Biomedical subjects

D Declerck

Publications and source records attributed to D Declerck.

At least 19 recordsLinked to original sources

PubMed2007

Caries patterns in primary dentition in 3-, 5- and 7-year-old children: spatial correlation and preventive consequences.

This study aimed to contribute to the descriptive information of oral health status in the primary dentition, especially concerning the distribution and spatial correlation of lesions. Data were obtained from two surveys. In the Signal-Tandmobiel project 4,468 7-year-old children in Flanders (Belgium) were selected by a stratified clustered random sample. In the Tandje de Voorste - Smile for Life (TDV) project, data were obtained from 1,291 3-year-old and 1,315 5-year-old children. The children were examined by trained dentists, using standardized and widely accepted criteria, based on the British Association for the Study of Community Dentistry criteria. At the population level, symmetry in the prevalence of caries experience across the midline was tested at the tooth and tooth surface levels using generalized estimating equations and alternating logistic regression (ALR) approaches. Individual symmetry was tested using an approach described by Hujoel et al. [J Dent Res 1994;73:1575-1580]. Descriptive observations suggested a symmetrical distribution of caries experience at the population level. The null hypothesis of symmetry could not be rejected at a 0.05 level, suggesting that caries experience might be symmetric in the deciduous dentition. Based on the ALR approach, 2 x 2 associations of caries experience at the tooth and surface levels, both in 5- and 7-year-olds, appeared to be strongest for the left-right pairs in the mandible, followed by the left-right pairs in the maxilla. At the individual level the hypothesis of random caries pattern was rejected (p < 0.0001). In conclusion, at the population level the null hypothesis of left-right symmetry could not be rejected, while at the individual level lesions tended to cluster on one side of the mouth.

Belgium↗

PubMed2005

An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students.

OBJECTIVE: To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students. DESIGN: Cross-cultural survey of dental students. SETTING: 18 cultural areas. PARTICIPANTS AND METHODS: 904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions. RESULTS: The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001). CONCLUSIONS: Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.

Asia↗

PubMed2004

Analysis of caries experience taking inter-observer bias and variability into account.

In larger oral health surveys, clinical measurements are often obtained using several examiners. This raises the issue of inter-observer variability in measurement. Often, the problem is dealt with by reporting kappa values obtained in a calibration exercise. In the present study, the limitations of this statistic are presented, and an alternative, based on a Bayesian approach, is proposed. When the alternative approach was applied to caries experience data obtained in an oral health screening survey in seven-year-old Flemish children (Signal Tandmobiel study), it could be ruled out that the observed geographic East-West gradient was due to bias induced by variability in scoring of the different dental examiners involved. The proposed method offers an opportunity to refine existing analytical approaches and is relevant to any health outcome study.

Bayes Theorem↗

PubMed2004

Variables associated with oral hygiene levels in 7-year-olds in Belgium.

OBJECTIVES: The present investigation aimed to delineate the extent of the correlation between each of a number of possible associated variables and the amount of plaque (as measured by a plaque index) present in 7-year-old Flemish children and to investigate the potential relation between caries experience and the amount of dental plaque. PARTICIPANTS: A sample of 4,468 children representative of children living in Flanders and born in 1989 was obtained. Their mean age was 7.1 (SD = 0.4) years with a boys/girls ratio of 51.8%-48.2%. METHODS: Analyses were performed with ordinal plaque index outcome, considering the children's school (i.e. class) as a random effect. Random effect models were estimated with the SAS procedure Proc NLMIXED. RESULTS: From the multiple logistic regression analysis, it could be concluded that the older the subjects the more dental plaque was observed (OR = 1.35; CI 1.08-1.68; p = 0.0081). Moreover, four explanatory variables could be identified as significant determinants for dental plaque in the mixed dentition: 'start of brushing after the age of 2' (OR = 1.161; CI: 1.09-1.23; p < 0.0001), 'brushing frequency of < 1x/day' (OR = 1.369; CI: 1.012-1.66; p = 0.0019), 'more than two in between meal snacks' (OR = 1.18; CI: 1.023-1.36; p = 0.0111) and 'daily intake of sugar containing drinks' (OR = 1.24; CI: 1.08-1.42; p = 0.0023). Further, being male was associated with a higher amount of plaque (OR = 1.16; CI: 1.00-1.34; p = 0.0506) and finally, a weak but significant correlation (Spearmans' rho: r = 0.23, p < 0.0001) between caries experience and the amount of cervical plaque was shown. CONCLUSION: The amount of cervical plaque in the mixed dentition was significantly related to variables associated with oral hygiene and dietary habits. A low but significant correlation between the amount of dental plaque and caries experience was observed.

Age Factors↗

PubMed2003

[The use of fluorides in dentistry in the year 2003].

During the 20th century the entire Western world has been plagued by a tremendous increase of carious lesions in the dentition of children and adults. Near the end of that century a definite decrease in the number of carious lesions was noticed. That improvement in dental health is mainly attributed to an increased presence of fluorides in the oral cavity. Fluorides can be administrated systemically or locally. Recent findings clearly suggest that a local administration is the preferred option. Correctly applicated the local use of fluorides provides a favourable and positive effect during demineralization and remineralisation processes under carious attack. Although fluorides are not the only measure in caries prevention it is widely believed that they have largely contributed to an improvement of oral health, the relief of dental pain and the safeguarding of financial means during the last twenty five years.

Cariogenic Agents↗

PubMed2002

Modelling tooth emergence data based on multivariate interval-censored data.

Studies on emergence of (permanent) teeth are published regularly in the dental literature. Besides descriptive statistics (mean or median values) on emergence times, comparisons between boys and girls are of interest. Gender comparisons are intersubject analyses, but also intrasubject questions, like 'Is there a left-right symmetry with respect to the mean (median) emergence times?' are of interest. Studies on emergence times most often are faced with interval-censored data. We will extend a GEE-type test proposed by Huster et al. for bivariate right-censored data to the multivariate setting with interval-censored data. Central to our paper is to provide appropriate statistical models to resolve some dental questions on emergence. The analyses are based on data from the longitudinal Signal-Tandmobiel study.

Age Factors↗

PubMed2001

Assessing risk indicators for dental caries in the primary dentition.

The aim of the present study was to assess indicators shown to be associated with the prevalence of caries in the primary dentition of 7-year-old Flemish schoolchildren. Cross-sectional first year data of the longitudinal Signal-Tandmobiel survey were analysed (n=4468). Gender, age, oral hygiene habits, use of fluorides, dietary habits, geographical factors and parental modelling were the considered predictors. From the multiple logistic regression analysis, including schools as a random effect, and after adjusting for the confounding variables-educational system and province (stratification variables), gender and age-it became clear that the following risk indicators remained significant (at 5% level) for the presence of caries: frequency of toothbrushing (P=0.05) with an OR 1.24 for brushing less than once a day, age at start of brushing (P<0.001) with an OR=1.22 for a delay of 1 year, regular use of fluoride supplements (P<0.001) with an OR=1.54 for no use, daily use of sugar-containing drinks between meals (P<0.001) with an OR=1.38, and number of between-meals snacks (P=0.012) with an OR=1.22 for using more than 2 between-meal snacks. There was a significant difference (P<0.05) in caries experience determined by the geographical spread, with an explicit trend of caries declining from the east to the west. In a model with an ordinal response outcome, the daily use of sugar-containing drinks between meals had a more pronounced effect when caries levels were high. From this study it became obvious that, in Flemish children, an early start of brushing and a brushing frequency of at least once a day need to be encouraged, while the use of sugar-containing drinks and snacks between meals needs to be restricted to a maximum of 2 per day. Geographical differences need to be investigated in more detail.

Age Factors↗

PubMed2001

Comprehensive dental care for children with rampant caries under general anaesthesia.

OBJECTIVE: Critical reflection on treatment strategy for dental rehabilitation of young children with rampant caries using day-stay general anaesthesia at a university dental clinic. DESIGN: Cross-sectional analysis of 98 cases. SETTING: The study was undertaken at the university paediatric dental clinic of Leuven, Belgium. SAMPLE AND METHODS: The sample consisted of 98 healthy patients referred for dental treatment under general anaesthesia with a mean age of 4.8 (+/- 1.1) years and mean dmft-score of 9.3 (+/- 3.0). Data were obtained by history taking, clinical examination, questionnaires (filled in by parents) and standardized data records (filled in by dentists and nurses in the recovery area and day-stay clinic). RESULTS: Most patients were referred by their private dentist (74.5%) because of a need for extensive dental treatment in an uncooperative child. Induction of anaesthesia was upsetting in a significant number of cases (68% of children). The mean duration of the whole procedure was 80.9 (+/- 24.7) minutes. A mean number of 7.2 (+/- 2.9) primary teeth were filled and 1.8 (+/- 2.0) extracted per patient. Post-operative problems (nausea/vomiting, temperature rise) were seen in only 8.2% of the patients. CONCLUSIONS: The technique used at this centre allows for extensive dental treatment of young children with a high level of acceptability and minimal morbidity, using day-stay general anaesthesia. Based on this review, it became clear that less upsetting methods for the induction of anaesthesia need to be explored. Criteria for the administration of antibiotics need to be defined more clearly and the use of stainless steel crowns should be envisaged for restorations on primary molars. The global outcome of this treatment provision in children at high caries risk should be evaluated over a longer period, including an evaluation of oral health status, restorative treatment (conservation vs. extraction) and behavioural aspects.

Ambulatory Surgical Procedures↗

PubMed2001

Parental occupational status related to dental caries experience in 7-year-old children in Flanders (Belgium).

OBJECTIVES: The study aimed to investigate differences in the oral health of 7-year-old Flemish children by the parents' occupational class and to explore behavioural and demographic factors linked to social inequalities in oral health. PARTICIPANTS: A stratified cluster sample of 1,500 primary school children in Flanders, born in 1989. METHOD: The clinical oral examination was performed in the first year of a longitudinal oral health project in Flanders (1996-2001) by 16 calibrated examiners. Information on occupational level of the parents and on oral health related behaviour was gained, respectively, by the school health care centres and the parents of the children using a structured questionnaire. RESULTS: The mean dmf values between the several SES groups, assessed by occupational status of the parents, were significantly different (P<0.001). The mean dmft and dmfs values were the lowest for the most advantaged children (1.3/2.7) and were threefold higher in the least advantaged children (3.9/9.1). The prevalence of caries-free children was 2.5 times higher among the highest SES families compared with the lowest SES families. In a logistic regression model adjusted for the stratification factors, the excess risk for caries in children increased with decreasing occupational level of the parents. There was a cumulative effect of decreasing occupational level and oral health habits on the caries prevalence. CONCLUSION: The results of the study allow the supposition that social inequalities in oral health among children exist in Flanders. Environmental factors and individual behavioural factors partially explain why social class might influence oral health.

Belgium↗

PubMed2001

[In the interests of taking one's time even when one reads a scientific article! Critical review of the literature on tooth eruption].

Nowadays everybody has access to the medical literature, not only through the libraries of the universities, but even more conveniently via Medline and Pubmed. It is very tempting only to read abstracts and summaries instead of "wasting time" by reading the whole article. Reading the article itself however enables the reader to select only these articles that have a good methodological and statistical basis. In this contribution several topics will be discussed that may help the reader to read scientific articles with a critical mind: definitions, quality of the data, study concepts, composition of the sample, control group, statistical analysis, sample size and interpretation of the results. Different items are exemplified with articles that deal with the emergence of permanent teeth.

Controlled Clinical Trials as Topic↗

PubMed2001

[Analysis of dental caries risk factors in the primary dentition].

Belgium↗

PubMed2001

[Factors determining dental plaque and their relation to the assessment of caries among 7-year-old Flemish children].

The present investigation aimed to assess the impact of a number of variables on the variation on the amount of dental plaque present in the mixed dentition of 7-year-old Flemish children and to investigate a potential correlation between caries experience and the amount of dental plaque. Analyses were performed with ordinal plaque index as outcome measure, considering the children's school (i.e. class) as a random effect. This random effect turned out to be of great importance when dealing with large clustered samples. From the multiple logistic regression analysis, it was concluded that the older the subjects the more dental plaque was observed (or = 1.35; CI: 1.08-1.68; P = 0.0081). Four exploratory variables, could be identified as important risk indicators for dental plaque accumulation in the mixed dentition: 'start of brushing after the age of 2 years' (or = 1.161; CI: 1.09-1.23; P < 0.0001), 'brushing frequency of < 1 x/day (or = 1.37; CI: 1.12-1.66; P = 0.0019), more than two in between meal snacks (or = 1.18; CI: 1.03-1.36; P = 0.02) and daily intake of sugar containing drinks (or = 1.24; CI: 1.08-1.42; P = 0.002). Further, being male was linked to a higher amount of plaque (or = 1.16; CI: 1.00-1.34; P = 0.0506). Finally a weak but significant correlation (spearman's rho: r = 0.23; P < 0.0001) between caries experience and the amount of cervical plaque was shown.

Belgium↗

PubMed2001

[Fluorosis: diagnosis, risk assessment and epidemiology].

Fluorosis is the most widespread side-effect of fluoride use and appears as discrete white spots on the enamel up to severe enamel dysplasia. There are different techniques for scoring fluorosis in epidemiological surveys. In the literature there is no uniform way of selection of teeth and data processing. Fluorosis risk is determined by environmental factors such as water and food fluoride content as well as individual factors such as use (or misuse) of fluoride supplements and fluoridated oral hygiene products. In a group of Flemish schoolchildren, fluorosis prevalence is low and mainly related to use of fluoride supplements and toothpaste in childhood.

Belgium↗

PubMed2000

Neuroendocrine tumors of the uterine cervix. Clinicopathologic study of five patients.

Four main clinicopathologic features of neuroendocrine tumors (NETs) of the cervix may be stressed: primary diagnosis at an advanced stage, early nodal metastasis even for low disease, early failure of appropriate local treatment (surgery and/or radiation therapy) and aggressive clinical treatment. Five patients with NET of the uterine cervix (small cell carcinoma type) are reported (one stage I, two stages II, one stage III and one stage IV). One patient was treated by surgery combined with radiation therapy, one by surgery combined with chemotherapy and one by surgery with radiation therapy and chemotherapy. Two patients received radiation therapy alone. Three early stage patients are alive with no evidence of disease 8, 26 and 41 months after diagnosis. The two patients with advanced stage died of disease, 3 and 12 months respectively, after diagnosis. Combination chemotherapy (cisplatin and etoposide) is warranted in disseminated NETs. Neoadjuvant or adjuvant chemotherapy should be combined with radiation therapy and surgery even in early stages.

Adult↗

PubMed2000

Oral hygiene in 12-year-old disabled children in Flanders, Belgium, related to manual dexterity.

As part of a larger epidemiological survey of a stratified sample of 12-year-old handicapped children in Flanders, Belgium, the present study describes gingival health, gingival hypertrophy, oral cleanliness and the presence of calculus. Statistical analysis was performed with motor skills, brushing help, the use of chemical agents, the use of anti-epileptic drugs, the knowledge of parents and educators (or caregivers) and their opinion of the oral hygiene of their children/ pupils as response variables. From this study, it became clear that mildly mentally retarded and learning-impaired children had significantly better manual dexterity skills than moderately and severely mentally retarded and physically impaired children. However, this was not reflected in improved oral hygiene. The use of chemical plaque controlling agents was found to be extremely low and, with the exception of children with gingival hyperplasia, the users of these agents did not have better oral hygiene. No difference was found between subtypes in the opinion of parents and educators on oral status. There was, however, a difference between their assessment and the clinical picture. It was concluded that there was a need for in-service training programmes in oral health care for educators as well as for parents.

Analysis of Variance↗

PubMed2000

[The problem of cross-infection during the administration of local anesthesia].

Serious infections can readily be transmitted in the dental situation when percutaneous injuries occur. In most cases needlestick injuries are responsible. In this way, dentists are at risk of professionally acquired infectious diseases with high morbidity and mortality, such as Human Immunodeficiency disease, Hepatitis B or C. Today, immunisation is only possible for HB virus and not for the other bloodborne infectious micro-organisms discussed. The transmission risk is influenced by the type and number of micro-organisms present in the blood, presence of visible blood on the needle, depth of the injury and size and type of needle used. Prevention is of paramount importance. Increased emphasis in the prevention of percutaneous injuries as part of infection control training is indicated.

Accidents, Occupational↗

PubMed1999

[Periarterial temporal halo in the ultrasonographic image of polyarteritis nodosa].

Explore the source record for details and available documents.

Giant Cell Arteritis↗

PubMed1999

Caries pattern and oral health habits in 2- to 6-year-old children exhibiting differing levels of caries.

The aim of the present study was to describe in detail the distribution of caries lesions among tooth types and surfaces in the primary dentition of young children with different levels of disease. A total of 125 children (between 2 and 6 years old) attending the pediatric dental clinic of the University Hospital of Leuven was allocated to three groups based on their caries experience: dmft = 1-5 formed the low caries experience group (LC, n = 27), dmft = 6-9 the moderate caries experience group (MC, n = 61) and those with dmft > = 10 the high caries experience group (HC, n = 37). Caries experience (at patient level, tooth and tooth surface level) and oral hygiene were evaluated. Oral health habits were recorded using a questionnaire (completed by parents). Caries lesions were not evenly distributed among different tooth types. Teeth most frequently affected were lower (first and second) primary molars. Primary incisors were rarely found to be carious. The distribution of the lesions followed a comparable pattern, irrespective of the disease level of the child. Decay on primary canines and buccal/lingual surfaces of primary molars was strongly indicative of a high caries experience. There was a clear link with reported oral hygiene habits and the use of a pacifier and baby bottle with sugared content.

Belgium↗