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Biomedical subjects

W S Driscoll

Publications and source records attributed to W S Driscoll.

At least 19 recordsLinked to original sources

Dental caries and dental fluorosis among schoolchildren who were lifelong residents of communities having either low or optimal levels of fluoride in drinking water.

OBJECTIVE: This paper reports findings for dental caries and dental fluorosis in 8-10- and 13-16-year-old schoolchildren who were lifelong residents of communities having either naturally occurring low (Broken Bow and Holdrege, NE; < 0.3 ppm) or optimal (Kewanee, IL; 1 ppm) levels of fluoride in drinking water. METHODS: Findings are reported for participants who received both dental caries and dental fluorosis examinations (n = 495). The DMFS and TSIF indices, respectively, were used to assess dental caries and dental fluorosis. RESULTS: The mean DMFS score adjusted for age, sealant presence, and fluoride use was significantly lower in Kewanee (1.8) than was the adjusted mean caries score in either Holdrege (2.9) or Broken Bow (3.6). Adjusted mean DMFS scores in Broken Bow and Holdrege were not statistically different. The mean percent of fluorosed tooth surfaces per person, adjusted for age and use of dietary fluoride supplements, was similar in the three communities (approximately 15%); more than 80 percent of tooth surfaces in all participants were fluorosis-free. CONCLUSIONS: Findings from the present study suggest that water fluoridation still is beneficial and that dental sealants can play a significant role in preventing dental caries. In addition, findings from this survey appear to support the premise that the difference in dental fluorosis prevalence between fluoridated and nonfluoridated communities has narrowed considerably in recent years.

Adolescent↗

Improved periodontal status through self-assessment. A 2-year longitudinal study in teenagers.

Short-term success of the use of self-assessment for motivating adults to improve their oral health status has been reported. The purpose of this trial was to evaluate the long-term effectiveness of two self-assessment strategies, one focused on gingival bleeding (group I) and another focused on plaque (group II). At baseline, 493 14- and 15-year-olds were assigned randomly to a group. Each subject was given a manual describing one of the self-assessment processes. Dental hygienists provided standardized classroom based instruction and two weeks later, individualized counselling. Examinations were conducted at baseline 6, 12, 18 and 24 months for gingival bleeding on probing, plaque, calculus, and probing depth; and at baseline and 24 months for recession and decayed, missing and filled surfaces (DMFS). Following the 12-month examination, subjects received an oral prophylaxis and individual counselling. The results revealed no statistically significant differences between groups for any clinical parameter at the final examination. However, the mean number of sites with gingival bleeding decreased steadily from baseline to 24 months with a 59% decrease and 55% decrease for groups I and II, respectively. This study suggests that self-assessment approaches can be effective in improving the long-term periodontal health status of teenagers.

Adolescent↗

Evaluation after 4 years of the combined use of fluoride and dental sealants.

This study evaluates the caries-preventive potential in permanent teeth of dental sealants when combined with an ongoing, school-based fluoride program. The investigation was designed as a sequential, cross-sectional comparison. Dental caries findings in 1987 for 416 children ages 7-11 and 14-17 who received dental sealants and fluorides were compared with corresponding data derived from 1983 baseline examinations of children who received fluoride therapy only. In addition, sealant retention status was determined. Overall mean DMFS scores in 1987 for children in two age groups combined were 51% lower than in 1983. Also, a surface-specific treatment effect was demonstrated in pit and fissures for both older and younger age groups. The overall proportion of sealants retained on occlusal surfaces of first molars after an average of 2 yr (92%) compared favorably with similar figures cited in the scientific literature. The results of this study suggest that pit and fissure sealants confer additional caries-preventive benefits beyond those of fluoride therapy alone.

Adolescent↗

Prevalence of dental caries and dental fluorosis in areas with optimal and above-optimal water fluoride concentrations: a 10-year follow-up survey.

OBJECTIVES: This paper presents findings for dental caries and fluorosis from an October 1990 follow-up survey in Illinois and compares results with those obtained from two similar school-based examinations conducted in 1980 and 1985 within the same communities. METHODS: The seven study sites were grouped into four categories according to the approximate relation of their water fluoride concentration to the recommended optimal fluoride level for the area. Tests for differences in dental caries and dental fluorosis across the four water fluoride groupings and three examinations were conducted. RESULTS: DMFS scores for children who resided in communities with above-optimal water fluoride levels did not change significantly from 1980 through 1990. At the optimal water fluoride concentration, caries scores did not change substantially from 1980 to 1985; however, the mean DMFS score in 1990, 1.9, was significantly lower than caries levels observed during the two previous exams. In the optimally fluoridated area, the proportion of fluorosed tooth surfaces increased significantly from 1980 to 1985, but then declined by 1990 to the level observed in 1980 for both age groups. CONCLUSIONS: The results suggest that: (1) in the optimally fluoridated community, the apparent increase in the prevalence of dental fluorosis observed from 1980 to 1985 did not continue from 1985 to 1990; and (2) at above-optimal water fluoride concentrations, dental fluorosis either remained stable or demonstrated no sustained increase over the decade.

Adolescent↗

The prevalence of dental fluorosis in a school-based program of fluoride mouthrinsing, fluoride tablets, and both procedures combined.

OBJECTIVES: The objective of the study was to describe and compare the prevalence and severity of dental fluorosis in children who participated in an eight-year clinical trial of the effectiveness of school-based fluoride procedures according to three treatment regimens and age of regimen initiation. METHODS: At baseline in 1981, 1,640 kindergarten and first grade children residing in a fluoride-deficient community (Springfield, OH) were assigned randomly to a group that (1) rinsed once a week with a 0.2 percent neutral NaF solution; (2) chewed, rinsed, and swallowed daily a neutral 2.2 mg NaF tablet; or (3) carried out both procedures. DMFS examinations were conducted at baseline and after two, five, and eight years of treatment. As a follow-up in 1992, fluorosis examinations using Dean's index were conducted on 448 remaining subjects. RESULTS: Overall, the prevalence of fluorosis was 4.4 percent with 20 children classified as having some definitive level of the condition. No statistically significant differences existed in the prevalence or severity of fluorosis: (1) among the preventive regimens; (2) among children who began the regimens at ages 5, 6, or 7; or (3) by eruptive status of teeth. CONCLUSION: These results reiterate the safety of school-based fluoride mouthrinse, fluoride tablet, or combined regimens in communities with fluoride-deficient water supplies.

Age Factors↗

A comparison of the caries-preventive effects of fluoride mouthrinsing, fluoride tablets, and both procedures combined: final results after eight years.

This paper presents final results of an eight-year clinical trial designed to compare the caries-preventive benefits of two self-administered fluoride procedures when used separately and in combination with one another. Children in kindergarten and first grade residing in Springfield, Ohio, a nonfluoridated community, were assigned randomly within school to one of three groups that either (a) rinsed once a week in school with a 0.2 percent neutral NaF solution; (b) chewed, rinsed with, and then swallowed daily in school a neutral 2.2 mg NaF tablet; or (c) carried out both procedures. At baseline (1981), 1,640 participants were examined clinically using the DMF surface index. Findings for 640 children remaining after eight years show that subjects in the combination group experienced a mean caries increment of 2.40 DMFS, 15.2 percent lower than the mean score of 2.83 DMFS for children in the tablet group and 32.8 percent lower than the 3.57 DMFS for those in the rinse group. Only the difference in incremental caries scores between the combined fluoride procedure and the fluoride rinse was statistically significant (P less than .05). The pattern of these findings is similar to that found on the two interim examinations. Even though the combined regimen showed an additional caries-preventive benefit compared with the rinse, considerations of cost effectiveness and feasibility do not support changing an ongoing rinse program to one that employs both procedures. For new programs the best choice appears to be the tablet procedure alone.

Adolescent↗

Evaluation of the comparative effectiveness of fluoride mouthrinsing, fluoride tablets, and both procedures in combination: interim findings after five years.

This article presents five-year interim findings of an eight-year clinical trial designed to compare the relative caries-preventive benefits of weekly fluoride mouthrinsing, daily fluoride tablet administration, and both procedures combined. Children in kindergarten and first grade residing in Springfield, Ohio, a nonfluoridated community, were assigned randomly in school to one of three groups that (1) rinses once a week in school with a 0.2 percent neutral NaF solution; (2) chews, rinses with, and then swallows daily in school a neutral 2.2 mg NaF tablet; or (3) carries out both procedures. At baseline (1981), 1,640 participants were examined clinically using the DMF surface index. After five years, 789 children were available for reexamination. Findings show that subjects in the combination group experienced a mean caries increment of 1.47 DMFS, 16.5 percent lower than the mean score of 1.76 DMFS for children in the tablet group and 31.3 percent lower than the 2.14 DMFS for those in the rinse group. Only the difference in incremental caries scores between the combined fluoride procedure and the fluoride rinse was statistically significant (P less than .05). Despite the finding of an additive caries-preventive benefit among children who followed the combined regimen, it would be premature to judge which procedure is best before results of the final examinations become known.

Child↗

Salivary levels of Streptococcus mutans and lactobacilli and dental caries experiences in a US adolescent population.

Dental caries exams and saliva samples were obtained from 541 adolescents, aged 10-15, initially and after 17 months as part of a 3-yr longitudinal study investigating the relationships of dietary intakes, specific microorganisms in saliva, and the prevalence and incidence of dental caries. The mean DMFS score detected in these subjects initially was 4.61, and they developed an average of 1.38 new DMFS during the first 17-month period. Initially, S. mutans and lactobacilli were detected in 64% and 56% of these subjects, respectively. Subjects with low levels of S. mutans and lactobacilli had significantly lower initial DMFS scores and developed significantly fewer new DMFS than subjects with high counts. The predictive values of a positive result for S. mutans or lactobacilli assays were low (31% and 39%), but those for a negative result were high (81% and 84%).

Adolescent↗

Combined fluoride, school-based program in a fluoride-deficient area: results of an 11-year study.

In 1972, a school-based fluoride program was initiated in elementary schools in Nelson County, VA, a fluoride-deficient area. For 11 years, participating children ingested daily in school a 1-mgm fluoride tablet and rinsed weekly with a .2% sodium fluoride solution. They also received fluoride dentifrice and toothbrushes for home use. The program was extended into junior high school in 1978 and into high school in 1980. In 1983, dental examinations of children aged 6 to 17 years, who had continuously participated in the program for 1 to 11 years depending on school grade, showed a mean prevalence of 3.12 DMFS, which was 65% lower than the corresponding score of 9.02 DMFS for children of the same ages at the baseline examinations. The preventive program inhibited decay in all types of surfaces: 54% in occlusal surfaces; 59% in buccolingual surfaces; and 90% in mesiodistal surfaces.

Adolescent↗

Prevalence of dental caries and dental fluorosis in areas with negligible, optimal, and above-optimal fluoride concentrations in drinking water.

The prevalence of dental caries and dental fluorosis was assessed in 1,123 children aged 8 to 16 years who were lifelong residents of areas with negligible, optimal, and above-optimal concentrations of natural fluoride in drinking water. Caries prevalence in the optimal fluoride area was 38.1% lower than it was in the negligible fluoride area, and, in the higher-than-optimal fluoride areas, even greater caries protection was evident. Caries protection was compromised in children with severe fluorosis. Findings do not support the contention that definite increases in the prevalence of fluorosis are occurring in communities with negligible and optimal water-fluoride concentrations because of increased total fluoride consumption from various sources.

Adolescent↗

Eight-year evaluation of a combined fluoride program in a nonfluoride area.

The purpose of this study is to measure the long-term effects of a combination of self-applied fluoride methods among schoolchildren living in a rural area with low concentrations of fluoride in drinking water. Participating children rinse weekly with a 0.2% sodium fluoride solution and ingest daily a 1-mg fluoride tablet in school under supervision of their teachers, and received fluoride toothpaste and toothbrushes for use at home. In 1980, dental examinations of children ages 6-14, who had continuously participated in the program for 1 to 8 years, depending on their school grade, had an overall mean caries prevalence of 3.22 DMFS, 49% lower than the corresponding mean score of 6.31 DMFS for children of the same ages at the baseline examination. The preventive program inhibited decay in all types of tooth surfaces: 37% in occlusal, 41% in buccolingual, and a striking 86% in mesiodistal. At each succeeding follow-up survey, benefits have continued to improve; the reductions in caries prevalence were 18% after 2 years, 35% after 4 years, 45% after 6 years, and 49% after 8 years. Findings in approximal tooth surfaces have also continued to improve as the length of the program has increased; reductions in caries in mesiodistal surfaces were 32%, 69%, 85%, and 86% after 2,4,6, and 8 years, respectively. Internal analyses of data indicate that the decline in dental caries prevalence resulted from the fluoride program and not from an unexplained natural decline in caries prevalence. The self-applied combined fluoride regimen used in this program has been shown to produce a pronounced anticaries effect.

Adolescent↗

A new method for assessing the prevalence of dental fluorosis--the Tooth Surface Index of Fluorosis.

A new index for measuring the prevalence of dental fluorosis, the Tooth Surface Index of Fluorosis (TSIF), was used to assess the condition in the permanent teeth of 807 children, aged 8 to 16, who had resided all their lives in one of seven Illinois communities with an optimal concentration of fluoride in its water or with 2, 3, or 4 times the optimal concentration. Fluorosis was absent in 84.5% of all tooth surfaces examined in the community with optimal fluoride. In contract, only 31.9% of tooth surfaces had no fluorosis in the community with 4-times the optimal fluoride level. In the optimal fluoride area, 79% of facial surfaces of maxillary anterior teeth, which are esthetically conspicuous, had no fluorosis, whereas only 15.8% of these surfaces in the 4-times optimal area were unaffected. The percentages of all tooth surfaces affected by fluorosis characterized by staining, pitting, or both were 1%, 8%, 19%, and 38%, respectively, in communities with 1-, 2-, 3-, and 4- times optimal fluoride. Differences in fluorosis based on maximum score for all tooth surfaces in a child were statistically significant (an extended chi 2 statistic) among all communities. First molars and incisors in children 8 to 10 years old were affected by more fluorosis than were the same teeth in children 13 to 16 years old. These teeth had been erupted for about 5 years longer in the older age group. The difference might result from abrasion or remineralization of these teeth in the older children or from greater consumption of fluoride by the younger children during tooth development.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Prevalence of dental caries and dental fluorosis in areas with optimal and above-optimal water fluoride concentrations.

The prevalence of dental caries and dental fluorosis was assessed among 807 schoolchildren in four areas of Illinois where the respective water supplies contained natural fluoride at concentrations of 1, 2, 3, and 4 times the recommended optimal for the geographic area. Mean caries scores in all three above-optimal fluoride areas were significantly lower than in the optimal area. The prevalence of dental fluorosis was characteristically low in the optimal fluoride area. Substantial increases in fluorosis occurred in the above-optimal fluoride areas, with the condition being most pronounced in the 4-times optimal area.

Adolescent↗

Caries-preventive effects of fluoride tablets in schoolchildren four years after discontinuation of treatments.

The Wayne County data indicate that administration of fluoride tablets in school should be recommended in nonfluoridated areas as an effective public health measure to prevent dental caries. In addition to reducing dental caries effectively, administering fluoride tablets in school has a number of other desirable features; it is safe and relatively inexpensive; it requires no paper products and thus eliminates waste disposal; it takes little time to administer (less than three minutes per day for a classroom of average size); it is easy for young children to learn and to do; and it can be supervised by teachers, aides, or volunteers after minimal training. Findings that benefits still persist, although perhaps to a slightly lesser degree, four years after treatment is discontinued further accentuate the public health appeal of the procedure. The data give no indication that two fluoride tablets a day are more protective than one tablet a day. Therefore, a single one-mg fluoride tablet daily is recommended for school programs because of lower cost and greater feasibility.

Acidulated Phosphate Fluoride↗

A program self-administered fluorides in a rural school system.

In 1972, a self-administered fluoride program was initiated in Nelson County, VA, a fluoride-deficient area. Children in elementary school (grades K-6) ingest daily a 1-mg fluoride tablet, rinse weekly with 0.2% NaF solution and receive fluoride dentifrice for home use. In 1978, dental examinations of elementary schoolchildren (ages 6-12) who had continuously participated in the program for 1 to 6 years showed a prevalence of 2.70 DMFS, 45% lower than the score of 4.89 DMFS for their cohorts at the baseline. The preventive program inhibited dental caries effectively in all types of surfaces, but the reduction in proximal surfaces of 85% is particularly striking. Findings of high school children (ages 13-17) in 1978, who had not participated in the elementary school program for 1-5 years, showed evidence of strong post-treatment effects. At each succeeding follow-up survey, benefits have continued to improve. For elementary school participants, benefits were 17.7% after 2 years, 35.3% after 4 years and 44.8% after 6 years. Weekly fluoride mouthrinsing and daily ingestion of a fluoride tablet are feasible school-based procedures for the prevention of dental caries. Combined with the use of a fluoride dentifrice at home, these procedures have a pronounced cariostatic effect.

Acidulated Phosphate Fluoride↗