Levels Of Dental Disease Research Articles

Level of dental disease and differences in dental treatment in stem cell transplant recipients: the OraStem study

Objectives There is a lack of an accepted standard of care for dental treatment before hematopoietic stem cell transplantation (HSCT). Therefore, in this international, prospective multicenter study (OraStem), we evaluated the differences in dental diseases, oral hygiene practices, and dental treatments before HSCT. Study Design Enrollment sites included Vancouver, BC (Canada); Gothenburg and Huddinge (Sweden); Nijmegen and Amsterdam (The Netherlands); and Charlotte, NC (USA). The frequency of dental diseases, oral hygiene practices, and dental treatments before HSCT are reported here. Results Data on the number, mean age, and gender (%) of the cohort included the following: Overall: n = 269, age 53.6 years, males 56%; Vancouver: n = 58, age 52.3 years, males 57%; Sweden: n = 29, age 57.2 years, males 56%; Nijmegen: n = 81, age 55.1 years, males 54%; Amsterdam: n = 43, age 55.2 years, males 59%; and Charlotte: n = 58, age 49.6 years, males 57%. Overall, the most frequent medical diagnoses necessitating HSCT were as follows: myeloma = 74 (27%), acute myelogenous leukemia = 67 (24%); lymphoma = 37 (13%), myelodysplastic syndrome = 19 (7%); and acute lymphoblastic leukemia = 17 (6%). Overall, most transplants were allogeneic (61%) versus autologous (36%). The numbers of patients reporting brushing 2 or more times per day were as follows: overall = 200 (73%); Vancouver = 40 (67%); Sweden = 27 (87%); Nijmegen = 63 (78%); Amsterdam = 34 (77%); and Charlotte = 36 (59%). The numbers of patients reporting seeing a dentist or dental therapist routinely were as follows: overall = 202 (73%); Vancouver = 41 (71%); Sweden = 24 (77%); Nijmegen = 70 (86%); Amsterdam = 37 (84%); and Charlotte = 30(49%). Conditions of teeth were recorded before and after dental treatment provided before HSCT. Upon enrollment, mean numbers of teeth with a natural root (with or without crown) were as follows: overall = 24.2; Vancouver = 23.2; Sweden = 26.3; Amsterdam = 23.5; Nijmegen = 23.8; and Charlotte = 25.5. The numbers of people who underwent tooth extraction and the numbers of dental extractions (% of existing teeth) before transplantation were as follows: overall: n = 44, 126 teeth (0.5%); Vancouver: n = 4, 5 teeth (0.1%); Sweden: n = 5, 28 teeth (0.32%); Nijmegen: n = 10, 41 teeth (0.5%); Amsterdam: n = 8, 14 teeth (0.3%); and Charlotte: n = 17, 59 teeth (1%). The numbers of teeth with periodontal pocketing greater than 5 mm left untreated were as follows: overall = 102 (0.4%); Vancouver = 23 (0.5%); Sweden = 25 (0.3%); Nijmegen = 25 (0.3%); Amsterdam = 12 (0.3%); and Charlotte = 35 (0.8%). The numbers of teeth with 1 or more carious lesions to dentin left untreated were as follows: overall = 246 (1.0%); Vancouver = 11 (0.2%); Sweden = 27 (0.3%); Nijmegen = 118 (1.5%); Amsterdam = 11 (0.3%); and Charlotte = 99 (1.7%). Conclusions This baseline report reveals variations in dental diseases, oral hygiene practices, and dental treatments rendered before HSCT among different study centers. Establishment of an international standard of care for dental treatment before HSCT is needed. Prospective OraStem study data will increase the understanding of risk factors related to oral complications during HSCT.

Oral Health Status of Patients Undergoing Treatment for Head and Neck Oncology in Northern Ireland.

This study aimed to collect data on the oral health status of patients undergoing treatment for head and neck oncology across Northern Ireland. Data were collected on all patients referred to the Northern Ireland Multidisciplinary Head and Neck Oncology Team for discussion and treatment planning. Each patient underwent pre-treatment dental assessment in the Centre for Dentistry, Queen's University Belfast, between June 2013 and November 2014. Data were collected from clinical oral examinations supplemented with intra-oral radiographs. During the course of the study 96 patients were assessed and the levels of dental disease observed in this cohort were high. On clinical examination 43% were diagnosed with caries and 46% with periodontal disease. Ten patients were completely edentate. The disease profile of this patient group presents significant challenges to dental services tasked with rendering patients dentally fit prior to undergoing oncology treatment.

Motivating Factors for Seeking Oral Health Care at a Teaching Dental Hospital in South India: A Cross-sectional Study

General health cannot be attained or maintained without oral health. The mouth is regarded as a mirror and the gateway to health.1,2 The dental health of the general population in developed countries has improved over the past four decades, but people from developing countries continue to have high levels of dental disease. In developing countries like India, evidence repeatedly shows suboptimal utilization of dental services.3 Preventive dental visits help in the early detection and treatment of oral diseases.4 But the provision of preventive dental care for adults depends on the individual patient’s initiatives in utilizing dental care. Utilization is the actual attendance by the members of the public at health care facilities to receive care.5,6 Utilization of dental services is influenced by a complex set of factors.7,8 Behavioral, sociodemographic, and culturally related factors contribute to people’s decision in choosing dental health care providers as well as utilization of dental services. In order to improve oral health outcomes, an adequate knowledge of the individuals’ use of health services and the factors predictive of this behavior is essential. The socio-demographic background of an individual is an important variable predictive of dental services use.7 There are 301 dental colleges in India, which exceeds the number of dental institutions in the United States, Brazil, and the whole of Europe. It is apparent that there is unequal distribution of dental colleges in India across its states, but this could be anticipated in a vast country like India with its huge cultural and economic diversity. The residual state of Andhra Pradesh, a south Indian state after bifurcation, has 13 dental institutions with the population of the state being near to 4.9 crores according to the 2011 census. There is unequal distribution of dental colleges across the 13 administrative areas (districts) of the state with no dental colleges in Vizianagaram, Prakasam, and Ananthapur districts. Guntur district is 1 of the 13 districts of Andhra Pradesh located along the east coast of the Bay of Bengal, bearing a population of 4,889,230 according to the 2011 census with an area spreading over 11,391 km.9 There is only one teaching-based dental institution available for the dental care of population in Guntur 1Postgraduate Student, 2Professor and Head, 3-5Reader 6Senior Lecturer 1-6Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India

EVALUAREA ATITUDINII ŞI COMPORTAMENTULUI FAŢĂ DE PROPRIA SĂNĂTATE ORALĂ LA UN GRUP DE STUDENŢI LA MEDICINĂ DENTARĂ

Aim. The purpose of this study was to examine and health attitudes/behavior of Romanian dental students (n = 110). Materials and methods. A questionnaire known as HU-DBI (Romanian version) was administered to 110 students in the last year of studies. In the same time was evaluated the prevalence of dental caries and some correspondence between the HU-DBI index and oral health status for every student. The questionnaire was administered after their written informed consent. Dental caries status was evaluated using the world health Organization (WHO) caries diagnostic criteria for decayed, missing and filled teeth and surfaces (DMF-T and DMF-S, respectively). Data were statistically analyzed. Results. The prevalence of dental caries was 60% only 6.7% (8 students) had DMF-T = 0. The mean DMF-T recorded was 7.3 (± 0.35). When relating the different DMF values to the HU-DBI responses, a statistically significant relation was found between seven items and DMF scores of their components and indices. The HU-DBI score ranged from 6 to 12 (mean 9.8). Low DS and DT values significantly correlated with a high total HU-DBI score (p < 0.05); that is subjects with low levels of dental disease had more positive oral health attitudes and behavior. Conclusions. The positive attitude of dental students towards the care of their own teeth and gums is important in determining the oral health conditions of their patients. In passing through the curricles the dental students should be able to set a personal example in oral health.

Caries Experience and Periodontal Status during Pregnancy in a Group of Pregnant Women with HIV+ Infections from Puerto Rico

ObjectivesThe aim of this study was to determine the caries rate and periodontal status in a sample of pregnant women with HIV+ infections from Puerto Rico.MethodsA pilot study was conducted on a cross sectional convenience sample of 25 pregnant women with HIV+ infections from Puerto Rico who visit the CEMI clinic (Centro de Estudios Materno Infantil) at the University of Puerto Rico. The women subjects were evaluated for caries, DMFT (D: Decay tooth; M: Missing tooth due to caries; F: Filled tooth) index, oral lesions associated with HIV+/AIDS and periodontal disease parameters, with a Florida probe by a calibrated dentist on periodontal indexes such as as bleeding on probing, CEJ (cemento-enamel junction) and pocket depth. Periodontal disease was classified as having 4 sites with pocket depth greater than 4 mm and caries were identified following the Radike criteria. Data was statistically analyzed using the SSPS Program (Statistical Software Program for Social Sciences) and descriptive statistics were calculated.ResultsMean DT (decayed teeth), MT (missing teeth due to caries), FT (filled teeth) and DMFT (decay, missing and filled teeth) were 4.8, 1.86, 5.3 and 12, respectively; mean sites of bleeding on probing=12.06; mean sites with pocket depth>4 mm=6.95 and mean sites with loss of attachment greater than 4 mm=7.66. [Almost 50% of the patients had generalized chronic periodontitis. A 72% prevalence of periodontal disease was found. No oral lesions related to HIV+/AIDS were reported. CD4 and viral load was statistically associated with bleeding on probing and severe signs of periodontal disease.ConclusionsHigh levels of dental disease were found in pregnant women with HIV+/AIDS infections from Puerto Rico, and these women were in need of substantial dental services.

California Children and Oral Health: Trends and Challenges

This paper highlights fundamental elements of the challenge of securing optimal oral health for California's children, now and in the future, and underscores the need for new strategies to reduce the risk of dental disease and expand access to effective services. Developing effective strategies to gain optimal oral health for California children, especially those that are most vulnerable to dental disease and its consequences, requires an appreciation of key dynamic factors that define this challenge and the degree to which these factors are modifiable in the near and long term. Particular attention is directed toward three principal elements: population demographics, levels of dental disease in California children, and factors affecting access to services for vulnerable groups of children. The concluding section addresses the need for strategic action.

Short and long term evaluation of changes in oral cleanliness, following repeated dental health education in high risk schools in Rochdale, England

Schools showing a high percentage of pupils needing referral for dental treatment following the last full dental inspection were targeted for intensive dental health education. The aims of the study were to improve the ability of children, from schools where the dental status is known to be poor, to clean their teeth effectively, and to evaluate any improvements in cleanliness following the implementation of repeated dental health education teaching module(s), and finally to discover whether actual cleanliness reflected reported brushing activity. All children were tested at baseline. The schools were divided into three groups: a control group and two test groups. One test group received intensive dental health education twice in a school year; the second test group received dental health education every term over a school year. These groups were again tested with the control. The control then received dental health education (once) and, one year on, all three groups were retested. At short term evaluation, both test groups scored higher on cleanliness than the original control, but those who received dental health education every term were very much cleaner.At the long term follow-up, there was no significant difference between the groups, however all three groups had retained improved cleanliness over baseline levels. Cleanliness of teeth matched well with reported toothbrushing activity in the morning. The study, initially, had been intended as a randomised control trial. However, the head teachers of schools randomly assigned as ‘controls’ refused, on the grounds that they considered it unethical to withhold dental health education from children who have high levels of dental disease. This study highlights the problems of following the ‘Medical Model’ of scientific study when applied to ‘population’ studies in the real world.

Dental health in children with cancer

This study investigated the dental health of children (aged 1–14 years) diagnosed with cancer 4–36 months earlier. Sixty patients were examined and interviewed; 43% had untreated decay and only 35%...

The Kilkenny integrated Oral Health Project

The Kilkenny Health Project, started in 1985, aims to reduce the level of risk factors in the community for coronary heart disease through health promotion. Dental disease and coronary heart disease share risk factors of tobacco use, alcohol consumption and poor dietary patterns. A baseline oral health survey demonstrated significant levels of dental disease in Kilkenny in the 429 adults and 523 children who were examined there in 1987. Seventy one per cent of adults required treatment for periodontal disease and 49% of children surveyed required treatment for dental decay. The Kilkenny Oral Health Project was developed as a community participation project aiming to reduce the level of common risk factors in the community for coronary heart disease and dental disease. It has run parallel with the main Kilkenny Health Project and is one of the first health promotion projects which has an integrated health message preventing dental disease and coronary heart disease.

Oral health screening of elderly people attending a Community Care Centre

A socio-dental survey was carried out to determine the level of dental disease and treatment requirement among elderly people attending a Community Care Centre. A screening programme involving 293 elderly people demonstrated a normative need of 82% and a felt need of 53%. Seventy-six per cent would have benefited from dental care. Many individuals who both needed and wanted dental care were not receiving it because they were discouraged from doing so predominantly because of poor mobility. It is recommended, therefore, that dentists be included in multi-disciplinary teams caring for elderly people so that they can be screened and given the opportunity to obtain dental care.

TOOTH LOSS, THE CULTURE OF DENTISTRY AND THE DELIVERY OF DENTAL CARE IN NEW ZEALAND

A recent cross‐national study has shown that a much higher proportion of adult New Zealanders have lost all their teeth — that is, are edentulous — in comparison with other countries with much the same levels of dental disease. Social class patterns of tooth loss also show a similar discrepancy.A subsequent nation‐wide survey of adult New Zealanders has shown that dental attitudes and practices are largely consistent with professional opinion, with some exceptions including attitudes to denture‐wearing and to the extraction of teeth. However, variations in such attitudes between those with and those without teeth could not account for the very different dental state of these two groups. This discrepancy between attitude and tooth loss was also apparent for other group comparisons. However, there were marked social group variations in the relationship to the dental care system.In conclusion it is argued that cultural variations in treatment preference, the shaping of professional norms of practice, and the skew in accessibility to services, must account for the pattern of dental care in New Zealand.