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PubMed1994

Attitudes toward dentists and the dental care system among the middle-aged and the elderly in Hong Kong.

A sample of 398 35-44-yr-old and 559 65-74-yr-old Hong Kong Chinese were interviewed by trained interviewers using a structured questionnaire in an oral health survey conducted in 1991. The present analysis aimed to describe the dental-care-seeking behaviour and attitudes of these subjects. It was found that 43% of the younger and 23% of the older age group had visited a dentist within the past year. More than half of the elderly and a quarter of the adults had not been to a dentist for 3 yr or more, and the main reason given by these subjects was that they felt that nothing was wrong. The vast majority of the subjects consulted a dentist only when they had toothache or other dental problems. Less than 20% of the 35-44-yr-olds visited a dentist for a check-up or teeth cleaning, and these subjects were described as having a prevention-oriented attitude toward oral care. The result of a logistic regression analysis showed that there was a higher chance for subjects to have this attitude if they had dental programme coverage, perceived their teeth to be good, had better dental health knowledge, had a more positive dental attitude, and were less anxious about dental care. However, the influence of these factors was quite weak, because the overall percentage of correct classification of the model was 83.7% and the sensitivity was only 23.3%.

Adult↗
PubMed2006

Dental attitudes: proximal basis for oral health disparities in adults.

OBJECTIVES: Behavioral science postulates that underlying characteristics of populations, rather than sociodemographic groupings, are more proximal causes of oral health disparities through differing oral health behaviors. To our knowledge this is the first report in the literature that examines longitudinal correlates of oral health and dental care using groups of persons holding similar attitudes and beliefs. METHODS: The subjects were 873 participants in the Florida Dental Care Study, a longitudinal study of oral health among dentate adults. Hierarchical cluster analysis identified four groups with similar dental attitudes that were labeled 'favorable attitudes about dental care', 'frustrated believers in dental care', 'negative attitudes and cost concerns', 'pessimistic about personal and professional oral care'. RESULTS: The attitudinal groups cut across race, sex, and age with race and educational status the best discriminators among sociodemographic and economic variables. The negative attitude group reported the least preventive care and the largest oral health decrements on clinical examination at baseline and 24 months. The group with favorable attitudes about dental care reported the highest number of preventive and restorative visits and the lowest point-prevalence of toothache pain, temperature sensitivity, and painful gums. The frustrated believers have access to dental care equivalent to the favorable attitude group, but may delay seeking dental care until oral disease becomes more severe, based on their pattern of preventive, restorative, and dental extraction visits. Additional group differences on oral health and dental care are reported. CONCLUSION: This study takes a novel approach to examining oral healthy disparities. Differences in oral health behaviors support the validity of the groups.

Adult↗
PubMed2005

Oral self-care behaviours: comparing Greek and Japanese dental students.

AIM: This study explored cross-cultural differences of self-reported oral health behaviours between Greek and Japanese dental students. PARTICIPANTS: The sample population included 877 dental students, 539 students registered at the University of Athens Dental School, and 338 registered at the Hiroshima University Dental School. MATERIAL AND METHODS: Oral health behaviour was assessed using the Greek and Japanese versions of a 20-item questionnaire entitled Hiroshima University-Dental Behavioural Inventory (HU-DBI). RESULTS: The mean questionnaire score of the Japanese students (7.40) was significantly greater than that of the Greek peers (6.86, P = 0.001), indicating better oral self-care behaviour amongst the Japanese students; however, the overall difference was mainly attributed to their additional sixth study year. Greek and Japanese students provided significantly different answers to 14 of 20 HU-DBI items. Greeks significantly more often were required by their dentist to evaluate their brushing technique (OR = 14.4, P < 0.01), checked their teeth in the mirror after brushing (OR = 8.1, P < 0.01), worried about bad breath (OR = 6.7, P < 0.01), and believed that gum disease is preventable by tooth brushing alone (OR = 2.1, P < 0.05), whereas their Japanese peers significantly more often felt comfortable to clean their teeth without the use of a toothpaste (OR = 0.3, P < 0.01), believed that they take much time to brush their teeth (OR = 0.3, P < 0.01), used a child-sized toothbrush (OR = 0.2, P < 0.01), and put off going to the dentist until having toothache (OR = 0.4, P < 0.01). CONCLUSIONS: Considerable differences in dental health attitudes/behaviour exist amongst students in the two countries reflecting the different culture and the health education system of the students; moreover, it is possible to distinguish Greek dental students from Japanese peers with a probability of more than 89% by using the HU-DBI instrument.

Adult↗
PubMed1984

Peptidergic nerves in human tooth pulp.

Substance P-like and enkephalin-like immunoreactive nerve fibers were observed in the human tooth pulp. Immunoreactivity for substance P could be demonstrated in thin, beaded nerve fibers and glomerular-type nerve structures both in the center and in more peripheral parts of the tooth pulp. Substance P-like nerve fibers predominated in the center of the pulp substance, while a thicker type of enkephalin-like nerve fibers were more commonly seen at the periphery of the pulp. Controls exhibited no immunoreactivity for either neuropeptide. It is tentatively suggested that a dual innervation by substance P-like fibers and enkephalin-like nerve fibers may be involved in the mediation of toothache in man.

Dental Pulp↗
PubMed2005

Willingness of dentists in Jordan to treat HIV-infected patients.

UNLABELLED: Reluctance of dentists to treat human immunodeficiency virus (HIV) positive patients represents a major concern. Many efforts have been extended towards the documentation of the extent of this reluctance and speculation of factors that influence it. OBJECTIVES: Assess the willingness of dentists in Jordan to treat HIV-infected patients. MATERIALS AND METHODS: Two hundred and forty-two general dental practices were surveyed for their willingness to provide treatment of toothache and routine dental care of an HIV-infected individual. RESULTS: Only 15% of the dental practices were willing to provide such care. Willingness to provide treatment did not seem to be influenced by financial factors or the local prevalence of HIV disease. CONCLUSION: Present data suggest that HIV-infected individuals will have difficulty in obtaining dental health care in Jordan.

Attitude of Health Personnel↗
PubMed1993

Oral function in dentate elderly with reduced dentitions.

This study covers the characteristics of reduced dentitions in a population of elderly people. The sample consisted of 329 independently living individuals between 55 and 75 years of age. They all had one or more natural teeth and were all interviewed and investigated clinically. The findings showed that 13% of the subjects had a natural dentition with at least the first molars; 4-7 natural occlusal units (defined as 'pairs of opposing teeth that support the occlusion') occurred in 37% of the subjects; 1-4 natural occlusal units in 41% and 0 units in 9% (only anterior contacts). A removable partial denture was worn by 39% of the subjects; most of them were acrylic based dentures (61%). The percentages of restored teeth per subject were high. The need for further restorations, however, was low. Periodontal problems were uncommon; 25% of the subjects had one pocket above 5 mm; 8% had severe problems. Poor oral hygiene was present in a quarter of the cases. Most of the subjects (70%) had no pain or noises in the temporomandibular joint. Only 10% of subjects had more than one sign of craniomandibular dysfunction. Most of the subjects (85%) visit their dentist regularly and 65% had their last tooth extraction more than three years ago. A majority mentioned that they have never had problems with their dentition in the past; 50% had had no real toothache for the last five years. However, problems with food-packing were often mentioned. It can be concluded that, although the dentitions of the elderly in this population are often reduced, their dentitions are in general in good condition and few give TMJ problems.

Aged↗
PubMed2002

Testing a model of the relationship between gender, ethnicity, clinical status and impact in older adults from minority ethnic groups.

OBJECTIVE: To identify the relationship between indicators of self-assessed symptom status, the reported impact of oral conditions and clinical indices, and the extent to which this relationship was moderated by gender and ethnicity. DESIGN: Secondary analysis of data from an oral health survey of minority ethnic groups. PARTICIPANTS: Purposive sample of 376 individuals from minority ethnic groups in the United Kingdom recruited through community groups. MEASURES: Numbers of decayed, missing and filled teeth. Measures of self assessed symptoms, and impact upon quality of life. RESULTS: Impact of oral conditions upon lifestyle was predicted by the number of missing teeth, the presence of pain on eating certain foods and the presence of toothache in the previous four weeks. Social variables (gender and ethnicity) did not predict impact either singly or through interaction with symptoms. CONCLUSIONS: The findings support a linear model of the relationship between the experience of oro-facial symptoms and impact on everyday life amongst older adults.

Black or African American↗
PubMed2002

Orofacial pain: racial and sex differences among older adults.

OBJECTIVES: This study investigated racial differences in orofacial pain symptoms in a sample of older adults. Orofacial pain prevalence, persistence, severity, and behavioral impact were assessed. We also tested whether sex and race interact, such that racial differences are only observed for a single sex, or whether sex differences only occur within a single racial group. METHODS: Telephone interviews were conducted with a stratified random sample of 1,636 community-dwelling older (age 65+ years) north Floridians. RESULTS: Racial differences were not found for 12-month prevalence or pain ratings for any painful oral symptom, or in the total number of symptoms. The most consistent racial differences were in behavioral impact associated with pain. Blacks reported greater behavioral impact as defined by pain having reduced their daily activities or motivating them to take some action in response to pain. For toothache pain, that action was more likely to have been some form of self-medication. These relationships persisted after controlling for socioeconomic status, approach to health care, and pain intensity in multivariable models. CONCLUSION: Although pain prevalence is an important public health variable, this study suggests that other pain-related variables, such as behavioral impacts, are useful when describing disparities associated with orofacial pain.

Black or African American↗
PubMed2006

A comparison of the impact of information from a clinician and research-based information on patient treatment choice in dentistry.

OBJECTIVES: There is an imperative that clinicians should employ an evidence-based approach to both clinical care and treatment, and involve patients in the decision-making process. In Britain, public policy emphasizes the importance of patient involvement, participation and partnership in health care, however little is known of the effect of evidence-based information on this. This study compares treatment decisions made by dental patients on the basis of two sources of evidence: clinician and research. METHOD: Vignette method with the two sources of evidence as experimental variables. The study population was a convenience sample of dental patients recruited from a clinic waiting area at a Dental Hospital (n=100). Each participant read a vignette describing a visit to the dentist for treatment of severe toothache in a back tooth. The nature and purpose of the visit was identical in each vignette. The participants indicated their decision about possible treatment, based on the information they had been given in the vignette and rated their confidence in the decision on a three point Likert scale. Additionally participants' were asked to rate their own oral health. RESULTS: Research evidence influences the confidence patients have in their in decision especially when it supports clinical judgement and where individuals value their oral health. Research evidence does not replace the confidence that patients have in the dentist's clinical judgement. CONCLUSION: Dental patients' willingness to engage in treatment is influenced by the dentist's clinical recommendation and the importance of oral health to the patient.

Adolescent↗
PubMedDate not supplied

A comparison of opinions from parents of disabled and non-disabled children on behavior management techniques used in dentistry.

The purposes of this study were to compare the acceptance of pediatric dental behavioral management techniques by 40 parents of children with disabilities with that of 40 parents whose children were not disabled and to determine the effect of prior information on the level of acceptance for both groups of parents. An instrument containing a demographic questionnaire and using a visual analog scale asked parents to indicate acceptance level of hand-over mouth, sedation, restraint using Papoose board, and general anesthesia for either a check-up/cleaning, dental filling, or treatment of a toothache. One half of each parent group received a written description and rationale for the behavior management technique prior to rating acceptance, and the other half did not. Although differences were found between parents of the disabled and non-disabled and between those informed and not informed, only one technique and procedure (restraint for check-up/cleaning) was significantly different for acceptability (p < or = 0.05), and that was between uninformed parents of non-disabled children and informed parents of disabled children. We conclude that having a disabled child or receiving a prior rational for pediatric behavior management techniques was not significantly related to differences in acceptance of the techniques for the procedures described.

Adult↗
PubMed1991

Comparison of dental needs with the treatments actually received.

The main purpose of the study was to determine the types, causes, dental needs, and follow-up treatments of the chief complaints of a socioeconomically disadvantaged population of patients attending a public dental hospital. Around half of the 301 patients examined were 45 years of age and older, and the vast majority were of caucasian origin. The most common dental complaints in 259 patients were toothache, broken teeth, lost fillings, and painful, broken or loose dentures. The most frequent causes of the chief complaints were judged to be dental caries, and inadequate restorations and removable prostheses. On examination, most of the patients also had one or more other unsatisfactory restorations or removable prostheses, especially in the 35 years and over age group. Deep periodontal pockets were also found most often in this age group. After four to six months, of the 259 patients with chief complaints, 113 had had their complaints treated and 45 had not, 47 patients were given a different form of treatment from that proposed, while 31 treatments were uncompleted, and 23 patients could not be followed up.

Adult↗
PubMed2000

Cross-cultural differences of self-reported oral health behaviour in Japanese and Finnish dental students.

OBJECTIVE: To determine whether any differences existed in dental health behaviour between Japanese and Finnish dental students. SETTING: Hiroshima University School of Dentistry and the University of Helsinki. DESIGN: Comparison of cross-cultural differences of self-reported oral health behaviour. SUBJECTS: Dental students, 337 in Japan and 113 in Finland. METHOD: Subjects were surveyed using the Japanese and Finnish versions of a 20-item questionnaire entitled Hiroshima University--Dental Behavioural Inventory (HU-DBI). RESULTS: Only 2 per cent of Finnish students reported that they put off going to the dentist until they had toothache, compared to 56 per cent of Japanese students. Similarly, significantly more Japanese students thought that their teeth were getting worse despite their daily brushing, compared to their Finnish peers. The mean HU-DBI score of Year 1 Finnish students was higher than that of their Japanese peers, which suggested a higher level of dental health awareness in Finnish students upon entry into dental school. The mean scores of the Japanese students were lower than those of their Finnish peers until Year 3. The mean scores of Year 5 and Year 6 Japanese students were higher than that of Year 1 students, indicating raised self-care levels influenced by the course in preventive dentistry. The gender difference of the HU-DBI score was not a major feature in either country. CONCLUSIONS: Self-reported oral health behaviours seemed to be very different between the two countries, which reflected different culture and/or health education systems of the students.

Chi-Square Distribution↗
PubMed1987

Prodromal features of asthma.

One hundred and thirty four ambulatory children with bronchial asthma were investigated in the Pediatric Pulmonary-Allergic Service. In 95 patients an interval characterised by prodromal respiratory symptoms (cough, rhinorrhoea, and wheezing), behavioural changes (irritability, apathy, anxiety, and sleep disorders), gastrointestinal symptoms (abdominal pain and anorexia), fever, itching, skin eruptions, and toothache preceded the onset of the attack of asthma. Each child had his own constant set of prodromal findings. A significant age related increase in serum IgE concentrations was observed in these patients. No such relation was observed in children with an acute onset of attack of asthma without any preceding symptoms. We suggest that awareness of these prodromal symptoms may lead to an early introduction of treatment, thus avoiding or abbreviating some of the acute attacks of asthma.

Adolescent↗
PubMed2005

Induction of apoptosis in human oral cancer cell lines, OC2 and TSCCa, by chingwaysan.

Chingwaysan, a Chinese herbal formula, contains Cimicfugae Rhizoma, Rehmanniae Radixet Rhizoma, Moutan Radicis Cortex, Coptidis Rhizoma and Angelicae Sinensis Radix. This medicine is well-known for its curing power for ulcerated gums, toothaches, cheek boils and bleeding gingiva. However, no reports can be found on its application in the treatment of oral cancers. We are therefore interested in whether Chingwaysan is capable of causing abnormal apoptosis processes, and whether this condition can be rectified through Chingwaysan herb treatment. We used aqueous extract to treat OC2 and TSCCa cells (both are human oral cancer cell lines) with different Chingwaysan concentrations (0, 10, 25, 50, 75 and 100 microl/ml). The MTT (3, (4, 5-dimethyl-thiazol) 2, 5-diphenyl-tetraxolium bromide) reduction assay was employed to quantify the differences in cell activity and viability. DNA ladder formation on agarose electrophoresis was also performed. The bax expression level was monitored using immunoblotting techniques. The patterns of the changes in expression were scanned and analyzed by NIH image 1.56 software. Taken together, drastic morphological changes, reduced cell viability and the presence of inter-nucleosomal DNA fragmentation all indicated that Chingwaysan is capable of inducing apoptosis in OC2 and TSCCa cell lines. Furthermore, the accumulation of wild type bax protein significantly increased in a dose-dependent manner upon treatment with Chingwaysan. In conclusion, Chingwaysan can induce apoptosis via a bax-dependent pathway in cells from these two particular oral cancer cell lines.

Angelica sinensis↗
PubMed2003

[History of a plant: the example of Echinacea].

In comparison with other medicinal plants, the history of use of Echinacea is relatively short. The plant originates from North America and was employed by the indigenous Indians. The first archaeological evidence dates from the 18th century. Included in the name Echinacea or purple coneflower are several species of the Asteraceae family: Echinacea purpurea (L.) Moench, Echinacea angustifolia DC. and Echinacea pallida (Nutt.) Nutt. Information about the use of the plant from traditional healers ranges from external application for wounds, burns and insect bites to the chewing of roots for toothache and throat infections, and internal application for pain, coughs, stomach cramps and snake bites. The interest of white settlers was also drawn to this medicinal plant. The first Echinacea preparation, known as Meyers Blood Purifier, arrived on the market around 1880, with rheumatism, neuralgia and rattlesnake bites as indications. At the beginning of the 20th century, Echinacea was the most frequently used plant preparation in the USA. Commercial cultivation was started in Germany around 1939. The introduction and cultivation of Echinacea in Switzerland by A. Vogel was around 1950. Chemists and pharmacologists became interested in Echinacea and many constituents are now known, such as polysaccharides, echinacoside, cichoric acid, ketoalkenes and alkylamides. The extracts exhibit immunostimulant properties and are mainly used in the prophylaxis and therapy of colds, flu and septic complaints. Although there are over 400 publications concerning the plant and dozens of preparations of Echinacea n the market, the true identity of the active principles still remains open.

Adjuvants, Immunologic↗
PubMedDate not supplied

Dental health knowledge, attitudes and behaviour among students at the Kuwait University Health Sciences Centre.

OBJECTIVE: The aim of the study was to determine the extent of dental health knowledge among students at the Kuwait University Health Sciences Centre (HSC), as well as their attitudes toward dental health and their oral hygiene habits. METHODS: A structured questionnaire was distributed to 450 of the 800 students enrolled in 3 faculties of the HSC from March to April 2000. The questionnaire was completed anonymously by the students. RESULTS: Four hundred and ten students (91.1%) completed the questionnaire. Of these, 64.6% believed that the main cause of tooth decay was 'not brushing properly'. Only 19.3% of the students believed that sugar could cause dental decay. Half of the students did not know if sugar-free drinks are harmful to their teeth, and 29.5% did not know about any measures to prevent gums from bleeding. Self-assessment questions showed that 84.5% of the students were satisfied with their dental health. A large majority of the students (94.8%) brushed their teeth at least once a day. Female students brushed their teeth more frequently than male students, as did those students who had visited a dentist in the past 6-12 months and those who rated their dental health to be very good. The main reason given for a dental visit was toothache (70.0%). Coffee was consumed daily by 68.9% of students, 76.6% of whom added sugar to their coffee. CONCLUSIONS: The findings indicate that although most of the students at the HSC seem to be satisfied with their dental health, they did not have correct knowledge about the causes and prevention of dental diseases. In general, female students were more aware and concerned about dental health issues and more engaged in dental behaviour than male students.

Adolescent↗
PubMed1996

Psychotic couvade: 2 case reports.

Couvade is a phenomenon, where the expectant father or another relative experiences somatic and/or psychiatric symptoms during a woman's pregnancy. Although epidemiological studies report a frequency of couvade symptoms between 11 and 36% during all pregnancies, psychotic couvade cases are very rare with few case reports. The authors report 2 cases of psychotic couvade and give a psychodynamic interpretation of the cases. They emphasize the important role of ego defect and double identification in the development of the cases. Couvade is a phenomenon, where the expectant father or another relative experiences somatic and/or psychiatric symptoms during a woman's pregnancy. The term couvade was first coined by Tylor in 1865. Somatic symptoms can include indigestion or colic, gastritic symptoms, food cravings, nausea and vomiting, increased or decreased appetite, diarrhea, toothache, headache, itch, muscle tremors, nosebleed or other pains. Abdominal bloating and pseudocyesis have also been reported. Although the psychiatric symptoms most often observed are depression, anxiety, insomnia, irritability, tension and hypochondria there are some reports on psychotic couvade too. In our article we present 2 cases of psychotic couvade.

Adult↗
PubMed2006

Psychometric properties and the prevalence, intensity and causes of oral impacts on daily performance (OIDP) in a population of older Tanzanians.

BACKGROUND: The objective was to study whether a Kiswahili version of the OIDP (Oral Impacts on Daily Performance) inventory was valid and reliable for use in a population of older adults in urban and rural areas of Tanzania; and to assess the area specific prevalence, intensity and perceived causes of OIDP. METHOD: A cross-sectional survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. A two-stage stratified cluster sample design was utilized. Information became available for 511 urban and 520 rural subjects (mean age 62.9 years) who were interviewed and participated in a full mouth clinical examination in their own homes. RESULTS: The Kiswahili version of the weighted OIDP inventory preserved the overall concept of the original English version. Cronbach's alpha was 0.83 and 0.90 in urban and rural areas, respectively, and the OIDP inventory varied systematically in the expected direction with self-reported oral health measures. The respective prevalence of oral impacts was 51.2% and 62.1% in urban and rural areas. Problems with eating was the performance reported most frequently (42.5% in urban, 55.1% in rural) followed by cleaning teeth (18.2% in urban, 30.6% in rural). More than half of the urban and rural residents with impacts had very little, little and moderate impact intensity. The most frequently reported causes of impacts were toothache and loose teeth. CONCLUSION: The Kiswahili OIDP inventory had acceptable psychometric properties among non-institutionalized adults 50 years and above in Tanzania. The impacts affecting their performances were relatively common but not very severe.

Activities of Daily Living↗