The effect of chewing gum containing xylitol on the incidence and progression of dental caries was tested in a sample of 274 children, aged eight and nine years, of low socio-economic status and high caries rate. They were divided into two experimental groups (15% and 65% xylitol chewing gum distributed three times a day at school) and one control group (without chewing gum). The three groups were exposed to the same basic preventive program. Children who chewed gum had a significantly lower net progression of decay (progressions-reversals) over a 24-month period than did the controls. Results for the two groups chewing gum were similar. Chewing xylitol gum had a beneficial effect on the caries process for all types of tooth surfaces, and especially for bucco-lingual surfaces. The two experimental groups had a DMF(S) increment of 2.24 surfaces, compared with 6.06 surfaces for the control group. For this indicator, there was no difference between the two experimental groups. Results for the plaque index were in agreement with those of the DMF(S) increment and the net progression of decay.
Although the real dental treatment needs of the elderly has been established, the costs for these needs has not been determined. This report compares dental services and costs required for older adults living in three different resident settings. Dental needs and costs have been evaluated from a sample of 305 aged persons living in nursing homes (N = 156), low-cost housing facilities (N = 79) or dependent on home care services (N = 70). This study indicates that the homebound or institutionalized elderly population presents with poor dental and periodontal conditions, a high rate of edentulousness, and inadequate dentures. Dental needs are essentially characterized by the repair or replacement of prosthesis, the screening and treatment of mucosal lesions of prosthetic origin, and scaling/curettage of remaining teeth. The average rehabilitative dental costs was Can. $720 and there was no difference between the three types of residence. Important differences in cost, however, were observed between the dentate and edentulous population. The F-test (P less than .05) and chi-square were used to analyze differences in dental treatment needs and costs between different residences. Maintenance care corresponds to Can. $80/year/person.
In 1991, a questionnaire aimed at evaluating the knowledge, attitudes and practices with regard to fluoride and dental fluorosis was mailed to all the general practitioners and pediatricians of the Montreal West Island territory. The response rate after two mailings was 47.9%. The pediatricians know better than the general practitioners the fluoridation status of the cities of the territory; similarly for physicians with more than 15 years experience since graduation versus the younger physicians. In practice, 92.3% of the physicians prescribe fluoride supplements or vitamins for at least some of their patients aged less than six years old. As much as 76.3% of the physicians believe that the pediatricians and the general practitioners are responsible for prescribing fluoride to children less than six years old who visit them; only 59.4% believe themselves responsible for the dental health of these children. There are educational needs concerning fluoride, fluoride prescribing and prevention of dental fluorosis. Public health dentists should assist the medical profession in this educational process.