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Biomedical subjects

G W Thompson

Publications and source records attributed to G W Thompson.

At least 37 records · Page 2Linked to original sources
PubMed1995

Denture replacement during a 14-year period in Alberta's universal dental plan for the elderly.

Since 1973 Alberta's dental plan for the elderly has made government-sponsored, premium-free, comprehensive dental care available from both dentists and denturists in private practice to all residents older than 64 years. This article is based on an analysis that covered 260,000 patients from 1978 to 1992. It presents the frequency, nature, and cost of denture replacements to patients and pays particular attention to replacements administered within the allowable 5-year time limit stated by the plan for complete and removable partial dentures. During the 14-year period, about 55,000 dentures were replaced; 47% of these were replaced in the year after the individual's 5-year time limit had expired. Within the 5-year limit 1974 dentures were replaced at a nominal cost of +1.09 million, with nearly one half of these costs being attributed to denturists. Relative to the total number of dentures provided during the 14-year period, the denture replacement rate for dentists was 7% to 8%, and for denturists it was nearly three times greater at 21% to 22%. The replacement process included many crossovers by patients between dentists and denturists; for example, nearly one quarter of the 190 complete dentures initially provided by dentists were replaced by denturists within 5 years.

Aged↗
PubMed1995

Alberta's universal dental plan for the elderly: differences in use over 6 years by two cohorts.

OBJECTIVES: Dental services use by two cohorts under the universal dental plan for the elderly in Alberta, Canada, was examined. METHODS: Two birth cohorts 65 to 69 years old at entry who used the plan from 1978 to 1979 (n = 17,816) or from 1985 to 1986 (n = 27,474) were analyzed over 6 successive years for differences in dental services use and costs. RESULTS: The 1985/86 cohort received 24% more visits per patient than the 1978/79 cohort. Their inflation-adjusted expenditures increased by 19% mainly as a result of increases in denturists' expenditures (33%) (dentists' expenditures increased just 4% because of lower plan fee increases). The 1985/86 cohort received relatively many more periodontal and fewer denture services. Annual attendance over 6 consecutive years was high, especially for the 1985/86 cohort and dentists' patients; 55% of the 1985/86 cohort who used dentists did so in 5 or all 6 years. CONCLUSIONS: Differences in plan expenditures per patient between the birth cohorts and dentists and denturists, along with the high continuity of care for dentists' patients, have important implications for planning and administering dental plans for the elderly. The large expenditure decreases for removable dentures and the large increases for periodontal services to the 1985/86 cohort are noteworthy.

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PubMed1994

Seasonal variation of vitamin A (retinol) status in older men and women.

OBJECTIVE: The present study was undertaken to determine vitamin A status in 59 free-living (26 males, 33 females) healthy older persons (65-74 years) in winter and summer. DESIGN: Three-day dietary intake data for vitamin A along with carbohydrate, lipid and protein were collected during the summer (June-September) and again during the winter (November-March). In addition, retinol and its carrier proteins, retinol-binding protein (RBP) and transthyretin (TTR), were measured in the plasma in each season. RESULTS: The mean vitamin A intake met the Canadian Recommended Intake (RNI) for both gender and season. However, probability analysis of dietary data revealed that 7 and 11% of males, and 8 and 14% of females, in summer and winter, respectively, were at risk of deficiency. None of the subjects in the present study exhibited biochemical evidence of vitamin A deficiency as determined by plasma levels of retinol and its transport proteins. Overall, the mean intake of vitamin A was significantly higher in males than in females; no seasonal effect was observed. On the other hand, the plasma levels of retinol and its carrier proteins were significantly lower in winter season than in summer, without any gender variation effect. CONCLUSION: Although mean values for dietary intake and plasma concentration of vitamin A may indicate nutritional adequacy, a small proportion of an older population may be at nutritional risk. The prevalence of risk appears to be generally higher in the winter than in the summer season and in females than in males.

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PubMed1994

Riboflavin status of the elderly: dietary intake and FAD-stimulating effect on erythrocyte glutathione reductase coefficients.

OBJECTIVE: The present study was undertaken to investigate the relationship between riboflavin intake and its biochemical status in elderly subjects (> or = 65 years). SUBJECTS: Thirty males and 30 females were randomly selected from a larger sample of free-living elderly residents of Edmonton, Canada. Subjects were contacted through a seniors' service organization and the Medical Officer of Health. Any subject using vitamin supplements or alcohol other than the occasional drink was excluded from the study. DESIGN: Dietary intake was estimated using a 3-nonconsecutive-day food record. Biochemical status was assessed by measuring the erythrocyte glutathione reductase activity coefficient (EGRAC), which is a functional test indicative of metabolic availability of riboflavin. RESULTS: Average daily riboflavin intake of the study population was above the recommended requirement (0.5 mg/1000 kcal). According to the frequently used criterion that an EGRAC value > or = 1.20 is indicative of inadequate riboflavin status, 23% of the males and 7% of the females were classified as being deficient in the vitamin. However, based on the recently suggested normal values (1.30-1.4) for EGRAC, it appeared that all male subjects but one had adequate riboflavin status. CONCLUSION: The criteria used for EGRAC values may affect the interpretation of riboflavin status. It is therefore important that guidelines for EGRAC are standardized for more reliable interpretations.

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PubMed1994

Changes in utilization of dental services of Alberta's universal dental plan for the elderly.

Since 1973, Alberta's dental plan for the elderly has made government-sponsored, premium-free comprehensive care by dentists and denturists available to all residents of the province over age 64. Details on the numbers and types of different services provided were previously unavailable from the annual reports. However, an examination of the plan's six-million records, covering nearly 260,000 different patients from 1978 to 1992, has now made it possible, for the first time, to conduct a detailed analysis of these dental services. Many time-related changes have occurred in the types of services provided. The number of removable prosthodontic services declined from 14 per cent of all services offered by dentists in 1978-79 to five per cent of these services in 1991-1992, but the services provided by denturists increased by a factor of four. The relative number of surgical and restorative dentistry services offered by dentists also declined. Preventive services grew modestly, but periodontal services grew dramatically from three per cent of all services provided by dentists to 22 per cent. These shifts in services from prosthodontics, restorative dentistry and oral surgery to preventive and periodontic services have important implications for the planning and administration of dental plans for the elderly.

Age Distribution↗
PubMed1994

Continuity of dental treatment by users of Alberta's universal dental plan for the elderly.

To evaluate the longitudinal utilization of Alberta's Extended Health Benefits dental plan for the elderly, its use over the preceding 13 years by patients over age 64, who had used the plan in 1991-92, was examined. Of these 96,596 patients, over half (56 per cent) were female and about two-thirds (68 per cent) received their dental care from a dentist only. However, for the older elderly and for those living outside Calgary and Edmonton, the percentage attending a denturist only or both a denturist and a dentist was greater. Only individuals over age 77, or about 20 per cent of plan participants in 1991-92, were eligible to use the plan over the entire 14-year period examined in this study. However, the regularity of previous annual utilization of the plan was high. About 60 per cent of 70-74 year olds had used the plan for five or more years, while close to 50 per cent of the 80-84 year olds--who were eligible to use the plan for the entire period of the study--had done so in eight or more of the previous 14 years. Despite varying plan eligibility according to patient age, the 96,596 patients who used the plan over the 14-year period made nearly 1.2-million patient visits, at which they received about 3.1-million dental services. The high continuity of annual usage demonstrates that this group is not under-utilizing dental services.

Age Distribution↗
PubMed1994

Family violence.

Explore the source record for details and available documents.

Canada↗
PubMed1994

Dental caries and fluorosis in 7-9 and 11-14 year old children who received fluoride supplements from birth.

One hundred and sixty children who had lived from birth in a region with low fluoride levels in the drinking water, and who had been offered sodium fluoride supplementation in the form of drops for daily use, were examined to evaluate dental caries and dental fluorosis. Two age ranges were selected: 7-9 years and 11-14 years. In addition to the dental examinations, questionnaires were mailed to the parents, followed-up by telephone interviews, to gather information on compliance with the fluoride supplementation program. The results showed no statistically significant differences in dental caries activity between the regular and irregular users of fluoride supplementation. Considerable dental fluorosis was found in both regular and irregular user groups of the fluoride supplement (38 to 63 per cent of the children seen), however, with no statistical difference between the user groups. Most of the fluorosis detected was of a mild degree. Fluoride supplementation under the daily control of a parent or child is not recommended because of the difficulty in maintaining regular compliance and the risk of fluorosis.

Adolescent↗
PubMed1992

Utilization in Alberta's universal dental plan for the elderly, 1974-91.

Since 1973 the government of Alberta, a Canadian province of 2.4 million people, has funded a dental care plan for all residents over 64 years old and their dependents. It is the only dental plan in North America that covers all seniors and their dependents residing in a state or province. Under this plan, just over 270,000 persons (in 1990-91) are eligible for comprehensive, premium-free dental services provided by dentists and denturists in private practice on a fee-for-service basis. The plan's design, administration, utilization, and costs are reviewed. Utilization increased from 27 percent of eligibles using the plan in 1974-75 to 44 percent in 1990-91, and the mean number of services per user rose from 4.9 to 6.9 during the same time period. Although the cost per eligible person has increased about 200 percent, from Canadian (C) $42 to C $131, these costs only began to exceed the rate of inflation in 1986-87. Even though just 12 percent of the two main providers participating in the plan are denturists, nearly 22 percent of plan patients attended denturists rather than dentists for their complete dentures. Fees paid to dentists by the plan have decreased over time relative to the standard fees for the various services listed annually in the Alberta Dental Association fee guide. The apparent growth of direct additional billing by dentists of plan users to recover the difference between their usual fees and those paid by the plan and the effects of greater plan utilization are discussed, as are future potential difficulties in the plan's administration.

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PubMed1992

Vitamin B12 and folate status of a selected group of free-living older persons.

Vitamin B12 and folate status was determined in 50 male and 47 female free-living subjects (65-77 years) in winter and summer. The mean intake calculated from 3-day food records met the Canadian recommended intake (RNI) for both gender and season, however, probability analysis of dietary data revealed a number of subjects at risk of deficiency. Although the mean plasma levels were within the acceptable range for both vitamins, some 9 to 14% of individual subjects had folate plasma levels below normal. Fewer subjects had subnormal plasma vitamin B12 levels. Although mean values for dietary intake and plasma concentration of folate and vitamin B12 may indicate nutritional adequacy, a proportion of an older population may be at nutritional risk.

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PubMed1990

Dental health status and treatment needs of elderly residents of Edmonton, Alberta.

The oral health of 140 independent elderly volunteers, selected from different sections of Edmonton, Alberta, was assessed in conjunction with their nutritional and medical status, in an attempt to evaluate the dental needs of this population. Dental caries was assessed using WHO standards and the CPITN was used in assessing periodontal and gingival health needs. The mean age of the participants was 70.9 +/- 2.6 years. The average time since they had last seen a dentist was 3.0 +/- 6.2 years. Twenty-six percent of the group were edentulous and wore full dentures. An evaluation of denture hygiene and retention showed that 53 per cent of all maxillary and 57 per cent of all mandibular appliances exhibited poor hygiene; 33 per cent and 54 per cent, respectively, had problems with retention and/or occlusion. Only 12 per cent of the group exhibited any sort of mucosal pathology, all of which was related to ill fitting dentures. The total population had a mean of 15.0 +/- 11.1 teeth, only 0.5 of these were decayed, while 8.9 were restored. CPITN scores taken from a total of 511 sextants with standing teeth showed that 16 per cent of the group exhibited bleeding upon probing, 29 per cent had calculus, 13 per cent exhibited pocketing, while 3.6 per cent had deep pockets. Sixty-seven per cent of the population required dental treatment, none of whom needed emergency intervention. Over 49 per cent of the dentate population could benefit from prophylaxis; 16 per cent required more definitive periodontal treatment. Forty-five per cent of the denture population required treatment.

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PubMed1990

Priorities for continuing education courses.

A mail questionnaire on continuing education was sent out to all dentists in Alberta and Atlantic Canada. A total of 415 completed questionnaires were received from Alberta dentists, while the response from Atlantic Canada was 235. A significant majority of the dentists indicated that continuing education was important to them. Those who thought that continuing education was important tended to be more supportive of mandatory continuing education. October is the month that is preferred for courses. In Atlantic Canada, November was the second choice, while February was second in Alberta. The three most significant factors in the selection of a continuing education course in order of importance were: course content, course speaker and location.

Alberta↗
PubMed1989

Ultraviolet light and dental caries in children.

Animal experimental work has suggested that ultraviolet radiation reduces dental caries incidence. The opportunity to complete a study on children in the 1-ppm water fluoridated community of Wetaskiwin, Alberta, Canada, through an experimental school design study, became possible between 1982 and 1984 as in winter children have to travel to and from school during hours of darkness. Two classrooms at the four primary schools in the city had full spectrum lighting introduced and the 102 children entering grade 5 spent 22 months of study in the same classrooms; 83 (81%) remained in the trial. Each child had DMFT, DMFS, including degree of caries involvement, gingivitis and oral hygiene indices recorded. Results showed that children receiving the full spectrum light had very low or no increase in caries incidence over the 22-month period compared with controls. DMFS findings, excluding 'sticky fissures' over the 22-month period, increased from 2.67 to 3.23 in the group receiving full spectrum light, compared with an increase of 2.32 to 4.46 in the control group (p less than 0.001).

Alberta↗
PubMed1989

The periodontal status of 13-year-old children in western Canada using the CPITN index.

A large study of the dental health of children in the Canadian province of Alberta was undertaken in 1985. A ten per cent sample of 13-year old children (3117) was selected. This study reports on the gingival status of the children using the community periodontal index of treatment needs (CPITN). The findings show that the children have few periodontal problems and that the main treatment needs are oral prophylaxis and improvement in personal oral hygiene. The World Health Organisation guideline for the year 2000 in respect of the long-term goals for periodontal health is met in this Canadian population.

Adolescent↗
PubMed1989

Nutritional assessment: a computer-based dietary analysis.

The Nutritional Assessment computer program is intended to assist dentists and other health professionals with an evaluation of an individual's nutritional intake by identifying intake inadequacies, excesses, or imbalances. The assessment is not intended as a substitute for a visit to the appropriate health professional. An assessment report shows if an individual is selecting appropriate foods to meet dietary guidelines or could benefit from diet counselling.

Computers↗
PubMed1988

Caries prevalence and length of residency in fluoridated and non-fluoridated communities.

The caries experience of grade 6 Canadian schoolchildren was examined related to length of residence in non-fluoridated Camrose (0.23 ppm) and adjacent fluoridated Wetaskiwin (1.08 ppm). The mean age was 11.94 +/- 0.65 years, 115 being examined in Camrose and 89 in Wetaskiwin. The mean DMFT and DMFS values were similar in both the non-fluoridated and fluoridated communities with DMFT of 2.39 and 2.65 and DMFS of 3.40 and 3.54, respectively. When a minimum 5-year residency requirement was imposed, the data changed, showing for those children with 5-year residency DMFT values of 2.43 and 2.26 and DMFS values of 3.35 and 2.79, respectively, for non-fluoridated Camrose and fluoridated Wetaskiwin. Although the fluoridated community had 17% less surfaces with caries, differences between the fluoridated and non-fluoridated communities were not statistically significant. Within the fluoridated community, differences in DMFT and DMFS between children resident less than 5 and greater than 5 years were statistically significant (DMFT p less than 0.05; DMFS p less than 0.01). When comparing regions where adjacent communities exist, with and without water fluoridation, and in making decisions on fluoride supplementation levels for children who have changed residency to such communities, it is important that this type of information is taken into account.

Alberta↗