Long-term Dental Health Research Articles

Oral Health Status of 12 and 15 years old school going children in rural and urban areas of Madhurawada Town

Brief Background Children's appearance, quality of life, food intake, and growth and development are all affected by oral disorders. To ensure long-term dental health and hygiene, good oral hygiene practices must begin at a young age. To assess the oral health status among 12 and 15 years old urban and rural school going children of Madhurawada Town, Vishakhapatnam. Material and Methods Multistage cluster sampling was used. The clinical examination of each subject was done at schools in Madhurawada Town, Visakhapatnam district with the WHO Oral health assessment form 2013. The total sample size calculate was 1700. Statistical analysis was done by using SPSS software version 21.0. Descriptive and Paired t test and chi-square test were used. Results Out of 1700 study participants, 850 are from rural and 850 are from urban area. The value of mean DMFT was 2.27±1.17, 1.85±1.71 among 12 years old age from rural and urban area respectively. Mean DMFT value was 1.85±1.54, 1.67±1.58 in 15 years old from rural and urban area. The mean bleeding on probing is 39.2%, 42.8% in 12 years old 77.6%, 56.2% in 15 years old age group from rural and urban areas respectively. Conclusions According to the findings of this study, the prevalence of oral disease was higher in children from rural areas than in children from urban areas. Key Words: Dental caries, Multistage cluster sampling, Oral health status, WHO assessment

Assessment of Oral Health Promotion Programs in Schools and their Long-Term Effects.

School-based oral health promotion initiatives are essential for enhancing children's and teenagers' oral health outcomes. However, the long-term efficacy of these initiatives is yet unknown. Over the course of a year, 500 children between the ages of 6 and 12 years participated in prospective observational research. Two groups of 250 participants each-the intervention group and the control group-were created. While the control group only got basic oral health information, the intervention group participated in a full program aimed at promoting oral health. Over the course of 2 years, baseline data on the participants' oral health condition were gathered, and follow-up evaluations were carried out every 6 months. At the 12-month follow-up, the intervention group showed a substantial decrease in dental caries prevalence (15.2% vs. 23.6%, P < 0.001) as compared to the control group. In addition, the intervention group showed better oral hygiene habits than the control group (P < 0.001), such as decreased plaque index and more frequent brushing. In conclusion, school-based initiatives to promote oral health are successful in enhancing children's and adolescents' long-term dental health outcomes. These initiatives are essential in lowering the prevalence of dental caries and encouraging good oral hygiene habits. Ensuring the long-term dental health and well-being of future generations requires sustained investment in school-based oral health promotion efforts.

Knowledge and Misconceptions of Orthognathic Surgery: A Quick Poll Survey of the National Dental Practice-Based Research Network

Background: Orthognathic surgery is an underutilized resource in the treatment of congenital, developmental, and post-traumatic skeletal abnormalities in addition to obstructive sleep apnea. Despite the documented volume of patients who would benefit from orthognathic surgery, most fail to receive appropriate treatment. Purpose: The purpose of this study was to evaluate knowledge and attitudes within the dental community regarding orthognathic surgery via an anonymous electronic survey, and to explore whether misconceptions about orthognathic surgery represent potential barriers to care. Methods: This preliminary 5-question cross-sectional study was conducted via a “quick poll” distributed by the National Dental Practice-Based Research Network (PBRN). Results: The final sample size was 280 general dentists and dental specialists. The majority of respondents agreed that orthognathic surgery could correct malocclusions affecting a patient’s speech, function, and long-term dental health. However, few respondents agreed that orthognathic surgery is an evidence-based treatment for obstructive sleep apnea or positively affects upper airway size. Conclusions: Our survey demonstrates that while most dental providers consider orthognathic surgery as an effective treatment for the surgical correction of dentofacial deformities, many fail to recognize its potential role in the treatment algorithm for obstructive sleep apnea.

Minimally Invasive Biological Treatment in Endodontics: A New Appraisal

Aim-The aim of minimally invasive biological treatment in endodontics is to effectively manage pulpal and Peri apical pathologies while preserving tooth structure, promoting healing, and enhancing patient comfort. Minimally invasive biological treatment in endodontics represents a contemporary approach expected at preserving tooth structure, promoting healing, and enhancing patient comfort. This treatment philosophy emphasizes conservative interventions that minimize trauma to the tooth and surrounding tissues while harnessing the body's natural healing mechanisms. Key principles include selective removal of diseased tissue, biocompatible disinfection, gentle instrumentation, and the use of biomimetic materials for obturation. By adhering to these principles, clinicians can achieve successful outcomes while preserving tooth vitality and promoting long-term dental health. This abstract explores the principles, techniques, and clinical considerations associated with minimally invasive biological treatment in endodontic, highlighting its benefits for both patients and practitioners.

Building Confident Smiles Using Aesthetic Crown Lengthening Procedures with Gingivectomy: A Report of Two Cases

AbstractWe live in a society that appreciates beauty. More than just restoring the teeth, naturally attractive, confident smiles mean restoring and increasing overall quality of life. Making efforts to improve one's physical appearance is now regarded as an investment in one's health and well-being. Superior periodontal health is the cornerstone for an individual's aesthetic regeneration. As an outcome, perio-aesthetics is a comprehensive strategy that improves the appearance of the smile while maintaining long-term dental health. Hence, getting the ideal aesthetic effect is both difficult and gratifying. Crown lengthening is a feasible option for improving aesthetic appearance or aiding restorative therapy. Yet, before planning a crown lengthening operation, the patient's overall periodontal status and cleanliness habits should be assessed. Furthermore, for enhanced, conservative, and predictable results in aesthetic areas, a precise diagnostic and interdisciplinary strategy is essential. This article attempts to discuss guidelines for treating individuals with excessive gingival display, as well as treatment options, using two case reports as examples.

Does orthodontic treatment affect caries levels?

Design A prospective cohort study.Exposure/sample selection In 2005/2006, the authors analysed data from participants in a previous oral epidemiological study conducted in 1988/1989. Children whom were clinically examined in the School Dental Clinics in South Australia in 1988/1989 were invited to a follow-up in 2005/2006. Respondents competed a questionnaire concerning their sociodemographic characteristics, dental health behaviours and the receipt of orthodontic treatment, and were invited for a clinical examination. Oral health information concerning decayed, missing and filled teeth (DMFT) and occlusal status using the Dental Aesthetic Index (DAI) were recorded by multiple trained calibrated dentists in accordance with the NIDR procedures. The study obtained ethical approval from the University of Adelaide and maintained informed consent at each stage of the study.Data analysis Data analysis was performed independently by the principle researcher. Analysis involved descriptive statistics, frequency distribution and cross tabulation. Explanatory variables for orthodontic treatment and dental outcomes were investigated for each DAI category using negative binominal regression using the online computer programme 'effect size calculator'. The statistical analysis was preformed using IBM SPSS statistics version 24. All explanatory variables were introduced into the adjusted negative binominal regression models based on their statistical significance from multiple linear regression models, with the p value set at 0.05.Results The response rate for the questionnaire was 34% (n = 632), with 74% (n = 473) of those attending for clinical examination. After exclusions, 24% (n = 448) of those originally contacted participated. Statistically significant differences in clinical outcomes were observed between those who had and had not visited the dentist in the last two years. These outcomes included missing teeth (MT), filled teeth (FT) and a higher DMFT score. In addition, brushing at least twice daily was associated with fewer decayed teeth (DT) and MT (p <0.001). Increased MT was observed among individuals who had orthodontic treatment across all DAI categories except for participants with very severe malocclusion. In this group, there were significantly more MT among the untreated participants (p <0.001). Thirty-five percent (n = 157) of participants reported a history of orthodontic treatment by the age of 30. No statistically significant associations were found between orthodontic treatment and all aspects of DMFT using adjusted models for participant self-reported sociodemographics, dental health behaviours and malocclusion.Conclusions Caries experience does not correlate with previous orthodontic treatment. Sociodemographic variables and dental health behaviours have a greater impact, and are associated with long-term disease outcomes, including numbers of DMFT. Caries experience is also associated with educational attainment and income level, frequency of tooth brushing and dental office attendance. In summary, orthodontic treatment does not provide superior long-term dental health outcomes in relation to caries. The hypothesis that those with previous orthodontic treatment would have lower caries experience was rejected.

Tooth Autotransplantation Part 1: uses, indications and factors affecting success

Management of severe traumatic injuries and complex dental anomalies in children requires a holistic approach with planning for both short- and long-term eventualities. The goal is to provide biological treatment that maximizes the long-term dental health, appearance and function. Tooth autotransplantation is one potential solution for tooth replacement that is able to fulfil these aims. This series of four articles provides an overview of autotransplantation, including a description of the biological basis for the technique and factors affecting success. It will also provide an outline of the indications and the procedures involved for performing autotransplantation, including the interdisciplinary approach to treatment planning and management. This first article discusses the history of tooth transplantation, indications and the factors that can influence outcome. CPD/Clinical Relevance: Orthodontists should be aware that tooth autotransplantation is a highly versatile technique with good success rates if used in favourable cases. This method should be considered part of the armamentarium for tooth replacement in a growing child.

The influence of orthodontic treatment on dental caries: An Australian cohort study.

To assess the influence of orthodontic treatment on long-term caries experience in 30-year-old South Australians. The research hypothesis that was tested was that those with previous orthodontic treatment would have lower caries experience. In 2005-2006, a sample of 1859 30-year-olds from Adelaide, South Australia, who comprised 47% of participants who had previously taken part in an oral epidemiology study in 1988-1989, were traced from the Australian electoral roll and invited to participate in a cross-sectional study investigating long-term dental health outcomes. Participants completed a questionnaire that collected information on socio-demographic characteristics, dental health behaviours and receipt of orthodontic treatment. This was followed by clinical examination. The outcome variables were the summed decayed, missing and filled teeth (DMFT) score, and its individual components. Data were analysed using negative binomial regression. The response rate for the questionnaire was 34% (n=632). There were no systematic differences between those who were followed up and those who were not followed up. Clinical data for 448 participants were available for analyses, representing 24% of the originally contacted individuals. By the age of 30, over a third of participants had received orthodontic treatment. Regardless of initial malocclusion classification, orthodontically treated participants had a lower DMFT score at age 30 but this did not reach statistical significance. Adjusted models controlling for socio-demographic, dental health behaviour and malocclusion status showed no associations between orthodontic treatment and decayed (Exp B: 1.00, 95% CI: 0.72-1.40), missing (Exp B: 1.00, 95% CI: 0.59-1.69), or filled teeth (Exp B: 1.18, 95% CI: 0.93-1.51) or overall DMFT (Exp B: 1.12, 95% CI: 0.88-1.41). There was no difference in the long-term caries experience of South Australians aged 30years based on past orthodontic treatment. Our study does not support the contention that those treated orthodontically have better dental health later in life.

Space supervision and guidance of eruption in management of lower transitional crowding: A non-extraction approach

Mandibular incisor crowding in the mixed dentition is one of the most common problems presenting to the orthodontist. Asymmetry of alignment, premature loss of primary canine(s), and disruption in arch integrity are all early benchmarks of a tooth size/arch length discrepancy in the transitional dentition that can occur independent of any skeletal discrepancy. Space supervision and guidance of eruption refer to treatment interventions during the early to mid-mixed dentition periods that influence the eruption patterns and positioning of the permanent teeth during their transition. Generally considered applicable to individuals with adequate overall arch dimensions to accommodate a normal complement of permanent teeth with an acceptable esthetic and functioning occlusion, guidance of eruption involves the implementation of directed interventions to optimize the eruption and alignment patterns of the permanent teeth as part of a non-extraction protocol.

Truth or consequences: the potential implications of short-term cosmetic orthodontics for general dental practitioners

Until recently, cosmetic dentistry has focused on the use of traditional restorative techniques, bleaching and the so-called facial rejuvenators such as injectable dermal fillers and Botox. More latterly, the short-term use of aesthetic removable aligners and ceramic fixed appliance brackets have been promoted for use by general dental practitioners as a means of minimising the invasive amount of restorative dental treatment that would otherwise be required to achieve the desired degree of aesthetic improvement. Nevertheless, there are inherent risks and complications associated with short-term orthodontic treatments that are deliberately limited in their outcomes and these, together with the potential ramifications for the long-term dental health of patients, are discussed.

Risk Assessment‐Based Individualized Treatment (RABIT): A Comprehensive Approach to Dental Patient Recall

Patient recall should be a tool to support prevention, allow early intervention, and ensure long-term dental health. Although the concept of patient-customized recall intervals has increased in popularity, recommendations vary significantly. Concepts of risk assessment-derived recalls are described in the literature separately for caries, periodontal disease, and edentulism, but no published guidelines exist for creating patient-centered recall systems that integrate all risks. Further, no recommendations exist regarding oral cancer risk assessment and recall intervals. The evidence shows that recall intervals of less than twelve months do not impact stage and tumor size at diagnosis although increasing this interval may significantly affect the outcome. The typical approach to recall scheduling is that the interval before the next oral health review should be chosen when no further treatment is indicated or on completion of a specific treatment journey. This article advocates a modified approach that supports individualized risk-based recall schedules not only after active therapy is completed but also during the course of treatment. The design of individualized recall schedules would address a patient's risk for caries and periodontal disease and the need to perform periodic oral cancer screenings. Evidence is also presented regarding the timing of recalls for edentulous patients. This article describes design principles for a Risk Assessment-Based Individualized Treatment (RABIT) system, presents an example of an electronic health record (EHR) recall module implemented at one dental school, and identifies barriers to implementation. As EHRs become more prevalent in dental practice, it is expected that the software industry and the profession will collaborate to include RABIT-like concepts in software management packages.

Porcelain pornography

I write to raise some issues involved in the blatant destruction of teeth, apparently being undertaken to cure patients affected by ‘porcelain deficiency disease’ (PDD). This is a newish disease, identified by some dentists who also seem to think that teeth suffer from ‘hyperenamelosis’ (an excess of enamel). It probably goes without saying that both of these conditions are imaginary yet it does appear to me, at times, that they are perceived to exist by some ‘cosmetic’ dentists. In this article I offer comments and case studies of patients who, arguably, have had unnecessarily aggressive treatment that was probably of more benefit to the profits of the dentists concerned than to the patients’ long-term dental health.

Gingival veneer: Mask the unesthetic

Periodontal diseases result in damage and destruction of the supporting structures of the teeth, including the bone and periodontal ligament. In some cases, there is loss of gingival coverage of the teeth in esthetic regions, with gingival recession and loss of interdental papilla. The surgical treatment in such situations is costly, requires prolonged healing time, and the results are often unpredictable; this makes it an unpopular choice. The reconstruction of these areas with prosthesis like gingival veneer can be useful to correct the deformities remaining after the control of periodontal diseases, especially in the maxillary anterior region. Dental practitioners can provide comfortable and accurately fitting gingival veneers, that are very stable and esthetically restore the interdental papilla and gingival recession defects. This method is an innovative treatment option for dealing with esthetic challenges and long-term dental health.

The Dental Safety Profile of High-Dose Radioiodine Therapy for Thyroid Cancer: Long-Term Results of a Longitudinal Cohort Study

The long-term dental safety profile of high-dose radioiodine therapy remained elusive despite more than 6 decades of clinical use. In a cohort study, we investigated the incidence of sialadenitis, xerostomia, caries, and tooth extractions after high-dose radioiodine therapy for differentiated thyroid cancer and explored risk factors by multiple regression models. One hundred seventy-six participants were recruited (median follow-up, 6.6 y; range, 1.1-32.6 y; patient-years: 8,472 before and 1,421 after radioiodine therapy). Scintigraphic salivary gland uptake during radioiodine treatment predicted development of sialadenitis (odds ratio: 1.31 [1.05-1.63], P = 0.015) and xerostomia (odds ratio: 1.58 [1.16-2.16], P = 0.004). The caries risk increased by postradioiodine xerostomia (% increase: 98.8 [26.5-212], P = 0.003). The long-term risk for postradioiodine tooth extractions increased with increasing cumulative radioiodine activities (% increase [per gigabequerel]: 8.14 [1.07, 15.7], P = 0.02). High-dose radioiodine treatment can impair the long-term dental health, depending on the cumulative radioiodine activity and individual salivary gland radioiodine uptake.

Cosmetic Rehabilitation Following Successful Treatment of Aggressive Periodontitis

With advances in periodontal therapy, many sufferers from aggressive periodontitis are retaining their teeth after successful treatment. This presents the practitioner with aesthetic and restorative challenges in these relatively young patients. Lifelong motivation is essential to the supportive therapy for these patients, and the maintenance of good aesthetics, combined with biologically acceptable corrective therapy, may help maintain a high level of motivation. Any treatment provided must naturally be conducive to maintaining long-term dental and periodontal health. This paper aims to demonstrate options for dealing with the aesthetic challenges posed by a number of patients who have undergone initial cause-related therapy for aggressive periodontitis. Loss of gingival tissue, tooth positional changes and tooth loss present practitioners with challenges in relation to patient satisfaction with aesthetics following advanced periodontal breakdown. A range of techniques will be required, tailored to the consequences of periodontal attachment loss, in order to satisfy patient demands.

Child nutrition: establishing good habits for lifelong dental health

In this article, Juliette Reeves turns her attention to how establishing good eating patterns in childhood and early adolescence can lead to long-term dental health.

Cost-effectiveness of a long-term dental health education program for the prevention of early childhood caries

To evaluate the benefit-cost (B/C) and cost-effectiveness (C/E) of a long-term dental health education program to prevention early childhood caries (ECC) through home visits. The data collected over a three year period in a dental health education programme (DHE), previously reported [Kowash et al., 2000] for infants aged 8 months at start were analysed for B/C and C/E. Dental caries indices (BASCD) for dmft and dmfs were used. Costs were based on British National Health Service (UK) fees for treating children by general dental practitioners and salaries for community dental officers in the Community Dental Services in the UK. Comparisons were made for B/C and C/E with results from a clinical trial of a slow releasing fluoride device (SRFD), community water fluoridation (CMF) and a school based fissure sealant program (FSP) using the hypothetical community of Niessen and Douglass, [1984]. The cavities, as ECC, saved over the three year period indicated a B/C ratio for the DHE of 5.21 compared with SRFD of 4.17; CWF of 1.15 and FSP of 0.42. The C/E results were 1.92, 2.40, 8.66 and 23.74 respectively. A dental health education program of home visits with mothers of young infants to prevent early childhood caries and starting at 8 months of age, gave better benefit-costs and costs effectiveness ratios than other preventive programs.

Orthodontics. Part 1: Who needs orthodontics?

There are various reasons for offering patients orthodontic treatment. Some of these include improved aesthetics, occlusal function and the long-term dental health.

It’s a knockout: survey of the management of avulsed teeth

Avulsion of a tooth is a not uncommon childhood injury, with up to 16% of dental injuries involving the loss of a tooth. Although this is an apparently ‘minor’ injury, for a child there may be long-term psychological and treatment problems. Correct advice in the early stages of this injury, and the recognition that prompt treatment may allow a tooth to be successfully reimplanted are vital in the management of these injuries. Often, nursing staff in the accident and emergency or paediatric department may be asked for advice either professionally or informally, and can influence the long-term dental health for these patients. This paper looks at the knowledge of parents and healthcare professionals in the management of these injuries.

Early childhood special education dental and oral hygiene procedures for young children with special needs

The provision of dental services, including dental treatment and oral hygiene maintenance, to special-needs children presents unique challenges to health care professionals as well as to the parents and guardians of these special patients. A knowledge of dental care and of the implications of the various disorders common to these patients is vital to the long-term dental health of children with special needs. Limitations in treatment choices must be carefully explained to parents or guardians if inappropriate expectations are to be avoided. Many of the techniques of delivering quality dental services are difficult, time-consuming, and complicated. Yet it should be noted that the restoration of a diseased mouth takes more time and is more costly both monetarily and psychologically than efforts to provide adequate maintenance and prevention. When caregivers take the time to offer assistance to the young child with special needs, the best form of health care is being provided: prevention.