Effects of dental attendance frequency in heavy and low private care-using young adults

In Finland, adults born in 1961 or later were progressively entitled to subsidies for dental care from private practitioners during 1986-90, while at the same time having access to care in the Public Dental Service. The aim of this study was to compare the effects of attendance frequency of private dental care on treatment costs and treatment spectrum for the heaviest and lowest users over a period. Three separate cohorts of recipients of reimbursements were formed, using the Social Insurance Register. The highest and lowest cost groups in 1986, 1990, and 1994 were followed up to 1997. Initially, the mean numbers of visits were 1.2-1.3 and 5.2-5.6 and cost Euro 48 53 and Euro 358-379 among low users and heavy users, respectively, in all cohorts. Among the heavy users (the high-cost category) infrequent attendance was related to higher and frequent attendance to lower mean annual costs of care. Among the low users (the low-cost category the opposite was true. Those who initially belonged to the high-cost category received in 1997 significantly more (P < 0.01) restorative treatment and, to a lesser extent, more (P < 0.01) preventive and periodontal treatment than those belonging to the low-cost category. Frequent dental care seemed to benefit those who received a lot of care. Frequency of attendance was not associated with being a low or a heavy user, indicating rigid check-up routines. The inclusion of simple oral health data would greatly improve the usefulness of the register as an evaluation tool for health-political decisions.     

Demographic, health and lifestyle factors associated with dental service attendance by young adults

BACKGROUND: The aim of this study was to describe the demographic and health and lifestyle factors associated with dental service attendance in the previous 12 months by young Australian adults (18-24 years). METHODS: Population-based data from the 2001 Australian National Health Survey were analysed. Proportions and single associations between variables of interest and dental service attendance were calculated. A logistic regression analysis using significant single association variables was then conducted. RESULTS: Overall, 41 per cent of young adults in this study had visited a dental professional in the previous 12 months. Females, those in cities, those with private insurance, those who spoke languages other than English, those in the highest socioeconomic group and those with healthy behaviours were subgroups most likely to have visited a dental professional. With logistic regression, factors found to be associated with dental services attendance were being female, having private health insurance and low alcohol consumption. CONCLUSIONS: In this study, the proportion of young adults who had visited a dental professional in the previous 12 months was only 41 per cent. It is therefore suggested that oral health policy and promotion activities be encouraged for this group, paying attention to young adults in groups with low attendance.     

Dental care attendance and refrainment from dental care among adults

Objective: The aim of this study was to analyse dental care utilization, refrainment from self-perceived needed dental care and the association with socioeconomic indicators among adult individuals.

Materials and methods: This cross-sectional survey included 3500 randomly selected adult individuals. Telephone interviews were conducted and the participants answered a battery of questions regarding dental visiting habits, health, socioeconomic position (SEP), behavioural factors and lifestyle indicators.

Results: The outcome ‘dental visits’ was significantly correlated with SEP, especially with monetary dimensions, such as income and economic resources for unforeseen expenditures. However, educational level was not a significant predictor in the tested statistical models. Furthermore, other covariates that contributed significantly to the models were ethnicity, dental anxiety and lifestyle factors, albeit with a different pattern of impact on the two outcome dimensions. Important features of the SEP variables were the stepwise gradient relative to the outcomes, implicating that the lower the SEP status, the greater the risk of reporting irregular dental visiting habits and refraining from dental care due to financial problems.

Conclusions: Dental care utilization and refraining from dental care for financial reasons clearly reveal associations with socioeconomic positions among adult individuals.     

Utilization of dental health services by Danish adolescents attending private or public dental health care systems

The objectives of the study were: 1) to describe the choice of dental care system among 16-year-olds, 2) to describe the utilization of dental services among 16-17-year-olds enrolled in either public or private dental care systems, and to compare the dental services provided by the alternative systems. The study comprised 1,245 adolescents from 3 municipalities; the historical cohort study design was applied; and data were collected from dental records (public dental service) and dental claims (private practice). At age 16, 12% preferred being enrolled in the private practice system, while 88% remained in the public dental care system. During the 2-year study period the attendance rate was 99% for the public system, while 90% attended the private practice system (P < 0.001). Preventive dental services were provided more frequently by the public than the private system (P < 0.001). Despite the fact that the economic barrier was eliminated a lower attendance rate was observed for patients transferred to the private practice system.     

Oral health and family characteristics of children attending private or public dental clinics

Abstract The City of North York Public Health Department (NYPHD) operates a school-based dental programme that provides preventive and treatment services to children according to evidence-based practice guidelines. This programme and private dental practices (PDP) represent the only sources of dental care for children in North York. The purpose of our study was to compare the oral health and family characteristics of clients from the NYPHD and PDP using a dental examination and a parent interview. Results showed that NYPHD and PDP clients had similar levels of lluorosis, calculus, and periodontal health, but NYPHD clients had experienced greater levels of decay. Clients of the NYPHD and PDP also had significantly different family characteristics, many of which were significantly associated with the presence of one or more decayed primary or permanent teeth. Multivariate logistic regression identified mother's immigration history, past caries experience, and parents' rationale for scheduling their child's dental appointments as the principle risk makers for dental decay. When compared with PDP clients, the NYPHD serves higher-needs children who otherwise might not receive care.     

北京市城乡居民口腔卫生服务利用与费用模型的研究

目的 建立北京市城乡居民口腔卫生服务利用预测模型，进行精确性研究，为开展口腔医疗保险提供依据。方法 采用分层、整群、随机抽样方法，抽取城乡居民共3395人进行调查，利用Logistic回归拟合就诊概率模型；利用对数线性回归拟合利用者的就诊频率和费用模型。利用平均预测偏差、预测残差均方和相对预测偏差进行模型预测效果评价。结果 城乡居民口腔卫生服务利用三部模型拟合较好，就诊概率模型的调整决定系数较高．城乡分别为0．621和0．642，而就诊频率和费用的调整决定系数较低。就诊概率模型预测精确度分别为城区83．7％，农村89．6％。就诊频率和费用相对预测偏差为8．85％～14．10％。结论 分解模型法是建立口腔卫生服务利用预测模型的较好方法，预测准确性较高，通过对数转换可改善资料的偏态性。预测模型可用来进行影响因素分析和保险基金与保险因子的测算。     

The frequency of dental attendance of Scottish dentate adults between 1978 and 1988

The dental attendance of a sample of dentate adults (n = 702) within the National Health Service in Scotland was monitored longitudinally between 1978 and 1988. The attendance pattern of the sample appeared to be no different between 1983-88 than in the preceding 5 years, which suggests that the attendance behaviour of the sample has not changed significantly. National figures, available for the same period, show an increase in the number of courses of dental treatment provided. These figures were examined in detail, and the analysis suggested that only 40% of the increase in number of courses provided in 1988 compared with 1978 could be accounted for by an improvement in attendance patterns among Scottish adults as a whole. The remaining 60% could be attributed to a greater requirement for dental care to cater for the increased proportion of the Scottish population who retained their own teeth in 1988. Only 16% of the sample consistently attended for dental care within 2 years of a previous dental course (which is the criterion for remaining under continuing care in the new General Dental Service contract).     

Cupped lesions of early onset dental erosion in young southeast Queensland adults

BACKGROUND: Dental erosion manifests as cupped lesions on cusp apices and in fissures of teeth in patients from southeast Queensland referred with excessive tooth wear. When found in young adults, these lesions may indicate early onset of active dental erosion. If the numbers and extent of cupped lesions increase with age, erosion may be a slow cumulative process. METHODS: This cross-sectional study recorded the presence or absence and the relative sizes of cupped lesions from all cusps and occlusal fissures on premolar and permanent molar teeth from study models by image analysis. Type-specimens of cupped lesions were examined. RESULTS: The incidence by tooth reflected time in the mouth, post-tooth emergence. A linear increase in lesion number and size, with age, was found. However, cupped lesions occurred on mandibular first molar cusp apices as often, and attained greater extent, in adults under 27 years compared with older subjects. CONCLUSION: Marked differences were found between lesion number and size, between maxillary and mandibular molar sites that reflect differences in salivary protection against dental erosion. The significance of this study is that the mandibular first permanent molar indicates the age of onset and severity of dental erosion.     

Dental attendance and anxiety among public and private school children in Jordan

AIM: To evaluate the levels of dental attendance and anxiety among children of public (lower to middle socioeconomic groups) and private schools (higher socioeconomic groups), and to explore the perceived source of dental fear among them. METHOD: A group of 1,021 children selected by a simple random method from 10 public schools in the five geographic areas of Irbid Governate, Jordan and all 10 private schools were included in this study. All children (mean age 13.1 +/- 0.87 years) completed a questionnaire modified from the Dental Fear Scale (DFS) which also contained items related to dental attendance. RESULTS: Private school children (31.4%) visited the dentist regularly more significantly than public school children (15.0%) (P < 0.001). However, the majority of children (public = 82.6%, private = 67.4%) attended the dentist only in an emergency. The main reason for irregular attendance was 'treatment not needed' (42.2%). About 43-44% of children had dental fear of 'low to moderate type', while the prevalence of 'high dental anxiety' was slightly higher among children of public (11.6%) than those of private schools (6.9%). Fear of specific stimuli (pain and trauma) was the most common source of dental fear reactions among 60-65% of children. The sight and sensation of an anaesthetic needle and sight, sound and sensation of the drill were the most fear eliciting stimuli. Moreover, public school children were found to be more anxious with a significantly higher 'overall dental fear' than private school children (P < 0.05).     

Utilization of dental health services among middle-aged people in Sweden and Denmark

In 1999, questionnaires were sent to random samples of 1001 Swedish citizens aged 55-79 years and 1175 Danish citizens aged 45-69 years. Various questions were asked concerning dental conditions, dental visit frequency per year, and money spent annually on dental care, etc. The objectives were to assess differences in the utilization of dental services and to compare out-of-pocket costs for dental care in Sweden and Denmark with control for age, gender, dental conditions and income. More than 80% of the subjects reported that a dentist had examined them less than 1 year previously. However, 77% of the Danes reported dental visits twice a year or more compared to 28% of the Swedes. Although the Danes reported a more frequent use of dental services, they had poorer dental conditions compared to the Swedes. Even though the Swedes used dental services less often than the Danes did, more subjects reported high 12-month out-of-pocket costs. In the present study, separate models were constructed for the two countries because there could be different mechanisms at play, as indicated by the results. The different insurance systems along with different degrees of commercialization in the two countries might be the most decisive factors in this context.     

Association between dental fear and dental attendance among adults in Finland

Objective. Our aim was to evaluate the association between dental attendance and dental fear while considering the simultaneous effects of perceived oral health and treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Material and methods. The two-stage stratified cluster sample (n=8028) represented Finnish adults aged 30 years and older. The response rate to this nationwide sample was 88%. Dental fear was measured with the question: “How afraid are you of visiting a dentist?” Multiple logistic regression analyses were used to determine the association between dental fear and dental attendance, including the following independent variables: perceived oral health, perceived treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Results. Among all ages, except 30 to 34-year-olds, irregular attenders were more likely to be very afraid of visiting a dentist than regular attenders were. The association was stronger the older the age group. Only age modified the association between dental fear and attendance. Irregular dental attendance can be attributed to high dental fear (etiologic fraction among exposed) in 41% of cases. Conclusion. Reducing dental fear would increase the number of regular attenders, especially among older age groups. Individuals for whom oral health services have been provided regularly since childhood seem to continue to use these services regularly despite high dental fear.     

Number of teeth,body mass index,and dental anxiety in middle-aged Swedish women

Risk factors for poor dental health include obesity, low socio-economic status, poor dietary habits, and dental anxiety. The aim of this study was to explore the complex relation between body mass index (BMI) and number of teeth in middle-aged women taking education, dietary intake patterns, dental care utilization, and dental anxiety into account. Three groups of women (37-60 years): reference women (group I, BMI 23.8 &#45 3.1 kg/m²), obese women (group II, BMI 35.0 &#45 2.6 kg/m²), and severely obese women (group III, BMI 41.0 &#45 3.4 kg/m²) were included. Questionnaires were used to assess education, smoking, number of teeth, dental care utilization, dental anxiety, dietary intake, and meal patterns. Age, education, and smoking habits did not differ significantly between groups. However, there were significant global differences in number of teeth (27.2 &#45 3.4, 23.0 &#45 9.2, 24.7 &#45 5.9) and reported daily energy intake (9756 &#45 3363 kJ, 10344 &#45 3850 kJ, 11970 &#45 3786 kJ in groups I, II, and III, respectively). In a multiple regression model, a lower number of teeth was independently associated with higher age, higher BMI, lower education, irregular dental care, high dental anxiety, higher energy intake, and lower iron intake. These variables explained 25% of the variation in number of teeth. In conclusion, BMI is an independent predictor of number of teeth in middle-aged women when socio-economic, dietary, and psychological factors are taken into account.     

Site-specificity of mineral ions in 2-day dental plaque obtained from children and young adults

The aim of this study was to determine the variation in mineral ions (Ca and P) concentrations in 2-day dental plaque taken from different areas of the deciduous and the permanent dentition that may be related to the caries status of tooth surfaces obtained from children and young adults. We also compared those minerals between the deciduous and the permanent dentition. Plaque samples were collected from eight dentition sites, including the upper-anterior-buccal (UAB) and -lingual (UAL), lower-anterior-buccal (LAB) and -lingual (LAL), upper-posterior-buccal (UPB) and -lingual (UPL), lower-posterior-buccal (LPB) and -lingual (LPL) regions. Significant differences among these eight different sites were determined from Ca and P ions concentrations, as well as the Ca/P ratio, calculated by ANOVA. Plaque associated with the LAL region closest to the main salivary ducts and that is less prone to caries, had significantly higher levels of Ca, P ions concentrations, a higher Ca/P ratio than any other dentition areas in both children and young adult subjects. Statistical differences were seen in minerals between children and young adults. Ca ion concentrations in dental plaque from young adults were significantly higher than those of children at the LAL site. Statistical analysis of the relationships between Ca and P ions showed that there were strong associations between Ca and P ions, especially in the UPB, LAL and LPL regions where there is a high exposure to saliva. We conclude that there is a site-specificity of plaque mineral content in both children and young adults, which may reflect the differences in exposure to saliva, resulting in differences in the local cariostatic challenge.     

Dental anxiety and regularity of dental attendance in younger adults

Dental anxiety constitutes a major problem for patients and dental care providers alike. The aim of this study was to examine the relationship between dental anxiety and regularity of dental attendance among young adults. A random sample of 15 course directors (1:50) was asked to participate in the study. Of these, only 10 course-directors agreed to handout the 500 questionnaires. All undergraduate students who participated in this study were asked to complete a questionnaire modified from Dental Fear Survey (DFS) questionnaire and 368 (73.6%) filled forms were returned for statistical analysis. The results showed that only 20.9% were regular dental attendee while the majority (79.1%) were irregular attendee. The reasons given for irregular attendance were 'lack of time' (36%), 'treatment not needed' (34.1%), 'fear from dentist' (13.3%) and 'cost' (16.6%). The sight and sensation of the injection and sight, sound, and sensation of the drill were the most common fear-eliciting stimuli. Increased heart rate was the commonest reported physiological response. Females had higher mean ratings, therefore tended to be more anxious than males. Dental anxiety represented by the mean responses to the items, was found to be higher in irregular dental attendee than regular attendee. In conclusion, this suggests that dental anxiety may affect the seeking of dental care, therefore to be taken into account when training dental care providers.     

Fluoride sources and dental attendance habits among adults in communities with optimal and low water fluoride concentrations

The aim of this study was to obtain data on local fluoride supply, dental attendance, and dental care habits in two sociologically similar municipalities with optimal, 1.0 ppm, and low, 0.3 ppm, water fluoride concentrations, respectively. The participants in the study were 30- to 40-year-old lifetime residents in the two municipalities: 569 individuals from the 1-ppm fluoride community and 466 from the low-fluoride community. There were no intergroup differences in the fluoride mouthrinse utilization rate of 1%. Fluoride toothpaste was much more common in the low-fluoride area. In the 1-ppm fluoride area more people drank tea, and they went more regularly to the dentist. It is suggested that dental attendance habits and various fluoride sources should be taken into account in studies evaluating the effect of fluoride in drinking water.     

Effect of the dental arches morphology on the masticatory muscles activities in normal occlusion young adults

Objectives:

The aim of this study was to assess the relationship between the morphology of dental arches and the activity of the masticatory muscles activities in healthy volunteers with full natural dentition.

Methods:

Two-hundred youthful Class I volunteers (113 females, 87 males) were clinically investigated. Alginate impressions of dental arches were taken, and plaster casts were prepared and measured. EMG data from eight masticatory muscles was recorded to assess their activities in central occlusion, lateral and protrusive movements.

Results:

Clinical measurements and plaster casts analyses confirmed normal values of parameters investigated. Most of the arch measurements were significantly larger in the males than in the females. Weak positive correlations were found between overbite and masseter activity in centric occlusion (the right Mm R?=?0·151, P≤0·05; the left Mm R?=?0·191, P≤0·05). Also, the range of protrusive movement positively correlated with masseter activities in central occlusion (the right Mm R?=?0·194, P≤0·05; the left R?=?0·201, P≤0·05).

Conclusions:

The null hypothesis that morphology of dental arches does not affect the masticatory muscles’ activities was rejected. The findings of this investigation indicate that systemic, longitudinal analyses of morphology of occlusion and muscular response, even in normal subjects, are needed.     

Effects of fluoride and regular dental care on personal dental expenditures of young adults in Finland

Abstract This paper analyzes the relationship among presence of fluoride in the drinking water, oral health and dental expenditures in four towns in Finland. A two-stage least-squares model is used to determine the effect of fluoridated water and other independent variables on the number of missing teeth and per capita annual dental service expenditures for 555 adults. The results show that regularity of dental visits is the only significant factor explaining per capita expenditures. In contrast, many factors affect the number of missing teeth; most importantly, the number of dentists per capita, level of fluoride, age, education, use of services and smoking habits. These findings suggest I hat fluoride significantly improves oral health status but does not reduce adult per capita dental expenditures.     

纵向研究0-2岁婴幼儿变异链球菌群与早期婴幼儿龋的关系

目的探讨8～32个月婴幼儿牙菌斑中变异链球菌群的定植情况,并分析其早期定植与龋病关系。方法收集广州市花都区新华镇225名8月龄婴幼儿,每半年复查一次,持续两年,至婴幼儿32月龄。复查内容包括龋病检查和前牙牙菌斑样本收集。WHO诊断标准用于龋病诊断,选择性培养基及生化实验用于变异链球菌群的分离鉴定。统计方法采用χ2检验或Fisher确切概率法。结果 8月、14月、20月、26月和32月龄变异链球菌群定植率分别为6.7%、31.2%、50.3%、61.0%和75.5%。其中,8月龄组有2名幼儿检出变异链球菌群未见乳牙萌出。变异链球菌群首次检出的平均年龄为（19.6±6.9）个月。婴幼儿乳牙变异链球菌群早期定植患龋率高于晚期定植,32月龄组差异有统计学意义（P=0.018）。结论变异链球菌群能在未萌牙口腔中检出,其定植率随年龄的增长而增加。变异链球菌群在前牙面的早期定植促进乳牙龋病的发生。