. All teeth showed "outer lesions", but the tendency to development of "cavity wall lesions" was negligible. A comparison with lesions produced previously in corresponding experiments with silver amalgam and silicate fillings has been done.     

Detailed examination of caries progression in 4-year-old children in a non-fluoridated area in Ireland

Abstract 314 4-year-old children were examined in Mallow, Ireland (a non-fluoridated area). 30.6% were found to be caries free. Investigation of the pattern of decay in the dentitions of these children showed the primary second molar as the tooth most commonly affected by caries irrespective of def score. The distribution of the disease is examined on a surface by surface basis. Decay occurring on the occlusal surface is predominant and no homogeneous pattern is found among the other surfaces. A statistical method for examining possible patterns of surface involvement is introduced.     

Dental practice in Northern Ireland, UK

Abstract A postal survey concerning clinical practice by general practitioners in Northern Ireland U.K. had a response rate of 71.2%. There were little differences in practice between chose who had graduated at the Dental School in Belfast (70%) and those who qualified elsewhere. Older dentists appeal- to undertake less ambitious dentistry and while this might be a reflection of their training, there were some practices of younger dentists such as not using a rubber dam for endodontic treatment which was certainly not taught to them at Dental School.     

Epidemiology of dental caries in 5-year-old children in Israel

The objective of this study was to assess the prevalence of dental caries in the earliest age at which children were organized as a group in the national education system and to find possible associations with variables that may help to identify "groups at risk" in this population. A total of 965 children, 5 years old, were examined. They were selected by a method to form a representative sample of all West Jerusalem compulsory kindergarten classes in 1971. Caries, gingivitis and oral hygiene were assessed and demogrphic data were collected. It was found that 84% of the children were affected with mean dif value of 4.7 (+/- 3.6). Association was found between caries and social class. The high morbidity suggests that organized services should be planned for this age group. Since the resources are limited, efforts should be directed mainly towards "groups at risk".     

Influence of selective caries excavation on marginal penetration of class II composite restorations in vitro

Selective caries excavation may support pulp preservation. This in vitro study investigated the influence of selective removal of demineralized dentin on marginal integrity of composite restorations as determined by dye penetration. Dentinal caries-like lesions were produced in the approximal surfaces of 40 extracted human molars (ethylenediaminetetraacetate, 0.5 M, 96 h). The following test procedures were established: complete excavation, selective excavation, and caries-free control. Two class II cavities with enamel at the cervical margins were prepared per tooth and demineralization volume was determined by micro-computed tomography for the purpose of a stratified distribution to receive complete excavation or selective excavation. After complete or selective excavation (30 cavities each), adhesive composite restorations were placed. Cavities without demineralized dentin (20 cavities) served as control. The marginal integrity of restorations was evaluated by dye penetration with and without thermocycling or mechanical loading. Results were analyzed by non-parametrical statistical tests (Mann-Whitney U Test) with an α = 0.05 level of significance. Dye penetration did not differ significantly among completely excavated, selectively excavated, or undemineralized teeth, but was increased by thermocycling and mechanical loading in all experimental groups. Selective caries removal did not increase marginal penetration in class II restorations. The presence of remaining demineralized dentin surrounded by sound dentin did not impair marginal integrity of restorations with margins placed in sound enamel.     

Changes of dental treatment pattern in Norway in the 1970s

With the aim of gauging utilization rates of dental services, a series of cross-sectional studies were performed in 1973, 1975 adnd 1977. Cluster samples of 1,600 individuals covering the Norwegian population aged 15 and above were interviewed by trained interviewers using standardized questions. The percentage of respondents who reported having seen a dentist within the last 12 months increased from 58 to 64. The receipt of tooth fillings was the predominant course of treatment and was reported by 55% of the interviewees. The percentage reporting preventive services increased from 15 to 26% at the expense of those reporting "blood and vulcanite" denistry. Fifty-two percent, increasing to 53% of the interviewers, claimed to have seen a dentist on a regular basis during the last 5 years. However, this proportion was conceivably overreported. Control questions indicated that 40-45% should be considered regular treatment attenders. Change is apparently taking place in the treatment pattern. The proportion of regular treatment attenders seems to increase by 0.5-1% per year. The treatment profile is also shifting: extractions and denture services are diminishing, preventive services are gaining, while restorative dentistry stands still - for the time being.     

Examiner variability in the assessment of dental restorations

A series of examiner variability studies were carried out in the assessment of restorations in adults made by extended duty ancillaries (E.D.A.s). While there were some differences between the two supervising team dentists these were smaller than those found when dentists who did not work in the project were examined. The use of indirect evaluation by examining bitewing radiographs for the presence of overhangs was no improvement over the clinical examination in terms of examiner agreement, and moreover only identified half of the restorations scheduled for replacement clinically. Using the results of these experiments, it is suggested that quality control should take into account examiner variability and consequently a 3-4% sample would be sufficient to maintain standards.     

Caries prevalence of preschoolchildren in Baja, Hungary in 1955 and 1975

In 1975 caries epidemiologic investigations were performed in 1,017 preschoolchildren of Baja, aged 3--6 years. The data were analyzed and compared with those of 620 preschoolchildren of the same city in 1955. A mean increase of 10.9% of the caries frequency (percentage of examinees with caries), and a mean increase of 43.5% of the caries intensity(dmft count per examinee) could be observed in spite of a better vitamin D prophylaxis. The possible cariogenic role of the increased surgar consumption (37.5 kg from 24.4 kg per individual during 20 years) is discussed.     

A simplified dental examination for detection of cavitated carious lesions in school setting

Objective:  The objective of the study was to compare a simplified dental examination involving the use of a wooden spatula and a toothpick (TS examination) with the conventional dental mirror and probe examination (MP examination) for detection of cavitated carious lesions in schoolchildren.
Methods:  The study involved three groups of caries-positive schoolchildren aged 4–5, 9–10 and 13–14 years with 179, 188 and 202 children, respectively. All children were examined by a trained and calibrated examiner using a wooden spatula and a toothpick under natural light. After a week the same examiner examined the three groups of children by a dental mirror and a Community Periodontal Index (CPI) probe. 'Teeth' were considered as units of measurement for data analysis. The WHO recommended criteria (2) for decayed, missing and filled teeth were followed for recording dental caries on a specially designed recording form. The sensitivity, specificity, positive predictive value, negative predictive value, false-positive rate and false-negative rate of TS examination were calculated using MP examination as the standard method.
Results:  The specificity of TS examination was well above 95% in three types of dentition. Although the sensitivity of this type of examination in deciduous and mixed dentitions was almost comparable with that of MP examination, it was the lowest for permanent dentition but still within the acceptable limits.
Conclusion:  The TS examination can provide an alternative to traditional MP examination to undertake regular check-ups of schoolchildren for dental caries.     

Intraindividual effect of daily supervised flossing on caries in schoolchildren.

The aim was to study the effect of flossing on proximal caries in children grouped according to different combinations of dietary and oral hygiene habits. 140 12--13-year-old children flossed the right or the left lateral region of the mouth once every school-day for 2 years by pulling a waxed floss once up and down through the proximal contacts. Proximal caries was recorded on bitewing films, taken at the baseline and at the 2-year registration. Diet history was obtained four times during the period. Oral hygiene was classified according to the number of bleeding points registered with a feather-loaded probe at the final examination. Caries increments on the control side during the experimental period were calculated for groups with the same habits. A logical border with respect to the amount of new caries was then established between suitable and unsuitable dietary habits as well as between sufficient and insufficient oral hygiene. No statistically significant difference was found between the control and experimental subgroups in the different combinations of dietary and oral hygiene habits, neither with respect to the whole material nor comparable contralateral surfaces. The numerical differences were so small that the technique of flossing studied here cannot be recommended.     

Marginal leakage along Concise® in relation to filling procedure

abstract – Bacteria beneath 58 class V Concise® restorations on permanent molars in vivo were registered. After an observation period of 1–4 months bacteria were found in all 13 cavities filled with Concise only, in 14 out of 15 cavities filled with resin and Concise, in 12 out of 15 acid-etched cavities with Concise only and in 8 out of 15 acid-etched cavities filled with resin and Concise. Only the difference between the two procedures: Concise only and acid + resin + Concise, was significant. The occurrence of bacteria in the dentinal tubules beneath the cavities was greatest when die cavities had been etched.     

Dental caries and dental treatment in the primary dentition in an industrialized South African community

This paper reports an examination of dental caries in the primary dentition of 2-5-yr-old white children in an industrialized South African city, in 1981 and 1983. There was a decrease in dental caries prevalence over the 2-yr period accompanied by an increase in dental treatment in 3-5-yr-olds. Treatment, however, remains low. Socioeconomic status had a varying effect on the trends, but in general there was a greater reduction in dental caries in the lower socioeconomic areas.     

Value of operating auxiliary personnel for caries diagnosis in dental epidemiology

The ability of a suitably trained operating auxiliary to obtain similar diagnostic results to those of a dentist was tested on 200 11--12 year-old boys and girls selected from a larger sample taking part in a 3-year caries prophylactic clinical trial. A clinical and radiographic examinati-n of all children was performed by both examiners at the beginning of the study and at three subsequent yearly examinations. The reliability of the caries prevalence and incremental data was high for both the dentist and hygienist. Differences between mean caries scores were consistently found between the examiners at the initial lesion level for clinical and radiographic diagnosis. Over the incremental periods of the study neither examiner revealed a significant difference between control and test groups until the end of the 3rd year when both measured a significant difference in mean DMFS at the clinical cavitation level, 26.2% for the dentist and 25.2% for the hygienist.     

Dental health in a group of drug addicts attending an addiction-clinic

The present study was undertaken to investigate the dental health of a group of parenteral drug addicts. The study population comprised 134 persons with a mean age of 25 yr (min. 18, max. 37) examined in 1977-81. Mean DMFT was 18.3 and mean DMFS was 50.2, approximately twice as much as found in comparable age groups in Denmark. Even free smooth surfaces were often involved. The oral hygiene was measured by the use of the Visible Plaque Index (VPI) and the Bleeding Index (BI). Both indices were high, mean VPI = 77.4 and mean BI = 71.3. 12-40% of the teeth selected had a loss of periodontal attachment of more than 4 mm. It is suggested that not only drug abuse, but also factors like low social status, low education and different barriers towards receiving dental treatment should be considered in a multifactorial cause-effect relationship. The effect of offering a free dental care system for this high-risk group will be dealt with in another paper.