National oral health survey Zimbabwe 1995: dental caries situation

Ten years after completion of the first national oral health survey, the second such survey was carried out in 1995. Application of a multi-stage sampling procedure resulted in 3,709 persons being examined according to the WHO oral health assessment form and criteria. The background variables studied were age, gender, type of location, socio-economic status. Comparison with results from major studies in other African nations are presented. It was concluded that the prevalence of dental caries in all age groups was high but that the severity was low. The prevalence of unmet treatment needs was very high with extraction as the predominant mode of treatment. The survey has shown that the vast majority of Zimbabweans are not receiving and/or are not seeking oral care.     

National oral health survey Zimbabwe 1995: quality of restorations.

In 1995, a second national oral health survey was carried out, ten years after the first. Application of a multi-stage sampling procedure resulted in 3709 persons being examined. The restorations were assessed using the criteria described by Kroeze et al (1990). Only ditches on the tooth/restoration margins that were wider than 0.4 mm were considered to be carious. The background variables studied were age, gender, type of location, socioeconomic status (SES) and level of education. The prevalence of restorations in all persons examined was 3.4 per cent. Restorations were found much more often among urban (95.5 per cent) than rural people (4.5 per cent) and also among those living in high (75 per cent) compared to low SES suburbs (25 per cent). Amalgam was more often used (89 per cent) than composite resin (10 per cent). The most frequently observed type of restoration was Class I (45 per cent) followed by Class II (39 per cent) and Class III (7 per cent). The prevalence of satisfactory restorations was 83.9 per cent. Failures were due to 'fractured restorations' (6.3 per cent), 'caries at the margin' and 'breakdown of restoration margin', both 4 per cent. Amongst adults, multiple-surface amalgam restorations failed more often than single-surface ones. It is concluded that the prevalence of restorations found was very low. There is a need to extend the provision of preventive and restorative oral health care by a more equitable distribution of oral health personnel and by making more finance available to rural and low-SES suburban areas.     

National survey of oral health care Finnish private old people''s homes

As oral health status depends greatly on the dental care arrangements available, the aim of this study was to investigate the dental services provided for elderly people living in private old people's homes in Finland. The study involved all 94 old people's homes that offered private care in 1987. The directors of the old people's homes were asked to fill in a questionnaire. The response rate was 100%. The study showed that the dental care arrangements were inadequate: regular oral examinations and comprehensive dental treatment were infrequent. In 96% of the homes the need for treatment normally came to light only when the residents themselves complained about a dental problem. In 60% of the homes the residents had to pay the full cost of their dental treatment. These must be considered the two greatest weaknesses in the dental service for the elderly in the old people's homes studied. The ignorance among the directors of the importance of oral health was alarming: only one fifth considered dental care of the elderly more important than services such as hairdressing. It is obvious that uniform regulations are needed for the whole country concerning dental services for the elderly in institutions.     

Skin colour is associated with periodontal disease in Brazilian adults: a population-based oral health survey

AIM: To estimate the prevalence of periodontal disease in Brazilian adults and to test its association with skin colour after controlling for socio-demographic variables. METHODS: The periodontal status of 11,342 Brazilian adults was informed by a nationwide oral health survey. Socio-demographic variables included skin colour, gender, schooling, per capita income, age and geographical region. The association between periodontal disease and skin colour was tested by a logistic regression model, adjusting for covariates. Interactions between skin colour and socio-demographic variables were tested. RESULTS: The prevalence of periodontal diseases was 9.0% [95% confidence interval (CI) 7.6-10.3]. Lighter-skinned black people (pardos) and dark-skinned black people (pretos) presented higher levels of periodontal disease when compared with white people [odds ratio (OR)=1.5; 95% CI 1.2; 1.8; OR=1.6; 95% CI 1.2; 2.1, respectively] even after controlling for age, gender, schooling, per capita income and geographic region. No interactions were statistically significant. CONCLUSION: Skin colour was significantly associated with periodontal disease among Brazilian adults after adjustment for socio-economic and demographic covariates.     

National survey of oral health care in Finnish municipal old people''s homes

As oral health is especially important for physically, mentally and socially handicapped old people, the aim of this study was to investigate the dental services provided for people living in municipal old people's homes in Finland. The study involved all the 431 municipal old people's homes in Finland in 1989. The directors of the old people's homes were asked to fill in a questionnaire. The response rate was 99.5%. The study showed that the dental services provided for the elderly vary greatly in different old people's homes. As a whole, however, dental care arrangements are inadequate: oral examinations on admission are performed always in 11% and never in 47% of the old people's homes, and oral examinations for residents are carried out annually in 23% and never in 21%. In 56% of the homes the need for treatment comes to light only when the old people themselves complain about a dental problem. Comprehensive dental care is available in 16% of the homes. One notable feature is that, although all the homes are publicly owned, the system of charging for the dental care of the elderly varies considerably between different homes. Comparing the results of this study with those from earlier investigations shows that, although there has been some progress in dental service arrangements in the 1980s, the oral care provided for these old people is still far from satisfactory. It is obvious that the value of oral health as an important component of human well-being is not yet widely recognized. To rectify the situation uniform regulations governing dental services for the elderly in institutions are required for the whole of the country.     

A clinical survey of periodontal conditions in Greece

Abstract The present study used full-mouth clinical assessments of plaque, calculus, bleeding on probing, probing pocket depth and probing attachment level to evaluate the periodontal conditions in a rural (A) and an urban (B) sample of 25–64 year old Greek adults, comprising 190 and 373 subjects, respectively. 13% of the subjects in sample (A) and 8% in sample (B) were edentulous, while mean values of teeth present in the four age cohorts ranged between 19.8—12.6 and 23.3—18.3. respectively. A poor level of oral hygiene was recorded in both samples with high plaque, calculus and bleeding scores. Deep pocketing was more pronounced in the rural than in the urban sample: between 1.7 and 8.0% of all sites probed showed a PPD of ≥6 mm and between 20 and 51.2% of the subjects in each age cohort had at least one deep pocket. Corresponding figures for the urban sample was 0.6-4.7% and 15.1-49.2%. However, the prevalence of severe attachment loss was of comparable magnitude in both samples: between 2.8–25.7% of the sites in sample (A) and 2.8–20.6% in sample (B) displayed a PAL of ≥6 mm, while 32.5-72.1% and 31.8-73.8% of the subjects, respectively, had at least one severely affected site. It was further found that the distribution of advanced disease in the samples was skewed; 14.4% of the subjects in sample (A) and 9.5% in sample (B) accounted for 75%, of all deep pockets, while 21.8 and 19.4% of the subjects, respectively, accounted for 75% of all sites with PAL of ≥6 mm. Multiple regression revealed that male sex and high plaque and bleeding scores had a significant, positive influence to the amount of attachment loss on a subject level.     

A radiographic survey of periodontal conditions in Greece

Abstract The present study used radiographic assessments to evaluate the pattern of destructive periodontal disease in a rural and an urban sample of 25—64 year old Greek adults. The rural sample (A) comprised 190 subjects and the urban sample (B) 400 subjects. 13% of the subjects in sample A and 8% in sample B were edentulous. Full-mouth intraoral radiographs were obtained from the 503 dentate subjects and were examined with respect to (i) number and type of teeth present, and (ii) alveolar bone level (ABL), i.e., the distance between the cementoenamel junction and the alveolar bone crest at the approximal tooth surfaces. The results revealed that alveolar bone loss was ubiquitous in both samples. Pronounced bone loss, however, (i.e., a subject mean ABL of >6 mm) affected 18% (sample A) and 8% (sample B) of the individuals. Although an ABL of >6 mm was scored at 7.2 sites/subject in sample A and at 4.5 sites/subject in sample B, more than 10 such sites were found in 23% (A) and 11% (B) of the examined subjects. 25%) of the subjects in the rural sample (A) and 12% in the urban sample (B) accounted for 75% of the total number of tooth sites with pronounced bone loss. Multiple regression revealed that age and number of remaining teeth were the parameters most strongly correlated with the amount of bone loss on both the individual subject and the tooth site level. The present findings (i) demonstrated a high prevalence and severity of destructive periodontal disease in these 2 samples, and (ii) confirmed the skewed distribution of advanced disease in the population.     

Oral health care: more than caries and periodontal disease. A survey of epidemiological studies on oral disease

A review is presented of the epidemiology of the common oral diseases other than dental caries and periodontal disease. It appears that conditions, such as masticatory dysfunction, traumatic dental and maxillofacial injuries, impactions and oral mucosal disease each normally affect one-quarter to one-half of populations examined. To plan and achieve total oral health care, it is, therefore, necessary to take these conditions into account. As no study to date appears to have registered the total oral health care needs for a given population in either developing or industrialized countries it is suggested that such investigations should be undertaken now by WHO and/or FDI. Only when this total information is at hand can a rational oral health policy be developed.     

椅旁健康教育对慢性牙周炎患者维护期口腔卫生状况的影响

目的探讨椅旁健康教育对慢性牙周炎患者维护期口腔卫生状况的影响。方法 120例慢性牙周炎患者随机分为实验组和对照组,均给予洁治、龈下刮治和根面平整,实验组同时给予全面的口腔健康教育。于基线、基线后1、3、6个月检查Quigley-Hein菌斑指数。采用两组完全随机化设计资料均数的t检验分析所得数据。结果基线、基线后1个月时,两组间菌斑指数差异无统计学意义（t0=1.543,P0=0.1227;t1=1.925,P1=0.063）;基线后3、6个月时,实验组菌斑指数显著低于对照组（t3=19.153,P3=0.001;t6=25.265,P6=0.001）。结论实施全面的口腔健康教育可以显著改善牙周炎患者的口腔卫生状况。     

National health care and the public's oral health

This article presents an outline of a proposal for a national health program, together with a discussion of the necessity of inclusion of dentistry for optimum benefit to the public. A thorough restructuring of current principles of coverage, benefits, methods of payment, administration, and methods of protection of the public is proposed. Disease prevention and the role and responsibility of public health dentistry would be enhanced in such a scheme. Current total dental care expenditures should be sufficient to cover most of the costs. It is the author's belief that further tinkering with the existing health care system and the application of more bandaids can only exacerbate existing problems.     

Relationships between self-rated oral health,subjective symptoms,oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University

Background

Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults.

Methods

This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed.

Results

In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health.

Conclusion

Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students.

     

National oral health knowledge, attitudes and behaviour survey of Israeli 12-year-olds, 2002

OBJECTIVE: To gather epidemiological information on oral health knowledge, attitudes and behaviour of Israeli 12-year-olds. MATERIALS AND METHODS: A stratified, cluster, random and convenience sample of 12-year-old children was drawn. Stratification was by size of community, by administrative areas (regions) and by ethnicity (Jewish/other). The representative sample of 12-year-olds was asked to self-complete the questionnaire of ICS II, which was translated into Hebrew. The questions gather information regarding knowledge, attitude and dental health behaviour. RESULTS: 1294 children completed the questionnaire, of which 84% reported brushing their teeth once or more per day. Girls brushed 1.68 times more frequently than boys. Of the children, 64% had visited a dentist in the last year. The vast majority of the children (90%) expressed satisfaction with their last visit. CONCLUSIONS: Oral health habits of 12-year-old Israeli children are comparable to those of other countries. The dental health education in Israel should focus health messages to different schoolchildren according to the differences found in this survey.     

Epidemiologic oral health survey of Argentine children

Abstract An epidemiologic oral health survey of 2279 children aged 7–8 and 12–13 was carried out in eight different regions of Argentina using methods and criteria recommended by the WHO. The children examined lived in rural or urban areas and were of Caucasian or Amerindian extraction. Periodontal status showed that 75% of this population had soft deposits, while calculus and gingivitis increased with age. Calculus: 0.4 at 7 yr to 16.1 at 13: gingivitis: 2.7% at 7 yr to 27.2% at 13. At age 8, the mean number of DMF per child was 3.9. The percentage of caries-free children with permanent dentition dropped from 60% at age 7 to 32% at age 13. In Amerindian children, all these parameters were higher. Both the mean DMF and DMF per child were substantially lower in natural fluoride areas than in non-fluoride areas. Data from this first nationwide epidemiologic study in this country provide baseline data for further investigations. According to the data obtained in this study, Argentine regions may be classified as high, medium or low risk areas, although a lack of adequate dental care was found in all regions. With these risk priorities as a guideline, we propose an initial strategy consisting of a carefully planned and selective program of primary dental health care.     

Changes in periodontal conditions of children and adolescents from Araraquara, Brazil: 1995-1998

The aim of this study was to compare the periodontal conditions in 7-15-year-olds from Araraquara, SP, Brazil in 1998 with data from 1995. A systematic random sample was drawn from the population of children and adolescents enrolled in all public schools in 1998. The survey was conducted by trained examiners using the CPITN and WHO diagnostic criteria. Results showed an increase in the percentage of students of all ages with healthy periodontal conditions (from 14% in 1995 to 33% in 1998; p < 0.01). An increase in the mean number of healthy sextants (from 3.2 to 4.4; p < 0.0001), a decrease in the mean number of bleeding sextants (from 2.5 to 1.2; p < 0.0001) and no difference in the mean number of sextants with calculus were also observed. At the age of 15, 54% of the students had 5-6 healthy sextants in 1998 compared to 19% in 1995 (p < 0.01). Despite the improvement observed in the periodontal conditions, efforts must be increased in order to achieve the WHO goal for the year 2010 of no more than one sextant affected by bleeding or calculus at the age of 15.     

Endodontic treatment outcome: survey of oral health care professionals

This study assessed the opinion of oral health care professionals regarding the predictability of initial endodontic treatment, expected long-term outcome and the importance of placing a coronal coverage after completion of treatment. An eight-item questionnaire was distributed among oral health care professionals. There were 49% of participants who responded that the expected retention rate of teeth 5 to 10 yr after endodontic treatment was more than 90%, whereas 44% responded that such retention rate was between 70 to 80%. The majority of the participants also responded that the need for additional treatment, such as retreatment, apical surgery or extraction, was expected to occur within the first 3 yr after endodontic treatment if initial treatment has failed. About 87% of participants responded that placing coronal coverage after completion of endodontic treatment in premolars and molars was very important for long-term tooth retention and 92% responded that overall, endodontic treatment was a predictable procedure with long-term tooth retention rate. Statistically significant associations were found between years of experience and expected rate of retention for both the total group of respondents (p < 0.001) and for general practitioners when examined separately (p < 0.002). Statistically significant associations were only found for general practitioners between years of experience and their responses regarding the need for additional treatment (p < 0.05) and overall predictability of endodontic treatment (p < 0.02). A trend was found between the professionals' years of experience and their opinion regarding the importance of coronal coverage. Of the group who had more than 20 yr of experience, about 87% considered coronal coverage to be very important for long-term tooth retention. In conclusion, it appears that most clinicians participating in this study consider endodontic therapy to be a predictable procedure with long-term tooth retention rate. Their opinions also reflect the variations that currently exist in the literature regarding the reported outcome of endodontic treatment.