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At least 1,225 records · Page 68Linked to original sources
PubMed1994

Evaluation of a dental public health program for old-age pensioners in Denmark.

A high priority is given to improvements in the oral health of the elderly in Scandinavia. In 1987 a Danish municipality established a dental public health care program for old-age pensioners. All 67-year-old citizens were offered school-based preventive and curative care using guidelines and principles established by the Danish Municipal Dental Service for children. Care was provided free of charge. Citizens not wishing to obtain care through the public system could do so from private dental practitioners. Reimbursement for care obtained from the private system was provided by the National Health Insurance and the municipality. The purpose of this study was to evaluate the outcome of the program after three years of operation. A follow-up design was used and data were collected by interviews and clinical registrations. At baseline and follow-up 216 (71%) and 235 (77%) pensioners, respectively, were interviewed about their self-assessments of dental health, dental knowledge, attitudes, and behavior. Clinical data were collected only for the elderly who participated in the public program, and included 194 persons at baseline and 187 at follow-up. These data included information on tooth loss, dental caries, periodontal health, and presence and function of removable dentures. At the follow-up, 86 percent of all respondents had regular dental visits of at least once a year compared to 46 percent at baseline; 75 percent participated in the public program and 11 percent obtained care from private practitioners. At the end of the intervention period, fewer elderly reported symptoms of poor oral health or impaired function of dentures.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2002

Dental caries experience of female inmates.

OBJECTIVES: The purpose of this study was to determine the extent of dental caries and level of unmet dental need among female offenders in a federal prison in Connecticut. METHODS: All inmates admitted into the Federal Correctional Institution at Danbury, Connecticut, from May 31, 1997, to May 21, 1998, were given oral screening examinations (n=500; age range=20-65 years). The data were analyzed in terms of race/ethnicity and age groupings. DMF and D/DF scores were determined. RESULTS: The mean DMFT and DMFS scores were 16.8 and 57.0, respectively; the scores were higher for non-Hispanic whites and Hispanics than non-Hispanic blacks, and increased with age. The mean DT/DFT and DS/DFS scores were 36.8 percent and 36.0 percent, respectively. These scores were higher for non-Hispanic blacks than non-Hispanic whites and Hispanics, and decreased with age. CONCLUSIONS: Female prisoners had high levels of dental caries and racial disparities persisted in the prison.

Adult↗
PubMed2005

Dental insurance and clinical dental outcomes in NHANES III.

OBJECTIVES: The National Health and Nutrition Examination Survey (NHANES III) 1988-1994 is one of the few nationally representative data sets with information on both private dental insurance and a clinical dental exam. The objective of this analysis was to examine the possible associations between private dental insurance and clinical exam outcomes, demographic variables, and dental visits. METHODS: Using NHANES III data, analysis was limited to persons aged 20 years or older who had a dental exam and reported on their private dental insurance status. Initial analyses were based on comparisons between those with and without private dental insurance. Propensity scoring method was used to examine the effects of dental insurance on clinical exam variables. RESULTS: The percentage of individuals with private dental insurance was significantly greater among non-Hispanic blacks, those with higher educational attainment, those living at/above the federal poverty level, and those with a dental visit in the past year compared to their respective counterparts. Those with untreated caries, those with a loss of attachment of greater than 4 mm, and those with 12-27 missing teeth were significantly less likely to have dental insurance (p < 0.05) than their respective counterparts. CONCLUSIONS: These results suggest that having private dental insurance is associated with better clinical oral health status.

Adult↗
PubMed2005

The strength of two indicators of social position on oral health among persons over the age of 80 years.

OBJECTIVE: The objective of the present study is to analyze how two dimensions of social position, education and social class, are associated with oral health among generally healthy, community-dwelling persons over the age of 80 years. METHODS: The present investigation is based on a sample of 157 community-dwelling individuals from The Kungsholmen Elders Oral Health Study (KEOHS) and included data from interviews and oral examinations. Social position was measured by education and social class. Oral health was measured by active coronal caries, active root caries, edentulism and use of dental services. RESULTS: The primary findings of the adjusted multivariate logistic regression analysis were that, compared to persons who had been in higher positions, persons who had been blue-collar/ white-collar workers had significantly greater odds of having coronal caries and high, but nonsignificant odds of being edentulous. Further, persons with elementary/ medium education tended to forego regular dental services more than persons with high education. CONCLUSION: The study identified social inequalities in oral health even in a population of independently living, generally healthy very old Swedes and in a country where the public health policies have tried to minimize these inequalities.

Age Factors↗
PubMedDate not supplied

A clinical evaluation of the restoration of root surface caries.

Root surface caries is of growing importance because its prevalence increases with age, and the population of the United States is growing older while edentulism and tooth loss rates have declined. Few clinical studies have evaluated materials used for the restoration of active root caries lesions. This study evaluated a Type II glass ionomer cement and a microfilled composite resin, both placed in preparations without mechanical retention or acid etching of enamel, in the restoration of root caries. Fifty adult volunteers with active root caries received one or both materials with the material chosen randomly. Patients were recalled after 24 months to evaluate restorations for retention, additional caries, marginal integrity, and overall clinical acceptability. Seventy-seven restorations were available for reevaluation. Forty-five percent of the glass ionomer and 73% of the composite restorations were clinically acceptable after 24 months. Of the glass ionomers, 39% were fully retained compared with 73% of composite restorations. Among those partially or fully retained, 25% of the glass ionomer restorations had minimal loss of marginal integrity and 30% had extensive loss while 53% and 9% of composite restorations had minimal and extensive loss, respectively. Most restorations were clinically unacceptable because of restorative material loss. Substantial numbers of glass ionomer cement and composite resin restorations were lost. This may be the result of difficulties in maintaining isolation and obtaining a proper gingival seal. Thus, routine use of mechanical retention is still highly recommended to reduce the loss of restorative material.

Adult↗
PubMedDate not supplied

Clinical and radiographic evaluation of juvenile rheumatoid arthritis: report of a case.

Rheumatoid arthritis (RA) is an inflammatory disease of the synovium which may lead to proliferative and degenerative changes in the body's joints, including the temporomandibular joint (TM Joint). Although the exact etiology of rheumatoid arthritis remains unknown, it is suspected that the disease is often initiated by an infectious organism, or by genetic and/or environmental factors. Juvenile rheumatoid arthritis (JRA) is a chronic disease of childhood with a spectrum of joint involvement and associated systemic and other organ involvement. Five percent of all rheumatoid arthritis patients are children. In the United States, approximately 150,000 children are affected by JRA. With upper limb involvement, routine oral hygiene procedures become difficult. Dental evaluations/screenings may not be included in the initial team assessment of these patients until the TM Joint is affected; however, prior to this time, the patient may have had years of poor oral hygiene which could contribute to severe decay and early tooth loss. This case report describes the oral health status of a child with polyarticular juvenile rheumatoid arthritis and the specific recommendations for dental management.

Arthritis, Juvenile↗
PubMed1992

Dental caries and periodontal disease in Fiji.

A national oral survey was conducted in Fiji in 1985/86. The results showed that the prevalence of caries was generally low and most commonly affected pit and fissure surfaces. Comparisons with previous surveys in 1948 and 1965 showed that the prevalence had fallen in primary teeth but remained relatively constant in permanent teeth. There were significant variations in prevalence between residential locations but not between ethnic groups. Periodontal disease was found to be a major public health problem. Except for the percentage of young children with caries-free dentitions, the current status of oral health in Fiji was generally better than that proposed in the WHO goals for the year 2000. The training of dental hygienists to help in the prevention of both dental caries and periodontal disease is discussed.

Adolescent↗
PubMed1998

Comparison of health behaviour and oral/medical conditions in non-insulin-dependent (type II) diabetics and non-diabetics.

One hundred and two dentate patients with type II diabetes mellitus and 98 non-diabetic subjects were examined for oral conditions and metabolic state. Self-reported health behaviour was analysed. From factor analysis four factors emerged: general health behaviour (GHB), perceived fatigue (PF), diet control (DC) and regular diet (RD). In diabetics PF, DC and RD were significantly higher than that in non-diabetics. Patients with diabetes were more likely to control their disease through a programme of decreased kilojoule intake leading to weight management. However, they tended to tire. The mean gingivitis index was significantly higher (p < 0.01) among diabetics (2.39) than among non-diabetics (1.99). The number of missing teeth was significantly higher (p < 0.01) for diabetics (6.7) when compared with non-diabetics (4.3). On the other hand, aetiological factors (plaque, calculus) and the level of dental health behaviour as expressed in the HU-DBI scores were similar. Probing pocket depth did not differ statistically between groups. The increasing number of missing teeth in diabetics may primarily result from severe periodontitis with tooth mobility or deep pockets. Findings in this study suggest that the difference in the severity of periodontitis between diabetics and non-diabetics was significant although aetiological factors and the level of dental health behaviour were similar.

Adult↗
PubMed2000

Preventive dentistry for the general dental practitioner.

Although the prevalence of dental caries has decreased gradually in the past three decades in the Australian population, dental caries remains the primary reason for tooth loss in Australia. At the community level, total health expenditure on the treatment of dental caries (and its consequences) is substantial. Accordingly, caries prevention is an important focus at both the individual and community levels. This paper outlines the principles upon which modern caries prevention is based and stresses the importance of manipulating the oral environment (in terms of salivary parameters, ions, pH and the oral flora) as a major strategy for effective long-term caries prevention. Practical advice is provided on the correct home use of preventive agents, including chewing gums, chlorhexidine, fluorides, bicarbonate rinses and phosphopeptides.

Alkalies↗
PubMed2002

Dental caries experience of preschool children from the North Brisbane region.

BACKGROUND: To report the dental caries experience of preschool children within the north Brisbane region and to investigate the association between selected social and demographic variables and disease presence. METHODS: A cross-sectional sample of 2515 children aged four to six years was examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) and percentage caries free indices. A self-administered questionnaire obtained information regarding selected social and demographic variables. The data were analysed using the chi-square and one way analysis of variance procedures at the 5 per cent level of significance. RESULTS: Overall, 1668 (66.3 per cent) children were disease free at the examination and mean dmft was 1.4+/-2.77 and dmfs was 2.28+/-6.00. Dental caries occurred more frequently and severely in children from non-Caucasian background (p<0.000), family language other than English (p=0.001) and lower socio-economic status (p<0.000). CONCLUSIONS: Significant associations between child ethnicity, language spoken at home, socio-economic status and caries presence have been identified. Epidemiological data can be used for improved public oral health service planning and resource allocation within the region.

Age Factors↗
PubMed2004

Caries prevalence and its relation to water fluoride levels among schoolchildren in Central Province of Saudi Arabia.

OBJECTIVE: To determine dental caries prevalence and severity among primary and intermediate schoolchildren in Riyadh and Qaseem Regions, and to determine any correlation between dental caries and fluoride levels in drinking water. DESIGN: Cross-sectional. METHODS: 1,104 children; 431 (6-7-year-old) primary schoolchildren (249 in Riyadh and 182 in Qaseem) and 673 (12-13-year-old) intermediate schoolchildren (392 in Riyadh and 281 in Qaseem) were examined for dental caries utilising the WHO criteria for diagnosis of dental caries. RESULTS: In primary schoolchildren the prevalence of caries was 91.2% both in Riyadh and Qaseem. The mean dmft scores were similar in Riyadh (6.53, SD 4.30) and Qaseem (6.35, SD 3.83). Among the intermediate schoolchildren the prevalence of dental caries was slightly higher in Riyadh (92.3%) than Qaseem (87.9%). The mean DMFT score was higher in Riyadh (5.06, SD 3.65) as compared with Qaseem (4.53, SD 3.57) with marginal statistical significance (p = 0.057). Among the primary schoolchildren there was statistically significant (p < 0.05) difference in mean dmft scores at various fluoride levels with lowest dmft scores at the optimum water fluoride level (0.61-0.80ppm) and highest at two extremes i.e. 0.0 to 0.3ppm and > 2.5ppm, while in intermediate schoolchildren no significant difference in overall mean DMFT scores of children at various water fluoride levels could be found. CONCLUSION: The caries experience among the primary and intermediate schoolchildren in Riyadh and Qaseem was very high, and that there was no linear correlation between water fluoride level and caries experience in these children.

Adolescent↗
PubMed2006

Porphyromonas gingivalis vesicles enhance attachment, and the leucine-rich repeat BspA protein is required for invasion of epithelial cells by "Tannerella forsythia".

The human oral cavity harbors more than 500 species of bacteria. Periodontitis, a bacterially induced inflammatory disease that leads to tooth loss, is believed to result from infection by a select group of gram-negative periodontopathogens that includes Porphyromonas gingivalis, Treponema denticola, and "Tannerella forsythia" (opinion on name change from Tannerella forsythensis pending; formerly Bacteroides forsythus). Epithelial cell invasion by periodontopathogens is considered to be an important virulence mechanism for evasion of the host defense responses. Further, the epithelial cells with invading bacteria also serve as reservoirs important in recurrent infections. The present study was therefore undertaken to address the epithelial cell adherence and invasion properties of T. forsythia and the role of the cell surface-associated protein BspA in these processes. Further, we were interested in determining if P. gingivalis, one of the pathogens frequently found associated in disease, or its outer membrane vesicles (OMVs) could modulate the epithelial cell adherence and invasion abilities of T. forsythia. Here we show that epithelial cell attachment and invasion by T. forsythia are dependent on the BspA protein. In addition, P. gingivalis or its OMVs enhance the attachment and invasion of T. forsythia to epithelial cells. Thus, interactions between these two bacteria may play important roles in virulence by promoting host cell attachment and invasion.

Antigens, Bacterial↗
PubMed1994

Immunization against Porphyromonas gingivalis inhibits progression of experimental periodontitis in nonhuman primates.

Periodontitis is a common infectious disease in which the attachment tissues of the teeth and their alveolar bone housing are destroyed, resulting in tooth loss. The gram-negative anaerobic microorganism Porphyromonas gingivalis has been closely linked to severe forms of the disease. We show for the first time that immunization of the primate Macaca fascicularis with killed P. gingivalis in Syntex Adjuvant Formulation-M inhibits progression of periodontal tissue destruction.

Animals↗
PubMed1998

Bone resorption caused by three periodontal pathogens in vivo in mice is mediated in part by prostaglandin.

Gingival inflammation, bacterial infection, alveolar bone destruction, and subsequent tooth loss are characteristic features of periodontal disease, but the precise mechanisms of bone loss are poorly understood. Most animal models of the disease require injury to gingival tissues or teeth, and the effects of microorganisms are thus complicated by host responses to tissue destruction. To determine whether three putative periodontal pathogens, Porphyromonas gingivalis, Campylobacter rectus, and Fusobacterium nucleatum, could cause localized bone resorption in vivo in the absence of tissue injury, we injected live or heat-killed preparations of these microorganisms into the subcutaneous tissues overlying the calvaria of normal mice once daily for 6 days and then examined the bones histologically. We found that all three microorganisms (both live and heat killed) stimulated bone resorption and that the strain of F. nucleatum used appeared to be the strongest inducer of osteoclast activity. Treatment of the mice concomitantly with indomethacin reduced but did not completely inhibit bone resorption by these microorganisms, suggesting that their effects were mediated, in part, by arachidonic acid metabolites (e.g., prostaglandins). Our findings indicate that these potential pathogens can stimulate bone resorption locally when placed beside a bone surface in vivo in the absence of prior tissue injury and support a role for them in the pathogenesis of bone loss around teeth in periodontitis.

Alveolar Bone Loss↗
PubMed1999

In vitro induction of activation-induced cell death in lymphocytes from chronic periodontal lesions by exogenous Fas ligand.

Periodontitis is a chronic inflammatory disease which gradually destroys the supporting tissues of the teeth, leading to tooth loss in adults. The lesions are characterized by a persistence of inflammatory cells in gingival and periodontal connective tissues. To understand what mechanisms are involved in the establishment of chronic lesions, we hypothesized that infiltrating lymphocytes might be resistant to apoptosis. However, both Bcl-2 and Bcl-xL were weakly detected in lymphocytes from the lesions, compared with those from peripheral blood, suggesting that these cells are susceptible to apoptosis. Nevertheless, very few apoptotic cells were observed in tissue sections from the lesions. Lymphocytes from the lesions expressed mRNA encoding Fas, whereas Fas-ligand mRNA was very weakly expressed in lymphocytes from the lesions and in periodontal tissues. Since the results indicated that lymphocytes in the lesions might be susceptible to Fas-mediated apoptosis but lack the death signal, we next investigated if these lymphocytes actually undergo apoptosis by the addition of anti-Fas antibodies in vitro. Fas-positive lymphocytes from the lesions underwent apoptosis by these antibodies, but Fas-negative lymphocytes and Fas-positive peripheral lymphocytes did not undergo apoptosis by these antibodies. These results indicate that lymphocytes in the lesions are susceptible to activation-induced cell death and are induced to die by apoptosis after the addition of exogenous Fas ligand.

Adult↗
PubMed2006

The hemoglobin receptor protein of porphyromonas gingivalis inhibits receptor activator NF-kappaB ligand-induced osteoclastogenesis from bone marrow macrophages.

Extracellular proteinaceous factors of Porphyromonas gingivalis, a periodontal pathogen, that influence receptor activator of nuclear factor-kappaB (NF-kappaB) ligand (RANKL)-induced osteoclastogenesis from bone marrow macrophages were investigated. The culture supernatant of P. gingivalis had the ability to inhibit RANKL-induced in vitro osteoclastogenesis. A major protein of the culture supernatant, hemoglobin receptor protein (HbR), suppressed RANKL-induced osteoclastogenesis in a dose-dependent fashion. HbR markedly inhibited RANKL-induced osteoclastogenesis when present in the culture for the first 24 h after addition of RANKL, whereas no significant inhibition was observed when HbR was added after 24 h or later, implying that HbR might interfere with only the initial stage of RANKL-mediated differentiation. HbR tightly bound to bone marrow macrophages and had the ability to induce phosphorylation of ERK, p38, NF-kappaB, and Akt. RANKL-induced phosphorylation of ERK, p38, and NF-kappaB was not suppressed by HbR, but that of Akt was markedly suppressed. HbR inhibited RANKL-mediated induction of c-Fos and NFATc1. HbR could induce beta interferon (IFN-beta) from bone marrow macrophages, but the induction level of IFN-beta might not be sufficient to suppress RANKL-mediated osteoclastogenesis, implying presence of an IFN-beta-independent pathway in HbR-mediated inhibition of osteoclastogenesis. Since rapid and extensive destruction of the alveolar bone causes tooth loss, resulting in loss of the gingival crevice that is an anatomical niche for periodontal pathogens such as P. gingivalis, the suppressive effect of HbR on osteoclastogenesis may help the microorganism exist long in the niche.

Animals↗