Patients'' preference for exodontia versus preservation in Malaysia

A total of 537 dentate adults from nine randomly selected government dental centers in three states in Malaysia were interviewed to assess their preference for either exodontia or preservation of teeth when they experience toothache, or have carious anterior or posterior teeth. The assumptions tested were i) patients prefer exodontia rather than preservation when they have toothache, and ii) patients are more willing to have posterior teeth extracted than anterior teeth for caries. Both these assumptions were rejected. Even though the majority of the subjects preferred preservation (59%) when having toothache, exodontia was the treatment of choice in a large proportion of subjects (41%). Significant differences in preference were found among the various ethnic, educational, income, and age groups. However, when ethnicity was held constant, binary regression indicated that the variations observed were determined by education, income, and age groups and not by ethnicity.     

Dental Discomfort Questionnaire: its use with children with a learning disability

This study investigated whether the behaviors from the Dental Discomfort Questionnaire (DDQ) could help identify toothaches in children with a learning disability, who have a limited capacity to self-report. The objectives were to examine whether the behaviors from the DDQ occur more often in children with a learning disability who have caries and a toothache than in children who do not have caries and a toothache; and secondly, to examine whether two additional items increase the specificity and sensitivity of the DDQ to recognize a toothache, in this particular population of children with a learning disability.
The DDQ was completed by a convenience sample of 58 parents on behalf of their children: 31% girls, aged between 6 and 13 years (mean = 7.5, SD = 2.7).
Of the total group, 26% (n = 15) suffered from a toothache and 43% (n = 25) had carious teeth. Children with caries and a toothache had a significantly higher mean DDQ score and displayed more toothache-related behaviors (e.g., problems with chewing, problems with brushing teeth) than children without caries or toothache.
The DDQ seems to be a functional and easy-to-use instrument to alert parents to the presence of a toothache in this specific group of children with a learning disability.     

Oral health status of preschool children attending Head Start in Maryland, 2000

PURPOSE: The objective of this study was to determine the oral health status of preschool children attending Head Start Centers in Maryland. METHODS: Clinical caries examinations were conducted on 482 children between ages 3-5 from 37 Maryland Head Start Centers in 2000. Additionally, 560 questionnaires were completed by their caretakers regarding their child's access to care, potential caries risk factors and history of toothaches. RESULTS: The overall prevalence of untreated decay was 52%, with a higher prevalence found in rural than urban centers (64% vs 48%). For all children, the mean decayed, filled surfaces (dfs) was 3.64, while the mean decayed surfaces (ds) was 2.90. For those who had caries experience, the dfs was 6.67 and the ds was 5.32. The percentage of children with caries increased by age from 43% for three-year-olds to 62% for four-year-olds. Of those children with caries experience, 17% had complained of a toothache and 9% reportedly cried because of a toothache. CONCLUSIONS: Of significance in this study were the findings that: caries is highly prevalent in this underserved preschool population; pain due to dental caries is not uncommon; and there is little utilization of dental care despite federally mandated and Head Start and Medicaid requirements.     

Caries prevalence and severity, and quality of life in Brazilian 2- to 4-year-old children

Gradella CMF, Bernabé E, Bönecker M, Oliveira LB. Caries prevalence and severity, and quality of life in Brazilian 2‐ to 4‐year‐old children. Community Dent Oral Epidemiol 2011; 39: 498–504. © 2011 John Wiley & Sons A/S Abstract – Objective: The purpose of this study was to assess the impact of caries and severe caries on preschool children’s quality of life. Methods: Data from 765 2‐ to 4‐year‐old children attending a statutory National Day of Children’s Vaccination in Macapá (Northern Brazil) were analysed. Caries and severe caries were indicated by the dmfs and pufa indices, respectively. Parents completed a questionnaire including questions on socioeconomic factors and the impact of oral conditions on their children’s quality of life using the Brazilian version of the Parental Perceptions Questionnaire for preschool children. Logistic regression was used to test the unadjusted and adjusted associations of caries and severe caries with different aspects of children’s quality of life. Results: Sixty‐two and five per cent of children had dental caries (dmfs index > 0) and severe caries (pufa index > 0), respectively. In the adjusted models, having caries was significantly related to toothache and problems eating certain foods as well as to be absent from school and ashamed to smile, whereas having severe caries was significantly related to toothache and problems eating certain foods only. Neither caries nor severe caries was related to stop playing with other children. Conclusions: This study shows that caries and severe caries may have a considerable impact on some aspects of preschool children’s quality of life.     

Intra-oral distribution and impact of caries experience among South Australian school children

A bstract — This report describes the intra-oral distribution of caries and frequency of reported toothache using data from 9690 South Australian children aged 5–15 years. School dental therapists and dentists recorded dmfs and DMFS data and a questionnaire to parents sought information about toothache and its impact. There were higher levels of cartes experience in deciduous teeth (mean 6-year-old dmfs=2.61) compared with permanent teeth (mean 12-year-old DMFS=1.15). In the deciduous dentition: between 11.4 per cent (9-year-olds) and 37.7 per cent (5-year-olds) of total dmfs was present as untreated decay; between 39.1 per cent (7-year-olds) and 42.8 per cent (10-year-olds) occurred on interproximal surfaces; and between 2.0 per cent (10-year-olds) and 27.8 per cent (5-year-olds) occurred in anterior teeth. In the permanent dentition, the majority of permanent caries experience occurred as fillings in pits and fissures of first molars and involved a single surface. Between 11.8 per cent (5-year-olds) and 31.8 per cent (12-year-olds) of children had a reported history of toothache, although the figure exceeded 50 per cent among children with all three forms of pit/fissure, interproximal and smooth-surface caries experience. The observed pattern of caries provides the basis for continued use of fissure sealants as a preventive measure among school children.     

辽宁省老年龋病高危人群Logistic回归模型研究

目的　了解辽宁省老年人群患龋状况,分析影响龋病发生的危险因素,为建立老年龋病高危人群Logistic模型提供基线研究资料。方法　2015年5—12月,采用随机抽样方法对辽宁省65 ~ 74岁年龄组的城乡居民1144名进行龋病临床调查,并进行问卷调查。采用SPSS13.0统计软件对患病情况和相关因素进行χ2检验及多因素Logistic回归分析。结果　辽宁省老年人群患龋率为68.53%,城市患龋率为73.12%,农村患龋率为63.92%,城乡间差异无统计学意义（P＞0.05）;男性患龋率为67.78%,女性患龋率为69.27%,性别间差异无统计学意义（P＞0.05）。Logistic回归分析显示：过去1年有牙痛史（OR = 1.550,95%CI：1.164-2.063）是老年人易患龋的危险因素;农村户口（OR = 0.676,95%CI：0.503-0.908）、不吸烟（OR = 0.681,95%CI：0.502-0.923）、不饮酒（OR = 0.628,95%CI：0.446-0.885）是老年人患龋的保护因素。结论    辽宁省老年人患龋率较高,口腔保健意识不强;过去一年有牙痛史、城市居民、有饮酒和吸烟习惯者更易患龋。     

The trend and risk factors of perceived toothache among Finnish adolescents from 1977 to 1997

Toothache is a subjective oral health indicator that should become uncommon when oral health is improving. The aim of this study was to assess changes in perceived toothache between 1977 and 1997 among Finnish adolescents. In the Adolescent Health and Lifestyle Survey, a self-administered questionnaire was mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns every second year. The sample sizes in the surveys varied from 2422 to 11,105, making a total of 35,349 subjects in the entire study. The incidence of toothache during the previous 2 years was requested in 1977, 1985, 1991, 1995, and 1997, and the prevalences were 31%, 25%, 28%, 29%, and 37%, respectively. The increase between 1995 and 1997 was highest among 16- and 18-year-olds. There was no tendency for perceived toothache to decline over the study period, despite the decrease in caries experience. Toothache varied by age, socioeconomic status (SES), place of residence, and toothbrushing frequency. The increase in the incidence of toothache reported after 1995 could be a warning signal that economic recession in Finland has caused changes in the dental care system.     

An assessment of oral self-care level among Japanese dental hygiene students and general nursing students using the Hiroshima University – Dental Behavioural Inventory (HU-DBI): Surveys in 1990/1999

PURPOSE: The purpose of this study was to determine the differences in oral self-care levels between Japanese dental hygiene students and general nursing students in 1999, and compare them with a similar study in 1990. METHODS: The examination was mainly based upon responses to a questionnaire titled "Hiroshima University--Dental Behavioural Inventory (HU-DBI)". Higher scores of the HU-DBI indicate better oral health attitudes/behaviour. RESULTS: The mean HU-DBI score of the 2nd-year dental hygiene students was significantly greater than that of the 2nd-year nursing students (9.56 and 6.65, respectively; p<0.001), and much higher than those of the 1st-year students at each course (dental hygiene course; 6.30, nursing course; 5.88). Except for the 2nd-year dental hygiene class, there were no significant differences in the HU-DBI score between the 1990 and 1999 subgroups of each class. About 1/3 of the 2nd-year nursing students reported a belief that they may eventually require false teeth, while 6% of the 2nd-year dental hygiene students held this belief. More than 60% of this study sample stated that they put off going to the dentist until they had toothache. The 2nd-year dental hygiene students were more likely to have this attitude than their 1990 peers. Flossing was not popular among the nursing students in either 1990 or 1999. CONCLUSION: Although the difference in the HU-DBI score across time was not major, the variation in HU-DBI and the favourable attitudes/behaviour toward oral health appeared to reflect the differences in schooling between student hygienists and student nurses.     

����ʡ����ȣ����Σ��ȺLogistic�ع�ģ���о�

??Objective??To study the status and the risk factors of dental caries in high-risk elderly people in Liaoning??in order to provide basic research data for establishing Logistic model of high-risk elderly people with dental caries. Methods??From May to December 2015??1144 elderly people aged 65??74 were randomly selected to take an oral examination?? and a questionnaire survey was also performed. Chi square tests and multifactor Logistic regression analysis were used to analyze the results by SPSS13.0 software. Results??The dental caries prevalence was 68.53%. Elderly people living in urban areas had no significant difference with those living in rural areas on caries prevalence??73.12% vs. 63.92%??P > 0.05??. The same status existed in gender difference??67.78% vs. 69.27%??P > 0.05??. A multiple Logistic regression analysis showed that rural residence ??OR = 0.676??95% CI??0.503-0.908????seldom smoking ??OR = 0.681??95% CI??0.502-0.923????and seldom drinking ??OR = 0.628??95% CI??0.446-0.885?? were negatively associated with dental caries in elderly people. The experience of toothache in the recent one year ??OR = 1.550??95% CI??1.164-2.063?? was the risk factor of the dental caries. Conclusion??The prevalence of dental caries is high in elderly people in Liaoning??with experience of toothache in the past 1 year being positive determints and rural residence??seldom smoking??and seldom drinking being negative determints.     

非牙源性牙痛

急性牙痛是口腔急症的最常见主诉症状,除牙源性疼痛以外,很多非牙源性疾病也可引起牙痛,容易出现漏诊或误诊。文章对急性上颌窦炎、三叉神经痛、带状疱疹、颞下颌关节紊乱病、心源性牙痛和丛集性头痛等疾病引起的非牙源性牙痛进行阐述,为临床医生诊断牙痛疾病提供参考。     

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??Acute toothache is the most common symptom of emergency cases in the dental department. There are many causes of nonodontagenic toothache besides for odontagenic pain??so misdiagnosis and missed diagnosis might occur. This review describes the nonodontagenic toothache caused by such diseases as acute maxillary sinusitis??trigeminal neuralgia??zoster herpes??temporomandibular disorders??cardiac pain??cluster headache??etc. and provides reference for clinical diagnosis of toothache disease.     

牙源性牙痛误诊误治68例分析

目的:分析引起牙源性牙痛误诊误治的相关影响因素,以期提高牙痛的正确诊断率。方法:选择2005—2009到广州市海珠区口腔医院就诊的牙痛病例中,对误诊误治并经再次诊治疼痛缓解的病人68例进行回顾性研究,记录病人临床资料信息,统计、分析其主要症状、体征。结果:牙痛误诊中牙髓炎占最大比例,牙髓炎又以深龋已充填未做牙髓治疗者占多数,其余依次为隐蔽龋、隐裂、楔形缺损、牙周牙髓联合病变、重度磨耗及畸形中央尖磨损等。此外龈乳头炎、牙根折也易出现误诊误治。结论:部分牙髓炎急性发作体征不典型,定位困难及医生询问病史、检查不仔细是牙痛误诊、误治主要原因。熟悉各种牙痛的临床表现及体征,抓住引发牙痛几个重要原因以及正确阅读X线片有助于提高牙痛病人的诊治成功率。     

早期咬合创伤性牙痛的临床初步分析

目的:分析早期咬合创伤性牙痛的特点,确定早期咬合的概念范围与定义。初步探讨诊断标准及防治方法。材料与方法:对临床诊断早期咬合创伤性牙痛的17例病例进行检查、治疗的临床分析。结果:17例早期咬合创伤性牙痛病例包括前牙3例,前磨牙5例,磨牙9例。表现为不明原因的牙痛,偶有咬合至某一个位置疼痛。有时定位不准确,检查偶有叩痛,经反复检查可查及咬合高点,但X线片检查牙体及牙周膜并未见改变。经调治疗后1周内症状可得到明显的缓解。结论:临床上确实存在单纯因咬合创伤引起的早期牙痛,仔细检查可查到咬合创伤点,但不能查到牙体及牙周组织的损害。在临床应引起重视,早期发现早期治疗,以免引起进一步的损伤。有关单纯性咬合创伤引起早期牙痛的发病原因及机理有待深入研究。     

Dental treatment in Medieval England

Medieval (12th-14th century) medical literature suggests that care of the teeth was largely limited to non-invasive treatment. Cures, mainly for toothache and "tooth worm" were based on herbal remedies, charms and amulets. Bloodletting was advised for certain types of toothache. There is also documentary evidence for powders to clean teeth and attempts at filling carious cavities. Surgical intervention for oral cancer and facial fracture is also known. Post-operative infection and abscess formation can be identified and early forms of false teeth are mentioned.     

Untreated cavitated dentine lesions: impact on children's quality of life

The aim of the present investigation was to assess the impact of dental caries prevalence and the consequences of untreated cavitated dentine lesions on quality of life of 6- and 7-year-old Brazilian children. A total of 826 schoolchildren were assessed using ICDAS and pufa (to score consequences of dental caries on soft tissues) indices. History of extraction and toothache was recorded. Oral health-related quality of life was assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). A multiple logistic regression model was used to analyze the relationship between the prevalence of dentine carious lesions, pufa, history of extraction and toothache with the B-ECOHIS scores. A total of 587 questionnaires were analyzed. The prevalence of cavitated dentine lesions and pufa was 74.8 and 26.2%, respectively. Some 21.8% of children reported toothache and 9.2% had had at least one tooth extraction. The chance (OR) for children with cavitated dentine lesions, pufa ≥1, history of extraction and toothache of having higher B-ECOHIS scores than those not affected was 1.90 (95% CI: 1.18-3.06), 6.26 (95% CI: 3.63-10.83), 6.87 (95% CI: 2.75-17.16) and 3.68 (95% CI: 2.12-6.39), respectively. Children's quality of life was negatively influenced by untreated cavitated dentine lesions and their consequences.     

沈阳市部分视力残疾学生口腔健康状况及其与龋病相关影响因素分析

目的    调查沈阳市盲校学生龋病、牙周病和错牙合畸形状况,探讨残疾学生患龋相关影响因素,为口腔疾病的综合干预提供基线资料。方法    采用第三次全国口腔健康流行病学调查标准和方法,2014年对沈阳市盲校103名6 ~ 20岁视力残疾学生进行口腔健康状况临床检查及口腔相关知识和行为习惯的问卷调查,通过logistic回归分析龋病影响因素。结果    103名视力残疾学生患龋率为78.64%,龋均为2.43 ± 2.75;牙龈出血检出率和牙石检出率分别为44.66%和67.96%;49.51%视力残疾学生存在错牙合畸形。女生患龋状况明显比男生严重（P＜0.05）。多因素logistic回归分析显示,母亲学历和牙疼经历是龋病的危险因素,使用含氟牙膏刷牙是预防龋病的保护因素。结论    视力残疾学生患龋率高,牙周状况较差,错牙合畸形严重,学校应加强对残疾学生的口腔宣教,并采取干预措施预防口腔疾病的发生。     

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??Objective    To investigate the oral health status of 6??20-year old visually impaired students in Shenyang and analyze the risk factors of caries. Methods    Oral health status??oral health knowledge and related behavioral habits of 103 students were surveyed by questionaires. The risk factors of caries were analyzed through logistic regression analysis. Results    Caries prevalence rate was 78.64%??and the total mean DMFT was 2.43 ± 2.75. The rate of gingival bleeding and dental calculus was 44.66% and 67.96% respectively. Malocclusion rate was 49.51%. Female students had significantly higher dental caries experience than the male ones??P??0.05??. Logistic regression analysis indicated that caries experience was related to the education degree of their mothers and the experience of toothache. Brushing teeth properly with fluoride toothpaste could reduce the incidence of dental caries. Conclusion    Oral health of visually impaired students is poor. Oral health education and promotion measures should be emphasized among disabled students.     

Prevalence and severity of clinical consequences of untreated dentine carious lesions in children from a deprived area of Brazil

Disadvantaged children suffer because tooth cavities are not being treated and their clinical consequences not being surveyed. The present study aimed to assess the prevalence and severity of clinical consequences of untreated dentine carious lesions in schoolchildren from a deprived area of Brazil and to investigate the determinants of the pufa index. A sample of 835 children aged 6-7 years, from six public schools, was examined by 3 calibrated examiners. Clinical consequences of untreated dentine carious lesions in primary teeth were diagnosed using the four codes of the pufa index: 'p' (pulpal involvement), 'u' (ulceration), 'f' (fistulae), 'a' (abscess). Effects of gender, age, school, history of extraction, and toothache on the prevalence of pufa codes were tested. The prevalence of pufa codes was 23.7%. The mean pufa score was 0.4 ± 0.9. Code 'p' was the most prevalent (19.5%), whereas code 'u' was least prevalent (0.1%). Children with a history of extracted primary teeth due to caries had a 2.7 times higher chance to have a pufa code than children with no previous extraction. Children with toothache had a 5.6 times higher chance to have a pufa code than children without toothache. The prevalence of clinical consequences of untreated dentine carious lesions was moderate and the severity was low. The pufa index is an epidemiological tool complementary to existing caries indices aimed to assess dental caries. However, there appears to be no need to include code 'u' nor to score codes 'f' and 'a' separately.     

24例非牙源性牙痛的临床分析

目的总结患者非牙源性牙痛的临床特点。方法对24例非牙源性牙痛患者的临床资料进行回顾性分析。结果本组病例虽伴有牙痛症状,但临床表现各异,最后诊断为三叉神经痛者15例,心源性牙痛者1例,带状疱疹者2例,颌面部肿瘤疼痛者1例,非典型牙痛者5例。结论非牙源性牙痛的病因多样,需认真鉴别。