Errors in mounting maxillary casts using face-bow records as a result of an anatomical variation

The relationship of the teeth to the intercondylar axis and horizontal plane is transferred to the articulator by means of a face-bow record. In most semi-adjustable articulators, the horizontal plane to which the maxillary cast is orientated is the Frankfort plane or its near equivalent, the orbital-axis plane. For this purpose the infraorbital notch is used as the anterior reference point Clinical observations of Cantonese patients suggest that in some individuals the Frankfort plane may not be horizontal, with the result that the orientation of the casts in the articulator is incorrect with respect to the horizontal plane, and a preliminary study has been undertaken to investigate this range of variation.

Lateral cephalometric radiographs were taken of 33 Cantonese male adult subjects in natural head posture. The cephalometric landmarks of the Frankfort plane were recorded relative to the true vertical axis and, by the use of a digitizer, fed into a computer for analysis. The results show that there is considerable individual variation in the orientation of the Frankfort plane. Variations ranging between +11° and -2° in relation to the horizontal were recorded. Large anatomical variations may make errors difficult to avoid when the manufacturers' recommended anterior reference point for a particular face-bow is the infraorbital notch. Clearly this is a source of potential error which should be recognized when treating this ethnic group.     

Excerpts from Presentation on Epidemiologic Data and Changing Demographics

Dental surveys provide epidemiologic and sociodemographic data useful for program planning, implementation, and evaluation. Dental public health decisions in North Carolina have been based on statewide oral health surveys. Results from the 1986–87North Carolina School Oral Health Survey and a comparison of these data to previous survey results and to recent national estimates of oral disease provide a basis for the discussions and deliberations during the symposium.     

Lack of Oral Care Policies in Toronto Daycares

Objectives: Currently, there is a deficit of information on policies regarding oral hygiene practices in Toronto daycares. It is unknown if any tooth-brushing programs are in existence and if children are permitted to follow professional advice on oral hygiene. The main objectives of this investigation were to a) determine the prevalence of oral care policies in daycares and b) examine the availability of resources. Methods: Telephone interviews were conducted with daycare supervisors using a pretested questionnaire. Summary statistics and the chi-square test were used to analyze the results. Results: Two hundred forty-nine questionnaires were completed (response rate of 99.6 percent), representing 38 percent of the total daycare population (650) in Toronto. Eighty-three percent did not have a policy on oral care and 11 percent would not cede to requests from parents or medical professionals to brush teeth. However, 50 daycares indicated that their centers used to have a tooth-brushing program, and most (79 percent) were open to establishing an oral care policy. Fifteen percent reported not having proper sinks for tooth brushing. Conclusions: Many daycares do not have a policy regarding oral hygiene. A policy that encourages and provides guidance on safe tooth-brushing procedures is needed and may improve the oral health of preschool children .     

Oral Health Knowledge and Habits of Senior Elementary School Students

Despite improvements in children's dental health, and significant resource allocation to health education programs, few recent studies have investigated the associations of oral health knowledge, behaviors, and status. This study of 11-year-old children (N = 6,329) in northeastern Ontario used a supervised self-complete questionnaire and a clinical examination to gather baseline data on, and test associations of, caries and periodontal knowledge, self-reported oral health behaviors and source of knowledge, and oral health status. Results show the children had poor knowledge of caries preventive measures such as water fluoridation, dental sealants, and choice of snack foods. Periodontal knowledge was better, but children confused plaque and calculus. Respondents claimed good oral health habits, with 73 percent claiming to brush at least twice daily, 88 percent claiming to use toothpaste, 42 percent claim to floss at least twice weekly, and 84 percent claiming an annual dental visit. Children with the best knowledge claimed dentist and school as the sources. High knowledge was associated with good oral health habits (P less than .001) and low DMFT score (P less than .001). Good habits were not related to DMFT score (P = .1095). Logistic regression showed high knowledge was associated with English cultural status, urban school area, good habits, having a dental sealant, and attending a fluoride-rinse school (P less than .05). Findings suggest a need to reinforce caries preventive teaching, to investigate the effect of cultural status, dental experience, and residence status on oral health knowledge, and to further test the efficacy of different oral health education programs delivered by different sources.     

Oral health care of the mentally retarded and other persons with disabilities in the Nordic countries: Present situation and plans for the future

In the Nordic countries, the general goal of policies for persons with disabilities is their Integration into society. At the same time, the social and economic situation has worsened, and, as a consequence, the structures of the welfare state seem gradually to break down. This paper describes the present situation and plans for the future of oral health care for the mentally retarded and others with disabilities in the changing society in the Nordic countries.     

Associations Between Exposure to Fluoridated Drinking Water and Dental Caries Experience among Children in Two Australian States

Objectives : This study assessed associations between exposure to fluoride in water and dental caries experience among children in two Australian states. Methods : Cross-sectional data were obtained from 9, 690 South Australian children aged 5–15 years and 10, 195 Queensland children aged 5–12 years. School dental service practitioners recorded DMFS and dmfs data. A questionnaire to parents gained information about residential history that was used to calculate children's percent of lifetime exposed to fluoridated water. Results : Greater exposure to fluoride in water was associated with lower dmfs and DMFS in both states (P<. 01), although in South Australia the effect for DMFS was statistically significant only after controlling for extent of unknown fluoridation exposure and for fluoride supplements. Caries-fluoridation associations were stronger for dmfs compared with DMFS and for Queensland (5% of population fluoridated) compared with South Australia (70% of population fluoridated). Effects for DMFS persisted after controlling for socioeconomic factors. Conclusions : Fluoridation was associated with lower caries experience. The weaker association with DMFS in South Australia may be due to less caries and more fissure sealants in that state, and is consistent with a "diffusion" effect, whereby a high proportion of the population exposed to fluoridation diminishes differences among exposure groups.     

Development of a screening tool to assess the suitability of people with a disability for oral care under sedation or general anesthesia

The aim of this study was to develop a screening tool to assess the suitability of people with disabilities for oral care in different settings. The objectives were to investigate retrospectively the uptake of general anesthetic (GA) services and use this information to develop a composite tool.
One hundred cases referred for GA were reviewed to generate data for a Delphi Panel. Patients with disabilities were the subject of a tool, devised by the Delphi Panel, to appropriately allocate patients to the most suitable care, including the patients' medical, behavioral, and social status as well as planned dental treatment complexity. A total of 124 patients, between the ages of 4 and 75 years, in seven centers were treated under sedation or GA, according to the tool. Agreement on behavior assessment between dentists and anesthesiologists was poor.
The tool has the potential to identify which people with disabilities can be effectively allocated for treatment under sedation or GA.     

Factors Affecting the Ingestion of Fluoride Dentifrice by Children

Several factors affecting the amount of fluoride ingested during toothbrushing by 2- to 7-year-old children were investigated. The specific purpose of this study was to determine the contribution of age, the amount of dentifrice used, and rinsing after brushing to the variation in the ingestion of fluoride dentifrice. Four hundred and five children brushed their teeth in front of a portable sink. The tubes of dentifrice in gel (0.24% NaF) were weighed before and after use to determine the amount of toothpaste used. The fluoride content of the collected liquids was determined with a fluoride-ion-specific electrode. The amount of fluoride ingested was derived by determining the difference between the amounts used and recovered. The amount of dentifrice used, the age, and the rinsing habits, entered in a multiple regression model, explained up to 66 percent of the total variation in the amount of fluoride ingested. The amount of dentifrice used accounted by itself for 60 percent of the total variation. Therefore, these results indicate that the quantity of dentifrice used was the most important factor affecting the ingestion of fluoride through toothbrushing by young children.     

Oral Health Status, Knowledge, and Practices in an Amish Population

This study was conducted in the summer of 1985 to assess the oral health status, knowledge, and practices of an Amish population in southwest Michigan. Dental caries experience, periodontal health, and oral hygiene status were recorded using decayed, missing, and filled surfaces (DMFS), periodontal index (PI), and simplified oral hygiene index (OHI-S). Data on oral health knowledge and practices were collected by interviews using a structured questionnaire. Results showed significantly lower levels of disease among Amish. DMFS scores for 5-17-year-old Amish children were almost half that of the US general population (NIDR 1979-80). PI score of all ages combined was 2.0, which was 3.6 times lower than a national sample (1971-74). Lower levels of disease in Amish could be related to their way of life and dietary patterns. A relatively higher level of unmet need for prosthodontic care, inadequate oral health knowledge, and barriers to dental care in the study population emphasize the need for dental public health and health education programs.     

Patterns of dental service use among homeless people using a targeted service

Objective: The objective of this study was to describe the patterns of dental service use among homeless people using a targeted dental service from 1992 to 2001.
Method: A case-note review of a selection of patients ( n  = 204) was undertaken using a pre-designed data abstraction form.
Results: For those presenting at their first contact, 40 percent ( n  = 68) expressed need in relation to oral pain and disease/tissue damage, and 28 percent ( n  = 33) in relation to dental checking and oral prophylaxis. Most homeless people had normative need for dental treatment (93 percent: n  = 153). The dental service was delivered using a mix of outreach and fixed site clinics, with 75 percent ( n  = 153) of all first contacts made at outreach clinics. The targeted service was moderately successful at getting people to attend the fixed site service for continuing care, with 51 percent ( n  = 87) attending for subsequent visits. Location of first contact with the targeted dental service did not predict subsequent attendance. Those who did attend for further care tended to have normative needs for periodontal disease and dental decay and have their presenting complaint met. Only 23 percent ( n  = 46) of people completed a treatment plan, over a mean of 8.2 (standard deviation ± 9.4) visits. No factors appeared to predict completion of treatment.
Conclusions: While the small sample limits the findings in this study, it is hypothesized that the presence of the dental service promoted uptake of dental care. Flexible attendance tended to result in multiple visits and delayed outcomes, which themselves could have acted as barriers to care.