Oral health status of homeless people in Hong Kong

The authors report on an oral health survey among Hong Kong Chinese homeless people. A total of 140 homeless men underwent clinical examination and were interviewed with a structured questionnaire. More than 90% had evidence of caries experience; most (75%) were related to untreated caries. The mean DMFT score was 9.0 (DT=3.2, MT=5.2. FT=0.6). Periodontal disease was highly prevalent, with 96% having periodontal pockets. The dental problems most frequently reported by the homeless were: bleeding gums or drifting teeth (62%), dental pain (52%) and tooth trauma (38%). More than 70% of the study's participants perceived a need for dental care. The population surveyed had poorer oral health compared to the general population. High levels of dental needs, both normative and perceived, were found. There is a need to provide more accessible and affordable oral health services to this group of people.     

Periodontal status and total tooth extraction in a medium-sized city in the Netherlands

A combined sociodental research project was started in the city of Groningen in 1982 aimed at gaining insight into the reasons for total tooth extraction. Patients showing up for total tooth extraction during 1982 participated in this study by filling out a questionnaire concerning the underlying reasons for their decision to have all their teeth extracted. The dentists in this city were asked to collect all the extracted teeth and to fill out a short questionnaire for each patient about the reason (diagnosis) for the total tooth extraction. The periodontal status of the extracted teeth was established afterwards by measuring the percentage of the loss of attachment (L.A.). It appeared that most surfaces in the molar region and the front teeth in the mandible were affected by periodontal disease. Advanced generalized periodontal disease was established in 17% of the patients, accounting for 64% of all teeth with an L.A. measurement of greater than 50%. Periodontal disease could not be identified as the main clinical condition requiring tooth extraction: even in the group of 55 yr of age and older advanced periodontal disease was found in only one third of the extracted teeth. Finally, the contribution of regular dental attendance to periodontal health is discussed.     

Dental caries in a group of 20-year-olds after previous participation in public child dental health services in Copenhagen, Denmark

The present study was undertaken to investigate the prevalence of dental caries in a group of 20-year-olds who had previously participated in Public Child Dental Health Services. Dental caries was related to social status and preventive vists to the private dentist after termination of school. The study population comprised 389 persons aged 20, out of which 313 (80.5%) were examined clinically and radiographically by one dentist according to standardized criteria. Mean DMFT was 10.4 and mean DMFS 16.7. Differences in relation to sex were not significant. The distribution of subjects according to DMFS was uneven. The 20% with the highest DMFS accounted for about 45% of the total amounts of DS. A consistent pattern with higher mean DMFS in the low social groups was found. Attendance to Regular Youth Dental Service was higher the longer the subjects had been students and higher mean DMFS was found in nonregular attenders. The presence of a high caries risk group is discussed in relation to the dental care system received by the study population.     

Survey of reasons for extraction of permanent teeth in Italy

Abstract The purpose of the study is to collect information on the reasons given by dentists, randomly selected from the Italian Dental and Maxillo-Facial Association's, for extracting permanent teeth in Italy. From the 164 dentists responding, 1056 teeth in 839 patients were extracted during two weeks of working activity. More than two-thirds of the teeth were extracted for dental caries (34.4%) and periodontal disease (33.1%). The mean number of teeth extracted per patient showed a significant increasing trend with increasing age, being 1.09 in those from 16 to 39 yr, 1.25 in the 40–59-yr-old group, to 1.54 in those over 59 yr of age (F = 21.44; P<0.0001). The third molar was the most frequently extracted tooth and 41.3% were removed due to impaction reasons, in particular from the mandible. The first and second molars and the premolars were extracted most often because of caries; more than half of the incisors and the canines were extracted for periodontal reasons; the majority of the teeth removed for prosthetic reasons, 57.1%, were incisors and canines, especially in the mandible; of the teeth extracted for orthodontic reasons, 47.4% were first and second premolars. The prevalence of subjects with at least one tooth extracted for dental caries and for orthodontic reasons were respectively significantly higher in the irregular than the regular attenders (chi-square=46.55; P<0.0001), and in the regular than the irregular dental attenders (chi-square=63.12; P<0.0001). Dental practitioners should promote targeted initiatives for prevention and treatment of diseases in order to reduce in particular the incidence of tooth extraction because of caries and periodontal disease.     

The Oral Health Status, Treatment Needs, and Dental Utilization Patterns of Native American Elders

The purpose of this study was to evaluate the oral health status, treatment needs, and dental care utilization patterns of a Native American population aged 65-74 years. A random sample of 688 individuals was chosen and approached regarding participation in the study. Data were gathered through an interviewer-administered questionnaire and an oral examination. A total of 204 individuals completed all aspects of the study. Only one participant had all 28 natural teeth, while 58.3 percent were totally endentulous. Of the 85 dentate participants, almost 53 percent required at least one extraction. The average number of required extractions in the dentate subjects was three. Although 94 percent of the sample stated they had a usual source of dental care, 40.7 percent had not visited a dentist within the last five years. Multiple regression analyses were used to determine the factors associated with total number of teeth present among the dentate participants. Years of education and time since last dental visit were the two significant predictors (P less than .05) of number of teeth present. The higher the level of education, the greater the number of teeth in later life. The number of teeth present was inversely related to years since dental treatment. Compared to the results of the National Survey of Oral Health in US Employed Adults and Seniors, this Native American sample had a higher prevalence of endentulism and utilized dental services less often than a comparable age group in the US population as a whole.     

Dental health services research in Scotland: a review of some 5-year results

A longitudinal study of dental treatment carried out by the Dental Health Services Research Unit in Dundee has provided a unique opportunity to investigate a variety of aspects of dental care received by a sample of dentate individuals over 5 yr. The distribution of treatment indicated that frequent attenders, especially those who changed dentist, were particularly prone to having teeth filled and that two-thirds of the restorative cost was spent on restoring tooth surfaces that had previously been filled. A quarter of the sample had severe periodontal disease and they tended to visit a dentist less frequently than those with mild periodontal disease. They were also more likely to have teeth extracted but less likely to have a scaling or other periodontal treatment than the moderately diseased. The findings suggest that there is considerable scope for a less treatment-orientated approach to the management of dental caries for those who currently receive most of the restorative treatment. The majority of the population who receive little dental care, especially those with severe periodontal disease, would probably gain by visiting a dentist more frequently. Dentists need to acquire a more positive attitude towards prevention and an increased ability to make intellectually based decisions not to treat.     

Dental health of Chatham Islanders: an investigation of the oral health of Chatham Islands residents

OBJECTIVES: To examine the self-reported and clinical oral health of Chatham Islanders. DESIGN: A cross-sectional oral health survey. SETTING: The Chatham Islands community. PARTICIPANTS AND METHODS: The investigation involved completion of dental self-report questionnaires by children who attended Chatham Islands schools, and adults who responded to a dental flyer. RESULTS: Eighty-seven children and 189 adults took part, all of whom had oral health examinations. Among the children, the prevalence of dental caries in the deciduous dentition was 67.8 percent, and the mean dfs, mean DFS and mean number of missing deciduous teeth due to caries were 5.9 (sd, 6.2), 0.5 (sd, 1.1) and 0.3 (sd, 0.8) respectively. Caries severity was higher in children who were episodic dental attenders, who had irregular brushing habits or whose dental experiences had had a negative impact on their lives. In adults, the prevalence of caries was 81.5 percent. The mean DFS and mean number of missing permanent teeth due to caries were 37.9 (sd, 13.1) and 4.7 (sd, 3.8) respectively. On average, caries severity was higher among infrequent and episodic dental attenders, irregular brushers and those for whom dental problems had had a negative life impact. CONCLUSIONS: While the oral health of Chatham Islands children is comparable with that of children in New Zealand, Chatham Islands adults may be dentally disadvantaged due to limited access to dental resources. The findings have important implications for the planning of dental health services for this remote area, and may provide a useful framework from which further investigations of remote community-dwellers' oral health may be developed.     

Long‐term patterns of dental attendance and caries experience among British adults: a retrospective analysis

There is inconclusive evidence on the value of regular dental attendance. This study explored the relationship between long‐term patterns of dental attendance and caries experience. We used retrospective data from 3,235 adults, ≥16 yrs of age, who participated in the Adult Dental Health Survey in the UK. Participants were classified into four groups (always, current, former, and never regular‐attenders) based on their responses to three questions on lifetime dental‐attendance patterns. The association between dental‐attendance patterns and caries experience, as measured using the decayed, missing, or filled teeth (DMFT) index, was tested in negative binomial regression models, adjusting for demographic (sex, age, and country of residence) and socio‐economic (educational attainment, household income, and social class) factors. A consistent pattern of association between long‐term dental attendance and caries experience was found in adjusted models. Former and never regular‐attenders had a significantly higher DMFT score and numbers of decayed and missing teeth, but fewer filled teeth, than always regular‐attenders. No differences in DMFT or its components were found between current and always regular‐attenders. The findings of this study show that adults with different lifetime trajectories of dental attendance had different dental statuses.     

Factors influencing the local planning of dental services

Findings from a survey of 796 high school children in four districts constituting a health administrative area were examined to ascertain the factors influencing their dental disease experience, treatment received and attendance pattern. In three of the four districts, over 60% of the children were regular attenders, enjoying the benefit of less active caries than irregular attenders. However, in the remaining district, much of which consisted of depressed, inner city areas undergoing re-development, only one third were regular attenders. Several local factors, such as availability and accessibility of services, probably influenced the numbers seeking regular care, but one of the most important appeared to be the level of provision in the salaried Community Dental Service. The implications of the findings for planning improvements in local services are discussed.     

The occurrence of dental pain and extractions over a 3-year period in a cohort of children aged 3-6 years

OBJECTIVES: To describe the occurrence of dental pain and extractions in young children in relation to the caries and restoration history of their primary molar teeth. METHODS: A prospective cohort study of 739 children aged 2.8 to 6.2 years attending 50 dental practices in the North West of England followed for 3 years. Incidence rates for pain and extraction in primary molar teeth were calculated for children with and without dental caries. Tooth years at risk of extraction or pain were calculated for each primary molar according to whether they were caries-free, carious and unrestored, or restored. RESULTS: A total of 119 (16.1 percent) children had caries at recruitment and 157 developed caries during follow-up. Each year approximately one in five children with caries, but only one in 100, who was caries-free, presented with dental pain. In the whole population, each year, approximately one in 40 children had a primary molar tooth extracted but in children with caries it was one in 10. In the total cohort, incidence.of pain was higher in unrestored carious teeth than restored, but incidence of extraction was higher in restored than in unrestored teeth. CONCLUSION: The majority of children attending general dental practice remained caries-free and did not experience pain or extraction over 3 years. Children with caries had a substantial risk of developing pain or having an extraction. The study was unable to demonstrate that restoring carious primary molar teeth prevents pain and extraction.     

1 080名15岁青少年患龋情况及社会-行为危险因素的影响

目的了解湖北省15岁青少年患龋情况和口腔健康行为,评价社会-行为危险因素对青少年患龋情况的影响。方法按照多阶段、分层、等容量、不等比、随机抽样的原则,对湖北省15岁青少年进行调查,临床检查评价青少年患龋的情况,采用问卷调查表收集人群的口腔健康知识、态度和行为。结果湖北省1 080名15岁青少年的龋均和患龋率分别为0.45和24.4％。每天刷牙至少2次和拜访牙医的青少年比例分别是11.4%和33.1%。Logistic回归分析显示,女生患龋的概率是男生的1.70倍;与从未拜访牙医、消耗含糖饮料频率较低的学生相比,拜访牙医、消耗含糖饮料频率较高的青少年患龋几率较高。结论湖北省青少年患龋水平较低,口腔卫生行为较差,性别和消耗含糖饮料是影响湖北省青少年龋病的社会-行为危险因素。     

1826名大学生口腔健康状况调查

目的：调查大学生口腔健康状况,指导大学生口腔保健。方法：按照WHO1997年制定的口腔健康调查基本方法,调查1826名大学生的的龋病、牙结石和第三磨牙萌出情况。结果：大学生的患龋率为43.37%,龋均1.82,龋齿充填率25.66%;患龋情况女生比男生严重、城市学生比农村学生严重（p〈0.01）;牙结石检出率为80.07%,平均区段数为3.97,牙结石检出情况男生比女生严重,农村学生比城市学生严重（p〈0.01）;第三磨牙萌出率为37.79%,城乡和性别上的差异均无统计学意义（p〉0.05）。结论：大学生口腔健康状况不佳,应重点防治龋病、牙周病和智齿冠周炎。     

An Oral Health Survey of Head Start Children in Alaska: Oral Health Status, Treatment Needs, and Cost of Treatment

The purpose of this study was to obtain information on the oral health status, treatment needs, and cost of treatment for Head Start children in Alaska. Twenty communities, representing five regions within the state, were selected for participation. The study consisted of three distinct parts: a caries status exam, a sociodemographic questionnaire, and a treatment needs examination. A total of 544 children between three and five years old were examined. The mean dmft and dmfs scores were 3.91 and 8.73, respectively. When stratified by race, the Alaska Native children had significantly higher mean dmft and dmfs scores. When stratified by community of residence, those children residing in the rural communities had higher rates of dental caries than the urban children. Forty-five percent of the total sample was in need of dental restorative treatment, excluding examinations, radiographs, and preventive services. The proportion of rural children needing care was much higher than the urban children (59% vs 27%). On average, each urban child needed treatment on 0.7 teeth, while each rural child needed treatment on 2.8 teeth. When all treatment factors including sedation and transportation costs are considered, the potential cost of treatment for the 1,475 children enrolled in the Alaska Head Start programs was $601,624.     

An assessment of the dental health of chronic institutionalized patients with psychiatric disease in Israel

Many institutionalized patients with psychiatric disease have been discharged into the community and the patients who remain hospitalized are at a particularly high risk for dental disease. This study assessed the oral health and treatment needs of chronically hospitalized patients with psychiatric disease in Israel. A random sample of 301 patients hospitalized for more than 1 year in 14 of 18 psychiatric institutions in Israel was drawn from the National Psychiatric Hospitalization Registry, and 84.4% of them were examined. Their dental status was evaluated using decayed, missing, filled teeth (DMF-T) index and demographic and medical data were retrieved from the patients' files. Of the 254 patients examined, 4 (1.6%) were caries-free, 176 (69%) patients had only a partial natural dentition, while 66 (26%) were edentulous. The average DMF-T score was 23.8. The caries component accounted for 2.7 of the DMF-T, the missing teeth component was 20, and the restored teeth component was only 1.1. There was a negative correlation between age and treated caries, and a positive correlation between age and missing teeth. Not all edentulous patients had dentures. These findings confirm the need to improve the oral health of chronic psychiatric inpatients and the need for dental treatment. The existing policy should be adjusted to integrate the currently separated delivery of the dental services for institutions and community settings. Dental professionals in the health service should be rewarded to restore teeth in this population rather than just to extract them.     

Dental caries and fluorosis in Arussi province, Ethiopia

A dental health survey was carried out in the Arussi province in Ethiopia. The survey comprised 1,700 persons between 6 and 54 years of age in five age groups from four areas of the province. The present paper deals with findings on dental fluorosis and dental caries. Dental fluorosis was found in 18% of the subjects, mainly in a very mild form. The fluoride content of the water (0.2-0.3 part/10(6) F-) in combination with a high tea consumption was assumed to give a fluoride intake optimal for caries prevention. The prevalence of dental caries was low. Thirty-eight percent of the 6-7-year-old group had decayed primary teeth and 51% of the total sample had decayed permanent teeth. Comparisons with a study from 1958 revealed that the prevalence of dental caries had increased in the last few decades, probably due to the recently adopted habit of using sugar in the diet.     

Dental caries among urban schoolchildren in Madagascar

Abstract An epidemiological survey of prevalence and severity of dental caries was carried out in an urban population of children in Madagascar. The study population comprised 1257 children in the age groups 4–5 yr to 14–15 yr equally distributed by sex. The children were examined according to the recording system for the Danish Child Dental Services. The caries experience in the primary dentition as well as in the permanent dentition was high. For example, among 6-yr-olds a mean number of 11.8 defs and 5.2 deft was observed and 82% of the children were affected by caries in primary teeth. In particular, primary molars in the mandibular and incisors in the maxilla were affected and approximate caries was frequent. Among 12-yr-olds mean DMFS was 4.0 and DM FT 2.4 and 75% of the children had caries in permanent teeth. In permanent teeth caries was located predominantly to mandibular molars and occlusal surfaces. In both dentitions almost all decay was untreated, indicating lack of dental treatment available due to the shortage of dental manpower. The establishment of a child dental service system is a matter of urgency. Dental health education and primary health care should be organized.     

青海省人群龋病流行病学抽样调查分析

目的了解青海省人群患龋状况及龋病发病的基线资料,为口腔卫生保健工作提供依据。方法根据第3次全国口腔健康流行病学抽样调查方案,首次对青海省5、12、35～44和65～74岁4个年龄组人群的患龋状况进行流行病学抽样调查。采用SPSS13.0软件对数据进行统计分析,以患龋率、龋均和龋充填率作为统计指标。结果5岁年龄组乳牙患龋率和龋均分别为71.63%和3.30。12岁年龄组恒牙冠龋患龋率和龋均分别为22.63%和0.40。35～44岁年龄组恒牙冠龋患龋率和龋均分别为64.47%和2.06。65～74岁年龄组恒牙冠龋患龋率和龋均分别为73.89%和3.08。4个年龄组龋充填率分别为1.85%、2.53%、8.00%和3.47%。结论青海省人群龋病状况不容乐观,龋齿充填率很低,应加强口腔健康教育,采取切实有效的措施,才能降低患龋率,提高龋齿的充填率。     

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目的了解沈阳市12岁学生12腔健康状况、口腔健康行为和口腔保健资源利用情况,为沈阳市学生12腔预防适宜措施的进一步实施提供依据。方法于2010年1月,沈阳市12腔医院和沈阳市牙病预防保健所采用多阶段分层等容量随机抽样的方法,抽取沈阳市市内5个区12岁学生880名,男女各半。参照《WHO口腔健康调查标准（第4版）》,检查他们全口恒牙牙冠龋病情况,统计患龋率、龋均等。此外,参考《第三次全国口腔健康流行病学问卷调查方案》,设计15个问卷题目,对440名受检学生进行现场询问,了解他们口腔饮食行为、I：2腔卫生行为、利用口腔医疗服务行为等。结果12岁学生恒牙患龋率为32．50％,龋均为0．56,牙龈出血及牙石检出率分别为45．91％和43．07％。每天刷牙1～2次者为91．17％,含氟牙膏使用率为80．30％。在看牙原因调查中以定期口腔健康检查及接受口腔预防措施为目的者占28．00％,仅占有效问卷数的8．56％。结论沈阳市12岁学生恒牙龋齿预防工作取得显著成绩,患龋率和龋均呈下降趋势,但牙龈出血和牙石检出率仍较高。学生口腔健康行为中,刷牙情况和含氟牙膏使用情况良好,但定期检查及采用预防措施行为不能令人满意。提示应重视组织适应目标人群心理特点的健康教育活动和对家长进行口腔健康教育,以促进12岁学生口腔健康行为的建立和巩固。     

A retrospective longitudinal study of caries prevalence during and 7 years after free dental care at school in Finland

ABSTRACT The objective of the study was to evaluate the benefit left from free dental care at public school after an average time interval of 7 years (mean: 7.03 years). The school dental service given to 66 Army recruits was extracted from their respective school dental care records, and then compared with the caries situation at the time of their military service. The results showed that the average number of 10.42 filled and extracted tooth surfaces at the end of school dental care had increased to a score of 36.72 DMFS 7 years later. The increase was significantly higher than expected on the basis of the average caries development between ages 7 and 15 years. Of the teeth filled during school dental care, only 26% were in no need of additional treatment, 15% had been properly retreated afterwards and the rest were either decayed (35%), retreated and redecayed (13%) or extracted (11%). Of the teeth that had been given root canal treatment at school, 27% had been extracted within the following 7 years. The caries situation was worst in the group of recruits who had had free dental care for the longest period of time. It was concluded that constant free repair of the teeth does not seem to give long term relief from the caries problem.