Dental fear and adult oral health in Australia

Abstract– Objective: This study aimed to investigate the association between dental fear and both dental caries and periodontal indicators. Methods: A three‐stage stratified clustered sample of the Australian adult population completed a computer‐assisted telephone interview followed by a clinical examination. Oral health measures were the DMFT index and its components, periodontitis and gingivitis. A total of 5364 adults aged 18–91 years were dentally examined. Results: Higher dental fear was significantly associated with more decayed teeth (DT), missing teeth (MT) and DMFT. There was an inverted ‘U’ association between dental fear and the number of filled teeth (FT). Periodontitis and gingivitis were not associated with dental fear. The association between dental fear and DMFT was significant for adults aged 18–29 and 30–44 years, but not in older ages. Dental fear was significantly associated with more DT, MT, and DMFT but with fewer FT after controlling for age, sex, income, employment status, tertiary education, dental insurance status and oral hygiene. Conclusion: This study helps reconcile some of the conflicting results of previous studies and establishes that dental fear is associated with more decayed and missing teeth but fewer FT. That people with higher dental fear have significantly more caries experience underlines the importance of identifying and then reducing dental fear as important steps in improving adult oral health.     

Ranking countries by dental status using the DMFT and FS-T indices

AIM: To test the hypothesis that the DMFT index does not adequately reflect the dental status as well as the FS-T index by comparing the country rankings of the DMFT and the FS-T indices in 18 and 35-44 year-olds in a range of countries. The FS-T is the number of filled or sound teeth and is a measure of functional status. METHOD: The DMFT data from WHO for 18-year-olds and 35-44-year-olds was used and FS-T index values were estimated for the 18-year-olds for 12 countries and for 35-44 age groups for 30 countries. RESULTS: The ranking by DMFT index scores was lower for developed countries than for developing countries. Despite the relatively high DMFT index in developed countries, their FS-T index was higher and therefore the developed countries ranked higher by FS-T compared to their ranking by DMFT. CONCLUSIONS: These findings suggest that it may be more useful to use the FS-T index with the DMFT index in studies comparing dental status between countries.     

Comparison between the DMF indices and two alternative composite indicators of dental health

The DMFT and DMFS indices employed in the majority of oral epidemiological studies have several limitations. In response to this problem, Sheiham et al. (Community Dent Health 1987;4:407–14) proposed two alternative dental health indicators: the number of functioning teeth (hereafter referred to as FS-T) and tissue health (T-Health). Using data from an epidemiological study on the dental health status of adults aged 35–44 from Quebec ( N =2110), this article compares the alternative indices with the conventional DMFT and DMFS indices. By comparing Pearsons correlation coefcient for the four indices in this study with the number of decayed, missing andlled surfaces, it is noted that the FS-T index bears the strongest correlation to the three variables. It is also the only index whose correlation coefcient is greater than 0.3 for each of the three DMFS components. A risk group was created for each index, composed of the 18% of people demonstrating the poorest index. The risk groups's FS-T index results in an average of 4.3 decayed surfaces (compared with 2.6 for the DMFT), 92.7 missing surfaces (74.4 for the DMFT) and 9.0 filled surfaces (compared with 26.9 for the DMFT). Using linear regression analysis with each index as a dependent variable, and peoples socio-demographic characteristics, regular use of dental services and perception of dental health as independent variables, it appears that the percentage of the explained variance (R²) is 21.2% for the FS-T index, 13.8% for the T-Health index, 12.3% for the DMFS index and only 7.6% for the DMFT index.     

Dental status and treatment needs among institutionalized mentally subnormal persons in Norway

ABSTRACT Dental status and treatment needs were studied in a random sample comprising 353 mentally subnormal persons. The sample was drawn to represent institutionalized mentally subnormal persons in Norway aged 5–45. The overall dental health was poor, primarily due to inadequate and fragmentary treatment facilities. Whereas the dental condition of children below 15 years of age was acceptable, as measured by the DMFT index, tooth loss increased rapidly with advancing age. Nearly every second dentulous person needed some conservation, and every tenth needed extraction of one or more teeth. One-third of the patients needed treatment requiring general anesthesia. It was concluded that a new system for the investigation of treatment requirements should be developed. This system must be based on diagnostic and social criteria, and should serve as a guideline for the planning and delivery of dental services to the various subgroups of mentally subnormal persons.     

Epidemiology of dental caries among adolescents in Tamil Nadu,India

Objective: Economic and dietary changes in the Indian state of Tamil Nadu have led to compromised oral health status of the adolescent population. Adequate epidemiological data are not available to address the prevention or treatment needs in this region of India. The aim of this study was to measure the prevalence and severity of dental caries among adolescents of Tamil Nadu, a southern state of India. Methods: The study sample included 974 adolescent school students (12–15 years of age) from both rural and urban areas of Tamil Nadu, India. The decayed, missing and filled teeth (DMFT) index of these students was measured using the World Health Organization oral health survey method, in a quantitative cross-sectional study. Results: The oral health survey indicated that the prevalence of dental caries among adolescents in rural and urban areas of Tamil Nadu was 61.4%, with an average DMFT score of 2.03. Multiple regression analyses indicated factors such as gender, mother’s education, type of school and caste as significant predictors of dental caries. Conclusion: Female gender, Scheduled Caste and Tribes attending public schools in rural areas were identified as the more vulnerable populations to be affected by dental caries. Oral health policies should be targeted to these adolescent populations in the Tamil Nadu region.Key words: Prevalence of dental caries, severity of dental caries, Thanjavur, Chennai, oral health survey     

The dental health of 12-year-old children in Dominica: a report of a survey using WHO methods

As part of the process of assisting in the planning of a primary dental health care system in the Commonwealth of Dominica, we conducted a survey of mostly 12-year-old children. The purpose of the survey was to assess the oral health status and identify the needs for treatment and prevention. Secondary purposes included training Dominican dental auxiliaries and assistants to collect epidemiologic data and to use the findings to compare oral health status by region and previous coverage by the auxiliaries. The sample was obtained from schools throughout the country. Examinations were conducted according to standard WHO methods, using mirrors and explorers. The findings were recorded on prepared forms and the data were processed in Toronto using microcomputers. We found 31% of children to be caries-free and the mean DMFT score to be 2.5 (95% CI 2.2-2.7). Only 8% of lesions had been treated. No differences were observed by region but in areas covered by dental auxiliaries, children had fewer decayed teeth, fewer DMFT and higher F/DMFT ratios. Only 17% scored 0 on the CPITN index and 63% scored 2, meaning they had calculus. Debris was 3.6 times more likely to be found among those with gingival bleeding or calculus compared to those with periodontal health. Single surface restorations made up 82% of the estimated 2.0 caries treatment services required. The survey findings will allow planners to design specific preventive and treatment programs to meet Dominica's needs.     

广东省先天性心脏病儿童口腔健康状况及就医行为初步调查

目的：了解广东省先天性心脏病儿童的口腔卫生现状,为先心病儿童的口腔卫生保健1作提供客观依据。方法：参照第二次全国口腔健康流行病学调查的相关内容及检查标准,选取广东省119名2～16岁先心病儿童调查其龋病、叮视菌斑指数及相关口腔就诊信息。结果：先心病儿童患龋率为72.3％,龋均、龋面均分别为（4．9±5．2）、（10.3±14．8）,可视菌斑指数为（48．1％±26．7％）。5-6岁年龄组龋均高于2。4岁组（P=0．002）。检出588颗龋齿,8颗已行充填治疗,龋齿充填率仅1．4％。14名儿童曾就诊牙医,因口腔问题就诊者占78．6％。结论：广东省先心病儿童口腔卫生状况差,患龋率高,龋患情况严重,但牙科治疗率低,与其父母缺乏口腔预防保健意识有关,提示加强和重视先心病儿童口腔卫生教育的必要性。     

Oral health status of adults from a California regional center for developmental disabilities

The oral health status and treatment needs of developmentally disabled adults (18 years and older) from a Los Angeles Regional Center who live in a variety of settings were measured as part of a comprehensive study to determine their overall health status. A dental assessment was performed on a sample of 325 persons which was similar in demographic composition to the entire population at the center. Approximately 80% of clients reported a personal dentist of record, and 73% brushed their own teeth. Edentulism was 9%. The mean number of retained teeth per person was 22. Subjectively, 15.7% of the sample was rated as having "good" overall dental health, 77.7%"fair," and 6.6%"poor." The major reasons rendering fair or poor assessments were oral hygiene, clinical periodontal disease, and dental caries. More females than males were assessed as having "good" overall dental health. The overall appearance of the teeth for a majority of the sample (76.5%) was rated as "same as most." Persons who brushed their own teeth had fewer missing teeth than those who did not. Persons with a dentist of record had fewer decayed and more filled teeth. Persons living at home with family or friends had a significantly lower DMFT index than those living independently or in facilities. In general, these findings are encouraging; however, caution must be exercised, since efforts to improve the oral health status of this population require continued attention.     

DMFT, dmft and treatment requirements of schoolchildren in Asturias, Spain

An epidemiological survey was carried out in 1992 to study the dental health status of schoolchildren aged 6, 9 and 12 in Asturias, Spain. It focused on the caries prevalence, dmtf, DMFT, restoration indices and dental treatment needs of this population. A representative sample of 1839 subjects, randomly selected and proportionally assigned by age group (6, 9 and 12) with the classroom as the sample unit, was examined. Analysis of the data showed that in 6-year-old children the caries prevalence in primary teeth was 45.8%. The mean caries in-dices were 2.10 dmft and 0.25 DMFT. At 9 years old the prevalence of caries in primary teeth was 62.8% and in the permanent teeth 49.1%. The mean level of caries was 2.38 dmft and 1.50 DMFT. At 12 years old the caries prevalence in permanent teeth was 71% and in first molars 64.2%. The mean caries experienced was 3.30 DMFT. In all groups the D-component constituted the major part of the caries index. The results for girls were higher than for boys in almost all age groups. Surface fillings were the treatment most required in all age groups.     

Oral health status of 1500 university students in Toulouse France.

BACKGROUND: The purpose of this study was to assess the oral health status among a population of students enrolled in the first year at the Paul Sabatier University in Toulouse (France), and to compare the results with those of similar investigations. METHODS: An epidemiologic survey of 1,500 students at the Centre for Preventive Medicine at Paul Sabatier University (UPS) will enable us to obtain the prevalence of certain variables such as DMFT, sugar consumption, tooth-brushing frequency, and mouthwash use, through a structured questionnaire and a standardised oral health examination. RESULTS: The Decayed, Missing and Filled Teeth (DMFT) index of these students was 4.4 (Standard Deviation = 3.72) (D = 1, M = 0.042 F = 3,454). Of the 1500 subjects, 27.6% smoke, while 43% eat sweets on a regular basis. The female students are more careful with their dental health (tooth-brushing frequency and mouthwash use are statistically significant (p < 0.001). CONCLUSION: Although the result of the DMFT index is lower in comparison to similar previous studies, a decrease in dental caries seems certain. The multifactorial knowledge of the caries aetiology motivates us to search for new, more sensitive indexes.     

Dental caries in postwar Bosnia and Herzegovina

OBJECTIVES: To present the prevalence of dental caries in postwar Bosnia and Herzegovina (BH). METHODS: A survey focused on dmft and DMFT indices was carried out in four cantons of the Federation of BH in 1997. The dental health of 6- and 12-year-olds was assessed in random samples (n = 238 and 318, respectively). DMFT index in adult population was assessed in clients coming to dental offices in the same area (35-44-year-olds; n = 401). All the subjects were clinically investigated. RESULTS: During the 1991-95 war, all four cantons were affected by the migration of population. The population per dentist ratio considerably increased in three cantons. In 6-year-olds, the average dmft (+/-SD) was 4.9 +/- 4.0, and 86% of the children were affected with dental caries. The average DMFT of 12-year-olds was 6.2 +/- 3.9. On the average, 94% of the 12-year-olds were affected with dental caries. Mean DMFT of adult clients was 15.1 +/- 7.0. Almost every adult (98%) was affected with dental caries. CONCLUSIONS: The dental status in postwar BH is rather poor and the mean DMFT in all investigated age groups may be considered high. The detrimental effect of 1991-95 war on social conditions and the health care system should be considered in explaining such poor dental health. Despite the limitations, the presented data may be used to assess the treatment needs, assure the visibility for dental issues in BH, and help the west European countries to plan dental services for refugees from BH.     

Caries prevalence, oral health behavior, and attitudes in children residing in radiation-contaminated and -noncontaminated towns in Ukraine

INTRODUCTION: Several studies investigating the oral health status of children living in Ukraine after the Chernobyl catastrophe revealed an increase of caries in children residing in radionucleotide-contaminated areas. PURPOSE: (1) To compare prevalence of dental caries in contaminated and noncontaminated towns; and (2) to determine if there is a difference between dental behaviors and attitudes of children residing in contaminated and noncontaminated areas that may have contributed to differences in caries prevalence. METHODS: Children aged 13-14 were randomly selected in two towns of approximately the same population size (33 000): Ovruch (n = 119) from a contaminated area and Mirgorod (n = 100) from a noncontaminated area. Data on behaviors and attitudes were collected via a self-administered questionnaire having six domains: (i) family background; (ii) dental anxiety; (iii) dental utilization; (iv) oral hygiene; (v) use of fluoride toothpaste; and (vi) sugar consumption. Oral examinations included information on carious lesions, restorations, missing teeth, and soft tissue abnormalities. Caries prevalence was compared using a t-test. Regression analysis was conducted to determine the independent contribution of oral hygiene behaviors and dental utilization. RESULTS: There was a significant difference in caries prevalence in the contaminated town (mean DMFT = 9.1 +/- 3.5) versus the noncontaminated town (mean DMFT = 5.7 +/- 1.4; P < 0.000). Oral hygiene practices, age, and utilization of dental services were not found to be associated with differences in DMFT score between the two communities. CONCLUSION: There was a significantly higher caries prevalence in a radiation-contaminated town compared to a noncontaminated town of Ukraine. The difference was not explained by differences in oral health knowledge, attitudes or behaviors.     

Oral health of South African Black (Xhosa) mine recruits

The oral health of 100 rural Black Xhosa men commencing employment on the gold mines was examined. Dental caries were present in 68%, the mean DMFT per mouth was 2.5 (s.d. 2.8) while the mean DMFT per carious mouth was 3.7 (s.d. 2.7). Oral hygiene was good and periodontal disease uncommon. Although the frequency of individuals with dental caries has increased since studies on similar groups were made 40 years ago, the severity of the disease in affected individuals has remained static.     

Sickle cell disease does not predispose to caries or periodontal disease

This study investigated the prevalence of dental caries and periodontal condition in a population with sickle cell disease (SCD), analyzing some associations with disease severity. The Decayed, Missing and Filled Teeth index (DMFT) and Community Periodontal Index (CPI) were recorded for 99 individuals with SCD and 91 matched controls. Socio-demographic status, oral health behaviors, and history of clinical severity of SCD were assessed. Statistical comparisons were performed between the group with SCD and the control group, as well as multivariate logistic regression analyses with DMFT index and CPI as the dependent variables. The mean number of decayed teeth was significantly higher in individuals with HbSS. Older age, female gender, and daily smoking were identified as risk factors for higher DMFT, while older age and absence of daily use of dental floss were risk factors for the development of periodontal disease. In conclusion, risk factors known to cause caries and periodontal disease had more influence on oral health than the direct impact of SCD.     

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目的    了解大连市开发区15岁学生人群恒牙龋病和牙周病患病状况及分布, 为口腔疾病防治策略提供依据。方法    于2009年10—11月,采用多阶段、等容量、随机抽样方法, 抽取大连市经济开发区 15岁学生480名, 男女各半。按照《第三次全国口腔健康流行病学调查方案》中的龋病、牙周病调查标准进行检查。以龋均、患龋率、龋齿充填率和牙石、牙龈出血、牙周袋检出率作为统计指标, 采用SPSS12.0软件包对数据的进行统计分析。 结果    大连市经济开发区15岁学生的恒牙患龋率为55.42% , 龋均为1.49, 龋齿充填率为26.19%, 龋均和患龋率男女之间差异均有统计学意义 （均 P < 0.05） ; 牙龈出血检出率和平均检出区段数分别为31.88%和0.49个 , 牙结石检出率和平均检出区段数分别为74.58%和1.57个, 牙周袋的检出率为2.50%, 牙结石检出率和平均检出区段数男女之间差异有统计学意义 （ P < 0.05）。结论    大连市开发区 15岁年龄组学生患龋较高, 龋齿充填率低, 牙周健康状况不良, 应加强口腔卫生服务, 以促进该人群口腔健康水平。     

上海市12岁儿童患龋状况调查分析

目的 了解上海市12岁儿童恒牙患龋状况,为龋病预防提供科学依据。方法 采取随机抽样方法 按照WHO口腔调查基本方法 中的龋病诊断标准对全市19个区县2 519名12岁学生进行口腔检查。结果 2 519名12岁儿童的患龋率和龋均分别为36.64%和0.61。其中97.14%的龋齿发生于窝沟。男女患龋率之间有显著性差异。显著性龋均指数为1.77,龋齿充填率为24.58%,窝沟封闭率为0.52。结论 上海12岁儿童龋患呈两极化分布,龋齿主要发生于第一恒磨牙的牙合面窝沟。     

Dental caries status and need for dental treatment of Pennsylvania public school children in grades 1, 3, 9, and 11

OBJECTIVES: This cross-sectional study was designed to determine the caries status and provide a general evaluation of the level of dental treatment need of Pennsylvania public school children in grades 1, 3, 9, and 11 on a statewide and regional basis. METHODS: Between September 1998 and May 2000, caries status and treatment need were assessed using a school-based dental examination, performed on a representative sample (n=6,040) of public school children in grades 1, 3, 9, and 11 (age range=6 to 21 years). Children's caries status in the primary and permanent dentition was assessed. Need for treatment was scored on a three-level categorical scale--no treatment need identified, routine treatment need, and urgent treatment need--and was based on the presence and severity of caries and other oral conditions. Population estimates of the prevalence of untreated dental caries, DMFT and dft scores, and treatment need were calculated by grade and geographically, using the six Pennsylvania health districts and the cities of Pittsburgh and Philadelphia. The inequality of caries distribution in the population was assessed for both permanent and primary caries using Lorenz curves and Gini coefficients. RESULTS: Dental caries has remained highly prevalent among Pennsylvania's public school children. Caries levels varied considerably by health districts and city. Urgent treatment needs were significant and also varied by health district and city. CONCLUSIONS: Dental caries remains the most prevalent disease affecting Pennsylvania's schoolchildren. Caries status varies significantly by region of the state, suggesting that environmental, social, and demographic contextual factors may be important determinants of disease prevalence.     

Dental Caries in Homeless Adults in Boston

Objectives : Information about the oral health status of the homeless is limited. The purpose of this study is to characterize the dental caries status among users of a dental treatment and referral program at homeless shelters in Boston, MA. Methods : Persons attending the program during a one-year period were assessed for evidence of dental caries experience by a single examiner. DMFT counts were abstracted from patient records. Results : The population examined (n=73) was 66 percent male with a mean age of 36 years. The racial composition was 51 percent African-American, 34 percent Caucasian, and 14 percent Hispanic. The 70 dentate people examined had a mean DFT of 11.1 (SD=6.1). The mean percent of DFT that was DT per person was 55.7 percent. Untreated caries was detected in 91.4 percent of those examined. Conclusions : These findings show evidence of previous dental services utilization by these homeless individuals, but demonstrate a high need for preventive and restorative dental therapy.     

Is there a gradient by job classification in dental status in Japanese men?

The objective of this study was to assess whether there is a gradient in dental health status by job classification in male Japanese workers. The study subjects were 16,261 male Japanese workers aged 20-69 yr. Jobs were classified into seven job groups. Oral examination was conducted using World Health Organization criteria for decayed, missing or filled teeth (DMFT). Professionals, managers, and office workers had a better oral status than those in service occupations and drivers. Professionals had significantly more natural and sound teeth than those in other job classes. The DMFT of professionals was significantly lower than in workers of other job classes. Professionals had a significantly higher restorative index than did workers of other job classes. The restorative index of office workers was significantly higher than that in managers, skilled workers, salespersons, those in service occupations, and drivers. Drivers were 1.8 times, and those in service occupations 1.3 times, more likely to have one or more carious teeth compared with professionals. Skilled workers, salespersons, those in service occupations, and drivers were 1.3, 1.3, 1.4, and 2.1 times, respectively, more likely to have a missing tooth compared with professionals. Skilled workers, those in service occupations, and drivers were 1.7, 1.9, and 3.1 times, respectively, more likely not to have 20 or more teeth compared with professionals aged 50-69 yr.     

Measuring inequalities in the distribution of dental caries

Abstract – Objectives: To evaluate different measurements of prevalence and inequality in the distribution of dental caries as to their partial collinearity, and ability in expressing associations with the supply of fluoridated tap water, indices of socioeconomic status and provision of dental services. Methods: The DMFT, the Significant Caries (SiC) Index, the proportions of children with high- (DMFT ≥ 4) and rampant- (DMFT ≥ 7) caries experience, caries-free children (DMFT = 0), the Gini coefficient and the Dental Health Inequality Index (DHII) were the dental outcomes appraised in a sample comprising 18 718 oral examination records for 11- and 12-year-old schoolchildren in 131 towns of the state of São Paulo, Brazil. Spatial data analysis assessed the association between aggregate figures of dental indices and several covariates. Results: The DMFT, the SiC Index and the proportions of children with high- and rampant-caries experience presented strong linear associations (Pearson r near or higher than 0.95), and an analogous profile of correlation with indicators of socioeconomic status, dental services and access to fluoride tap water. The same was observed for the DHII, the Gini coefficient and the proportion of caries-free children. These observations involve the perception of variables in each set as interchangeable tools for ecological studies assessing factors influencing, respectively, prevalence levels and inequality in the distribution of dental disease. Conclusion: An improved characterization of the skewed distribution of caries experience demands the concurrent estimation of figures of prevalence and inequality in dental outcomes. This strategy may contribute to the design of socially appropriate programmes of oral health promotion.