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PubMed1995

The effect of 25 years of water fluoridation in Newcastle assessed in four surveys of 5-year-old children over an 18-year period.

In 1994, the dental health of 496 5-year-old children who had lived in continuously fluoridated (at 1.0 mg F/litre) Newcastle was compared with the dental health of 436 children of the same age in non-fluoridated (less than 0.1 mg F/litre) south east Northumberland. The study also reported changes in the dental health of 5-year-old children in four surveys in these areas during the period 1976 to 1994. The mean dmft of children in the fluoridated area was 1.33 compared with 2.41 in the non-fluoridated area--a difference of 1.08 per child (45%). The corresponding dmfs scores were 2.80 in the fluoridated area and 5.77 in the non-fluoridated area--a difference of 2.97 tooth surfaces per child (52%). Thirty-nine per cent of children in the fluoridated area had experienced dental caries, compared with 55% in the non-fluoridated area. Only 10% of children in the fluoridated area had experienced dental caries in more than four teeth, compared with 22% in the non-fluoridated area. The prevalences of lifetime experience of toothache, extractions and general anaesthesia for dental extractions were greater in the non-fluoridated area than in the fluoridated area. When the results of this survey were compared with the results of similar surveys in the same areas in 1976, 1981 and 1987, it appeared that there has been a further reduction in dental caries levels following the levelling off observed between 1976 and 1981.

Chi-Square Distribution↗
PubMed1998

A public perception of access to NHS dentistry.

OBJECTIVE: To quantify the level of unmet dental access need which had been reported locally and to provide information about the perceived need for dental treatment with particular reference to those not registered for continuing NHS care. DESIGN: A postal survey of adults resident in Aylesbury Vale, Buckinghamshire was carried out toward the end of 1994. SUBJECTS AND METHODS: 2000 adults aged between 35 and 54 years were randomly selected: RESULTS: A response rate of 68% matched well with the population under study. 16% of people were unable to access any regular dental care and this group had the highest treatment need, with more experience of broken fillings and toothache within the previous year. 15% thought they were registered with an NHS dentist, but were not. Only 28% of all respondents were confirmed registered with an NHS dentist. 27% said they received private care, and one-third of these said it was because they had been unable to find an NHS dentist. In total, 74% of the population under study thought they were receiving regular dental care and only 6% did not want regular care. More than one-third of respondents volunteered comments about dental services. The majority were supportive of dentists but critical of the lack of NHS provision. CONCLUSIONS: This survey indicates a substantial unmet perceived need in Aylesbury Vale, with more than one-third of this population unable to access continuing NHS dental services which they prefer. There is also a need for emergency and occasional dental treatment for a small proportion of this population. It is likely that a similar situation exists elsewhere in England.

Adult↗
PubMed1998

Sickle cell disorder and orofacial pain in Jamaican patients.

AIM: The aim of this study was to investigate the prevalence of orofacial pain in a large group of sickle cell disorder (SCD) sufferers. METHODS: In 1996, 51 Jamaican adults and teenagers with SCD and 51 matched subjects (non-SCD) without any sickle cell problems were questioned about their experience of pain in the maxilla or mandible, and pain in their teeth. The subjects, aged 13 to 45 years, had oral examinations and the state of the teeth was recorded together with the presence or absence of deep periodontal pockets, vertical or horizontal mobility, sepsis, trauma and severe erosion. RESULTS: Mandibular or maxillary pain during the previous 12 months was reported by 49% of those with SCD and only 8% of the non-SCD subjects. Among the SCD group reporting this pain, 68% were found to have no dental problems which could have caused the pain. Dental disease accounted for the facial pain in all non-SCD subjects. Headaches were experienced by 77% of the SCD group and only 47% of the non-SCD group. Experience of toothache during the previous year was reported by 67% of the SCD group and 57% of the non-SCD. In half of these SCD subjects there was no obvious dental pathology to account for the dental pain but none of the controls had dental pain in the absence of dental pathology. CONCLUSION: People who suffer from sickle cell disorders are likely to suffer orofacial and dental pain in the absence of dental pathology and this is probably because of sickling crises within the microcirculation of the facial bones and dental pulps and small areas of necrosis in the bone marrow.

Adolescent↗
PubMed2003

GC-MS analysis and bioactivity testing of the volatile oil from the leaves of the toothbrush tree Salvadora persica L.

Upon GC-MS analysis of the volatile oil extracted from Salvadora persica L. leaves, we were able to identify benzyl nitrile, eugenol, thymol, isothymol, eucalyptol, isoterpinolene, and beta-caryophyllene. Toxicity of the aroma was evaluated using brine shrimp lethality test which gave an LC50 > 1,000 ppm. Using Disc Diffusion Test, it was found that the extract of the leaves has a considerable antibacterial effect on several different oral aerobic bacteria with comparable results to known antibiotics. The extract can be used effectively as a natural tool for teeth cleaning and as a natural analgesic for the disturbing toothache.

Analgesics↗
PubMed2004

Dental treatment needs of children in a rural subcounty of Uganda.

OBJECTIVES: To describe normative dental treatment needs of 5-7 and 12-year-olds in a rural sub county of Uganda and devise a strategy to improve oral health. DESIGN: Clinical survey. SETTING: Primary schools in the subcounty. SAMPLE AND METHODS: School-based random cluster sample of 236 5-7-year-olds and 202 12-year-olds. Dental status and treatment need data were collected according to WHO Oral Health Surveys Basic Methods. Additional data for 12-year-olds included dental fluorosis using the Thylstrup and Fejerskov index (TFI), oral hygiene procedures and experience of oral pain in the previous month. RESULTS: In the 5-7-year-olds, mean dmft was 1.47 (50.8% dmft = 0). A total of 52.5% needed fillings and almost one third needed a tooth extracted. Among the 12-year-olds, mean DMFT was 0.64 (65.8% DMFT = 0), 28.5% had dental fluorosis and 6.7% had TFI > 2. Toothache in the previous four weeks was reported by 36.5%, 30.2% needed a filling and 6.4% needed one or more teeth extracted. CONCLUSIONS: Dental disease is a significant public health problem in this population. An efficient way to meet the needs of the children would be to increase the availability of fluoride toothpaste and to develop a service to provide treatment using Atraumatic Restorative Technique.

Adolescent↗
PubMed2004

Social inequalities in oral health and in use of oral health care services among adolescents in Uganda.

OBJECTIVE: The aim of this study was to describe clinical and self-perceived indicators of oral health status and the use of oral health care services by social and demographic characteristics. METHODS: In 2001, a cross-sectional random sample survey was conducted in urban and rural settings in Uganda (Kampala and Lira, respectively), and 1146 secondary school students with a mean age of 15.8 years completed questionnaires in school. Dental caries was recorded by one examiner on a random subsample of 372 students. RESULTS: Logistic regression analyses revealed that being an urban resident was associated with higher odds for having dental caries (dmft > 0), seeking care because of toothache (delayed treatment demand) and being dissatisfied with one's own oral health status [adjusted odds ratio (OR) = 1.5-2.1]. Being an urban resident was associated with lower odds for oral health care attendance generally and for having missing teeth in particular (adjusted OR = 0.6-0.4). Students who had parents with a higher education and those with weak social ties were, respectively, less and more likely to be dissatisfied with their oral health status. As compared to caries-free participants, the odds for being dissatisfied with oral health and delayed treatment demand increased significantly with an increasing dmft score (adjusted OR = 2.1-3.2). CONCLUSION: Urban students were most likely to have a dmft > 0 and to rate their oral health status negatively. Having received dental care and the prevalence of missing teeth, and delayed treatment demand were, respectively, most and least prevalent among rural students. Dental caries at different diagnostic cut-off points and weak social ties affected self-reported oral health negatively, independently of social and demographic characteristics.

Adolescent↗
PubMed2006

Further dental treatment needs of children receiving exodontia under general anaesthesia at a teaching hospital in the UK.

OBJECTIVES: The aim of this study was to investigate the subsequent dental treatment needs of children who had dental extractions under general anaesthesia (GA) in 1997 in the Day Case Unit at Leeds Dental Institute (LDI), Leeds, UK, and the reasons for repeat dental GAs (DGAs). STUDY DESIGN: The authors conducted a retrospective longitudinal analysis. SUBJECTS AND METHODS: Information collected from hospital records for the 6-year period following the first DGA included: reasons for the DGA in 1997 and teeth extracted; the number of subsequent DGAs, reasons and treatment; incidents of and reasons for toothache or swelling after 1997; treatment under local anaesthesia (LA) or inhalation sedation (IS) at LDI during the 6 years following the DGA in 1997. RESULTS: The study population consisted of 484 children, who received GA exodontia at LDI with a mean age of 6.35 years [95% confidence interval (CI) = 6.1, 6.6] and age range of 1-16 years. The most common reason for extractions at the original DGA in 1997 was dental caries, and the mean number of extractions was 4.24 (95% CI = 4.05, 4.43). Primary teeth extractions accounted for 82% of the cases. In total, 143 children (27.5%) had a record of follow-up treatment at LDI. Of these children, 32% had treatment under LA, 7% under LA and IS, and 15% received preventive care only. The overall repeat rate for DGA was 10.7%, with caries (84%) being the main reason for this. Of the teeth subsequently extracted, 72% were recorded as caries-free or unerupted at the time of the DGA in 1997. CONCLUSIONS: A large proportion of the follow-up visits were to treat newly developed dental disease during the 6 years following the DGA in 1997. A more proactive approach towards preventive care may have resulted in the reduction of the development of new dental disease.

Adolescent↗
PubMed2004

Impact of oral health on the life quality of periodontal patients.

OBJECTIVES: To assess the impact of oral health on the life quality of a periodontal patient group. MATERIALS AND METHODS: Two hundred and five patients attending a private periodontal clinic completed a questionnaire incorporating the 16-item UK oral health-related quality-of-life measure (OHQoL-UK), a check list of questions about their periodontal health over the past year and a comprehensive periodontal examination. RESULTS: The effect of oral health on quality of life was considerable, with many individuals experiencing negative impacts across a broad range of physical, social and psychological aspects of life quality. OHQoL-UK(Copyright ) scores was associated with patient's self-reported periodontal health in the past year: experiences of "swollen gums" (p<0.01), "sore gums" (p<0.01), "receding gums" (p<0.01), "loose teeth" (p<0.01), "drifting teeth" (p<0.01), "bad breath" (p<0.01) and "toothache" (p<0.01). In addition, OHQoL-UK scores were correlated with the number of teeth with pocket depths of 5 mm or more (r(s)-0.42, p<0.01). New patients had poorer oral health-related quality of life compared with the treated maintenance group (p<0.01). CONCLUSIONS: Periodontal status impacts on life quality. This has implications in understanding the consequences of periodontal health and in the use of patient-centred outcomes in periodontal research.

Affect↗
PubMed1987

Prevalence of oral and facial pain and discomfort: preliminary results of a mail survey.

A mail survey was undertaken to estimate the prevalence of oral and facial pain and discomfort in the City of Toronto. Self-complete questionnaires were sent to a random sample of 1014 persons drawn from the voter's list. Replies were received from 72% of those eligible. Overall, 53% of respondents had experienced some pain or discomfort in the 4 wk prior to the completion of the questionnaire. The most common kinds of pain and discomfort reported were pain in the teeth with hot or cold fluids (28.8%), sore and bleeding gums (26.3%) and toothache (14.1%). Pain in jaws, face and oral mucosa was reported by less than 10% of the subjects. While much of the pain experienced by the respondents was classified as mild, half (50.1%) said that it was moderately severe or severe. Only 40% of those reporting pain had sought the advice of a dentist or doctor. Sex differences in the reporting of pain were small and statistically non-significant, although age differences were marked and significant. The younger age groups were more likely to report both pain and discomfort than the older age groups. The survey has revealed a substantial amount of oral and facial pain in the community, much of which is not subject to professional attention.

Adolescent↗
PubMed1987

Dental needs, demands and patterns of service utilization in a selected Malaysian urban population.

The dental needs, demands and patterns of service utilization were assessed in a randomly selected sample of 750 subjects attending the Dental Faculty, University of Malaya, Kuala Lumpur. Toothache accounted for the most frequent overall dental complaint. However, the most common motives for seeking dental care varied among children (2-12 yr), adolescents (13-18 yr) and adults (19 + yr). The attendance behavior of women is more preventively orientated and more inclined towards rehabilitation compared to that of men. The proportion of normative needs of the patients varies from 7.5% for dentures to 66% for dental caries. About 50% of service utilization for the first visit consisted primarily of extractions in the oral surgery department.

Adolescent↗
PubMed1996

Oral impacts affecting daily performance in a low dental disease Thai population.

The aim of the study was to measure incidence of oral impacts on daily performances and their related features in a low dental disease population. 501 people aged 35-44 years in 16 rural villages in Ban Phang district, Khon Kaen, Thailand, were interviewed about oral impacts on nine physical, psychological and social aspects of performance during the past 6 months, and then had an oral examination. The clinical and behavioural data showed that the sample had low caries (DMFT = 2.7) and a low utilization of dental services. 73.6% of all subjects had at least one daily performance affected by an oral impact. The highest incidence of performances affected were Eating (49.7%), Emotional stability (46.5%) and Smiling (26.1%). Eating, Emotional stability and Cleaning teeth performances had a high frequency or long duration of impacts, but a low severity. The low frequency performances; Physical activities, Major role activity and Sleeping were rated as high severity. Pain and discomfort were mainly perceived as the causes of impacts (40.1%) for almost every performance except Smiling. Toothache was the major causal oral condition (32.7%) of almost all aspects of performance. It was concluded that this low caries people have as high an incidence of oral impacts as industrialized, high dental disease populations. Frequency and severity presented the paradoxical effect on different performances and should both be taken into account for overall estimation of impacts.

Activities of Daily Living↗
PubMed2005

Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form.

OBJECTIVE: The aim of the study is to evaluate the measurement properties of the Brazilian version of the short form of the Oral Health Impact Profile (OHIP14). METHODS: Data were obtained from a cross-sectional study designed to assess the impact of toothache on quality of life during pregnancy. The sample consisted of 504 postpartum women (mean age 24 years; SD 6.2), most of whom had unsolved dental problems and belonged to low-income families. The questionnaire was administered in the form of interviews by two trained interviewers who also performed clinical examinations. Reliability was assessed in terms of internal consistency and stability. Construct validity was evaluated based on comparison of the total scores among groups according to: self-perceived and normative oral health care needs, self-perceived general and oral health status, presence of carious lesions and tooth loss. It was also hypothesized that the scores of OHIP14 and Oral Impacts on Daily Performances (OIDP) would correlate with each other. RESULTS: Both test-retest stability and internal consistency, as measured by the intra-class correlation coefficient (0.87) and by Cronbach's alpha (0.91), proved to be adequate. Construct validity was confirmed as the correlation between OHIP14 scores with self-perceived general and oral health were in the expected direction, and the differences in scores of the groups formed according to the selected attributes were significant at values of P < or = 0.05 (Mann-Whitney test). Moreover, the correlation coefficient between OIDP and OHIP14 was 0.76 (rs). CONCLUSION: The Brazilian version of OHIP14 has good psychometric properties, which are similar to those of the original instrument.

Adult↗
PubMedDate not supplied

Dental self-care among dentate adults: contrasting problem-oriented dental attenders and regular dental attenders.

Self-care behaviors are common and can act as substitutes for or supplements to formal health care services. We tested the hypothesis that problem-oriented dental attenders (POAs) report more dental self-care behaviors than do regular dental attenders (RAs), presumably as a substitute for professional care. The Florida Dental Care Study is a longitudinal cohort study of changes in oral health, in which we measured dental self-care behaviors related to three common dental problems: toothache pain, bleeding gums, and tooth loss. Despite using less dental care, POAs were less likely to report "conventional" methods as means to prevent the three dental problems; however, they were more likely to report that homemade remedies, topical medications, or mouthwashes were ways to prevent or treat these problems. POAs were also more likely to believe that "nothing can be done" to prevent these problems. Additionally, POAs had more negative dental attitudes, used less dental care during follow-up, had more dental disease, were the only persons who extracted at least one of their own teeth, and were more likely to use tobacco. With the exception of dental self-extractions, no single self-care belief or behavior distinguished POAs from RAs, nor were POAs likely to have different explanations for dental problems. Instead, the pattern was one of modest differences on a number of items. Although POAs use less dental care, they do not compensate by employing more "conventional" dental self-care behaviors, but report being more likely to employ "unconventional" behaviors. They also are more likely to believe that nothing can be done to prevent dental problems.

Adult↗
PubMedDate not supplied

The implications of visual impairment in an elderly population in recognizing oral disease and maintaining oral health.

The incidence of impairment and disability increases in the elderly population. Disability can affect elderly people's ability to maintain oral health, maintain access to dental care, and accept dental treatment. The oral health of visually impaired people can be disadvantaged, since they are not in a position to detect and recognize early oral disease and may be unable to take immediate action unless informed of the situation. The aim of this pilot study was to identify the problems experienced by a visually impaired elderly population regarding the maintenance of oral health and the need to seek treatment. Sixty-two legally blind people underwent a structured interview and a clinical dental examination. Data are presented descriptively. All the participants would be potentially able to maintain their own adequate oral health level if given the appropriate stimulus. At the time of the study, 53% brushed their own teeth, 39% of whom brushed daily. Of the denture wearers, 58% cleaned them at least once a week. Most of the participants were independent. Eighty-two percent believed that they did not need help to brush their teeth or dentures, even though 85% had never been shown how to brush their teeth. Eighty percent of people did not realize that regular oral reviews were necessary. Other barriers to regular care included poor health, mobility problems, cost, and fear. Twenty-one percent of the sample had toothache or a denture problem. The professionally assessed treatment need was high in the dentate group, and 32% of denture wearers had denture-related pathology. The professionally assessed treatment need was greater than the visually impaired people's perceived need for care. The majority of visually impaired elderly were capable of maintaining a reasonable level of oral hygiene by themselves and were aware of their own dental needs but either had no reason to seek care or were unable to access oral health care services. It is important for visually impaired persons to realize that they need supervision to maintain good oral hygiene standards and to ensure the early identification of oral pathology. Also, the barriers to access to oral health services need to be reduced.

Activities of Daily Living↗
PubMed1996

Oral conditions and their social impact among HIV dental patients.

This study aimed to assess oral health status and the social impact of oral conditions among dental patients with HIV infection in comparison with general dental patients receiving public-funded care in Adelaide, South Australia. DMFT and CPITN indices were recorded by one dentist at a clinic for HIV dental patients. The data were compared with information from an existing survey of general dental patients. Social impact was assessed using the Oral Health Impact Profile questionnaire and responses from HIV dental patients were compared with responses from a telephone interview survey of Adelaide residents. HIV patients were aged 21 to 49 years (median = 34), 90.7 percent were male and 29.6 percent had stage 4 HIV infection. Oral candida was present among 32.0 percent, hairy leukoplakia among 24.1 percent, HIV gingivitis among 18.5 percent, and HIV periodontitis among 33.3 percent. The DMFT index and its components did not differ significantly between HIV and general dental patients, while CPITN scores were lower among HIV patients (p = 0.01). However social impact among HIV patients was frequent: 64.6 percent reported toothache, 43.7 percent avoided foods, and 16.7 percent avoided going out because of dental problems. HIV patients reported significantly greater levels of social impact than the Adelaide sample (p < 0.01). Patients to this clinic frequently presented with severe and disabling oral conditions which were not adequately captured using standard clinical indices.

Adult↗
PubMed2005

An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students.

OBJECTIVE: To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students. DESIGN: Cross-cultural survey of dental students. SETTING: 18 cultural areas. PARTICIPANTS AND METHODS: 904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions. RESULTS: The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001). CONCLUSIONS: Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.

Asia↗
PubMed2003

Burning mouth syndrome and other oral sensory disorders: a unifying hypothesis.

Burning Mouth Syndrome (BMS) is a sensory disorder which results in constant, bilateral burning pain of the tongue, lips, and other oral mucous membranes. Atypical odontalgia (AO) is another sensory disorder, usually defined as a toothache-like pain for which no dental cause can be identified. Previous literature has suggested that AO is often associated with a concomitant temporomandibular disorder (TMD). This hypothesis paper explores the possibility that BMS, AO and TMD can be related through hyperactivity of both the sensory and motor components of the trigeminal nerve following loss of central inhibition as a result of taste damage in the chorda tympani and/or the glossopharyngeal nerves.

Burning Mouth Syndrome↗
PubMed2002

Dental visits to hospital emergency departments by adults receiving Medicaid: assessing their use.

BACKGROUND: Pain from toothaches represents a significant problem. People lacking access to private dental services may use hospital emergency departments, or EDs. In 1993, Maryland eliminated Medicaid reimbursement to dentists for adult emergency services. METHODS: The authors used the change in Medicaid policy that eliminated dentist reimbursement to establish two study periods. Data tapes describing patients' use of EDs were obtained from the Maryland Medicaid Management Information System. A total of 3,639 people visited EDs for dental problems sometime during the four-year study period. RESULTS: After controlling for age, race and sex, the authors found that the rate of ED claims was 12 percent higher in the postchange period than in the prechange period. Comparisons between periods show significant rate increases during the postchange period for men, whites, African-Americans and patients aged 21 through 44 years and 45 through 64 years. CONCLUSIONS: The change in Medicaid policy that eliminated dentist reimbursement and participation in the program appears to have increased the use of EDs for the treatment of dental problems. Practice Implications. Many EDs lack dental services and are not capable of providing definitive treatment. When definitive treatment is not provided, this pattern of care may be repeated if patients are forced to return for treatment.

Adult↗