A challenge to Lancet readers.
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International Cooperation↗
Biomedical subjects
E Bjertness
Publications and source records attributed to E Bjertness.
Changes in endodontic status 1973-1993 among 35-year-olds in Oslo, Norway.
Epidemiological investigations from Scandinavia have documented high prevalence of apical periodontitis and inferior quality and results of endodontic treatment performed in general practice. The present investigation is part of a 20-year follow-up study on oral health in 35-year-old Oslo citizens focusing on endodontic conditions. The results indicate reduced prevalence of apical periodontitis and statistically significant improvement in endodontic status compared with results from a similar study performed in 1984.
Adult↗
Changes in periodontal treatment needs. A follow-up study of Oslo citizens from the ages of 35 to 50 years.
A random sample of 35-year-old subjects from Oslo took part in a dental survey in 1973 and were re-examined in 1988. Eighty-one subjects (85%) attended the final examination. The need for periodontal treatment was assessed by the Periodontal Treatment Need System (PTNS), and the oral hygiene by the Simplified Oral Hygiene Index (OHI-S). The participants attended a structured interview and answered a questionnaire about general and dental health habits as well as psycho-social factors. Only small changes in the distribution of subjects in the different PTNS categories were found to have taken place during the 15 years. In 1973, 56.8% were in need of scaling (Class B) and 32.1% had one or more deep inflamed pockets (Class C), and in 1988 the scores were 54.3% and 30.1% respectively. A logistic regression model was used to study the associations between risk factors and increased treatment need, as expressed by increase in the number of C-quadrants. Increased number of C-quadrants was positively associated both with short duration of education and with no interdental cleaning. Using a socio-ecological model for periodontal diseases, variables describing the items "behaviour" and "environment" were found to be most closely associated with increased need for periodontal treatment.
Adult↗
Protective effect of apoE epsilon 2 in Alzheimer's disease.
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Aged↗
Caries prevalence of young adults in Oslo, Norway, and Porto, Portugal. A comparative analysis.
The purpose of the present study was primarily to establish the oral health status of young adults in the area of Porto, Portugal. The assessment is based on a random sample of 30- to 39-year-olds with criteria identical to those of a Norwegian study of 35-year-olds. This makes it possible also to present a comparative analysis of the caries prevalence in Oslo, Norway, and Porto, Portugal. The results indicate lower DMF scores among the Portuguese (DMFS = 46.2) than the Norwegian (DMFS = 85.0) adults. The difference is primarily due to a greater number of filled surfaces among the Norwegians (FS = 59.7) than the Portuguese (FS = 4.4). However, carious surfaces are more prevalent among Portuguese than Norwegian adults (DS = 9.2 versus DS = 3.3). Both among Portuguese and Norwegian adults, oral hygiene and dental visits seem to play an important role with regard to the prevalence of decayed surfaces. Decayed surfaces were more prevalent among men than women, and a correlation between social status and prevalence of decayed surfaces was present in both societies.
Adult↗
Oral hygiene and periodontitis in young adults.
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Adult↗
A socio-ecologic model for periodontal diseases.
A socio-ecologic conceptual model for periodontal diseases has been proposed. The model, which includes 4 items: health-care organization, human biology, behavioral factors, and environment, has been tested on a random-sample of 50-year-old Oslo citizens. The investigation is based on a clinical examination as well as a questionnaire and structured interview. A logistic regression model was used to study associations between risk factors and the probability of deep periodontal pockets (> 5.5 mm). The risk of periodontal pockets was positively associated with: short duration of education, being of male gender, previous periodontal treatment, poor oral hygiene and infrequent toothbrushing. Variables describing behavioral factors and human biology were the items found to be most closely associated with periodontal pocketing.
Biology↗
Aluminium accumulation, beta-amyloid deposition and neurofibrillary changes in the central nervous system.
Deposition of beta-amyloid and the formation of neurofibrillary tangles (NFTs) are central to the aetiopathogenesis of Alzheimer's disease (AD). The possible effects of aluminium on these processes have been investigated in patients with renal failure who are exposed chronically to high blood levels of aluminium. Focal accumulation of aluminium was observed in neurons with high densities of transferrin receptors, indicating transferrin-mediated uptake, in regions such as cortex and hippocampus which are selectively vulnerable in AD. Increased staining for the beta-amyloid precursor protein (APP) in cortical pyramidal neurons was evident in the majority of renal patients and immature senile plaques were present in 30% of cases, suggesting that aluminium may induce or accelerate beta-amyloid deposition. The absence of neurofibrillary changes in this group of renal patients indicates that aluminium does not directly cause the formation of NFTs. The brain aluminium content was not raised in neuropathologically assessed cases of AD and we have been unable to confirm claims of defective transferrin binding in this disorder. If aluminium contributes to the development of sporadic AD, it must do so indirectly, perhaps via effects on the synthesis or metabolism of APP, or by contributing generally to the age-related attrition of neurons and thus reducing the threshold for deficits produced by more specific disease-related processes.
Aluminum↗
Remaining teeth, oral dryness and dental health habits in middle-aged Norwegian rheumatoid arthritis patients.
The aim of the study was to assess the effect of rheumatoid arthritis (RA) upon dental health. A questionnaire was mailed to all seropositive rheumatoid arthritis (RA) patients aged 44-56 yr in the files of the two main departments of rheumatology in South Eastern Norway. Data were obtained from 125 patients, constituting 91% of the target group. The number of remaining teeth in these patients was not related to disease duration or physical dysfunction, whereas a relationship to prolonged use of medication for pain relief was indicated. Factors known to affect tooth loss in the general population, such as smoking habits, dental attendance, interdental cleaning habits, previous dental disease, and place of residence were found to be important in RA patients as well. The RA patients from Oslo had a mean number of 25 remaining teeth, which is the same as reported for the general Oslo population at this age. Oral dryness was reported by more than 50% of the RA patients, but was not related to the number of teeth. The conclusion is that serious and long lasting rheumatoid arthritis had little influence on the number of remaining teeth in this middle-aged group of Norwegians.
Acetaminophen↗
Effects of food preservatives on growth and metabolism of plaque bacteria in vitro and in vivo.
The aims of the present study were to assess the consumption of food preservatives during the last decades, and to study the effect of the preservatives, sorbic and benzoic acid, on growth and glycolysis of oral bacteria in vitro, and on acid formation by dental plaque in vivo. Five consumption reports from the Central Bureau of Statistics of Norway were used to estimate alterations in consumption of staple food containing the two preservatives. A modified broth dilution method was used to determine the MIC values of the preservatives against Streptococcus sobrinus and Streptococcus sanguis. Extracellular 14C-glycolytic metabolites were studied by HPLC analyses. Plaque-pH measurements were used to assess possible effects on acid production. The consumption reports indicated increased consumption of preservatives. The in vitro testing suggested that legal concentrations of preservatives may inhibit the growth of oral streptococci. However, the preservatives did not inhibit in vitro glycolysis at tested concentrations. In vivo testing with similar concentrations (0.4% w/v) showed a significant effect. A higher concentration (2% w/v potassium sorbate) had a tendency to inhibit acid-formation by dental plaque even more.
Acids↗
Design of a socio-ecologic caries model and testing on 50-year-old citizens of Oslo, Norway.
The purpose of the present study was to design a socio-ecologic caries model based on a general health model and to test the fit of data collected from a random sample of 200 50-year-old Oslo citizens to this designed model. The intention was also to investigate the relative importance of the four items environmental, behavioral, human biology, and health care organization factors. The dependent variable, number of carious surfaces, was recorded clinically and radiologically. The mean number of carious surfaces was 3.0 (SD, 3.5), with a range from 0 to 17, and the four items explained 5%, 25%, 28%, and 13% of the variance in number of carious surfaces, respectively. The complete model explained 42%, whereas traditionally used variables on the basis of the Keyes triad explained only 22% of the variance. The findings from the present study indicate that dental caries is a multifactorial disease with both behavioral and biologic determinants, and the socio-ecologic caries model represents a relevant supplement to the Keyes triad.
Attitude to Health↗
Factors of importance for changes in dental caries among adults. A follow-up study of Oslo citizens from the age of 35 to 50 years.
Eighty-one 35-year-old Oslo citizens examined in 1973 were reexamined after 15 years, to monitor changes in their caries situation expressed as carious surfaces (DS + DFS). Factors considered to be of importance for a change in the number of carious surfaces over this 15-year period were arranged under four items: environment, behavior, human biology, and health care organization. The results showed a slight but not statistically significant increase in the overall caries experience expressed as DMFS. A statistically significant reduction in DS + DFS from the age of 35 to 50 years was demonstrated. Despite this reduction 23% of the 50-year-olds had more carious surfaces than at age 35. The results indicate that the improvement in the number of untreated carious surfaces reported from many Western societies is also valid for adult Norwegians. However, this improvement is not shared by all. Multivariate analyses showed that behavioral factors had the greatest impact on the observed changes in dental health.
Adult↗
Concepts of health and disease and caries prediction: a literature review.
Biomedical determinants of dental caries have been more extensively investigated than psychosocial factors and their impact on caries prevalence and incidence seems to be greater. However, a majority of these investigations relate to children and adolescents. An implementation of social and psychologic variables may be more relevant regarding dental caries in adults. In addition, a multidisciplinary approach might improve our understanding of dental caries as a multifactorial disease and bridge the gap between a biomedical concept and a more holistic approach to dental health.
Dental Caries↗
Prevalence of apical periodontitis and results of endodontic treatment in middle-aged adults in Norway.
The present investigation based on a random sample of 50-year-olds from Oslo, Norway, indicate a prevalence of apical periodontitis of 3.5% of the teeth present. Forty-four percent of the endodontically treated teeth presented with a radiographically detectable periapical radiolucency. There was a statistically significant negative correlation between the quality of the root fillings evaluated and prevalence of apical periodontitis.
Humans↗
The importance of oral hygiene on variation in dental caries in adults.
The aim of the present study was to analyze the relative importance of oral hygiene and other selected independent variables on the number of carious surfaces in a random sample of 35-year-old Oslo citizens. In addition to oral hygiene status (OHI-S), the independent variables frequency of tooth cleaning, regular dental visits, years at school, sex, and number of filled and missing surfaces were included in the analyses. Multiple Classification Analysis (MCA) was used for statistical evaluation of the results. The results indicate that oral hygiene status was the most important predictor in explaining variation in the number of carious surfaces. The total explanation factor was, however, low (R2 = 0.146).
Adult↗
[Alzheimer's disease--a challenge for dental personnel].
It is likely that dental personnel have little knowledge about Alzheimer's disease (AD), the most common of the degenerative diseases. The number of patients with AD will increase in the future, due to an increasing number of the aged. The number of AD-patients in need of dental treatment will also increase because of a continually higher number of remaining teeth among the elderly. To meet this category of patients, it is of importance to increase the knowledge of AD. The criteria for the diagnosis of AD may be summarized as loss of intellectual accomplishment, loss of memory, slowly progressive course of the disease and either loss of abstract thinking, loss of judgement, loss of higher cortical functions or personality disturbances. The prevalence of senile dementia in Oslo has been estimated to 72% in nursing homes and 11% for the population living at home for the age group <75 years. Among these, between 50 and 70 percent suffer from AD. The etiology of AD is unknown, but the two most accepted hypotheses are the genetic and the toxic. Epidemiological and molecular biological evidence points to the possible involvement of aluminum in the aetiopathogenesis of Alzheimer's disease.
Aged↗
[Preservatives and dental caries. Can preservatives in food and beverages influence oral health?].
There has been a pronounced decline in dental caries in industrialized countries during the last decades. The most obvious explanation is exposure to fluorides. However, the decline started before fluorides were extensively used. Theoretically, a contributory factor may have been increased consumption of foods containing preservatives. The aims of the present study were to find out whether increased intake of preservatives has occurred, and to assess the effect of two commonly used preservatives, sorbic acid and benzoic acid, on bacterial growth and on plaque acidogenity in vivo. Results from five consumption reports from the Central Bureau of Statistics of Norway were used to estimate changes in consumption of basic foods containing the preservatives mentioned. A modified broth dilution method was used to determine the growth inhibitory effects on selected oral streptococci. Plaque-pH measurements were performed with a microelectrode to assess possible effects on acid production. Data pointed towards increased consumption of preservatives. Legal concentrations of preservatives inhibited bacterial growth. Similar concentrations of the preservatives had a negligible effect on acid production in dental plaque (0.4% W/V), whereas higher concentrations (2% W/V) had an inhibitory effect.
Benzoates↗
Changes in periodontal disease indicators in 35-year-old Oslo citizens from 1973 to 1984.
Periodontal disease indicators were evaluated according to the periodontal treatment need system (PTNS) in random samples of 35-year-old citizens of Oslo in 1973 and 1984. The study indicated that although periodontal disease was a common finding in both samples, there was a significant reduction in score C (indicating need for complex periodontal treatment) in 1984 compared to 1973. Whereas 37.9% of the subjects showed inflamed pockets deeper than 5 mm (score C) in 1973, only 22.9% scored C in 1984 (non-Caucasians excluded). This reduction was most pronounced in females. The mean number of C-quadrants in subjects needing complex periodontal treatment was also reduced from 2.0 in 1973 to 1.7 in 1984. Further analyses of the 1984 sample showed that the mean number of C-quadrants was significantly lower in subjects with low OHI-S scores and in regular dental visitors, whereas sex, years at school, toothbrushing frequency, interdental cleaning habits, previous periodontal therapy, self-experienced need for treatment, health attitude or smoking habits, did not seem to influence the prevalence of score C.
Adult↗