Dental attendance and dental status

This article examines the relationship between differences in dental attendance patterns and variations in dental status. A sample of 336 dentate men and 110 dentate women were selected at random from employees of two industrial plants in N.W. England in 1980. They were given a dental examination and asked about visits to the dentist. Regression analysis showed that while the more frequent the dental visits, the lower the rate of tooth loss and the fewer the number of teeth with active decay, the higher, however, the average number of fillings. There were significant differences, moreover, between manual and non-manual workers, the former being more likely to lose their teeth and the latter to have their teeth filled, at each given age and frequency of dental visit. Though the more frequent dental attenders had the advantage over the less frequent of having, on average, a higher number of functioning teeth, restored or otherwise sound, they also had the disadvantage of having higher levels of treated disease and thus of disease experience. The results suggest that while frequent dental visits help to postpone tooth loss and to maintain dental function, they do not apparently help to prevent the onset of further disease.     

A two-wave interview study of frequency of dental visits and dental complaints

A panel of 268 persons were interviewed twice at an interval of 2 years concerning their visits to dentists and their dental status. The answers they gave on the two occasions agreed well, except for the year of the last visit if it had taken place long ago. This was true both for the people who had gone to the dentist between the interviews and for those who had not. The panel was also asked whether they had any dental complaints. Sixteen percent of them reported complaints at one or both interviews. Complaints were more common among persons who did not often go to the dentist. The persons with complaints did not always get rid of them by going to a dentist. It is concluded that interview data be used for investigating the dental health and behavior of people who do not often go to the dentist, and that dentists are more successful in maintaining good dental health in people who have no dental complaints than in people who report having complaints.     

Use of fluoride tablets and effect on prevalence of dental caries and dental fluorosis

A study was executed to investigate the relation between the use of fluoride tablets by children in the age period 1.5-6 yr on the one hand and the caries experience at the age of 6 and 15 yr and the prevalence of fluorosis at the age of 15 yr on the other hand. The year of birth of the child, the motivation of the mother to engage in preventive dental behavior, the level of her school education and her place of birth were taken into account as possible confounding factors. A significant relation was found between the use of fluoride tablets and the prevalence of fluorosis. The most important predicting factor for the caries experience of the child was the mother's motivation to engage in preventive dental behavior. An effect of fluoride tablets on the caries experience could not be demonstrated.     

Exploring the associations between somatization and dental fear and dental visiting

While somatization has been investigated as an important variable in relation to excessive health-service utilization, its role in relation to dental visiting and dental fear has received limited attention. It was hypothesized that an excessive focus on physical symptoms might lead somatizers to experience dental treatment as more traumatic, resulting in greater dental fear. The aims of this study were to determine whether somatization was associated with dental fear, reduced dental visiting, and symptomatic visiting. Questionnaire data were collected from 5,806 dentate Finnish adults, with somatization measured using 12 items from the Symptom Check List (SCL-90). Dental fear was measured using a single-item question and dental visiting was assessed by questions relating to time since last dental visit and the usual reason for dental visiting. Multinomial logistic regression analyses indicated that somatization has a statistically significant positive association with both dental fear and symptomatic dental visiting after controlling for age, gender, and education. However, the association between dental-visiting frequency and somatization was not statistically significant. The results were consistent with the hypothesized role of somatization in the development of dental fear. Further investigation of how somatization is related to dental fear and dental-service utilization appears warranted.     

大学生牙科焦虑症及对选择种植修复选择的影响分析

目的了解大学生的牙科焦虑症情况和牙科焦虑症对种植修复选择的影响。方法用改良牙科焦虑量表对126名大学生进行问卷调查。根据性别分析牙科焦虑症情况,并按问卷得分将研究对象分成两组:牙科焦虑症患者和非牙科焦虑症患者。对两组的种植修复的选择情况进行分析,并按组统计不选择种植修复的原因。结果大学生中女性牙科焦虑症发病率较男性高。牙科焦虑症患者对种植修复选择相对较少。不选择种植修复的原因以害怕手术和害怕疼痛为主。结论提高对种植牙的认识,减轻对种植牙的焦虑,可以让更多人选择种植。     

Answers from dentists, dental hygienists and dental assistants to questions asked by patients concerning preventive dental matters

142 dentists, 21 dental hygienists and 35 dental assistants were asked lo fill in a questionnaire which consisted of 40 questions about preventive dental matters regularly asked by Dutch dental patients. The 40 questions were submitted to experts in the field of preventive dentistry. The experts were in agreement on 26 questions. It was decided to use these questions for analysis. The average percentage of correctly answered questions was: for the dentists 53%, for the dental hygienists 58% and for the dental assistants 37%. The group of 142 dentists was further analyzed. It appears that the knowledge about preventive dental matters increases subsequently with each year of gradual ion. Analysis of the dentists who graduated from Dutch dental schools in their capacity as private practitioner, as faculty member or in the school dental service, revealed that there was no difference in knowledge between these groups. With some reservations the conclusion can be stated that an obvious necessity exists for post-academic courses in preventive dentistry in the groups concerned. Greater uniformity is needed between the views of the experts and the dental professionals who treat patients daily.     

Behavioural and physiological effect of dental environment sensory adaptation on children's dental anxiety

Dental anxiety is a serious obstacle in conventional oral healthcare delivery. A sensory adapted dental environment (SDE) might be effective in reducing anxiety and inducing relaxation. This study aimed to assess the efficacy of a Snoezelen SDE in reducing anxiety among children undergoing scaling and polishing by a dental hygienist. The Snoezelen environment consists of a partially dimmed room with lighting effects, vibroacoustic stimuli, and deep pressure. Nineteen children, aged 6-11 yr, participated in a cross-over intervention trial. Behavioral parameters included the mean number, duration, and magnitude of anxious behaviors, as monitored by videotaped recordings. Physiological parameters reflecting arousal were monitored by changes in dermal resistance. Results, by all measures, consistently indicated that both behavioral and psychophysiological measures of relaxation improved significantly in the SDE compared with a conventional dental environment. The findings support recommending the SDE as an effective and practical alternative in oral healthcare delivery to anxious children.     

Accuracy of dental hygienists in diagnosing dental decay

Abstract During recent decades, the duties and care rendered by Swedish dental hygienists have continuously expanded, and since 1991 they are licensed to practice dental hygiene independently. The aim of the present study was to investigate the accuracy of dental hygienists in examining and recording dental caries in comparison with dentists performing identical examinations. The study included two parts: A) Registration of carious lesions from radiographs of 100 extracted teeth, where the correct diagnosis could be verified, and B) clinical examination and registration of carious lesions in 213 patients. No statistically significant differences could be found between the dental hygienists” and their control dentists' accuracy to diagnose and record dental decay, with the exception of the number of initial lesions (white spot lesions) registered clinically, where the dental hygienists recorded more buccal and lingual lesions. Irrespective of the group of examiners (dental hygienists or dentists), however, the inter-examiner variation was wide. The variation decreased with the size of the lesion and increased with the age of the patient. This study suggests that no patient with a restorative treatment need would have been neglected if the dental hygienists had performed the examination, and, possibly, a more accurate non-restorative treatment need would have been addressed.     

Demand for and utilization of dental services among Hong Kong employees with and without dental benefit coverage

Abstract The objectives of the present study were to investigate the effects of employer-provided dental benefits on the pattern of demand for and utilization of denial services among Hong Kong employees and to analyse whether employees' awareness about an existing denial benefit programme influenced their denial service demand and utilization. Staff from 11 selected companies with and without dental benefits responded to questionnaires concerning their personal factors, demand for dental services, and utilization of denial services and about their awareness of their dental benefit coverage. Overall response rate was 67%. The socio-demographic characteristics of those respondents who were covered and those who were not were similar. Forty per cent of the covered respondents were not aware of their dental benefit coverage, so analysis was performed with three groups of respondents, covered and aware, covered and unaware, and uncovered. A larger proportion of employees in the “aware” group had visited a dentist in the previous 12 months and had visited a dentist for asymptomatic reasons. The “aware” group reported more “low expenditure” items and less “high expenditure” items. Those who were aware of their dental benefit coverage irrespective of the type of scheme reported a significantly higher demand than those who were not aware of their coverage. Demand and utilization of the covered, but unaware, group was more similar to the uncovered group than lo the “aware” group. Coverage per se had no apparent effect on the demand for dental services. Further studies will be necessary lo establish that higher dental care demand and utilization induced by third party schemes also leads to improved oral health.     

Dimensionality of dental anxiety measurements

A survey among 620, 30-40-yr-olds, was carried out in order to measure dental anxiety with Corah's DAS, Weiner's AALC, and some other questions on anxiety, among which was the duration of psychophysiologic responses prior to a dental appointment. The data were analyzed with a Non Metric Components analysis. The DAS turned out to be unidimensional. The AALC on the other hand appeared to contain four components. A second stage analysis comprising the DAS component, the four AALC components, and the remaining variables revealed a two-dimensional structure, of which only the first component is dentistry related. This component showed better differentiation of the respondents than with DAS or AALC alone. Part of AALC's questions and a question about anxiety in daily life proved to be superfluous for measuring dental anxiety. It is concluded that dental anxiety and anxiety in general have to be measured with questions covering different aspects.     

The relationship between dental anxiety and dental decay experience in antenatal mothers

Esa R, Savithri V, Humphris G, Freeman R. The relationship between dental anxiety and dental decay experience in antenatal mothers. Eur J Oral Sci 2010; 118: 59–65 . © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci
The aim of this study was to investigate the relationship between dental anxiety and dental decay experience among antenatal mothers attending Maternal and Child Health clinics in Malaysia. A cross-sectional study was conducted on a consecutive sample of 407 antenatal mothers in Seremban, Malaysia. The questionnaire consisted of participants' demographic profile and the Dental Fear Survey. The D_3cvMFS was employed as the outcome measure and was assessed by a single examiner (intraclass correlation = 0.98). A structural equation model was designed to inspect the relationship between dental anxiety and dental decay experience. The mean Dental Fear Survey score for all participants was 35.1 [95% confidence interval (34.0, 36.3)]. The mean D_3cvMFS score was 10.8 [95% confidence interval (9.5, 12.1)]. Participants from low socio-economic status groups had significantly higher D_3cvMFS counts than those from high socio-economic status groups. The path model with dental anxiety and socio-economic status as predictors of D_3cvMFS showed satisfactory fit. The correlation between dental anxiety and dental decay experience was 0.30 (standardized estimate), indicating a positive association. Socio-economic status was also statistically significantly associated with the D_3cvMFS count (β = 0.19). This study presented robust evidence for the significant relationship between dental anxiety and dental decay experience in antenatal mothers.     

Child abuse and dental neglect: the dental team's role in identification and prevention

Abstract:  Health, education and social services are placing increasing emphasis on preventing abuse and neglect by early intervention to support families where children and young people may be at risk. Dental hygienist and dental assistants, like all other health professionals, can have a part in recognizing and preventing children from those who would cause them harm. They should be aware of the warning signs, recognizing what to consider as abuse or dental neglect and know how to deal with these young patients, and to fulfil their legal and ethical obligation to report suspected cases.
The purpose of this report is to review the oral and dental aspects of child abuse and dental neglect thus helping the dental team in detecting such conditions. In particular, this report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, early childhood caries and diseases that may be indicative of child abuse or neglect.
Emphasis is placed on an appropriate protocol to follow in the dental practice to best treat and protect children who may have suffered abuse, helping the team in the diagnosis and documentation.