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R J Hunt

Publications and source records attributed to R J Hunt.

At least 55 records · Page 3Linked to original sources
PubMed1988

Is it time to reassess the public health implications of periodontal diseases? A review of current concepts.

In 1981 the American Association of Public Health Dentists' Subcommittee on Preventive Periodontics called for a national initiative toward controlling periodontal disease, including the development of national policy statements from national dental organizations and the development of education programs for the public and the profession. Since the 1981 report, the findings of a diverse group of studies raises a variety of questions about the prevalence of periodontal diseases, the etiology and progression of the diseases, and the feasibility and practicality of controlling them. An examination of this new information leads to the conclusion that it is time to reassess the public health implications of periodontal diseases.

Health Policy↗
PubMed1988

Incidence of tooth loss among elderly Iowans.

This study investigated the 18-month incidence of tooth loss in a random sample of 451 dentate noninstitutionalized Iowans aged 65 and older residing in two rural counties. They had a mean of 19.0 teeth at baseline and lost an average of 0.4 teeth during the subsequent 18 months. Twenty-one per cent of the population lost at least one tooth. Four people had all their teeth extracted. Of the teeth present at baseline, 1.9 per cent subsequently were extracted. The highest incidence of tooth loss occurred among mandibular molars (3.7 per cent), followed by maxillary premolars and canines (3.1 per cent each). The best predictors of tooth loss were previous coronal and root caries.

Aged↗
PubMed1988

Identification of high caries risk adults: attitudes, social factors and diseases.

Since agent, host and environmental factors have been associated with caries, the development of multivariate risk assessment models is warranted. This process comprises the identification of risk factors, the development and testing of risk models, assessment and targeting. Work-in-progress by the authors in delineating oral, social/behavioural and medical risk factors for root caries in older adults shows that regression models explain 48 per cent of the variance in root caries scores for males and 47 per cent for females. Discriminant analyses using the risk factors identified in the regressions differentiated between people who did and did not get root caries during an 18-month period. The sensitivity of the predictions for men was 0.75 and the specificity was 0.79. For women, the sensitivity was 0.79 and the specificity was 0.83. These results suggest that it will be possible to develop a clinically useful risk assessment model. Future studies should include data on oral risk factors, such as micro-organisms present, salivary flow and buffering capacity, that can be added to the multivariate model.

Adult↗
PubMed1987

The efficiency of half-mouth examinations in estimating the prevalence of periodontal disease.

Several studies, including the NIDR 1985 national survey of working adults, have used periodontal examinations of only two quadrants of the mouth to estimate the prevalence of periodontal conditions. To investigate the efficiency of half-mouth periodontal examinations, I compared the results from the examination of all teeth in a sample of 477 dentate elderly people with scores that would have been obtained if randomly selected pairs of quadrants had been examined instead. In this elderly dentate population, relatively little information would have been lost if diagonal half-mouth or same-side half-mouth scores instead of whole-mouth scores had been used to estimate the number or proportion of teeth with periodontal conditions. However, the proportion of people with the less prevalent conditions, i.e., deep pocketing and mobility, was underestimated slightly. Slightly less efficiency was also noted for the less prevalent conditions. These findings suggest that half-mouth recording may be useful for prevalence surveys, but cannot be recommended for incidence surveys or clinical trials, where incremental changes may be small.

Aged↗
PubMed1986

Percent agreement, Pearson's correlation, and kappa as measures of inter-examiner reliability.

Percent agreement and Pearson's correlation coefficient are frequently used to represent inter-examiner reliability, but these measures can be misleading. The use of percent agreement to measure inter-examiner agreement should be discouraged, because it does not take into account the agreement due solely to chance. Caution must be used in the interpretation of Pearson's correlation, because it is unaffected by the presence of any systematic biases. Analyses of data from a reliability study show that even though percent agreement and kappa were consistently high among three examiners, the reliability measured by Pearson's correlation was inconsistent. This study shows that correlation and kappa can be used together to uncover non-random examiner error.

Dental Caries↗
PubMed1985

Methodological considerations in a dental epidemiologic survey of an elderly population.

The proportion of the US population that is age 65 or over is increasing and edentulism rates are declining. The community's elderly population is becoming an increasingly important constituency for dental public health. Little is known, however, about the actual oral health status of these people. An assessment of oral health in the elderly presents many considerations not found in an assessment of oral health among children. The selection of subjects to represent all the elderly in the community is difficult. Caries assessment is complicated by the need to distinguish between coronal caries and root caries and by the inability to determine accurately the reason for prior tooth loss. Periodontal assessment is more difficult than in younger populations because the conditions tend to be advanced. The recruitment of participants is difficult because each potential subject must be contacted individually. These assessments are needed so the oral status of adult populations can be determined.

Aged↗
PubMed1985

Prevalence of root and coronal caries in a noninstitutionalized older population.

This paper describes the prevalence of coronal caries and root caries in a sample of 520 people representative of the noninstitutionalized, dentate population older than age 65 in two rural Iowa counties. The subjects were examined in their homes by trained dental examiners. All prevalence rates were age- and gender-adjusted. Both types of caries were prevalent in the population age 65 and older. If projections of increased numbers of older people and increased retention of teeth are reasonably accurate, caries in older populations may become a significantly greater dental problem, and increased prevention and treatment of caries will be needed for these people.

Aged↗
PubMed1985

Edentulism and oral health problems among elderly rural Iowans: the Iowa 65+ rural health study.

A household health interview survey of 3,673 noninstitutionalized people aged 65 and over in two rural Iowa counties included questions about loss of teeth, use of dentures, and presence of oral health problems. Edentulism rates were 10-15 per cent lower than those found a decade earlier in national health surveys. A log-linear analysis found that the best demographic predictors of edentulism were education, age, and marital status. Spouses tended to be of similar dentition status, i.e., both edentulous or both dentate. No association was found between the loss of teeth and prevalence of digestive problems. Only 7 per cent of the edentulous people felt they needed to visit a dentist, even though 70 per cent had not seen one for over five years. About 40 per cent had dentures that were over 20 years old, with half of these being over 30 years old. Many dentures were loose and causing soreness in the mouth or difficulty in eating. These elderly people appeared to expect some problems with dentures and oral pain and accepted them without feeling a need to seek treatment.

Aged↗