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.
AIM: The aim of the present study was to evaluate the association between educational level and dental disease, treatment needs and oral hygiene habits. MATERIAL AND METHODS: Randomized samples of 35-, 50-, 65- and 75-year-olds, classified according to the educational level: [low (LE): elementary school or higher (HE)], were identified. In 1091 subjects, a number of characteristics such as (i) number of teeth, (ii) periodontal attachment levels (PAL), (iii) caries and (iv) occlusal function were recorded. Educational level, oral hygiene and dietary habits were self-reported. Non-parametric variables were analyzed by chi2, Mann-Whitney U-Wilcoxon's rank sum tests, and parametric variables by Student's t-test (level of significance 95%). A two-way anova was performed on decayed, missing and filled surfaces to investigate the interaction between age and educational level. All statistical procedures were performed in the SPSS statistical package. RESULTS: The number of remaining teeth was similar for LE and HE in the 35-year olds (25.8 versus 26.6), but in the older age groups LE had significantly a larger number of missing teeth. The LE groups (except in 65-year olds) exhibited significantly more PAL loss. LE had significantly fewer healthy gingival units in all but the 75-year age group. In all age groups, LE had fewer intact tooth surfaces and a significantly poorer occlusal function. The frequency of tooth cleaning measures and dietary habits did not differ between LE and HE. CONCLUSION: Educational level was shown to influence the oral conditions and should be considered in assessing risk, and in planning appropriate preventive measures.
It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful.
The aim of this study was to evaluate some intra-oral caries-associated variables and tobacco use on dental caries.
The participants were randomly recruited from three cross-sectional studies in Jönköping, Sweden, in 1983, 1993 and 2003. Each study consisted of 130 individuals in each of the 20, 30, 40, 50, 60 and 70-year age groups. Of these, 550, 552 and 523 dentate individuals attended respective year of examination. They were all examined both clinically and radiographically. A questionnaire was completed in conjunction with the examination. In the studies, 345 were smokers, 104 snus users and 1142 non-tobacco users, in total 1591 individuals.
In 1983 and 1993, there were no significant differences in mean DFS between non-users and smokers, but a statistically significantly higher mean DFS in comparison with snus users. In 2003, there was no statistically significant difference in mean DFS between the groups. Multiple regressions showed that, after adjusting for age, gender and socio-demographic variables, there was a statistically significant association between DFS and smoking in 1983 (smoking excluded in favour of lactobacilli when further analysed) and DFS and plaque index (PLI) in 1993. In 2003, there was no association, apart from buffer capacity (Power rising) between DFS and the examined intra-oral caries-associated variables and tobacco use.
The results of these epidemiological studies, performed in 1993 and 2003, indicate that daily smoking or snus use does not increase the risk of dental caries.
To determine the changes, since 1980, in the number of nontreated caries in elderly people who have retained their teeth and are in residential and long-term care centres (CHSLDs) in the province of Quebec, Canada, and the changes in their perception of their oral health problems and use of dental services.
A secondary analysis of data from a 2004-2005 survey about the oral health problems of people who were at least 65 years of age and living in CHSLD institutions in the Montreal, Montérégie and Quebec City regions was done. The inclusion criterion for the secondary analysis was that the residents had to have at least 1 natural tooth. Data from the 152 residents who met the inclusion criterion were analyzed, and compared with those from a similar study done in 1980.
Since 1980, the average number of teeth retained rose from 11.05 (SD 6.78) teeth to 12.91 (SD 7.82) in 2004. The average number of decayed teeth requiring treatment fell from 2.43 (SD 2.88) to 1.62 (SD 2.53); 49.3% (75/152) of the elderly participants had caries, compared with 74.1% in 1980. Only 3.4% (5/149) of the participants reported problems with, or pain or discomfort in their gums, compared with 8.9% in 1980. About half (48.7% or 74/152) of the participants examined needed periodontal treatment; 63.8% (83/130) had had recourse to services within the previous 5 years. The last time care was sought was, on average ,7.1 years ago, compared with 11.0 years in 1980.
Between 1980 and 2004, the number of retained teeth increased and the number of untreated caries fell among institutionalized elderly people. Their perception of the need for dental care remained poor. Their use of services improved, but was not ideal, given the numerous oral health problems diagnosed in this population.
BACKGROUND: The number of patients with kidney failure who require dialysis is growing by 10% to 15% annually, and the likelihood that dentists will treat such patients is also increasing. The dental care of patients undergoing dialysis can be complex, given the prevalence of comorbid conditions such as diabetes, hypertension, renal osteodystrophy and immunosuppression, the presence of nondental prosthetic devices, and the use of antihypertensives and anticoagulants or antiplatelet agents. These patients appear to be predisposed to a variety of dental problems such as periodontal disease, narrowing of the pulp chamber, enamel abnormalities, premature tooth loss and xerostomia. Dental care, as well as primary preventive measures, seems to have been neglected in these patients. Therefore, a study of the dental health of dialysis patients was undertaken. METHOD: Completion of a questionnaire and a noninvasive oral examination was obtained from hemodialysis and peritoneal dialysis patients registered in the dialysis program at St. Paul's Hospital in Saskatoon, Saskatchewan, as of March 1, 1999. Information was also gathered from the medical chart. Medication history as well as history of diabetes, hypertension, and nondental prosthetic devices were also recorded. RESULTS: Of 226 dialysis patients in central and northern Saskatchewan, 147 were interviewed and examined. Of these, 94 (64%) were dentate, and the same number had been on dialysis for a mean of more than 2 years; about a third were diabetic, almost all were hypertensive and all had nondental prosthetic devices or arteriovenous fistulae, or both. Sixty (64%) of the dentate patients were candidates for kidney transplantation. Most of the dentate patients reported brushing once or more daily, but they flossed infrequently or never. Dental visits were infrequent, less than every 5 years in 59 (63%) of the dentate patients. Findings in the dentate group included increased tooth mobility, fractures, erosion, attrition, recession, gingivitis and a high plaque index. A patient's dentist was contacted if the patient had seen him or her since starting dialysis (31 of the 94 dentate patients). Most (81%) of the dentists were aware that they were treating a dialysis patient. Medication records were incomplete for 29% of the patients, and only 2 (6%) of the patients had received antibiotic prophylaxis despite the fact that all had prosthetic devices or arteriovenous fistulae. CLINICAL SIGNIFICANCE: We conclude that the dental health of dialysis patients is poor and requires greater attention.
The study was done to identify toddlers who have an increased risk of developing dental decay at school age. Six variables-Cariostat score, mother's ethnicity, evidence of baby bottle tooth decay, mother;s dental health status, toddler's age at first tooth, and frequency of brushing - showed a significant association with decay status at school age with odds ratios ranging from 1.89 to 2.63. The Cariostat score and the frequency of brushing remained significant in a logistic regression. No interaction terms were significant. The Cariostat caries activity test would be a useful screening tool for identifying toddlers most likely to develop decay or could be used periodically as the deciduous molars erupt and become colonized with oral bacteria. The findings confirm that good oral hygiene practices can have an impact on future dental health, and caregivers should be encouraged to brush young children's teeth regularly.
All 55-yr-old citizens (n = 1012) of Oulu (a middle-sized Finnish town) were invited to a clinical examination; 780 agreed to participate. The associations of lifestyle with decayed tooth surfaces and the number of teeth were studied in the 533 dentate subjects. Measures of lifestyle included dietary habits, a smoking habit, alcohol consumption and physical activity. When the associations of dental caries with lifestyle, sex, dental health behavior, social class and number of teeth were studied by logistic regression analysis, lifestyle was shown to have an independent association with dental caries. Further analysis of the data showed that dental caries increased with a more negative lifestyle in every social class, but most significantly in the lowest. Number of teeth was not associated with lifestyle, but subjects with lower social status had fewer teeth than those with higher social status. The association of lifestyle with dental caries supports the idea that behavior in a broader sense should be taken into consideration in caries prevention.
Physical inactivity is prevalent among patients with intellectual disability. Because little is known about the oral effects of poor mobility, we reviewed the medical and dental charts of institutionalized dentate patients (n = 214; 40.2 years +/- 12.1) of the Special Welfare District of Southwestern Finland. The number of decayed, missing, and filled teeth (DMFT), the number of retained teeth, dental treatment visits, and the type of the first treatment visit were recorded. Physical activity was good in 55% and severely reduced or completely absent in 45% of the patients. The degree of intellectual disability was mild or moderate in 40% and severe or profound in 60% of the patients. The walking patients weighed more (64.3 (19.6) versus 44.4 (14.4) kg; P
OBJECTIVE: The aim of this study was to determine whether the presence of active initial caries lesions among 11 to 12-year-old schoolchildren is associated with parental and child-related factors and whether there are gender differences in these associations. MATERIAL AND METHODS: The data were gathered by questionnaires from children and their parents, who replied without knowing the other's answers. All the children were invited to participate in a screening for the presence or absence of active initial caries lesions. Factors associated with children's initial caries were studied with logistic regression analyses. RESULTS: The parents' self-assessed poor dental health, the parents' and the child's poor oral health-related behavior, and the child's response "I don't know" to the question concerning his/her parents' possible dental caries were associated with the presence of active initial caries lesions. The results of logistic regression analyses were different between girls and boys. Among the girls, many parent-related factors were associated with the presence of initial caries. Among the boys, most factors were related to the child; and of the parent-related factors, only parents' poor self-assessed dental health was associated with initial caries; the effect was modified by the father's occupational level. CONCLUSIONS: Parental factors affect boys' and girls' dental health differently. Among boys, the effect of the fathers was seen as the father's occupational level; among girls, parental knowledge and behavior were important. When school interventions to promote health are planned, the important role of the parents should be emphasized.