Abrasion lesions were recorded in 818 individuals representing the adult population of 430,000 residents of the Stockholm region, Sweden. The subjects were asked about toothbrushing habits, toothbrush quality and dentifrice usage; these factors were related to abrasion criteria. Abrasion was prevalent in 30% and wedge-like or deep depressions were observed in 12%. The relationship between abrasion and toothbrushing was evident, the prevalence and severity of abrasion being correlated to toothbrushing consumption. The importance of the toothbrushing technique for the development of abrasion lesions was elucidated. Horizontal brushing technique was strongly correlated to abrasion. It was demonstrated by treating the data with the statistical AID analysis that toothbrushing factors related to the individual (brushing frequency and brushing technique) exert a greater influence than material-oriented toothbrushing factor such as dentifrice abrasivity and bristle stiffness.
The study was aimed at analyzing intra- and inter-examiner variations in computerized measurement and in non-measurability of alveolar bone level in a cross-sectional, epidemiologic material. At each interproximal tooth surface, alveolar bone height in percentage of root length (B/R) and tooth length (B/T) were determined twice by one examiner and once by a second examiner from x5-magnified periapical radiographs. The overall intra- and inter-examiner variations in measurement were 2.85% and 3.84% of root length and 1.97% and 2.82% of tooth length, respectively. The variations were different for different tooth groups and for different degrees of severity of marginal periodontitis. The overall proportions of non-measurable tooth surfaces varied with examiner from 32% to 39% and from 43% to 48% of the available interproximal tooth surfaces for B/R and B/T, respectively. With regard to the level of reliability, the computerized method reported is appropriate to cross-sectional, epidemiologic investigations from radiographs.
Tobacco smoking is a factor claimed to be of influence on alveolar bone loss. The purpose of the present study was to investigate whether the effect of changed smoking habits is associated with the progress of proximal marginal alveolar bone loss as measured on intraoral radiographs. The study comprised 349 individuals with twenty or more remaining teeth examined in 1970 and 1980. The bone loss in the period was measured as the difference in the ratios "bone height/root length" at proximal tooth sides between the two examinations. It was found that the marginal bone loss in "Non smokers in 1970 and 1980" was as a mean 3.9 per cent of the root length. The corresponding value among "Smokers 1970 and 1980" was 6.0 per cent. The difference is statistically significant (p = 0.001). In individuals who had given up smoking during the 10-year period (bone loss: 4.4 per cent) as compared with those who had smoked regularly, the progression of bone loss was significantly (p
The plaque and gingival condition in 232 Swedish schoolchildren aged 13-14 years has been related to the following predictors; plaque, toothbrushing frequency and technique, bristle stiffness of the toothbrush, smoking habits, use of snuff, social class and sex. Multiple regression analyses have been performed in order to explain the variation of plaque index and of gingival index employing these predictors. Significant predictors of plaque index were toothbrushing frequency, sex (boys), number of cigarettes and social class. The predictors which significantly aggravated gingival inflammation were: plaque, use of snuff and the toothbrushing method "modified Bass". The slight gingival inflammation due to toothbrushing with the modified Bass' method was not due to inferior plaque removal.
In Sweden people in all age groups now have more remaining teeth than previously. An investigation has been made to identify some predictors of alveolar bone loss in a 10-year period in subjects with at least 20 remaining teeth. The material consisted of 349 individuals, examined radiographically, clinically, and by interview in 1970 and in 1980. These subjects, born in 1904-1952, constituted a subgroup, with regard to remaining teeth, of an unselected sample of the population of the old county of Stockholm. In the unselected sample statistically significant predictors of alveolar bone loss found in a stepwise multiple regression analysis were alveolar bone loss in 1970, age, number of lost teeth, and Russell's Periodontal Index (PI). In the subgroup the predictors were in the order Russell's PI and smoking. The prediction values (R2) of further variables were marginal. The analyses showed that there was an interaction between PI and smoking, implying that the effect of smoking on alveolar bone loss was increased in individuals with high PI values. Furthermore, a tendency was found for a dose-response effect of tobacco consumption. This tendency almost disappeared when controlling for PI.
Nearly all Swedish private dentists are affiliated with the Dental Care Insurance. Proposed treatment plans, including radiographs, are submitted to the Social Insurance Office for prior approval. In this study the quality of a sample of intraoral radiographs submitted by 404 private dental practitioners was analysed. Forty-four per cent of 3,708 periapical radiographs, simultaneously evaluated by two examiners, were satisfactory. The most frequent errors were excessive vertical angulation (18 per cent), missing apex (12 per cent), film positioning error (11 per cent) and underexposure (10 per cent). Fifty-five per cent of 294 bitewing radiographs were satisfactory; the major error was missing bone margin (33 per cent). The radiographs of 15 per cent of the 2,844 teeth proposed for therapy had insufficient radiographic documentation, six per cent because of missing radiograph and nine per cent because of missing apex on the radiograph. These errors applied to every second dentist. Compared to a similar study ten years ago, the present results do not indicate that the quality of intraoral radiographs has improved.
A group of 232 schoolchildren aged 13-14 years in the Municipality of Huddinge, on the outskirts of Stockholm, were examined in order to study the effects of smoking and oral use of snuff in relation to oral health. Of the schoolchildren 21.5% smoked regularly. Snuff was taken regularly by 11% of the boys, but none of the girls. Snuff was present in the oral cavity for an average of 3.5 hours every day. The variable "number of cigarettes" was found to be a significant (p less than 0.01) predictor to the dependent variable "plaque" after controlling for the predictors "frequency of tooth-brushing" and "sex". Snuff usage showed a strongly significant correlation to gingival index after controlling for plaque. The result showed that use of snuff may influence on the gingival tissue directly whereas smoking affects plaque accumulation.