The effect of water fluoridation and social inequalities on dental caries in 5-year-old children.
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BACKGROUND: Many studies have shown that water fluoridation dramatically reduces dental caries, but the effect that water fluoridation has upon reducing dental health inequalities is less clear. The aim of this study is to describe the effect that water fluoridation has upon the association between material deprivation and dental caries experience in 5-year-old children. METHODS: It is an ecological descriptive study of dental caries experience using previously obtained data from the British Association for the Study of Community Dentistry's biennial surveys of 5-year-old children. This study examined the following data from seven fluoridated districts and seven comparable non-fluoridated districts in England: 1) dental caries experience using the dmft (decayed, missing, filled teeth) index; 2) the Townsend Deprivation Index of the electoral ward in which the child lived; 3) whether fluoride was present at an optimal concentration in the drinking water or not. RESULTS: A statistically significant interaction was observed between material deprivation (measured by the Townsend Deprivation Index) and water fluoridation (P < 0.001). This means that the social class gradient between material deprivation and dental caries experience is much flatter in fluoridated areas. CONCLUSION: Water fluoridation reduces dental caries experience more in materially deprived wards than in affluent wards and the introduction of water fluoridation would substantially reduce inequalities in dental health. (+info)
Patients' expectations for oral health care in the 21st century.
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BACKGROUND: This article examines trends in patient demographics and dental disease patterns. Data suggest the patient expectations about oral health are increasing, as is their knowledge of oral health services. CLINICAL IMPLICATIONS: Changing patient demographics and technological advances will lead to higher patient expectations and greater demands for oral health care in the 21st century than they had been during most of the 20th century. (+info)
Dental caries in Quebec adults aged 35 to 44 years.
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BACKGROUND: The purpose of this study was to assess the prevalence of dental caries in Quebec adults aged 35 to 44. METHODS: A stratified sample was used. The participation rate was 77% for the questionnaire and 44.5% for the oral examination. A total of 2,110 people were examined. The World Health Organization's caries criteria were used. Examiner agreement with gold standard dentist was excellent at the end of the nine-day training session (Kappa index > 0.8). RESULTS: The level of caries experience is very high in Quebec adults aged 35 to 44. Almost half of dental surfaces (65 of 148) have been affected. These surfaces are mostly missing (39.3) or filled (23.9). However, there were 1.8 decayed surfaces in need of treatment per adult, and more than half the people (55.5%) had no untreated decayed surfaces. Almost three-quarters of decayed surfaces were present in only 14% of the people; lower family income and lower education are risk factors. CONCLUSION: Comparison between Quebec and industrialized countries (United States, England and the Netherlands) shows that in adults 35 to 44, the mean number of decayed teeth is low (between 1.0 and 2.2) and the mean number of filled teeth is relatively similar (between 9.6 and 11.1); however, Quebec has a higher percentage than the United States of edentulous people. As well, in dentate adults, there are 1.6 times more missing teeth among Quebecers than among Americans. (+info)
The association between caries and childhood lead exposure.
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Epidemiologic studies suggest an association between lead exposure and caries. Our objective was to establish whether children with a higher lead exposure as toddlers had more caries at school age than children with a lower lead exposure. We used a retrospective cohort design. A sample of children who attended second and fifth grades in the Rochester, New York, public schools during the 1995-1996 and 1996-1997 school years were examined for caries through a dental screening program. For each child we assessed the number of decayed, missing, or filled surfaces on permanent teeth (DMFS), and the number of decayed or filled surfaces on deciduous teeth (dfs); the number of surfaces at risk (SAR) was also recorded. Lead exposure was defined as the mean of all blood lead levels collected between 18 and 37 months of age by fingerstick [provided the blood lead level was [less than/equal to] 10 microg/dL)] or venipuncture. A total of 248 children (197 second graders and 51 fifth graders) were examined for caries and had a record of blood lead levels to define lead exposure. The mean dfs was 3.4 (range 0-29); the mean DMFS was 0.5 (range 0-8). Logistic regression was used to examine the association between the proportion of children with DMFS [Greater/equal to] 1, and the proportion with dfs [Greater/equal to] 1, and lead exposure [< 0.48 micromol/L vs. [Greater/equal to] 0.48 micromol/L (< 10 microg/dL vs. [Greater/equal to] 10 microg/dL)] while controlling for SAR, age at examination, and grade in school. For DMFS, the adjusted odds ratio was 0.95 [95% confidence interval (CI), 0.43-2.09; p = 0.89); for dfs, the odds ratio was 1.77 (95% CI, 0.97-3.24; p = 0.07). This study did not demonstrate that lead exposure > 10 microg/dL as a toddler was a strong predictor of caries among school-age children. However, the results should be interpreted cautiously because of limitations in the assessment of lead exposure and limited statistical power. (+info)
Disease activity and need for dental care in a capitation plan based on risk assessment.
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This article describes a capitation model of care which would stimulate both dentists and patients to apply existing preventive knowledge. (+info)
Caries among 3-year-olds in greater Manchester.
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OBJECTIVE: To measure the prevalence of caries, including nursing caries, amongst 3-year-old children in three districts of Greater Manchester in the North West of England. DESIGN: A cross-sectional survey of 762 randomly selected 3-year-old children using the dmft and dmfs indices. Three definitions of nursing caries were used in order to assess the varying prevalence of the disease according to which definition was applied. SUBJECTS: Children, aged 36-48 months, attending day nurseries, play groups and nurseries attached to primary schools were examined by three trained examiners under standardised conditions in three health districts in Greater Manchester. A random selection process was used to produce a quota sample to reflect the balance of childcare provision in each district. RESULTS: The overall proportion of children affected by general caries was 32%. The mean dmft score was 1.4 (sd = 2.8) and the mean dmfs was 2.8 (sd = 7.3). There were significant differences across the three districts. The prevalence of nursing caries varied widely when differing definitions of types were applied; 1.6% of the children had nursing caries according to the narrow definition, 7.2% showed the wider definition type and 9.8% had nursing caries of the broadest definition. In total 19% of children had caries which affected their upper incisors. Children of Asian origin had the highest levels of nursing and overall caries. CONCLUSIONS: Caries is a widespread problem in some very young children in the districts involved. Caries of upper anterior teeth contributes significantly to the overall level of caries in each of the localities in question. The prevalence of nursing caries is highly dependent on the case definition used. (+info)
Dental caries experience in Indians of the Upper Xingu, Brazil.
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The present study describes the experience of dental caries in Indians communities of the Xingu, in order to supply parameters for further analysis of trends of the disease in Indians. We performed oral health examination in 288 Indians from four communities (Yawalapiti, Aweti, Mehinaku and Kamaiura) living in the southern part of the Xingu National Park, using international criteria defined by the World Health Organization. The outcome measures were the DMFT and dmft scores, and the care index. Indians of the Upper Xingu presented high levels of caries, in all age groups. The average DMFT for 11 to 13-year-old children - 5.93 - was lower than the index measured in 1993 for 12-year-old schoolchildren in nearby cities - 8.23 -, whose United Nations' human development index ranked medium. However, Indians presented a much lower care index, per age group, than these cities, and a high ratio of missing teeth for persons above 20 years old. These observations indicate low incorporation of dental care services. The irregularity of the services programmed for these communities, and the changing dietary and cultural patterns, mainly derived from their contact with the non-indigenous population of Brazil, reinforce the pressing need for health promotion initiatives aimed at these groups. (+info)
Association of Streptococcus mutants with human dental decay.
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The association of Streptococcus mutans with human dental decay was investigated by using several types of samples: (i) paraffin-stimulated saliva samples taken from children with from 0 to 15 decayed teeth; (ii) pooled occlusal and approximal plaque taken from children with no decayed or filled teeth, or from children with rampant caries of 10 or more teeth; (iii) plaque removed from single occlusal fissures that were either carious or noncarious. The results showed a significant association between plaque levels of S. mutans and caries. The strongest association, P < 0.0001, was found when plaque was removed from single occlusal fissures. Seventy-one percent of the carious fissures had S. mutans accounting for more than 10% of the viable flora, whereas 70% of the fissures that were caries free had no detectable S. mutans. Sixty-five percent of the pooled plaque samples from the children with rampant caries had S. mutans accounting for more than 10% of the viable flora, whereas 40% of the pooled samples from children that were caries free had no detectable S. mutans. Saliva samples tended to have low levels of S. mutans and were equivocal in demonstrating a relationship between S. mutans and caries. (+info)