PubMed · 4380084
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D Jackson. 1966. Errors in clinical trials.. https://pubmed.ncbi.nlm.nih.gov/4380084/
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From a preventive point of view collection of data concerning carious and non-carious cervical tooth defects is definitely important. Consequently, the prevalence and distribution of different root lesions were studied and correlated with behavioral and biological factors in 50- to 60-year-old German individuals (n = 298). Additionally, the data were correlated with characteristics concerning oral health and known risk factors such as gender, educational level, and presence of plaque. An interview included questions on sociodemographic and socioeconomic characteristics, dental and general health status, and various behavioral parameters. During clinical examination data concerning coronal and root lesions, restorations, probing depth, gingival bleeding, and dental plaque were obtained. The participants represented a social middle class population with a high awareness of dental health. Obviously, for the participants, known risk factors for root decay such as gender, educational level and plaque index were of minor importance. Factors correlating with root caries were: (a) number of missing teeth, (b) probing depth, (c) smoking habit, (d) regular dental attendance and (e) the reason for the last dental treatment. Additionally, the prevalence of non cariogenic lesions, primarily resulting from increased but wrongly performed oral self care, seems gradually to relieve carious root destruction.
As longitudinal epidemiologic studies of dental caries address increasingly complex research questions, approaches to analysis of data from those studies have become more sophisticated. This review examines methods available for analyzing and reporting data from such studies. Traditional analytic methods utilize the DMFS increment as the outcome measure in longitudinal studies of caries. However, two other outcome measures may be needed to address some research issues: cumulative incidence, which quantifies caries risk; and incidence density, which quantifies caries rate. Four major analytic decisions have to be addressed when computing DMFS increment: examiner misclassification ("reversals"), teeth lost due to caries, findings from more than two examinations, and multiple events such as caries initiation and progression. We present a uniform approach for enumerating caries events that permits the same analytic decisions made in calculating DMFS increment to be applied to cumulative incidence and incidence density calculations. In view of the variety of analytic decisions that must be made when enumerating events in longitudinal studies of caries, authors should specify how all potential changes in caries status were handled. Furthermore, if a study uses more than one outcome measure, the same decisions for enumerating events should be used when computing those measures.
BACKGROUND AND OVERVIEW: Patterns of clinical care are closely linked to the nature of diseases in the population. During the past decade, the nature of both dental caries and periodontitis has undergone a transformation that has implications for dental practice. Especially in younger cohorts, the overall need for extensive restorative and periodontal treatment is much reduced, compared with that of prior generations. CONCLUSIONS: Over the next several decades, there will be a slowly declining per-capita need for restorative and surgical care. The overall mix of services will continue to shift toward diagnostic and preventive services. PRACTICE IMPLICATIONS: At least in terms of today's conventional dental care, each provider in the future should be able to manage the oral health care needs of larger numbers of patients than is possible today.