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Biomedical subjects

H S Horowitz

Publications and source records attributed to H S Horowitz.

At least 73 records · Page 4Linked to original sources
PubMed1979

Evaluation of a combination of self-administered fluoride procedures for the control of dental caries in a nonfluoride area: findings after four years.

Nearly all children who attend elementary school (grades K through 6) in a rural community have participated since 1972 in a school-based caries preventive program consisting of daily ingestion of a 1-mg fluoride tablet and weekly rinsing with a 0.2% sodium fluoride solution. 3they also regularly receive toothbrushes and a fluoride dentifrice for use at home. Examinations conducted after four years showed that the prevalence of dental caries among continuous participants, 7 through 12 years of age, was reduced by 35% compared with baseline findings; mean DMFS scores in 1972 and 1976 were 5.39 and 3.49, respectively. The preventive program inhibited decay in all three types of surfaces: approximal surfaces received about twice the relative protection against decay (70%) as buccolingual surfaces (34%) and more than three times as much as occlusal surfaces (22%). A comparison of estimates of four-year increments of decay taken from cross-sectional data at the baseline and actual increments from the 1972 and 1976 examinations showed that, for children ages 6 through 15, the incremental DMFS score was 41% lower during the period of the program than before its initiation. Findings in older children (ages 13 through 15) in 1976 who had stopped participation when they left elementary school at about age 12 showed evidence of strong posttreatment effects--as great as 31% fewer DMFS for 14-year-old children.

Acidulated Phosphate Fluoride↗
PubMed1979

Methods of assessing the cost-effectiveness of caries preventive agents and procedures.

Before public finance is committed to a particular public health measure it is essential that the project should be analytically evaluated. Cost-benefit analysis is one method of choosing between alternative programmes. It suffers from the disadvantage that, while costs can be accurately assessed, the benefit to an individual of freedom from pain, discomfort or inconvenience cannot be simply expressed in monetary terms. Such benefits may therefore be omitted from calculations of cost-benefit and a programme with valuable indirect or intangible benefits may not receive adequate consideration in competition with other alternatives. Futhermore, since benefits may only accrue some time after expenditure has been incurred, inflation distorts the significance of cost-benefit calculations. Cost-effectiveness analysis is an alternative method which enables one to determine the least expensive of several alternative methods of achieving a stated objective. The application of these concepts to preventive programmes against dental caries is described. Distinction must be made between the effectiveness of preventive measures during controlled clinical trials on limited numbers of subjects and their value when applied under field conditions to the whole community. Detailed comparisons are made between various methods of the application of fluorides caries prevention by community fluoridation water supply, school water fluoridation and topical application of fluorides. It is concluded that while completely accurate and valid analyses of cost-effectiveness are not possible, they do enable dentistry to view its activities more objectively and to indentify the real issues which should affect future decisions.

Attitude↗
PubMed1979

Some thoughts on epidemiologic indexes for assessing the need for treatment of periodontal diseases.

Various indexes have been developed and used to collect information on the prevalence, aetiology and prevention of periodontal disease, but few efforts have been made to utilize this information to assess treatment needs in the populations examined. Recently, Johansen et al. (1973) have developed the Periodontal Treatment Needs System and Møller and Beck (1976) included an assessment of treatment requirements in the Collaborative Study of Dental Manpower Systems sponsored by WHO and the USPHS. The value of these various indexes and the problems encountered in their application to field studies are discussed in detail. The lessons learned have been incorporated into the second edition of the booklet Oral Health Surveys (WHO, 1977), but it is contended that the methods advocated are still less than perfect. Particular doubt is cast on the recommendation for the use of a periodontal probe in field surveys often conducted in primitive conditions and by examiners with minimal training and experience. It is suggested that the critical depth of 3 mm is too small to be regarded as requiring radical treatment. The need for a treatment index is questioned in the light of the probability that treatment needs could not be fully met even in developed countries.

Dental Health Surveys↗
PubMed1978

Comparison of blind and non-blind assessments of occlusal sealant retention.

A comparison was made of scoring the retention status of BIS-GMA occlusal sealants 5 years after they had been placed, according to a non-blind and blind method of identification of teeth that had been sealed. Subjects were 175 children ages 15--18. One examiner made all the assessments. Retention of sealant was classified as all present, partly missing or all missing. There was 90.5% complete agreement between non-blind and blind examinations in scoring the retention status of 893 occlusal sites. Essentially no difference in agreement was found between sites on maxillary and mandibular teeth nor according to sites in specific teeth. There was only a slight tendency to classify more sites as having sealant present at the non-blind examinations than at the blind examinations, 56.7% and 55.1%, respectively. These findings would seem to indicate that whether examinations are done blindly or non-blindly is of minor importance in making an accurate assessment of sealant retention.

Adolescent↗
PubMed1978

Overview of ethical issues in clinical studies.

Research in human subjects should be conducted only if the rights and welfare of the participants are protected. Prospective study subjects must be given adequate information about all aspects of a study so that they can make a rationally exercised decision about participation; coercive techniques to solicit participants should not be used. Research in humans may be classified in one of three categories: A. Research on treatment of existing conditions; B. Research on preventive measures; and C. Research other than for treatment or prevention. Different concerns and aspects of informed consent assume particular importance in each category. In research on the treatment of existing conditions, untreated or placebo-treated control groups are rarely justified if the condition is irreversible. In research on preventive methods prospective subjects should be informed of the likelihood of receiving an ineffective treatment, if one or more placebo groups are included. A randomized clinical trial is usually the best design for studies of preventive methods. Nonrandomized designs, that are feasible and statistically valid, may be employed in order to avoid depriving some subjects from receiving effective preventive methods. In social or behavioral research, confidentiality of collected information and privacy of the subject are essential considerations.

Adult↗
PubMed1978

Effect of school water fluoridation on dental caries: results in Seagrove, NC, after eight years.

In 1968 at Seagrove, NC, fluoride was added to the water supply of a rural school (grades 1 through 12) at a level of 6.3 ppm, seven times the optimum level recommended for community water fluoridation in the area. Findings after eight years showed that children in grades 1 through 8 had approximately 40% fewer DMF surfaces than did their counterparts on the baseline. A comparison of these findings with those of another school fluoridation study, in which a level of 4.5 times the optimum concentration had been tested, showed only a slight advantage to the children at Seagrove. However, the full potential of school water fluoridation at seven times the optimum level cannot be determined until children in all grades will have been exposed since entering the first grade.

Adolescent↗
PubMed1977

Overview of ethical aspects of clinical studies.

Research in human subjects should be conducted only if the rights and welfare of the participants are protected. Prospective study subjects must be given adequate information about all aspects of a study so that they can make a rationally exercised decision about participation; coercive techniques to solicit participants should not be used. Research in humans may be classified in one of three categories: (1) research on treatment of existing conditions; (2) research on preventive measures; and (3) research other than for treatment or prevention. Different concerns and aspects of informed consent assume particular importance in each category. In research on the treatment of existing conditions, untreated or placebo-treated control groups are rarely justified if the condition is irreversible. In research on preventive methods prospective subjects should be informed of the likelihood of receiving an ineffective treatment, if one or more placebo groups are included. A randomized clinical trial is usually the best design for studies of preventive methods. Non-randomized designs, which are feasible and statistically valid, may be employed in order to avoid depriving some subjects from receiving effective preventive methods. In social or behavioral research, confidentiality of collected information and privacy of the subject are essential considerations.

Behavioral Research↗
PubMed1977

Effect of acidulated phosphate-fluoride chewable tablets in schoolchildren: results after 55 months.

Two groups of children initially in the first and second grades chewed, rinsed with, and swallowed an acidulated phosphate-fluoride tablet containing 1 mg of fluoride either once or twice a day in school. A control group of children followed the procedure once a day using a placebo tablet. An interim evaluation after 55 months showed that the children receiving two fluoride tablets daily had a significant reduction in incremental caries on early erupting teeth, which received primarily topical exposure to the fluoride, as well as on late erupting teeth, which received mainly preeruptive, systemic exposure. The findings also suggested that the use of a single fluoride table daily may reduce dental caries, although the presence of a benefit was less definitive than it was for the two-tablet procedure.

Acids↗
PubMed1977

Retention and effectiveness of a single application of an adhesive sealant in preventing occlusal caries: final report after five years of a study in Kalispell, Montana.

The single application of a BIS-GMA adhesive sealant in Kalispell on a paired half-moouth basis and the annual monitoring of the sealed sites for five years is not a recommended preventive regimen. The study does proved information on the potential long-term in vivo retention of the sealant and its ability to prevent dental caries. The findings of this study clearly show that when this pit and fissure sealant is retained, its is effective in preventing caries in sealed tooth surfaces. Moreover, on occlusal surfaces, the usual susceptibility to decay is not altered by having been treated with a sealant that is not retained.

Adolescent↗
PubMed1976

Ethical considerations of study participants in dental caries clinical trials.

During the past 30 years there has been increasing concern for ethical considerations that pertain to the conduct of human biomedical research. Consequently, many national and international medical and dental organizations and agencies have developed regulations, policies or ethical guidelines for the protection of human subjects who take part in clinical investigations. In the United States, more than 500 research institutions have established permanent committees to review research in humans conducted by their institutions. Members of these committees must represent a broad range of backgrounds, interests, and concerns. Prospective study subjects must be able to make an informed decision on whether to participate in any study, without any element of force, deceit, duress, or other form of constraint or coercion. Obtaining informed consent for studies of children, the mentally infirm, and persons with restricted civil freedom presents special problems. Ethical considerations also raise questions on appropriate designs for clinical studies, e.g. use of untreated controls. Dental studies, particularly those testing caries-preventive agents, raise special questions of design, informed consent, ethical procedures and the use of diagnostic radiographs. The director of a clinical study is responsible for the conduct of all personnel connected with the investigation.

Child↗
PubMed1976

Prevalence of dental caries in white and black children in Nelson County, Virginia, a rural southern community.

Until a few years ago, the results of most surveys of the prevalence of dental caries among school-age children in the United States, particularly those done in the south, showed that black children had a lower prevalence of dental caries than did white children who lived in the same community.4-6,11,16,19,20-23,25 However, in several recent surveys, the formerly observed race-caries relation has not been detected.2,8,17,18,26 In connection with a study initiated in 1972 in Nelson County, Virginia to determine the effectiveness of a combination of self-applied procedures for the administration of fluoride, baseline data on dental caries experience were collected for 1,374 white and 761 black children attending the County's public schools. The availability of data for large numbers of white and black children prompted a cross-racial comparison of prevalence of dental caries. Findings of the comparative analysis are contained in this report.

Adolescent↗