This study will compare the clinical outcomes of 139 elders residing in long-term care (LTC) who received dental treatment with those who did not receive care under a comprehensive dental programme over 5 years.
Numerous studies have documented very poor oral health and limited access to dental care among frail older adults residing in LTC facilities. The University of British Columbia and Providence Healthcare developed a comprehensive dental programme to serve elderly LTC residents within seven Vancouver hospitals. Since 2002, the Geriatric Dentistry Programme has provided annual oral health assessments and access to comprehensive dental care.
A comprehensive oral health assessment was provided using CODE (an index of Clinical Oral Disorders in Elders). A change in oral health status (improvement or worsening) was evaluated by measuring CODE scores including caries and periodontal condition, and other aspects of the dentition.
Eighty-three residents received dental treatment of some form over the 5 years, while 56 did not receive any treatment beyond an annual examination. The percentage of residents initially recommended for treatment in 2002 was 97%, which declined to 70-73% after the 3rd year. The percentage of residents treated increased after the first year and remained at 56-72% thereafter. The comparison between CODE scores from baseline and 5 years later showed an improvement for those receiving care (p = 0.02, chi(2) = 7.9, df = 2).
Within the limitations of this study, residents who did consent and receive care showed an improvement in their oral health status after 5 years.
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 purpose of this study was to compare the diagnostic performance of a digital radiography system that uses 6- and 8-bit displays with conventional D-speed film for the detection of simulated periodontal bone lesions. Eleven human hemimandibles were used as specimens. Simulated lesions were created at the buccal cortical plate in the marginal bone area with the use of a round bur 1.4 mm in diameter. Lesions were created in a defined sequence to preclude visual cues as to the depth of the lesions. Lesion size progressed in 0.5 mm increments. At each stage the mandibles were imaged with a Sens-A-Ray system (REGAM Medical Systems AB, Sundsvall, Sweden) and D-speed film. Exposure parameters for each specimen/receptor combination were standardized by either the mean optical density or mean gray value at the approximal crestal bone area. Film images and digital images displayed with 64 and 256 gray levels were presented to six observers for evaluation. Observers were ask to rate their confidence as to the presence or absence of a lesion using a 5-point confidence scale. A total of 96 lesion sites and 96 control sites were presented to the observers. Receiver operating characteristic curves were generated for each system. The area under the curve was used as the index of diagnostic accuracy. The mean receiver operating characteristic areas for 6-bit and 8-bit displays and D-speed film were 0.746 +/- 0.043, 0.717 +/- 0.056 and 0.742 +/- 0.059, respectively. Analysis of variance was used to compare the means. No statistical difference was found between any of the three image displays (p > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
BACKGROUND: To date only a few studies have evaluated the long-term influence of smoking and smoking cessation on periodontal health. The present study, therefore, was undertaken with the aim to prospectively investigate the influence of smoking exposure over time on the periodontal health condition in a targeted population before and after a follow-up interval of 10 years. METHODS: The primary study base consisted of a population of occupational musicians that was investigated the first time in 1982 and scheduled for reinvestigation in 1992 and 2002. The 1992 investigation included 101 individuals from the baseline study constituting a prospective cohort including 16 smokers, who had continued to smoke throughout the entire length of the 10-year period; 28 former smokers who had ceased smoking an average of approximately 9 years before the commencement of the baseline study; 40 non-smokers, who denied ever having smoked tobacco; and 17 individuals whose smoking pattern changed or for whom incomplete data were available. The clinical and radiographic variables used for the assessment of the periodontal health condition of the individual were frequency of periodontally diseased sites (probing depth > or =4 mm), gingival bleeding (%), and periodontal bone height (%). The oral hygiene standard was evaluated by means of a standard plaque index. RESULTS: The changes over the 10 years with respect to frequency of diseased sites indicated an increased frequency in continuous smokers versus decreased frequencies in former smokers and non-smokers. Controlling for age and frequency of diseased sites at baseline, the 10-year change was significantly associated with smoking (P
There is strong scientific evidence from clinical and epidemiological studies that tobacco use, particularly cigarette smoking, is linked to periodontal disease as well as other serious but less common oral health diseases. Given the strength of this evidence, dentists must include tobacco cessation services (TCS) as part of their routine care. This paper describes barriers to the adoption of TCS as identified by Alberta dentists participating in a randomized intervention trial and discusses strategies for overcoming these barriers. As well, suggestions are made to professional associations and educational institutes on ways to increase the incorporation of tobacco cessation into professional practice standards.
Comment In: J Can Dent Assoc. 2001 Mar;67(3):12711315384
The purpose of the present study was to investigate the prevalence of adolescents with high periodontal risk and to identify factors with influence on the decision to refer a patient to a specialist clinic of Periodontology, on compliance rate and on treatment outcome. The investigation was conducted as a retrospective study on adolescents at age 13-17. In total, clinical examinations and risk evaluations according to caries- and periodontal risk were performed on 50347 adolescents in general dentistry at ages 13, 15 and 17 in 2007. Individuals with a high periodontal risk were included in the present investigation. A high periodontal risk was defined as presence of sites with periodontal pocket depths >6mm and loss of periodontal tissue support. Multiple logistic regression analyses were adopted to calculate the influence of the potential predictors on the investigated dependent variables. In total, 0.5% of the adolescents were found to have high periodontal risk. The diagnosis local periodontitis and the number of periodontal pockets with probing depths >6 mm were positively and significantly correlated to referral to a periodontist. Eighteen percent dropped out before the treatment was completed. Smokers had a significantly lower compliance than non-smokers. The success rate was significantly lower for individuals with many periodontal pockets and for those with the diagnosis local periodontitis. The prevalence of adolescents classified as having high periodontal risk was low. A large frequency of subjects dropped out before the periodontal treatment was completed, especially at the specialist clinics.
In 1990, as part of a major health status assessment, a dental survey was carried out on a 20 per cent random sample of the adult population in the Keewatin region of the Northwest Territories. A 73 per cent response rate was obtained. Of the 397 people examined, 334 (88 per cent) identified themselves as Inuit. More than 20 per cent of the respondents were edentulous, including 10 per cent of those 18 to 34 years old. The median DMFT was 24 for all respondents and 21 for dentulous respondents. There was a significant difference between Inuit and non-Inuit respondents, which was most marked in the 18 to 34 year old age group (mean DMFT 22.1 versus 15.6, p
Utilization of dental services by 30 diabetic and 30 nondiabetic subjects was assessed by longitudinal monitoring over a period of 3 years. All subjects were examined clinically three times, and their treatment consisted mainly of cariologic and periodontal treatment. The treatment was delivered by a dentist and an expanded-duty dental hygienist. The study groups were similar with regard to the total number of dental visits needed. However, the treatment of diabetic subjects was more demanding in that more dentist's workload was needed for the diabetic group. They also missed more appointments without cancellation and therefore more office time had to be reserved for them.