Search PubMed⌕ Search

Biomedical subjects

R C Graves

Publications and source records attributed to R C Graves.

At least 37 records · Page 2Linked to original sources
PubMed1986

Application of life table methodology in determining dental caries rates.

Probabilities of caries risk over time measured from eruption of first and second molars are illustrated using life table methodology. Life table rates based on 4,365 children in the National Preventive Dentistry Demonstration Program indicate that both fluoridation and sealants are effective in preventing caries on occlusal and buccal/lingual surfaces of molars. Effectiveness would probably have been greater on occlusal surfaces if sealants had been applied closer to the time of eruption. Similarities and differences between conventional DMFS indices and life table probabilities are discussed.

Actuarial Analysis↗
PubMed1986

Identifying children who will experience high caries increments.

An 18-month longitudinal study of 197 5 to 18-yr-old children was conducted to assess the performance of multiple baseline variables in predicting which children would experience high increments of caries. Nine predictors were assessed; DMFS and defs scores, number of permanent teeth, indices of fissure retentiveness and occlusal morphology, S. mutans and lactobacilli levels, and sex and race. Discriminant analyses were applied to data for children in five age groups to identify the 30% who would have the largest 18-month DMFS increments. Prediction performance was assessed by comparisons with the actual high increment group, defined as those children with increments in the upper quartiles of the DMFS distributions within age groups. The analyses predicted between 56% and 91% of actual high increment children depending on age group. The children identified in the analyses experienced between 59% and 91% of the disease experienced by the actual high increment groups.

Adolescent↗
PubMed1986

Recent dental caries and treatment patterns in US children.

This report presents dental caries and treatment patterns found in a longitudinal study of US children between 1978 and 1982 who were geographically dispersed across several fluoridated and nonfluoridated sites. The analyses include first- and fifth-grade children examined annually for four years in the National Preventive Dentistry Demonstration Program and who did not receive effective preventive procedures. The results indicate that in association with the caries decline in US children, treatment ratios increased by over 20 percent during the study period. FS/DFS ratios averaged 79 percent for the four grade/fluoridation status cohorts analyzed and were significantly higher in fluoridated than in nonfluoridated sites. The single-fissured surface was the dominant treatment or disease area observed and these surfaces tended to be restored early. In assessing tooth-surface status changes annually, tooth surfaces were more than twice as likely to change from sound to filled than from sound to decayed between yearly examinations at fluoridated sites. The lower levels of decay and higher degree of restorative care observed were not observed in lower SES and black children nearly to the extent as those for higher SES and white children in the population. The dental profession should shift its emphasis from the early restoration of fissured-surface defects to an expanded use of sealants for those with reduced decay and focus resources on a minority of the population with high caries levels who receive limited care.

Black People↗
PubMed1985

Operation of the National Preventive Dentistry Demonstration Program.

Operation of large-scale, multiple-site demonstration programs is an infrequent activity, one for which most investigators have had little previous experience. The success of a demonstration program, however, often rests on operational aspects. Following the completion of a major demonstration, the writers discuss the design of their program, the problems they encountered in its operation, and the aspects they would change in future demonstrations.

Audiovisual Aids↗
PubMed1985

Effect of secular decline in caries on the evaluation of preventive dentistry demonstrations.

Studies of dental preventive interventions often do not incorporate a concurrent, longitudinal control group in their study design. The existence of a secular decline in dental caries during the conduct of these studies may result in an overstatement of the effectiveness of the preventive intervention. Results of a recent large caries preventive study are analyzed using both a concurrent, longitudinal control group and an historical comparison group to demonstrate this effect. Differences in effectiveness of preventive procedures determined using the two types of control groups are sufficient to suggest a probable misinterpretation of results of studies using only historical comparisons.

Adolescent↗
PubMed1985

The cost and effectiveness of school-based preventive dental care.

The National Preventive Dentistry Demonstration Program assessed the cost and effectiveness of various types and combinations of school-based preventive dental care procedures. The program involved 20,052 first, second, and fifth graders from five fluoridated and five nonfluoridated communities. These children were examined at baseline and assigned to one of six treatment regimens. Four years later, 9,566 members of this group were examined again. Analyses of their dental examination data showed that dental health lessons, brushing and flossing, fluoride tablets and mouthrinsing, and professionally applied topical fluorides were not effective in reducing a substantial amount of dental decay, even when all of these procedures were used together. Occlusal sealants prevented one to two carious surfaces in four years. Children who were especially susceptible to decay did not benefit appreciably more from any of the preventive measures than did children in general. Annual direct per capita costs were $23 for sealant or fluoride prophy/gel applications and $3.29 for fluoride mouthrinsing. Communal water fluoridation was reaffirmed as the most cost-effective means of reducing tooth decay in children.

Child↗
PubMed1984

Comparison of two screening tests for Streptococcus mutans and evaluation of their suitability for mass screenings and private practice.

Two simple microbiological tests for quantitating salivary Streptococcus mutans levels were compared with each other and evaluated for suitability for mass screenings and private practice. Both tests use mitis salivarius medium with bacitracin (MSB) and are selective for S. mutans. One test estimates colonies grown on agar (MSBA) and the other estimates colonies grown in broth that adhere to glass (MSBB). Both are scored from 1 (lowest) to 5 (highest). Children (293) in grades 5 and 6 in Tallahassee, Florida (nonfluoridated) were tested for S. mutans levels. Scores of children by both tests were significantly similar (chi 2, regression and Kappa statistical analysis). Correlation coefficients (regression) between scores and DMFS increments of the previous 4 yr were 0.35 (MSBA) and 0.26 (MSBB). Both tests were very good in identifying children with low caries increments, but positive scores did not correlate well with high caries increments. Sampling and interpreting took 2 min (MSBA) and 1 min (MSBB). Cost of MSBA/child was $1.15, and MSBB/child $1.25. These tests are economical and suitable for mass screenings to identify low risk populations who do not require preventive treatment.

Bacteriological Techniques↗
PubMed1984

Indications for sealant use in a community-based preventive dentistry program.

Dental caries is a disease that recently has undergone, and may still be undergoing, dramatic changes in distribution of incidence and prevalence. The most recent epidemiologic data available have been reviewed in this paper to illustrate that caries is becoming a disease primarily of pits and fissures, with less differentiation than previously acknowledged between fluoridated and fluoride-deficient areas. The present distribution of caries suggests that prevention may be accomplished more effectively through targeted sealant programs than through currently popular mass preventive programs. Existing information can be used to identify logical target groups for sealant programs, and age specific tooth eruption and caries attack information can be used to design delivery methods. Although the adoption of targeted sealant programs represents a departure from the traditional mass approach to prevention in dental programs, the present-day caries distribution requires that the initiation of such programs be given serious consideration. At the very least program administrators are encouraged to invoke the planning-implementation-evaluation process. Current programs should be evaluated carefully in view of today's disease patterns and the clinical significance of the results achieved. The content, design, and timing of future community-based programs should reflect individualized community diagnosis and the application of new epidemiologic data as well as a careful evaluation of the results achieved by current preventive procedures.

Adolescent↗
PubMed1981

Branhamella catarrhalis pneumonia: report of two cases and review of the literature.

Branhamella (Neisseria) catarrhalis is a saprophytic inhabitant of the human oropharynx with the capacity to cause infection, particularly in immunodeficient hosts. There have been 2 cases of Branhamella catarrhalis pneumonia reported in the literature. Two additional cases are described and the subject reviewed. An 80-yr-old woman with chronic lymphocytic leukemia presented with left lower lobe pneumonia. Gram stain of transtracheal aspirate revealed intraleukocytic and extraleukocytic gram-negative diplococci, and a beta-lactamase producing strain of Branhamella catarrhalis was cultured. Therapy with erythromycin resulted in resolution of symptoms and eradication of the organism. A 64-ye-old alcoholic man presented with fever and multiple seizures. Chest roentgenogram revealed left lower lobe pneumonia. Cultures of endotracheal aspirate and blood grew a strain of Branhamella catarrhalis sensitive to penicillin. Penicillin treatment resulted in resolution of pulmonary infiltrate and eradication of the organism. The potential for Branhamella catarrhalis to produce pneumonia and the choice of antimicrobial therapy is discussed. It is emphasized that this organism should not be assumed to be a "normal" isolate and that penicillin may be ineffective in the treatment of Branhamella catarrhalis infections.

Aged↗
PubMed1980

Providing preventive dental care in the community using the team approach: a comparison of five training programs.

Five dental schools developed training programs for dental and dental auxiliary students in planning and delivering preventive dental services in a community setting. The schools (1) designed a curriculum that would train dental students to plan, organize, and manage the delivery of community preventive services using a team approach; (2) developed a related curriculum for dental auxiliary students; (3) implemented the program intramurally and extramurally in selected community settings; and (4) planned and conducted an evaluation of the program. Each school individualized the program to the interests of its students, the constraints of its curriculum, and the needs of community groups. A total of 228 dental and 576 dental auxiliary students were trained. A full range of community sites and target populations were provided with preventive dentistry services.

Clinical Competence↗