Decayed, Missing, Or Filled Teeth Research Articles

Diagnostic Validity of Self-Perceived Dental Caries in Indonesian Young Adolescents Aged 12-15 Years

Objective: To compare self-perceived information and clinically diagnosed dental caries status among Indonesian children aged 12–15 years. Material and Methods: In this cross-sectional study, a questionnaire was used to obtain self-perceived information. Clinical examinations were conducted to determine the mean number of decayed, missing or filled teeth (DMFT) and the presence of severely decayed teeth with visible pulpal involvement, ulceration caused by dislocated tooth fragments, fistula, and abscess (PUFA). The study included 494 children aged 12–15 years recruited from six junior high schools in Jakarta, Indonesia. The clinical examination results and responses to the self-perceived assessment questionnaire were compared to determine the sensitivity and specificity. Results: The proportions of children with dental caries and clinical consequences of untreated dental caries in this study were 69.4% and 17.6%, respectively, with mean DMFT and PUFA index scores of 2.4 and 0.2, respectively. For the DMFT index, the self-perceived need for oral treatment had the highest sensitivity (86%), while the dental pain had the highest specificity (89%). For the PUFA index, the self perceived oral health condition had the highest sensitivity (92%), while the self-perceived dental pain had the highest specificity (82%). However, none of the self-perceived variables had both high sensitivity and specificity. Conclusion: Self-perceived information obtained from the questionnaire can not properly evaluate the clinical status of dental caries.

Influence of dialysis therapies on oral health: a pilot study.

Chronic kidney disease (CKD) is a public health problem worldwide. Currently, the link between oral health status, dialysis modality, and dialysis vintage is still not clear. The aim of this study was to evaluate periodontal disease, dental caries, and Candida colonization among patients under hemodialysis (HD) therapy, peritoneal dialysis (PD) therapy, and PD with previous history of HD (HD/PD). The clinical history, smoking, and oral hygiene habits were recorded. Decayed, missing, or filled teeth (DMFT) index, Visible Plaque Index (VPI), clinical attachment level (CAL), bleeding on probing, saliva flow rate, saliva pH, and oral yeast colonization were assessed. HD/PD patients were generally submitted to longer periods of dialysis therapy than the other groups. The number of decayed and filled teeth did not differ between groups; HD patients presented a higher number of teeth, but poor periodontal status. Among the three groups, HD patients presented higher VPI, CAL, and oral Candida colonization, independently of the time under dialysis therapy. Candida albicans (HD and PD), Candida krusei (HD), and Candida carpophila (PD) were isolated in these patients. HD presented a more adverse impact on oral health than PD, particularly periodontal disease and oral Candida colonization; however, this impact on oral health appears to be reduced or ameliorated when patients change from HD to PD therapy.

Transgender HIV status, self-perceived dental care barriers, and residents' stigma, willingness to treat them in a community dental outreach program: Cross-sectional study.

Assess the association between high risk transgender (TG) HIV status, self-perceived barriers toward oral care, and the residents' stigma and willingness to treat during community dental outreach. Demographics, tobacco habits, HIV status, willingness for rapid HIV testing, and self- perceived oral health, barriers toward oral care were assessed in a cross-sectional study among 212 transgender in South India. Further, the residents' stigma across three subscales and residents' willingness to treat the transgender was evaluated. Overall, 88% had begging as the sole income, and 93% lived in slums and used some form of tobacco. Oral health was perceived to be poor by more than half, and the mean probing pocket depth (PPD) and decayed, missing, or filled teeth (DMFT) was 4.2mm and 3.67, respectively. The residents reported significantly low regard and willingness to treat TG irrespective of high/low stigma and when the transgender HIV status was positive/do not know. Residents with greater fear of exposure expressed least regard and willingness to treat TG (P<0.05). The self-perceived oral health of transgender' was poor corresponding to the clinical examination findings. Moreover, the stigmatizing attitude and low regard to provide oral care is rampant among the dental residents, which further frustrates dental care.

The association between minor recurrent aphthous stomatitis (RAS), children\u2019s poor oral condition, and underlying negative\xa0psychosocial habits and attitudes towards oral hygiene

BackgroundMinor Recurrent Aphthous Stomatitis (RAS) represents a disease which is very difficult to prevent. This case-control study focused on possible associations between minor Recurrent Aphthous Stomatitis in children, their oral health, and underlying behavioral indexes of children’s attitudes and habits pertaining to (home) oral hygiene, with the further goal of enabling the dentist to prevent these specific kind of lesions, both from a clinical and a broader psychosocial perspective.MethodsFour hundred one school-children (5–10 years old) in Milan (Italy) were submitted to an intra-oral examination, and interviewed with the aid of a brief psychosocial questionnaire.ResultsAt the clinical level, statistically significant associations were observed between the presence of decayed teeth and minor Recurrent Aphthous Stomatitis (Odds Ratio: 3.15; 95% CI: lower limit 1.06; upper limit: 9.36; Z-test: 2.07, p = 0.039; Chi-square = 4.71, p = 0.030), and between the Decayed Missing or Filled Teeth (DMFT) index and minor aphthous stomatitis (Odds Ratio: 3.30; 95% CI: lower limit 1.13; upper limit: 9.67; Z-test = 2.18, p = 0.029; Chi-square = 5.27; p = 0.022), both results pointing to a significant increase—by circa 3 times—in the risk of developing minor Recurrent Aphthous Stomatitis in children exposed to the two above-identified factors (i.e., the presence of decayed teeth and a clearly compromised oral condition, as signaled by the DMFT index), if compared with the risk run by their non-exposed counterparts. At the psychosocial level of analysis, statistically significant associations were observed (1) between children’s practice of spontaneously brushing teeth when not at home and a comparatively lower (i.e. better) Decayed Missing or Filled Teeth index (Chi-square: 8.95; p = 0.011), and (2) between receiving parental aid (e.g., proper brushing instructions) while practicing home oral hygiene and a significantly reduced presence of decayed teeth (Chi-square = 5.40; p = .067; Spearman’s Rho, p = .038). Further, significant associations were also observed between children’s reported severity of dental pain and both (a) the presence of decayed teeth (Chi-square = 10.80; p = 0.011), and (b) children’s (poor) oral health condition as expressed by the Decayed Missing or Filled Teeth index (Chi-square = 6.29; p = 0.043). Interestingly, specific lifestyles and social status, showed no systematic association to other clinical or psychological/psychosocial indices.ConclusionsThese systematic relations suggest that, in the presence of Recurrent Aphthous Stomatitis in pediatric patients, the dentist should carefully monitor children for potential carious lesions, implement protocols of prevention to control Recurrent Aphthous Stomatitis disease in children affected by caries, and also be particularly aware of the right or wrong habits children may acquire in the course of continued social exchange with their caregivers and peers.

Relationship Between Mothers' Knowledge and Attitude Towards the Importance of Oral Health and Dental Status of their Young Children.

To examine the relationship between mothers' knowledge, attitude and dental caries status and their young children's dental caries status. In this cross-sectional study, 153 2- to 6-year old children old and their mothers were dentally examined. Mothers' decayed, missing or filled teeth (DMFT) and children's decayed, missing or filled teeth (dmft) were recorded. A validated questionnaire was used to examine maternal knowledge and attitudes regarding the importance for the oral health of their children. The average age of children and mothers were 5.1 and 31 years, respectively. The mothers' and children's mean DMFT and dmft were 12 and 6, respectively. The mean level of mothers' knowledge was 31.5 out of 40, while the mean attitude was 24.5 out of 30 points. There was a statistically significant inverse correlation between mothers' knowledge and their DMFT (r = -0.7), and between mothers' knowledge and children's dmft (r = -0.6). Also, there was an inverse correlation between mothers' attitude and DMFT (r = -0.8), and between mothers' attitude and dmft (r = -0.7). A direct correlation between mothers' DMFT and children's dmft (r = +0.6) was observed. Attempts at improving the knowledge and attitude in parents have a substantial impact on improving the oral health of next generation.

Contemporary perspective on the role of community pharmacists in oral health promotion.

Our oral health is an important part of our general health and wellbeing, and requires a range of providers to work in partnership to effectively provide oral health promotion. Cheryl Else, from Manchester Metropolitan University, explores the role community pharmacies can play in reducing oral health inequalities.[Image omitted: See PDF.]According to a recent report by Public Health England (PHE)[1] for local authorities, it was acknowledged that oral health is an important part of general health and wellbeing, and that both share common risk factors such as smoking, alcohol misuse and unhealthy diets.Since 2012, local authorities have been statutorily required to provide or commission oral health promotion programmes to improve the oral health of their local population to a standard appropriate for their area.[1] They can integrate these programmes into existing services or tender for new partnerships.[1] A range of providers already deliver oral health programmes that have been developed from evidence-based research.[1]To be effective, oral health promotion requires a range of providers who can work in partnership, and community pharmacists could play a specific role in this area.According to a review by Mann et al.,[2] community pharmacists already provide essential services in general health promotion and are frequently asked questions on oral health issues. Furthermore, pharmacists are willing to incorporate oral health promotion into their existing role as long as the right support is in place.[2] This support would need to include further training in understanding contemporary evidence-based dental public health interventions and incorporation of oral health promotion into their existing NHS contract.[2]The Royal Society for Public Health (RSPH) and PHE[3] researched the role community pharmacies currently play in health promotion and the future role they could play with the right support in place. This would enable them to reach their full potential in health-promoting activities.[3] Through the 'community pharmacy contractual framework', some health-promoting activities are already an integral part of the community pharmacies role including prescription-linked healthy lifestyle advice, smoking cessation and signposting to other health services.[3] In addition, many pharmacies are commissioned by local authorities to deliver other public health services such as weight management programmes or NHS health checks, but as the report highlighted, there are challenges that still need to be overcome to make 'healthy living pharmacies' a truly viable option across the UK.[3] These challenges include financial, infrastructure and training issues.[3] However, policies and structures could be put in place to address these issues allowing all community pharmacies on our high streets to play an important part in reducing health and oral health inequalities.Oral Health InequalitiesWhile there has been a general decline in dental decay, it remains a disease that has become increasingly concentrated in high-risk groups and closely linked with social and economic deprivation.[4]In 2016, PHE published their epidemiology report on the prevalence and severity of dental decay,[5] which revealed huge variations at local and regional authority levels and confirmed previous studies which found that most of the dental decay is found in children of poor economic and social backgrounds, with ethnicity also a factor.The results of that epidemiology survey found that the overall percentage of 5-year-old children in England free from visually obvious dental decay was 75.2% and the national average overall for England with regard to number of teeth affected by dental decay was 0.8 decayed, missing or filled teeth (DMFT); but this number increases to 3. …

Prediction of Periodontitis Occurrence: Influence of Classification and Sociodemographic and General Health Information.

Prediction of periodontitis development is challenging. Use of oral health-related data alone, especially in a young population, might underestimate disease risk. This study investigates accuracy of oral, systemic, and socioeconomic data on estimating periodontitis development in a population-based prospective cohort. General health history and sociodemographic information were collected throughout the life-course of individuals. Oral examinations were performed at ages 24 and 31 years in the Pelotas 1982 birth cohort. Periodontitis at age 31 years according to six classifications was used as the gold standard to compute area under the receiver operating characteristic curve (AUC). Multivariable binomial regression models were used to evaluate the effects of oral health, general health, and socioeconomic characteristics on accuracy of periodontitis development prediction. Complete data for 471 participants were used. Periodontitis classifications with lower thresholds yielded superior predictive power. Calculus, pocket, or bleeding presence at age 24 years separately presented fair accuracy. Accuracy increased using multivariable models; for example, the Beck et al. classification AUC from 0.59 to 0.75 combining proportion of teeth with calculus, bleeding, or pocket with income; number of lost teeth; sex; education; people living in the house; prosthetic needs; or number of decayed, missing, or filled teeth (DMFT). Proportion of teeth with pocket, bleeding, or calculus; number of DMFT; toothbrushing frequency; blood pressure; sex; and income were most frequently associated. Choice of classification might have an impact on accuracy to predict periodontitis occurrence. Regardless of the classification, predictive value for development of periodontitis in young adults might be increased by combining periodontal information, sociodemographic information, and general health history.

Association between unmet needs for dental treatment and the DMFT index among Korean adults

Objectives: Unmet needs for dental treatment are one of the potential contributing factors to poor oral health because oral health problems worsen if left untreated. This study aimed to demonstrate the prevalence of and the causes for unmet dental needs, and to evaluate the association between unmet needs for dental treatment and oral health status. Methods: Data on 3,883 subjects aged ≥18 years from the Korean National Oral Health Survey 2006 were analyzed. Information regarding unmet needs for dental treatment was obtained using standard ized questionnaires. Eight trained dentists examined decayed, missing, or filled teeth (DMFT). Multiple regression models were built to assess the association between unmet needs for dental treatment and the DMFT scores. Results: The prevalence of perceived unmet needs for dental treatment was 34.7% among the adult Korean population. Economic constraints were the main cause (38.6%) for unmet dental needs. The average DMFT scores were higher in the subjects with unmet needs for dental treatment than in those without. In individuals with unmet needs for dental treatment within the past 1 year, the number of de cayed teeth after adjusting for confounders was likely to be greater by 0.58 and that of missing teeth by 0.27 compared to that in their counterparts with no unmet dental needs in the past 1 year. Conclusions: Perceived unmet needs for dental treatment were significantly associated with poor oral health status among the adult Korean population. Further studies are needed to clarify the direct and indirect effects of unmet needs for dental treatment on an individual’s oral health status by investigating critical variables of the causal pathways among perceived dental needs, dental care utilization, and oral health status.

Assessment of dental caries prevention program applied to a cohort of elementary school children of Kebemer, a city in Senegal.

Objective:Dental caries is frequently observed in children, particularly among those residing in developing countries. The most adapted strategies against this pathology remains prevention based on information, education, and communication (IEC), as well as on early diagnosis and treatment. We carried out a study that aimed to analyze the development of dental caries in a cohort of school children followed during their primary education. The objective was to assess the evolution of the dental status of a cohort of students during their elementary curriculum.Materials and Methods:A cohort of school children was followed during 6 years from the first grade to the sixth grade. Monitoring of these school children focused every year on IEC based on learning methods of brushing messages, dietary advice, systematic visits, fluoride use, and primary dental care. During the school year, the students were periodically subjected to education and communication briefings (IEC). Primary care consisted of extracting and descaling rhizalyzed teeth in the same period. The data from this review were collected using the World Health Organization questionnaire, and statistical analysis was performed with the software Epi-info version 6.04 d.Results:The mean age of the 171 school children was 6 years in the first grade and 11 years in the sixth grade. In the first grade, the decayed permanent teeth prevalence was 31.6% and the In permanent teeth: Decayed, missing or filled teeth (DMF/T) was 0.47. The decayed primary teeth prevalence was 75% and the in primary teeth: decayed or filled teeth (df/t) 2.23. In the sixth year, the prevalence of decayed permanent teeth was 51% and DMF/T 0.36 whereas the decayed primary teeth prevalence was 12% and the df/t was 0.19. The prevalence of decayed permanent teeth increased from 31.6 to 51% whereas the mean DMF/T was not statistically different between school children of the first and sixth grade class.Conclusion:The promotion of oral health by IEC messages and monitoring of children constitute an effective preventive method for children's oral care.

Comparison of linear and zero-inflated negative binomial regression models for appraisal of risk factors associated with dental caries.

Dental caries among children has been described as a pandemic disease with a multifactorial nature. Various sociodemographic factors and oral hygiene practices are commonly tested for their influence on dental caries. In recent years, a recent statistical model that allows for covariate adjustment has been developed and is commonly referred zero-inflated negative binomial (ZINB) models. To compare the fit of the two models, the conventional linear regression (LR) model and ZINB model to assess the risk factors associated with dental caries. A cross-sectional survey was conducted on 1138 12-year-old school children in Moradabad Town, Uttar Pradesh during months of February-August 2014. Selected participants were interviewed using a questionnaire. Dental caries was assessed by recording decayed, missing, or filled teeth (DMFT) index. To assess the risk factor associated with dental caries in children, two approaches have been applied - LR model and ZINB model. The prevalence of caries-free subjects was 24.1%, and mean DMFT was 3.4 ± 1.8. In LR model, all the variables were statistically significant. Whereas in ZINB model, negative binomial part showed place of residence, father's education level, tooth brushing frequency, and dental visit statistically significant implying that the degree of being caries-free (DMFT = 0) increases for group of children who are living in urban, whose father is university pass out, who brushes twice a day and if have ever visited a dentist. The current study report that the LR model is a poorly fitted model and may lead to spurious conclusions whereas ZINB model has shown better goodness of fit (Akaike information criterion values - LR: 3.94; ZINB: 2.39) and can be preferred if high variance and number of an excess of zeroes are present.

Evaluation of Salivary Secretory Immunoglobulin A Levels in Diabetic Patients and Association with Oral and Dental Manifestations.

Oral and dental manifestations in diabetic patients can arise due to numerous factors, including elevated salivary secretory immunoglobulin A (s-IgA) levels. This study aimed to evaluate s-IgA concentrations in patients with type 2 diabetes mellitus (T2DM) and to investigate the association between s-IgA levels and oral and dental manifestations of T2DM. This cross-sectional descriptive study was carried out between October 2011 and September 2012 in Kerman, Iran, and included 260 subjects (128 patients with T2DM and 132 healthy controls). Unstimulated salivary samples were collected from all subjects and s-IgA levels were determined using the immunoturbidimetric method. The oral cavities and teeth of T2DM patients were evaluated for oral and dental manifestations. Both diabetic and control subjects with higher concentrations of s-IgA had significantly higher numbers of decayed, missing or filled teeth (DMFT) and periodontal index (PDI) scores (P <0.050). s-IgA levels were significantly higher in subjects with oral candidiasis (P <0.050). Among diabetic patients, significantly higher s-IgA levels were concomitant with xerostomia and denture stomatitis (P ≤0.050). There were no significant differences between s-IgA concentrations and other oral or dental manifestations in either group. Individuals with a greater number of DMFT, a higher PDI score and oral candidiasis had significantly higher s-IgA levels. s-IgA levels were not significantly higher among diabetic patients in comparison to the control group. However, significantly higher s-IgA levels occurred with xerostomia and denture stomatitis in diabetic patients. In addition, s-IgA was significantly higher in patients with uncontrolled diabetes compared to those with controlled diabetes.

Factors associated with dental caries experience and oral health status among New South Wales adolescents

ObjectiveTo investigate the potential social and behavioural risk factors influencing the oral health of teenagers aged 14 and 15 years living in New South Wales Australia. MethodsQuantitative and qualitative methodologies were used in this research project. Data were obtained from both the clinical and questionnaire components of the NSW Teen Dental Survey 2010 and were analysed in SAS 9.2. The analyses allowed for various demographic and behavioural risk factors to be assessed using caries experience, severe caries and DMFT (decayed, missing or filled teeth) counts as the key outcome variables. ResultsOf the 1,256 14– and 15‐year‐olds who had a dental examination, 1,199 (95.5%) provided questionnaire data. The clinical examinations found that 44.4% of teenagers overall had caries experience in at least one tooth, while 10.6% of the sample had experienced severe caries. Severe dental caries was found to be significantly related to a variety of factors, including family income, fluoridation status, tooth brushing behaviour and sugary drink consumption. ConclusionsThe oral health of 14– and 15‐year‐olds in NSW is influenced by social and dietary factors as well as access to fluoridated water supplies. There was also a strong relationship between self‐rated oral health status with DMFT and with caries experience. ImplicationsThe findings of this study will assist policy makers by highlighting the current caries risk factors that should be part of future health promotion programs.

Can black extrinsic tooth discoloration predict a lower caries score rate in young adults

The aim of this study was to examine the association between black extrinsic tooth discoloration and caries prevalence in an adult population. This association has been previously shown in children and adolescents but has never been examined in an adult population. Young adults, aged 18 to 29 years old, were examined for black extrinsic tooth discoloration and caries prevalence. The study group included 110 young adults with black stain; the control group consisted of 170 young adults without black stain. The decayed, missing, or filled teeth (DMFT) index score was determined for each subject. The mean DMFT score was calculated for both groups and compared between groups (independent t test). Multiple logistic regression analysis was applied to identify independent influences (age, pigmentation, gender, and smoking) on DMFT. Mean DMFT score was 4.2 ± 3.9 for the study group and 5.98 ± 4.8 for the control group, which was statistically significant (P < .001). Mean D score (untreated caries) was 1.6 ± 2.5 (study) and 2.4 ± 3.5 (control) (P < .05). Age had a positive correlation with the DMFT score; however, gender and smoking were negatively correlated. The association between black stain and reduced rates of dental caries was demonstrated in a young adult population for the first time.

Trends in oral health inequality in 12-year-old Korean children: A study using the Gini coefficient

Objectives: This study was conducted to analyze the current state and tendency of oral health inequality in 12-year-old Korean children by calculating the Gini coefficient from decayed, missing, or filled teeth (DMFT) data. Methods: Ten-year trends were empirically estimated by calculating the Gini coefficient from the Lorenz curve plotted based on the DMFT data of 12-year-old children, obtained from the Korean National Oral Health Survey from 2000 to 2010. Results: While the oral health improved in general, oral health inequalities increased with the decrease in the number of DMFT each year, and the DMFT-based Gini coefficient increased from 0.53 in 2000 to 0.61 in 2010. The increase in the number of decayed and missing teeth was strongly affected by the increase in oral health inequality. Conclusions: To resolve Korea’s continually increasing oral health inequality, it is necessary to establish support measures for vulnerable populations and to develop and manage a surveillance system for continuous monitoring of oral health inequality in the future.

Determinación de los Índices CPO-D e IHOS en estudiantes de la Universidad Veracruzana, México

Introduction: Knowledge of the dental health of the population constitutes a fundamental task of public health, since oral diseases- such as cavities and periodontal disease- are the health conditions with highest incidence and prevalence around the world. The objective of this study was to determine the index of decayed, missing or filled teeth (DMFT) and the simplified oral health index (OHI-S) of first year university students in the state of Veracruz, province of Mexico.Material y method: A descriptive, cross-sectional, observational study was carried out, applying a comprehensive health exam which consisted of two parts: a questionnaire and a clinical exam. Results: The DMFT index was 13.1. The prevalence of cavities was 80.9, missing teeth was 37.9 y filled teeth was 47.0. The OHI-S was the following: 81.5%

Use of The ART Technique Within the School Setting Can be A Practical and Effective Method of Treating Caries Among Large Populations of Underserved Children

The study sample was composed of 197 children, mean age 12.560.6 years at baseline, attending 4 schools in Deyang City, Sichuan Province, China. They had a mean decayed, missing, or filled teeth (DMFT) score of 0.6, with a mean decayed teeth (DT) score of 0.4. At the 6-year follow-up, 117 children (59% of original cohort) remained in the study. The primary study factor was caries treatment using atraumatic restorative treatment (ART) restorative therapy. A total of 294 ART restorations were placed by 5 local assistant dentists, who had received a short training course in the procedure. Seventy-eight percent were single-surface restorations not involving more than half of the surface (so-called "small" restorations); the remaining 22% involved either more than half of a single surface or extended onto more than one surface (so-called "large" restorations), including 5% that were class II restorations. The main outcome measure was failure of the ART restoration at 6 years. Failure included loss of the restoration (total or partial), replacement by another restoration, or the presence of either a gross defect or gross wear. Assessment using US Public Health Service criteria, including caries assessment, at 5 years was also reported. The principal findings were that 76% of small ART restorations and 59% of large restorations had not failed at 6 years. The large restorations were nearly 6 times more likely to fail as compared with the small (hazard ratio = 5.87, P <.05). Loss of the restoration was the principal reason for failure for both small and large restorations. Recurrent caries was specifically diagnosed at 5-year follow-up, and found to be present in around 6% of small restorations, with none of the larger restorations having been diagnosed as carious. The authors concluded that the 6-year survival of ART restorations in this study sample was high, with the likelihood of success related to restoration size. They further concluded that application of this treatment technique at school could be used to help address the needs of large populations of underserved children.

Correlation between Streptococcus mutans level in saliva and caries status in children

To investigate the distribution pattern of salivary Streptococcus mutans (Sm) level in children and its association with caries status. Three hundred and sixty-five 11- 12-year-old children participated in this study. Scores of decayed, missing or filled teeth (DMFT) for the permanent dentition were recorded. Salivary Sm concentrations were determined by species-specific monoclonal antibodies. Caries-affected children harbored more Sm in saliva [5.53 (1.50, 18.00) x 10(7)/L] than their caries-free counterparts [3.42 (1.60, 8.10) x 10(7)/L] (P = 0.002). Salivary Sm concentration tended to rise with the increase of DMFT score. Spearman's correlation coefficient for Sm concentration was 0.136 (P = 0.010). When salivary Sm concentration reached 8.64 x 10(7)/L, children's caries experience doubled. Salivary Sm level has a skewed distribution among the children studied and associates positively with caries presence. Determination of salivary Sm levels could be used to predict children's caries status.

Oral Health and Bone Density in Adolescents and Young Women with Anorexia Nervosa

To evaluate the dental and periodontal health of adolescents and young women with restrictive anorexia nervosa (AN), and relationship between bone mineral density (BMD) assessed by dual energy Xray absorptiometry (DXA) and dental radiographs. Twenty-three young women, median age 17.6 years (range 14.4-27.2), were studied within three months of entering a clinical trial. DXA BMD measurements were obtained and subjects underwent a comprehensive dental examination, including panoramic and bitewing dental radiographs. Three observers assessed mandibular cortical width (MCW) in the mental foramen region on panoramic radiographs. Dental findings included very good to excellent oral hygiene. Gingival recession was evident in 10 participants (43%). Dental erosion was not seen and the mean decayed missing or filled teeth (DMFT) was 8.6. There was a weak positive correlation between BMD by DXA and MCW on radiographs. We report dental manifestations associated with restrictive AN, and the association between bone assessments by DXA and dental radiographs in this patient group. Despite subnormal DXA measurements in most patients, essentially all adolescents had a normal dental examination. Dental providers should be cognizant of the fact that many patients with eating disorders may not display the "classic" findings reported in the literature.

Caries and dental fluorosis in a western Saharan population of refugee children

The aim of this study was to investigate the relationship between dental fluorosis and dental caries among western Saharan refugee children. The western Saharan child population is characterized by adverse living conditions, an unbalanced diet, poor oral hygiene habits, and a concentration of fluoride in the drinking water of around 2 p.p.m. (2 mg l(-1)). A sample consisting of 360 children, 6-7 yr of age, and 212 children, 11-13 yr of age, was obtained from four refugee camps (Smara, Awsard, El-Aaiun, and 27-February) situated in the vicinity of Tindouf (southern Algeria). The children were examined using the World Health Organization criteria for caries diagnosis and Dean's index for fluorosis. The decayed, missing or filled teeth (DMFT) score was 0.48 in the 6-7-yr-old children and 1.69 in the 11-13-yr-old children, with a caries prevalence (DMFT > 0 or decayed and filled primary teeth (dft) > 0) of 47.2% and 63.2%, respectively. Among the 6-7 yr-old children examined, 36.9% were free of fluorosis, 15.6% presented moderate fluorosis, and 7.8% presented severe fluorosis. Among 11-13 yr-old children, only 4.2% were free of fluorosis, 30.2% exhibited moderate fluorosis, and 27.4% presented severe fluorosis. The mean DMFT, decayed permanent teeth (DT), and caries prevalence (DMFT > 0 and DMFT or dft > 0) scores were significantly higher among the children affected by severe fluorosis, suggesting that severe fluorosis might increase the susceptibility to dental caries.

Tooth Loss and Lack of Regular Oral Hygiene Are Associated with Higher Risk of Esophageal Squamous Cell Carcinoma

We tested the association between tooth loss and oral hygiene and the risk of esophageal squamous cell carcinoma (ESCC) in people living in a high-risk area of Iran. We used a case-control study of pathologically confirmed ESCC cases (n = 283) and controls (n = 560) matched on sex, age, and neighborhood. Subjects with ESCC had significantly more decayed, missing, or filled teeth (DMFT) with a median (interquartile range) of 31 (23-32) compared with controls 28 (16-32; P = 0.0045). Subjects with ESCC were significantly more likely than controls to fail to practice regular oral hygiene (78% versus 58%). In multivariate-adjusted conditional logistic regression models, having 32 DMFT compared with < or = 15 conferred an odds ratio (95% confidence interval) of 2.10 (1.19-3.70). Compared with daily tooth brushing, practicing no regular oral hygiene conferred an odds ratio (95% confidence interval) of 2.37 (1.42-3.97). Restricting the analysis to subjects that had never smoked tobacco did not materially alter these results. We found significant associations between two markers of poor oral hygiene, a larger number of DMFT and lack of daily tooth brushing, and risk of ESCC in a population at high risk for ESCC where many cases occur in never smokers. Our results are consistent with several previous analyses in other high-risk populations.