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PubMed1998

Trends in caries prevalence in Dutch adults between 1983 and 1995.

In 1995, a dental survey was performed among adults aged 25-54 in the Dutch city of 's-Hertogenbosch. A similar study was performed in the same city in 1983 and the aim of the present study was to describe trends in oral health from 1983 to 1995. National data show that the percentage of edentulous persons aged 30-39 and 40-49 decreased from 11.3 to 3.3 and from 28.5 to 13.8, respectively, between 1984 and 1993/94. The same trend was found in 's-Hertogenbosch. In persons with natural dentition under the age of 35 the mean number of DMFT decreased significantly between 1983 and 1995. In 1995 the mean number of FT was higher, and the mean numbers of DT and MT were lower than in 1983 in all age categories. It can be concluded that oral health in Dutch adults, as measured by caries prevalence, treatment level of caries and percentage of edentulous persons, improved significantly between 1983 and 1995.

Adult↗
PubMed1993

Restorative considerations for special needs patients.

Individuals are living longer with more chronic and disabling conditions than previous generations of adults. In addition, they are retaining more of their natural dentition than ever before. As a result, it will be common for a dentist in practice in the next 20 to 30 years to care for many patients with special needs. These individuals offer unique challenges to the dental practitioner. Dentists must be knowledgeable in the oral aspects of various medical conditions and the systemic manifestation of oral diseases. In addition to the oral medicine aspects of practice, dentists must be skilled clinically to care for the unique restorative needs with which these patients present. As individuals age or become chronically ill, people deserve the opportunity to select from all that modern dentistry has to offer. Patients must be involved intimately in the decision-making process. No dental professional should assume because a patient is old or chronically ill that he or she lacks the financial resources or the desire to maintain his or her oral health.

Aged↗
PubMed1993

Geriatric prosthodontics: an overview. Part II. Treatment considerations.

This two-part paper discusses treatment considerations for geriatric patients--a population that is on the rise. The first part of this paper examined the effects of aging on general health and on the oral environment. The second part discusses restorative treatment options for geriatric patients with caries, tooth wear, or missing teeth.

Aged↗
PubMedDate not supplied

Dental caries in older adults. Current status and management.

Despite encouraging reports of decreasing caries prevalence in children and young adults, dental decay continues to be the major cause of tooth loss in adults. The risk for both coronal and root surface caries, in their primary and secondary forms, increases with advancing age. With recent trends of increasing retention of the natural dentition over a longer period of time, and increasing utilization of dental care services by older adults, the number of restorative procedures performed by dental practitioners is anticipated to increase. Keeping retained teeth healthy in advancing age is a challenge and depends to a large extent on the dentist's ability to develop and implement a preventive-restorative protocol that fits the functional ability and risk status of the individual patient.

Aged↗
PubMed2005

Dental abnormalities in children preparing for pediatric bone marrow transplantation.

The purpose of our study was to describe the types and frequencies of altered dental development in pediatric patients preparing for bone marrow transplantation (BMT). Retrospective review of the medical records and panoramic radiographs of all patients who underwent BMT at St Jude Children's Research Hospital between 1990 and 2000 for whom pre-BMT dental examination and panoramic radiography records were available. All patients were treated on institutional protocols. We recorded patient demographics and radiographic evidence of microdontia, hypodontia, taurodontia, root stunting, caries, enamel pearls, and pulpal calcifications. The 259 patients identified (150 male and 109 female) had a median age of 12.82 years (range, 3.18-25.93 years) at the time of BMT. In total, 203 were Caucasian, 38 were African-American, and 18 were of other races. In all, 150 (57.9%) had abnormal dentition. The most common dental abnormalities were caries (n=84), pulpal calcifications (n = 34), and dental extractions (n = 33). Developmental abnormalities occurred less frequently: taurodontia (n = 8), hypodontia (n = 10), microdontia (n = 11), and root stunting (n = 11). Dental abnormalities are prevalent in children undergoing BMT. Pre-transplant oral hygiene and dental examination should be standard care in order to minimize potential sites of infection.

Adolescent↗
PubMed2006

A proposal for a new classification of lesions of exposed tooth surfaces.

In the presence of improved methods of identification and treatment of lesions on the exposed surfaces of teeth, it should now be acknowledged that the GV Black "classification of carious cavities" is out of date. This paper describes a new system, proposed in 1997, discussed broadly throughout the profession, and eventually modified. The system has been adopted in several regions around the world as being a useful corollary to the current developing concept of minimal intervention dentistry. It is now desirable to adopt a new approach to the identification and recording of the lesions caused by both caries and non-carious tooth loss. A major advantage arising from its adoption would be that it would encourage the profession to minimise the amount of normal healthy tooth structure that is often sacrificed in pursuit of the cavity designs as suggested by Black. The authors are members of a Project Group of the FDI Science Committee, and this paper explains the concept and offers justification for the adoption of the system.

Dental Caries↗
PubMedDate not supplied

Clinical manifestations and treatment of caries from 1953 to global changes in the 20th century.

Manifestations and treatment of caries are strongly dependent on caries risk and the severity of the attacking factors which determine the degree of caries activity. Caries activity in turn will be modified and can be minimized by effective preventive measures. Exemplary cases and events will be discussed to illustrate what has happened since the establishment of ORCA 50 years ago.

Dental Caries↗
PubMed1996

Dental caries, restoration and tooth conditions in U.S. adults, 1988-1991. Selected findings from the Third National Health and Nutrition Examination Survey.

This article provides estimates of dental caries experience and selected restorative and tooth conditions among U.S. adults, obtained from Phase 1 (1988-1991) of the Third National Health and Nutrition Examination Survey. Between 1988 and 1991, 94 percent of adults in the United States showed evidence of past or present coronal caries. Based on the data collected, the authors estimate that about 40.5 percent, or 61.6 million, dentate adults had at least one tooth or tooth space that could potentially benefit from professional treatment. Minimally, it is estimated that 135.6 million tooth or tooth spaces among U.S. adults may benefit from professional treatment. These estimates supplement information available from the DMF index to provide a broader profile of the impact of dental caries on permanent tooth of U.S. adults.

Adolescent↗
PubMed1998

Prevalence of dental caries: retrospect and prospect.

In spite of the general decline in dental caries, as illustrated in national surveys of children's health and by BASCD surveys, considerable unmet need remains. If good oral health is to be ensured for all sections of the UK community, the issues discussed in this article must be addressed.

Adolescent↗
PubMed1995

A method for adjusting caries increments for reversals due to examiner misclassification.

Two types of reversals occur in longitudinal caries studies, remineralization (true reversals) and reversals due to examiner misclassification (D3 to S; F to S). Since 1966, the standard practice has been to subtract examiner reversals from the crude increment (CCI), resulting in a net caries increment (NCI). The use of the NCI has been based on the assumption that examiners make an equal number of false positive and false negative errors both at baseline and follow-up examination. Consequently, the difference between the two caries prevalence scores would provide an unbiased estimate of caries incidence between examinations. The NCI considers all reversals to be true reversals which is an extreme strategy, particulary when the level of diagnosis is set at lower thresholds. In this study we compromised between the NCI and CCI by creating a simple formula to calculate the caries increment using a prevalence-based adjustment for reversals. The formula is ADJCI = y2(1-(y3/(y3 + y4))), where y2 = S to D or F; y3 = D or F to S; y4 = D to D/F or F to F. The impact of this adjustment is illustrated using data from a random sample of 452 older black and white adults followed over a 3-yr period. The ADJCI was more likely to result in higher caries increments and more observed intergroup differences than the NCI, a finding that has implications for clinical trials. For example, the crude 3-yr coronal DS increment for whites was 0.62, the NCI was 0.26 and the ADJCI was 0.56. There were significant black-white differences for the CCI and ADJCI, but not the NCI. We conclude that the NCI was too severe of an adjustment for reversals for this study population.

Adult↗
PubMed1989

[Study of ultrasonography applied to dental diagnosis. Examination of gingival morphology including epulis in relation to root surface].

Examination of gingival morphology was conducted using ultrasonic imaging equipment in a 57-year-old female with epulis. The ultrasonogram showed external gingival morphology including epulis and root surface caries which was difficult to detect because of masking by gingival enlargement. It appears that ultrasonograms are useful not only in examining gingival morphology but also in detecting changes in root surfaces hidden by the gingiva.

Female↗
PubMed1989

Older adults: demographics and need for quality care.

The elderly are becoming important consumers of dental care because of several factors. These include (1) decreasing caries rates among children and young adults, (2) increasing numbers of older adults in the population, (3) increasing retention of natural teeth by the elderly, (4) increasing prevalence of coronal and root surface caries associated with advanced age, (5) large unmet need for prosthodontic care projected for coming years, and (6) significant disposable income available to many older persons. This article reviews the importance to dentists of physiologic and pathologic changes associated with aging and the need for developed diagnostic and clinical skills in providing dental care.

Aged↗
PubMed1997

The benefits of high-potency fluoride dentifrices.

National surveys show that the incidence of caries in children, adults, and seniors is still quite high, despite interpretations to the contrary. The dental profession and general public agree that the standard level of 1,000 ppm to 1,500 ppm fluoride (F) in most dentifrices reduces dental caries. Many studies using higher concentrations of fluoride in dentifrices and gels, 2,000 to 5,000 ppm F, have shown that caries prevention increases with fluoride concentration.

Adolescent↗
PubMed2003

Evaluation of a computer-based caries risk assessment program in an elderly group of individuals.

The aim of this study was to evaluate a caries risk assessment computer program, the Cariogram, by comparing the risk assessment of the program with the actual caries increment in a group of elderly individuals over a period of 5 years. The participants were examined and interviewed at baseline about their general health and dietary habits. Data on oral hygiene and use of fluoride were obtained and saliva analyses included mutans streptococci, lactobacilli, buffering capacity, and secretion rate. Based on the baseline recordings, the individuals were divided into 4 risk groups according to the Cariogram. Where the program predicted 0% 20% (high risk), 21%-40%, 41%-60%, and 61%- 100% (low/rather low risk) "chance of avoiding caries", 13, 32, 23, and 48% respectively, had no new DFS over 5 years and 18, 40, 72, and 84%, respectively, had no new lesions at the 5th year. The mean DMFS increment over 5 years was 12.8 in the high/rather high risk group (0% 40% "chance of avoiding caries"), which included 43% of the individuals. In the low/rather low risk group (61%-100% "chance of avoiding caries"), the corresponding value was 5.2%, and 21% of the participants were sorted to this group. The mean DMFS increment for the whole group of elderly individuals was 9.5. In this particular study the Cariogram was able to sort the elderly individuals into risk groups that reflected the actual caries outcome.

Aged↗
PubMed1998

A new cavity classification.

With the development of adhesive restorative materials and a far better understanding of the action of the fluoride ion it is suggested that the time has arrived for a reassessment of the traditional cavity classification as set out by G.V. Black over one hundred years ago. When preventive measures and remineralization fail and a carious lesion has progressed through the enamel into the dentine there is a need to remove the infected dentine, and possibly some of the affected dentine as well, to eliminate cavitation and avoid further accumulation of plaque. In most situations this will involve removal of enamel to achieve access to the infected dentine but, in the presence of fluoride, both enamel and dentine are capable of being remineralized and therefore conserved, at least to a degree. The principle of minimal extension must be encouraged to allow maximum preservation of natural tooth structure. A new cavity classification is proposed which is designed to make the most of the potential for healing which is inherent in both enamel and dentine. However, it must be accepted that a considerable proportion of restorative dentistry is carried out to replace failed restorations and, in this case, cavity design will be complicated by existing loss of tooth structure.

Adhesives↗
PubMed1992

Evaluation of the cariogenic potential of the intense natural sweeteners stevioside and rebaudioside A.

Stevioside and rebaudioside A, two intense natural sweeteners, that are constituents of the South American plant Stevia rebaudiana, were tested for cariogenicity in albino Sprague-Dawley rats. Sixty rat pups colonized with Streptococcus sobrinus were divided into four groups and fed stevioside, rebaudioside A or sucrose added to basal diet 2000 as follows: group 1, 30% sucrose; group 2, 0.5% stevioside; group 3, 0.5% rebaudioside A, and group 4, no addition. All four groups were sacrificed after 5 weeks. S. sobrinus counts were made and caries was evaluated according to Keyes' technique. There were no differences in food and water intake and weight gains between the four groups. There were significant differences in sulcal caries scores (p < 0.02) and S. sobrinus counts (p < 0.05) between group 1 and the other three groups. There were no significant differences between the stevioside, rebaudioside A and no-addition groups. It was concluded that neither stevioside nor rebaudioside A is cariogenic under the conditions of this study.

Animals↗