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.
Ethnicity has long been suspected to play a role in the risk of macular degeneration as well as its neovascular complications. We carried out a study to determine the prevalence of retinal diseases in Chinese-Canadians presenting for fluorescein angiography compared to a matched group of Canadians of European origin.
We reviewed 20,000 consecutive fluorescein angiograms obtained between December 1987 and November 1993 at a tertiary referral centre for ophthalmic care in Vancouver. All patients identified by name as being of Chinese ancestry were identified and matched to a patient of European ancestry. The two groups were compared in regard to the prevalence of specific retinal diseases, including age-related macular degeneration (AMD).
Among the first 10,000 fluorescein angiograms, 417 patients of Chinese ancestry were identified, of whom 61 (14.6%) had the primary diagnosis of AMD. The rate among the patients of European ancestry was 30.4% (127/417) (odds ratio [OR] 2.12, 95% confidence interval [CI] 1.79 to 2.56) (p
BACKGROUND: Photoscreening allows lay persons to adapt the Enhanced Brückner Test to preschoolers in an attempt to identify refractive amblyopia. The Alaska Blind Child Discovery (ABCD) project is charitably funded and administered. METHODS: MTI photoscreening was offered to children in rural and urban communities in southern Alaska from 1996 through June 1999. Parents answered questions concerning the child's health, family ocular history and whether the child had any eye "Warning Signs." The MTI images were interpreted by two eye doctors using a modification in MTI published guidelines. RESULTS: Out of 4000 screenings performed on 3930 children, there was an overall "not normal" interpretation of 9% and an inconclusive rate of 1%. The mean S.D. age was 3.9 2 years. Only 6% had had a prior eye exam. The average number of Polaroid pictures per screening was 1.16. Follow-up data on "not normal" results was obtained on just over 50%. The positive predictive value during the first two years was 77% but improved to 92% from 1998-1999. Affirmative answers to the questions concerning previous eye exam, child's health, siblings eye health and positive "Warning Signs" were significantly associated with "not normal" interpretations but affirmative answers about eye health of mother, father and relatives were not. Community penetrance of photoscreening to the target age-group ranged from only 5% for Anchorage to almost 100% for the Bristol Bay public health nurses. Five percent of parents of "positive" results surveyed would not have recommended screening for their friends. Equipment functioned dependably even in remote Alaska. CONCLUSION: Charitable volunteer Polaroid photoscreening detected amblyopia and significant pediatric eye disease in over 300 children during the first 3.5 years of ABCD.
BACKGROUND: Photoscreening can allow early detection of amblyopia. The Gateway DV-S20, and similar models of miniature, digital flash cameras, have similar optical dimensions to existing photoscreeners for less than $200. METHODS: These cameras were calibrated on known, threshold amblyogenic refractive errors induced by placing minus and toric contact lenses on a normal subject's left eye. The DV-S20 was then applied to known amblyopic patients. Students under age 7 were vision screened with patched acuity and sequential photoscreeners (MTI and Gateway). RESULTS: The digital cameras and the MTI photoscreeners produced similar magnitude interpretable crescents for amblyopiagenic refractive errors. They had very similar validation with sensitivities of 80-90% and specificities of 98% for serious eye disorders in known patients and school-aged children. CONCLUSION: Combined with careful interpretation, pocket-sized, digital flash cameras provide a portable and inexpensive digital alternative for pediatric photoscreening. A category 3 CPT code (0065T) can be used for this valid, public health technique: Amblyopia Detection By Camera (ADBC).
In 1957 a woman was murdered in Oslo. Her left breast exhibited tooth marks. A man was arrested and sentenced to life imprisonment partly because of the dental evidence. He never admitted guilt and filed a petition for retrial. The present author was appointed as new dental expert. The material consisted of the fixed breast, models of the bite mark and models of the teeth of the convict, and several photographs. By means of visual examination, a magnifying glass, a lens stereoscope and a stereomicroscope characteristic details were noted. Stereoscopic picture pairs were taken, the material was studied by means of scanning electron microscopy and a stereometricgraphic plotting method permitting the outline of the tooth mark or the biting edge of a tooth to be registered in great detail in all three dimensions in the form of a contour map. This method has not previously been applied in the analysis of tooth marks in human skin. These examinations revealed no discrepancies but showed many corresponding characteristic features between the tooth marks and the teeth of the convict, resulting in the conclusion that it is highly probable that the tooth marks in the breast were made by the teeth of the convict.