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Biomedical subjects

A Sheiham

Publications and source records attributed to A Sheiham.

At least 37 records · Page 2Linked to original sources
PubMed2001

Prevalence and correlates of traumatic injuries to the permanent teeth of schoolchildren aged 9-14 years in Belo Horizonte, Brazil.

A cross-sectional survey was carried out on 3702 boys and girls aged 9-14 years, attending public and private primary schools in Belo Horizonte, Brazil. A multi-stage sampling technique using an equal probability scheme was adopted to select the children. The response rate for the total sample was 97%. Dental examinations were carried out by one dentist (MISC). Intra-examiner agreement was very good. The prevalence of dental injuries increased from 8% at the age of 9 years to 13.6% at 12 and 16.1% at 14 years. Adjusted results showed that children from high socio-economic backgrounds were 1.4 (95% CI = 1.15-1.79) times more likely to present with a dental injury than children with low SES. Boys were 1.7 times (95% CI = 1.41-2.16) more likely to have dental injuries than girls. Children with an overjet size greater than 5.0 mm were 1.37 times (95% CI = 1.06-1.80) more likely to have a dental injury than children with an overjet size equal or lower than 5.0 mm. Finally, children with an adequate lip coverage were 0.56 times (95% CI = 0.44-0.72) less likely to have a traumatic dental injury than those with inadequate lip coverage.

Adolescent↗
PubMed2001

Prevalence, causes and correlates of traumatic dental injuries among 13-year-olds in Brazil.

A cross-sectional survey was carried out. This involved 652 out of a total of 764 (85%) 13-year-old adolescents enrolled in private and public schools located in urban areas in Cianorte, Brazil. They were interviewed and examined for traumatic dental injuries by one trained examiner (B.N.) using validated criteria. Sociodemographic data included sex, family structure (nuclear families, single parents and step-parents) and socio-economic indicators. Anthropometric measures included height and weight. The body mass index (BMI) was calculated (mean=20.1; SD=3.7). Those who had BMI scores equal or above the 85% percentile were considered overweight (BMI >23). The prevalence of traumatic injuries to the permanent incisors was 20.4%. The most common reported cause of injuries to the permanent incisors was falls (24.1%) followed by collisions with people or inanimate objects (15%), traffic accidents (10.5%), misuse of the teeth (6%), sports (2.3%) and violence (1.5%). Unknown causes accounted for 40.6%. Children from non-nuclear families, overweight children and boys were 2.18, 1.93 and 2.19 times respectively more likely to have dental injuries than children from nuclear families, non-overweight children and girls (P<0.01) after adjusting for family structure, BMI, sex, family income and level of education of the parents. The relationship between dental injuries and socioeconomic indicators was not statistically significant. In conclusion, being from a non-nuclear family, overweight and a boy increased the risk of having traumatic dental injury, but the relationship with socio-economic indicators was not statistically significant.

Accidental Falls↗
PubMed2001

The relationship between sweetness preference, levels of salivary mutans streptococci and caries experience in Brazilian pre-school children.

AIM: To analyse the relationship between preference for sweetness, levels of salivary mutans streptococci and levels of caries in low socio-economic 4-5-year-old Brazilian children. DESIGN: A cross-sectional survey. SUBJECTS AND METHODS: 298 children of both sexes, who, in 1998, were regularly attending public nurseries were randomly selected. Caries experience was assessed according to WHO guidelines. Saliva samples were analysed for mutans streptococci using the spatula method. Children's preference for sugar was measured using the 'Sweet Preference Inventory'. Personal interviews with the mothers were conducted. RESULTS: 255 children completed all aspects of the research, a response rate of 85.6%. 34.9% of them were caries-free. The mean dmf-s was 4.25 (SD 6.16), the decayed component being 3.56 (SD 5.82) and the filled surfaces, 0.69 (SD 1.85). For these pre-school children; male sex (P < 0.01), single parent (P < 0.01), habit of eating or drinking items that contained non-milk extrinsic sugar between meal times (P < 0.05) and high levels of salivary mutans streptococci (P < 0.001) were significantly associated with higher dmfs scores. There was no statistical relationship between sweetness preference and dental caries and with mutans streptococci levels. CONCLUSION: Levels of salivary mutans streptococci but not sweetness preference were potential good predictors of caries experience among 4-5 year-old-children living in urban area of Brazil.

Brazil↗
PubMed2001

Does the condition of the mouth and teeth affect the ability to eat certain foods, nutrient and dietary intake and nutritional status amongst older people?

OBJECTIVES: To assess how the dental status of older people affected their stated ability to eat common foods, their nutrient intake and some nutrition-related blood analytes. DESIGN: Cross-sectional survey part of nation-wide British National Diet and Nutrition Survey: people aged 65 years and older. Data from a questionnaire were linked to clinical data and data from four-day weighed dietary records. Two separate representative samples: a free-living and an institutional sample. Seven-hundred-and-fifty-three free-living and 196 institution subjects had a dental exam and interview. RESULTS: About one in five dentate (with natural teeth) free-living people had difficulty eating raw carrots, apples, well-done steak or nuts. Foods such as nuts, apples and raw carrots could not be eaten easily by over half edentate (without natural teeth but with dentures) people in institutions. In free-living, intakes of most nutrients and fruit and vegetables were significantly lower in edentate than dentate. Perceived chewing ability increased with increasing number of teeth. Daily intake of non-starch polysaccharides, protein, calcium, non-haem iron, niacin, vitamin C and intrinsic and milk sugars were significantly lower in edentate. Plasma ascorbate and retinol were significantly lower in the edentate than dentate. Plasma ascorbate was significantly related to the number of teeth and posterior contacting pairs of teeth. CONCLUSIONS: The presence, number and distribution of natural teeth are related to the ability to eat certain foods, affecting nutrient intakes and two biochemical measures of nutritional status.

Aged↗
PubMed2001

Dietary effects on dental diseases.

Dental caries is a highly prevalent chronic disease and its consequences cause a lot of pain and suffering. Sugars, particularly sucrose, are the most important dietary aetiological cause of caries. Both the frequency of consumption and total amount of sugars is important in the aetiology of caries. The evidence establishing sugars as an aetiological factor in dental caries is overwhelming. The foundation of this lies in the multiplicity of studies rather than the power of any one. That statement by the British Nutrition Foundation's Task Force on Oral Health, Diet and Other Factors, sums up the relationship between sugars and caries in Europe. There is no evidence that sugars naturally incorporated in the cellular structure of foods (intrinsic sugars) or lactose in milk or milk products (milk sugars) have adverse effects on health. Foods rich in starch, without the addition of sugars, play a small role in coronal dental caries. The intake of extrinsic sugars beyond four times a day leads to an increase risk of dental caries. The current dose-response relationship between caries and extrinsic sugars suggests that the sugars levels above 60 g/person/day for teenagers and adults increases the rate of caries. For pre-school and young children the intakes should be proportional to those for teenagers; about 30 g/person/day for pre-school children. Fluoride, particularly in toothpastes, is a very important preventive agent against dental caries. Toothbrushing without fluorides has little effect on caries. As additional fluoride to that currently available in toothpaste does not appear to be benefiting the teeth of the majority of people, the main strategy to further reduce the levels of caries, is reducing the frequency of sugars intakes in the diet. Dental erosion rates are considered to be increasing. The aetiology is acids in foods and drinks and to a much lesser extent from regurgitation.

Acids↗
PubMed2001

Socio-economic determinants of selected dietary indicators in British pre-school children.

OBJECTIVES: To assess the proportion of pre-school children meeting reference nutrient intakes (RNIs) and recommendations for daily intakes of iron, zinc, vitamins C and A, and energy from non-milk extrinsic sugars. To assess whether meeting these five dietary requirements was related to a series of socio-economic variables. DESIGN: Secondary analysis of data on daily consumption of foods and drinks from the National Diet and Nutrition Survey (NDNS) of children aged 1.5-4.5 years based on 4-day weighed intakes. SUBJECTS: One thousand six hundred and seventy-five British pre-school children aged 1.5-4.5 years in 1993. RESULTS: Only 1% of children met all five RNIs/recommendations examined; 76% met only two or fewer. Very few children met the recommendations for intakes of zinc (aged over four years) and non-milk extrinsic sugars (all ages). The number of RNIs/recommendations met was related to measures of socio-economic class. Children from families in Scotland and the North of England, who had a manual head of household and whose mothers had fewest qualifications, met the least number of RNIs/recommendations. CONCLUSIONS: Very few pre-school children have diets that meet all the RNIs and recommendations for iron, zinc, vitamins C and A, and energy from non-milk extrinsic sugars. Dietary adequacy with respect to these five parameters is related to socio-economic factors. The findings emphasise the need for a range of public health policies that focus upon the social and economic determinants of food choice within families.

Ascorbic Acid↗
PubMed2001

Assessing the difference between sociodental and normative approaches to assessing prosthetic dental treatment needs in dentate older people.

OBJECTIVE: To illustrate differences in assessed need using normative and sociodental approaches to assess prosthetic treatment needs of dentate older people. DESIGN: A cross-sectional study using non-random sample. SETTING: Metropolitan area of Chiang Mai, Thailand. SUBJECTS: 707 older individuals, 549 of the total sample were dentate, living independently, aged 60 to 74 years. RESULTS: The dentate population examined consisted of 289 classified as 'normal health' and 44 with a nutritional problem. Of the total population, 60% (333) had a normative need for partial dentures. Excluding the 44 with a nutritional problem, 50% (146) of the NTM group had 'impact-related treatment need' and of the latter 146, 69% (102) had a high propensity for health behaviour. 41% of the 102 who had 'impact-related' and 'propensity related treatment need' had 'accessible treatment need'. That is 14.5 per 100 of those with normative need. The gap between normative and 'accessible need' was greater among those with 'general health related treatment need' due to underweight. Of the 44 with a NTM and had a health problem, 45% (20) had a 'propensity related treatment need'. 40% of the group with a 'propensity related treatment need' had 'accessible treatment need'. Overall of the 44 older people with a normative need for a prosthesis and who had a health problem, only 2.4% had 'accessible treatment need' mainly due to lack of finance. If the treatment were subsidised then 45% of those with 'propensity related treatment need' would be eligible for treatment. CONCLUSION: Large differences of estimated treatment need were found between a sociodental and a normative approach to assess prosthetic dental treatment needs of older Thai people.

Activities of Daily Living↗
PubMed2001

Clinical and behavioural risk indicators for root caries in older people.

OBJECTIVE: To investigate the clinical and behavioural factors indicating root caries risk among older people. DESIGN: Cross-sectional clinical and interview data from the National Diet and Nutrition Survey (aged 65 years and over) in Great Britain. Logistic regression models of the prevalence of root caries and linear regression models of the extent of root caries were constructed to quantify the role of a range of clinical and behavioural risk indicators, including sugars intake. SETTING: A national sample of older British adults, free-living and institutionalised. PARTICIPANTS: 462 dentate adults aged 65 years or over. RESULTS: Nine or more intakes of sugars per day more than doubled the odds of root caries being present (OR 2.2-2.4). Other clinical and behavioural factors affecting root caries included wearing a partial denture in the presence of heavy plaque deposits (OR 2.1-2.6) and infrequent tooth brushing (OR 2.8-4.1). Linear regression models showed that, amongst those that had root caries, sucking sweets in the presence of a dry mouth, poor hygiene, partial dentures and living in an institution contributed to the extent of root caries, as measured by the RCI(d). CONCLUSIONS: Of the factors open to possible clinical or behavioural intervention, frequent sugars intake, poor hygiene and partial dentures were all associated with large increases in risk.

Aged↗
PubMed2001

The prevalence of dental impacts on daily performances in older people in Northern Thailand.

OBJECTIVE: To assess the prevalence of oral related impacts on the quality of daily life in older Thais. DESIGN: A cross-sectional study on a non-random sample. SETTING: Metropolitan area of Chiang Mai, Thailand Subjects: 707 older individuals living independently, aged 60 to 74 years, 549 were dentate, 158 were edentate. METHODS: Clinical examination and questionnaire for the Oral Impacts on Daily Performances (OIDP) index and on dental behaviours. RESULTS: About one half of the older people interviewed (52.8%) had at least one OIDP oral impact. The most common performance affected was eating (47.2%). The two main symptoms that caused oral impacts in the total sample were functional limitation and pain. The majority of older people had low OIDP scores below 8.0 (76.4%). Almost one in 10 had OIDP scores above 16.0. Individuals with a high income were more likely to have lower OIDP score (p<0.001). Subjects who had attended a dentist were more likely to have no oral impacts (p=0.02). There was a significant difference between OIDP scores related to some clinical variables; dental status (p=0.002), having mobile teeth (p=0.005), periodontal attachment loss (p<0.001), missing anterior and posterior teeth (p<0.001). CONCLUSIONS: Oral impacts that affected quality of life of older people were relatively common but not severe. The impacts were related to some social and clinical variables.

Aged↗
PubMed2001

Evaluation of a modified version of the index of Oral Impacts On Daily Performances (OIDP) in elderly populations in two European countries.

OBJECTIVE: To examine the psychometric properties of a modified version of the index of Oral Impacts on Daily Performance (OIDP) in elderly populations in two European countries, namely Great Britain and Greece. The psychometric properties examined in this study refer to internal consistency and face, content, criterion and construct validity. DESIGN AND SETTING: Cross-sectional epidemiologic surveys of independently living people aged 65 years or older. Data were collected by interviewers through structured questionnaires. The British sample consisted of the randomly selected independently living persons that participated in the dental component of the National Diet and Nutrition Survey (NDNS) of adults aged 65 years or over. The Greek sample is an opportunity sample drawn from eligible people living in two municipalities of the Athens region. SUBJECTS: 753 people participated in the British and 681 in the Greek sample. RESULTS: Through pilot work in both countries, the OIDP index was modified and both Greek and British modified versions demonstrated satisfactory face and content validity. In the main studies, Cronbach's alpha of the modified OIDP was 0.77 for the Greek and 0.69 for the British sample. In both samples, the index showed very significant associations with perceived dental treatment need (p<0.001), perceived general health (p<0.001 in Greek, p=0.002 in British) and intermediate oral impacts (p<0.001), as well as with satisfaction with oral health in the Greek sample (p<0.001). CONCLUSIONS: Overall, this study has demonstrated that the modified OIDP is a valid and reliable measure of oral health related quality of life in elderly people in Great Britain and Greece.

Aged↗
PubMed2001

The relationship among dental status, nutrient intake, and nutritional status in older people.

Dental health status may influence nutrition. The objective of this part of the National Diet and Nutrition Survey was to assess if there is a relationship between dental status in people 65 years and older and intake of certain nutrients and any link between dental status and blood-derived values of key nutrients. Random national samples of independently living subjects and those living in institutions had dental examinations, interviews, four-day food diaries, and blood and urine analyzed. In the sample living independently, intakes of most nutrients were lower in edentate than dentate subjects. Intake of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C was significantly lower in edentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly of non-starch polysaccharide. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and plasma retinol were the only analytes significantly associated with dental status.

Aged↗
PubMed2001

Cross-cultural differences in oral impacts on daily performance between Greek and British older adults.

OBJECTIVE: To examine whether there are significant cross-cultural differences in oral health-related quality of life and perceived treatment need between older people of similar clinical oral status living in Greece and Britain. BASIC RESEARCH DESIGN: Cross-sectional surveys of adults living independently aged 65 years or older. In Britain, data from the national diet and nutrition survey were used, while the Greek sample was drawn from two municipalities in Athens. Participants 753 in Britain and 681 in Greece. MAIN OUTCOME MEASURES: Oral health-related quality of life, assessed through the modified Oral Impacts on Daily Performance (OIDP) indicator, and perceived need for dental treatment. RESULTS: Thirty-nine per cent of Greek and 12.3% of British dentate and 47.6% of Greek and 16.3% of British edentulous participants had experienced oral impacts affecting their daily life in the last six months. The most prevalent impact was difficulty eating. Apart from that, 56.3% of Greek and 37.1% of British dentate and 33.5% of Greek and 25.3% of British edentulous participants perceived dental treatment need. After controlling for sociodemographic variables, perceived general health and clinical oral status, Greek dentate and edentulous participants were significantly more likely to experience oral impacts than their British counterparts, while in relation to perceived treatment need significant cross-cultural differences existed only between dentate respondents. CONCLUSIONS: The results indicated an independent cultural influence in the perception of oral impacts in older people.

Aged↗
PubMed2001

Prevalence and impact of dental pain in 8-10-year-olds in the western Cape.

The purpose of this study was to investigate the prevalence of acute dental pain in 8-10-year-old schoolchildren in the Western Cape. The study sample was drawn from schools in Stellenbosch, Malmesbury, Mitchells Plain, Mossel Bay and Robertson. Eighty eight per cent reported that they had experienced dental pain and 70% within the last two months. The prevalence and severity of pain in this study is much higher than reported studies in England and the USA. A high percentage of children not only live with pain on a daily basis, but also missed school on account of it (70%). There is an urgent necessity for oral health to be given a greater priority within the district health system to improve access to integrated oral health care services with appropriate preventive and treatment measures.

Absenteeism↗
PubMed2000

The common risk factor approach: a rational basis for promoting oral health.

Conventional oral health education is not effective nor efficient. Many oral health programmes are developed and implemented in isolation from other health programmes. This often leads, at best to a duplication of effort, or worse, conflicting messages being delivered to the public. In addition, oral health programmes tend to concentrate on individual behaviour change and largely ignore the influence of socio-political factors as the key determinants of health. Based upon the general principles of health promotion this paper presents a rationale for an alternative approach for oral health policy. The common risk factor approach addresses risk factors common to many chronic conditions within the context of the wider socio-environmental milieu. Oral health is determined by diet, hygiene, smoking, alcohol use, stress and trauma. As these causes are common to a number of other chronic diseases, adopting a collaborative approach is more rational than one that is disease specific. The common risk factor approach can be implemented in a variety of ways. Food policy development and the Health Promoting Schools initiative are used as examples of effective ways of promoting oral health.

Adolescent↗
PubMed2000

Clinical decision-making in restorative dentistry. Content-analysis of diagnostic thinking processes and concurrent concepts used in an educational environment.

CONTEXT: Dental practice is affected by variation in diagnosis and treatment planning between clinicians. The process underlying the decisions leading to management of dental caries is poorly understood. OBJECTIVE: To explore diagnostic thinking and identify information used in the diagnosis, management and treatment of caries. SUBJECTS/MATERIALS: 15 senior dental students (mean age, 23.1 years; 66% female) in Mexico City were interviewed using a Simulated Patient Model (SPM). METHODS: The SPM consultation session and its review, aimed at eliciting an introspective recall description of the Diagnostic Thinking Processes (DTP) and the pieces of information (concepts) employed, were transcribed and content-analyzed (CA). CA reproducibility coefficients were 0.53 to 0.64. The cognitive psychology Gale & Marsden (GM) model was used to structure DTP and concepts. Data were analyzed with chi-squared tests. RESULTS: DTP utilization was similar to the original report in endocrinology and neurology cases. A wide variety of concepts were combined with DTP to describe the strategies and information preferentially resorted to while addressing four areas identified in the consultation. CONCLUSIONS: Narrow arrays of concepts of restorative concern (mostly physical features present in/on teeth) were often investigated using DTP 1, 2 and 4 in combination with the use of dental explorers. The heuristics detected link features common to the GM model and to an indirect pattern-recognition model, whereby reliance on visual/tactile concepts facilitates the acquisition of a clinically meaningful image. Non-clinical factors believed to be at play in the application of strategies were not investigated but were controlled for in the SPM.

Adult↗
PubMed2000

The relationships between dietary guidelines, sugar intake and caries in primary teeth in low income Brazilian 3-year-olds: a longitudinal study.

OBJECTIVES: To investigate the effects of dietary guidelines on sugar and sugar intake at day nurseries, and other potential risk factors on dental caries in two groups of low socio-economic nursery schoolchildren. DESIGN: Nursery based, longitudinal study. SETTING: Metropolitan area of Recife, north-eastern Brazil. SAMPLE AND METHODS: The study population comprised 510, 3-year-old low socio-economic nursery schoolchildren. Sugar intake at the nursery was based upon a weighed inventory method during 2 non-consecutive days. Parents answered a questionnaire. RESULTS: Children attending nurseries not adopting guidelines on reduction of sugar intake had a higher caries risk, with an odds ratio of 3.6 compared to those attending nurseries with guidelines. A higher caries increment was related to higher daily frequency and weight of sugar intake at nursery, overall daily frequency of sugar intake (sugar intake at home plus nursery), past caries experience, use of fluoride, and habits related to toothbrushing. Children having more than 32.6 g of sugar daily at nursery were 2.99 times more likely to have high caries increment than those having less than that amount. CONCLUSIONS: Sugar intake at nursery and the adoption of guidelines on sugar were associated with lower caries increment in low income nursery schoolchildren. A number of modifiable factors such as a higher daily frequency and weight of sugar intake at nursery, use of fluoride and habits related to toothbrushing were strongly related to caries increment.

Brazil↗
PubMed2000

How do routines of daily activities and flexibility of daily activities affect tooth-cleaning behavior?

OBJECTIVES: The aims of this study were: (1) to investigate the level of routines and flexibility of people's daily activity and to identify how tooth cleaning fits into these activities; and (2) to evaluate the impact of different levels of routines and flexibility in daily living on pattern (frequency of tooth cleaning), structure (range of items used in tooth cleaning), performance (relative effectiveness of tooth cleaning) and the outcome of performance (gingival bleeding on probing) in tooth cleaning. METHODS: A convenience sample of 471 Brazilians aged 24 to 44 years was selected from factories, offices, banks, shops, and hospitals. Behavioral, socioeconomic, and clinical data were collected through structured interviews. Dental plaque and gingival bleeding were assessed by clinical examination. Data were analyzed by means of logistic regression. RESULTS: A highly significant relationship was observed between routines of daily activities and tooth-cleaning pattern (OR = 2.3; 95% CI = 1.34, 3.92) after adjusting for age, sex, marital status, and socioeconomic status. No significant associations were observed between routines of daily activities and gingival bleeding. A significant association was observed between tooth-cleaning frequency (OR = 1.6; 95% CI = 1.07, 2.49), performance (OR = 2.7; 95% CI = 1.77, 4.14), outcome (OR = 2.3; 95% CI = 1.31, 3.18), and flexibility of daily activities. Those who had more flexibility of daily activities had lower gingival bleeding scores. CONCLUSION: People who have a less routinized and more flexible day have higher tooth-cleaning frequency than those who have a less flexible and more routinized day. In this study, those with a more flexible day also cleaned their teeth more effectively than those who had a less flexible day, and had reduced gingival bleeding.

Activities of Daily Living↗