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Biomedical subjects

A Sheiham

Publications and source records attributed to A Sheiham.

At least 127 records · Page 7Linked to original sources
PubMed1987

A new measure of teeth-cleaning efficiency and periodontal disease.

This paper presents a new measure of teeth-cleaning efficiency based on information from a random sample of 400 factory employees and a separate (non-random) sample of some 400 skilled manual workers and their wives. Regression analysis showed that only 1/3 of the variance in calculus levels in the random sample was explained by age, frequency of visits to a dentist, socioeconomic group and smoking habits (other variables tested--gender, date of last dental visit, frequency of teeth-brushing and sugar consumption--were not significant). The corresponding regression for the skilled manual sample gave a broadly similar result, though the proportion of explained variance (1/5) was lower than for the random sample. These results indicated the presence of one or more additional factors, of which teeth-cleaning efficiency is likely to be the most important. A new measure of cleaning efficiency was then constructed by expressing the actual calculus level as a proportion of the level estimated from the regression equation, and deducting this proportion from unity. If this new measure is, indeed, a genuine indicator of teeth-cleaning efficiency, then one should expect it to be an important element in an explanation of the level of periodontal disease, but not of dental caries (which is a resultant essentially of dietary habits). This hypothesis was tested and confirmed by multiple regression analysis. Though the new measure of teeth cleaning efficiency is essentially experimental, and has yet to be validated by clinical testing.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Sucrose and dental caries.

Sucrose is unequivocally implicated in the cause of dental caries. Biochemical, microbiological, animal and human clinical and epidemiological evidence support a causal relationship. The risk of caries is related both to the amount and the frequency of intake of sucrose. The evidence that sucrose is important is that a) extracellular synthesis of polysaccharides by plaque bacteria is dependent on high concentration of sucrose. Without synthesis of polymers S. mutans cannot colonize the mouth in large numbers. b) studies on animals show a relationship between sucrose content of a food and its cariogenicity, c) there is a direct relationship between the quantity of sucrose consumed and caries in humans, d) the relationship between dietary sucrose and caries in humans approximates an S-shaped curve that rises more steeply when the sucrose-containing products are consumed frequently and when newly erupted teeth are present in young children and adolescents. Following the sharp rise, the curve flattens out. Sucrose is much more cariogenic than starch in humans. Reduction in sucrose consumption levels by half will benefit dental health and is unlikely to have any detrimental effects on health.

Cariogenic Agents↗
PubMed1985

Dental attendance and dental status.

This article examines the relationship between differences in dental attendance patterns and variations in dental status. A sample of 336 dentate men and 110 dentate women were selected at random from employees of two industrial plants in N.W. England in 1980. They were given a dental examination and asked about visits to the dentist. Regression analysis showed that while the more frequent the dental visits, the lower the rate of tooth loss and the fewer the number of teeth with active decay, the higher, however, the average number of fillings. There were significant differences, moreover, between manual and non-manual workers, the former being more likely to lose their teeth and the latter to have their teeth filled, at each given age and frequency of dental visit. Though the more frequent dental attenders had the advantage over the less frequent of having, on average, a higher number of functioning teeth, restored or otherwise sound, they also had the disadvantage of having higher levels of treated disease and thus of disease experience. The results suggest that while frequent dental visits help to postpone tooth loss and to maintain dental function, they do not apparently help to prevent the onset of further disease.

Adolescent↗
PubMed1984

Changing trends in dental caries.

In underdeveloped countries the number of dental caries is increasing at a frightening rate whereas in industrialized countries the caries rate has declined by about 40% in the past 10 years. In 1982, for the first time ever, the average 12-year-old in underdeveloped countries, where 80% of the world's children live, had a higher dental caries score (decayed, missing, filled-DMF) than those in industrialized countries. The increase in caries is associated with increases in sugar consumption. By 1984, sugar consumption in underdeveloped countries is predicted to exceed that of industrialized countries. The decline in caries is associated with the widespread availability of fluoride toothpaste, changes in the pattern and quantity of sugar consumption and possibly with the frequent use of antibiotics. The declines have been greater in areas with fluoridated water supplies. The trends in rates of dental caries have important public health implications. They include the urgent need for a food policy to limit the consumption of refined sugars, policies to ensure the availability of fluoride, a reduction in the number of dentists in industrialized countries, the greater use of dental therapists and increasing the interval between dental check-ups to two years or more.

Adolescent↗
PubMed1983

Sugars and dental decay.

Sugar is the principal cause of the most common disease in industrialised countries, dental caries. The sugars implicated in dental caries, in decreasing order of cariogenicity, are sucrose, glucose, and fructose; brown sugars are as cariogenic as white. The level of sugar consumption at which most of the population will not get dental caries is 15 kg/person/year. The goal should therefore be to reduce consumption to this level and below. The following policies should be introduced to achieve this goal: sugars should not be added to dietary items such as baby foods; a range of acceptable sugar-free snacks and drinks should be developed; non-cariogenic sweeteners should be substituted for added sucrose and glucose in foods, confections, and drinks; sugar-containing foods should be modified to make them less cariogenic; and the levels of added sugars in commonly used foods should be reduced. The transmission to the public of information on sugars and dental health should be improved.

Dental Caries↗
PubMed1983

Promoting periodontal health--effective programmes of education and promotion.

A realistic aim for a preventive programme is to reduce dental plaque to levels compatible with rates of progression of periodontal disease which will allow functional and aesthetically and socially acceptable dentitions to be maintained throughout life. Since tooth cleaning is mainly influenced by socialization, and most people do brush their teeth, the objective of health education is to improve the effectiveness of oral hygiene behaviour. However, most dental health education programmes, whether directed at individuals or groups, are based upon an incorrect concept. Instead of attempting to change the commonly used scrub technique, encouragement should be given to use the scrub method more effectively. Oral health should be integrated with programmes dealing with general hygiene and grooming; a diversity of approaches and maximal participation by the community, individuals and professionals should be encouraged. The dentist/hygienist-centred strategy is not likely to be effective in reducing periodontal disease at a community level. Social and educational strategies directed at groups are more likely to be useful. Programmes should concentrate on educating significant individuals in the community, educating educators and educating the dental team. The programme should be continuous and low key and refrain from victim-blaming exhortations to clean teeth with devices of questionable usefulness.

Health Education, Dental↗