INTRODUCTION: Surveys of dental health among Aboriginal children in Canada, using scales such as the Decayed, Missing, and Filled Teeth (DMFT) score, indicate that Aboriginal children have 2 to 3 times poorer oral health compared with other populations. A remote First Nations community approached requested assistance in addressing the health of their children. The objective was to work with the community to improve oral health and knowledge among school children. The hypothesis formulated was that after 3 years of the program there would be a significant decrease in dmft/DMFT (primary/permanent) score.METHODS: This was a cross-sectional study of all school-aged children in a small, remote First Nations community. Pre- and post- intervention evaluation of oral health was conducted by a dentist not involved in the study. The intervention consisted of a school-based program with daily brush-ins, fluoride application, educational presentations, and a recognition/incentive scheme.RESULTS: Twenty-six children were assessed prior to the intervention, representing 45% of the 58 children then in the community. All 40 children in the community were assessed following the intervention. Prior to the intervention, 8% of children were cavity free. Following 3 years of the intervention, 32% were cavity free. Among the 13 children assessed both pre- and post-intervention, dmft/DMFT score improved significantly (p
The treatment-mix, treatment time, and dental status of 268 male industrial workers entitled to employer-provided dental care were studied. The data were collected from treatment records of the covered workers over the 5-year period 1989-93. Treatment time was based on clinical treatment time recorded per patient visit, and the treatment procedure codes were reclassified into a treatment-mix according to American Dental Association categories, with a modification combining endodontics and restorative treatment. The mean number of check-ups followed by prescribed treatment (treatment courses) during the 5 years was 3.7 among those who had entered the in-house dental care program prior to the monitored period (old attenders). Their treatment time was stable, 57-63 min per year, while the first-year mean treatment time (170 min) of those who had entered the program during the study period (new attenders) was significantly higher (P
The objective was to perform a long-term follow-up study of patients that had received high cost dental care within the Swedish National Dental Insurance System in 1977-1978 with special focus on remaining teeth, periodontal disease progression, change in the prevalence of root-filled teeth and teeth with apical periodontitis as well as the survival of fixed prosthetic reconstructions. All 262 patients who had had their treatment plans sent for approval for high-cost dental care in 4 local health insurance districts and who were sampled for base-line studies in 1977-1978, were offered a free clinical examination including radiographs in 1998. 177 patients (68 % of the original sample) could be reached for telephone interview and 104 of them (40 % of the original sample) were examined clinically and radiographically. Comparisons were made with records and radiographs from 1977-1978. The analyses were performed with the individual patient as the studied unit. The low progression of severe periodontal disease during the 20-23 year follow-up period and the decrease in number of teeth with apical periodontitis among a majority of the patients examined, indicated that the dental care received resulted in a limitation of dental disease on the individual level. Furthermore 63 % of the patients had the fixed prosthetic reconstructions, received after approval 1977-1978, in full extention after 20-23 years. However, more tooth losses were observed among the patients in this study than in similar studies in Swedish general populations over the same decades. Furthermore multiple tooth extractions were significantly more frequent in patients with severe periodontitis at baseline and in patients with less apical periodontitis at follow-up in this study. Thus it seems that tooth extraction not seldom was a treatment choice for teeth with severe periodontitis and apical periodontitis among the patients examined clinically in this study.
Very few studies have addressed long-term development and risks associated with untreated malocclusion. The purpose of this study was to examine changes in occlusion in a lifelong perspective and to compare oral health and attitudes toward teeth among persons with malocclusion with those having normal occlusion.
In 1950 an epidemiologic survey of 2349 8-year-olds was conducted and included 4 intraoral photographs. Three selected samples with different malocclusions (deep bite, crossbite, or irregular teeth) and 1 sample with normal occlusion (a total of 183 subjects) were, 57 years later, invited for examination and an extensive interview about dental experiences and attitudes. Sixty-nine responded (38%) and constitute the subjects studied.
Malocclusion remained the same or worsened except in subjects having deep bite in childhood, which in some improved and in others became worse. Crowding generally increased. Sixteen persons reported moderate or severe temporomandular joint (TMJ) problems, and of these 7 belonged to the group with crossbite in childhood. With few exceptions, the subjects in all samples had good oral hygiene, visited the dentist regularly, and had well-preserved dentitions. Mean number of missing teeth was significantly lower among those with normal occlusion compared with the malocclusion groups. Individuals with normal occlusion responded favorably to all questions related to attitudes and experiences about their teeth, while responses in the malocclusion groups varied.
Persons with the particular malocclusions examined experienced more problems related to teeth later in life compared with those having normal occlusion in childhood.
To analyze occlusal changes between the ages of 8 and 65 years in 18 persons with normal occlusion at the age of 8 (N-group), to describe their attitudes toward dental esthetics and their experiences regarding their dentition.
The N-group is considered as the reference group in comparison with malocclusion groups that will be presented in subsequent articles. Documentation is based on intraoral photographs and personal interviews.
In general, the occlusal changes were moderate. The probands were all satisfied with their teeth and tooth position. They were all examined at regular intervals by their dentists and practiced generally good oral hygiene. The average number of missing teeth was 1.4 (0-6) and the number of prosthodontically -restored or replaced teeth was 6.4 (0-24). Fifteen persons reported well-positioned teeth to be important. However, 17 found that visibly poor oral hygiene, discolored or missing teeth or the "total impression", to be more important than malpositioned front teeth.
Generally speaking, occlusal changes were moderate and satisfaction with the dentition was good. Discolored or missing teeth and poor oral hygiene were found to be the most disturbing negative traits with respect to dental esthetics.
A population of persons born in 1897 and resident in Glostrup and eight surrounding municipalities was investigated when these persons were 70, 80 and 85 years old. Some of the results are mentioned from the cross-sectional, epidemiological survey on the socio-psychological conditions and general health and disorders in this representative population which includes almost 2% of the Danish 85-year-olds. The examination programme was extensive, and of data rather comprehensive. The aim of this article is to make known some of the information, observations and results of several tests performed, including 56 different laboratory tests and nutritional analyses. It is worth mentioning that about three fourths of the 85-year-olds were self-reliant and contended with their actual life and lifestyle. Nevertheless suggestions or recommendations for interventions were given to 85% of the participants as well as the general practitioners. The data have already formed the basis of several frames of references.
The aim of this study was to compare the estimation ability of a dental hygienist to that of a dentist when, independently, recording the oral health status and treatment need in a population of elderly, receiving home nursing. Seventy-three persons, enrolled in a home nursing long-time care programme, were recruited. For the oral examination a newly developed protocol with comparatively blunt measurement variables was used. The oral examination protocol was tested for construct validity and for internal consistency reliability. Statistical analyses were performed using Wilcoxon matched pairs signed rank sum test for testing differences, while inter-examiner agreement was estimated by calculating the kappa-values. Comparing the two examiners, good agreement was demonstrated for all mucosal recordings, colour, form, wounds, blisters, mucosal index, and for the palatal but not the lingual mucosa. For the latter, the dental hygienist recorded significantly more changes. The dental hygienist also recorded significantly higher plaque index values. Also regarding treatment intention and treatment need, the dental hygienist's estimation was somewhat higher. In conclusion, when comparing the dental hygienist's and the dentist's ability to estimate oral health status, treatment intention, and treatment need, some differences were observed, the dental hygienist tending to register "on the safe side", calling attention to the importance of inter-examiner calibration. However, for practical purpose the inter-examiner agreement was acceptable, constituting a promising basis for future out-reach activities.
This study was undertaken to determine the proportion of persons primarily with developmental disabilities who encounter difficulties accessing dental care in Ontario, to identify perceived barriers to accessing dental care and to determine if persons with disabilities and their caregivers believe that oral health is important.
Community organizations providing services mainly to persons with developmental disabilities in Ontario were recruited to circulate a questionnaire to their members by mail or the Internet. Fourteen organizations mailed out a total of 1,755 paper questionnaires in autumn 2006, of which 420 (23.9%) were returned; in addition, 236 Internet questionnaires were returned.
Of the 656 paper and Internet responses, 634 were deemed valid. Most of the respondents had developmental disabilities. Almost three-quarters of respondents (464 [73.2%] ) reported being able to access dental services in Ontario. Personal (internal) factors were more likely to represent barriers to dental care than external factors.
The majority of persons with disabilities and most caregivers believed that oral health is important for overall health.