Caries among Danish schoolchildren in birth-cohorts 1950-78

Data on caries prevalence are reported from 8- and 16-yr-old children living in a Danish community which established the Public Child Dental Health Service in 1957. Every fourth birth-cohort from 1950 through 1970 was followed longitudinally. In the 8-yr-olds, caries prevalence decreased in the primary dentition from 17 to 3 dmfs and in the permanent dentition from 3.4 to 0.3 DMFS over a 28-yr period. Among the 16-yr-olds, a reduction was observed from 16.4 to 5.1 DMFS over 20 yr. Time trends in the decreasing caries prevalence are related to various organizational events and preventive measures. Moreover, the possible influence of general changes in living conditions and health behavior is pointed out.

Mandibular dysfunction in adulthood in relation to morphologic malocclusion at adolescence

The purpose of this 20-year follow-up study was to assess whether pronounced morphologic traits of malocclusion, persisting from adolescence to about 35 years of age, imply an increased risk of persistent and severe mandibular dysfunction. In 1965-66 malocclusion was recorded in 176 adolescents; in 1981 these persons responded to a questionnaire concerning symptoms of functional disorders, and in 1986-87 malocclusion and signs of dysfunction were registered. Highly significant associations were observed between some of the self-reported symptoms and the signs registered 5-6 years later. Spearman correlation coefficients between the persistent traits of malocclusion, occurring at both examinations, and the signs of mandibular dysfunction were low in general. No association was found between the most severe and persistent functional disorders and any particular malocclusion. It is concluded that orthodontic screening of morphologic malocclusion in childhood would seem of limited value in attempts to predict mandibular dysfunction in adulthood.

[Association among general health, diet and need of dental care among retired pensioners living at home]

A pilot project was established in a Danish municipality with the aim of improving the nutrition of 67-85-year-olds living at home but who were dependent on domestic aid for purchasing or preparing their food. The project comprised health education and information concerning dietary habits as well as an offer of dental treatment to those who were physically or mentally handicapped. At initiation of the project, the persons (n = 110; 89% of the target population) were interviewed about their general and dental health, ailments, drug consumption, and diet. Furthermore, a clinical dental examination was made (n = 106). From these baseline registrations, the elderly were divided into subgroups: unbalanced, moderate, and balanced diet; low, moderate, and high consumption of, respectively, water/milk and coffee/tea; great, moderate, and no need for dental care. Systematic associations were found between general health problems and unbalanced diet. A tendency was observed toward more frequent complaints in the groups with relatively high consumption of water/milk and water/milk/coffee/tea. The strongest associations were found between general health complaints, handicaps, and masticatory deficiency on the one hand and great need for dental care on the other. Also, the group with great need for dental care was overrepresented in the group with unbalanced diet. It is argued that accessibility to dental care would improve the chances for the elderly to stay in their own homes.

Individual changes in malocclusion from adolescence to 35 years of age

It was the aim of this follow-up study to assess the extent of individual changes in the occurrence of specific pronounced traits of malocclusion in a sample of 176 subjects who were selected from a catchment population examined in adolescence in 1965-66 and who were re-examined in 1986-87 (mean age, 35.5 years). Orthodontic treatment had been received by 10% of the subjects, and extraction rates were low. Deep overbite and mandibular crowding, especially in the incisor segment, tended to increase in frequency. However, on the whole, the various malocclusion traits remained remarkably stable in the orthodontically untreated individuals.

Causal relation between malocclusion and caries

In this second report of a follow-up study of long-term adverse oral health effects of malocclusion it is assessed whether various occlusal and space anomalies imply an increased risk of caries. In 1965-66 malocclusion was recorded in 176 adolescents who were re-examined in 1986-87 at the age of 33-39 years. DMFS scores, in the dentition as a whole and in the segments of the dental arches, were compared between subjects displaying specified traits of malocclusion at both examinations and a comparison group comprising subjects without malocclusion at both examinations. No relationship was found between the malocclusion traits and caries prevalence.

Causal relation between malocclusion and periodontal health

The purpose of this 20-year follow-up study was to assess whether persistent traits of morphologic malocclusion imply an increased risk of periodontal disease. In 1965-66 malocclusion was recorded in 176 adolescents who were re-examined in 1986-87 at the age of 33-39 years. Markedly healthier periodontal conditions were found in women than men, in the higher social group than the lower one, and in the maxilla than the mandible. Subjects with specified malocclusion traits at both examinations were compared with subjects without malocclusion for the occurrence of calculus, gingivitis (bleeding), and pocketing. Controlling for the effect of sex and social group, periodontal disease was significantly more frequent in the maxilla in connection with crowding, extreme maxillary overjet, and cross-bite (p less than 0.05). No association was found in the mandible. The presence of certain malocclusion traits in adolescence may probably often call for special professional efforts of oral hygiene education rather than orthodontic therapy.

Changes in prevalence of approximal caries in 17-year-olds and related restorative treatment strategies over a 6-year period

Two cohorts of 17-yr-olds treated in a municipal child dental service in 1978-79 and 1984-85 had bitewing radiographs taken at the examination before the last course of treatment in the service. All radiographs were read by one examiner, who did not know to which cohort the individual belonged. The subsequent treatment was recorded from the treatment records by another examiner, who was unaware of the results of the radiographic examination. According to radiographic scores, the proportion of decayed or filled (DFS) approximal surfaces had decreased from 23.2% to 17.4% during the period (difference: 25%). The proportion of unfilled surfaces which were decayed (DS) had remained almost constant, while 9.6% of the surfaces were filled (FS) in 1978-79 compared to 3.1% in 1984-85 (difference: 68%). Thus, in spite of a 25% decrease in total caries experience (DFS), a reduction of 68% would be claimed if fillings (FS) were interpreted as expression of disease prevalence. The risk of an approximal surface being filled decreased to about one fifth from 1978-79 to 1984-85, and the risk of being filled was nearly three times as high for approximal surfaces of children who already had approximal fillings at the time of examination. Thus, both the year of examination and the subject's previously received treatment seemed to influence the treatment strategy of the dentist.

Forecasts of preserved teeth and denture wearers among Danish adults early in the next century

To assist in the planning of oral health services, forecasts were made and goals specified with regard to the numbers of preserved teeth and subjects wearing full or partial dentures among Danish adults in 1992 and 2002. Forecasting was based on existing data, viz. a survey in 1982, including clinical examination, of a representative sample of 20-80-yr-olds (n = 2548), on register data from the National Health Insurance, and survival rates. By combining information from these sources, an increase was estimated in number of preserved teeth among 20-99-yr-olds from 68 million in 1982 to 82 and 92 million in 1992 and 2002, respectively. Correspondingly, a 28% increase in the mean number of remaining teeth was proposed as a goal for the year 2002. A decrease was estimated in the number of denture wearers, from 1.4 million in 1982 to 1.07 and 0.74 million in 1992 and 2002, respectively. The corresponding goal was specified as a 50% reduction in the proportion of denture wearers in 2002. In the middle aged and older part of the population the increasing number of remaining teeth may be expected to imply considerable needs for professional care even in the beginning of the next century.

Uncertainties in designation of age at menarche in the nineteenth century: revised mean for Denmark, 1835

The earliest Danish study of mean age at menarche by Ravn (Fenger 1850) is analysed with special reference to age recordings and their subsequent groupings into age-classes. Uncertainties of interpretation of the age designations are discussed, and it is argued that, in all probability, mean age at menarche was 17 years in the samples of Danish women born around 1820, rather than below 16 years as believed previously.

Effect of separate malocclusion traits on concern for dental appearance

Effects of separate traits of malocclusion on concern for dental appearance were isolated by means of multiple regression analysis in a 15-yr follow-up study of 30-yr-old Danes. On the basis of questionnaires (response rate 86%, n = 841), the dependent "concern-for-dental-appearance" variable was constructed from the respondents' replies about recalled perceptions and societal reactions concerning their dental appearance at the time of adolescence. In the same individuals, separate traits of malocclusion had been recorded clinically 15 yr earlier. These traits were inserted as independent dummy variables into the regression model. In both sexes the closest relationship with the dependent variable was displayed by the most conspicuous traits in the anterior region of the dentition. Some traits showed significant associations only in women, whose regression coefficients were, in general, higher than those of men. About half of the variation in the dependent variable was explained by the model.

Psychosocial implications of malocclusion: a 15-year follow-up study in 30-year-old Danes

Long-term psychosocial effects of malocclusion should be studied longitudinally from childhood to adulthood in orthodontically untreated populations. In 1965-66, the occurrence of morphologic traits of malocclusion was recorded in 977 Danish adolescents who had no access to organized orthodontic care. In a follow-up study 15 years later, a questionnaire was mailed to the subjects; this contained general questions about body image and specific inquiries concerning self-perception and social implications of dental appearance. The response rate was 86%. Ten percent had received orthodontic treatment. In the remaining individuals, only one entry among thirteen items of body image--the teeth--was rated significantly less satisfactory by subjects with malocclusion at adolescence than by subjects without malocclusion at adolescence. The lowest ratings were observed in subjects with extreme maxillary overjet, extreme deep bite, and crowding. Highly significant differences were found between the two groups (subjects with and without malocclusion) in recalling adolescent awareness of malocclusion, dissatisfaction with the appearance of the teeth, and unfavorable appearance of the teeth compared with those of peers. Schoolmates' teasing occurred seven times more often in the presence of malocclusion. Differences were less marked in the perceptions of the same individuals in adulthood. However, in both adolescence and adulthood unfavorable perceptions of the teeth were expressed significantly more often by subjects with extreme maxillary overjet, extreme deep bite, and crowding. No association was found between malocclusion and present occupational status. It was concluded that certain malocclusions, especially conspicuous occlusal and space anomalies, may adversely affect body image and self-concept, not only at adolescence but also in adulthood.

Malocclusion at adolescence related to self-reported tooth loss and functional disorders in adulthood

It has been argued that malocclusion may predispose to tooth loss and functional disorders of the masticatory system. It was the purpose of this study to examine relationships between untreated malocclusion, recorded at adolescence, and self-reported tooth loss and functional disorders in adulthood. In 1965-66, the occurrence of morphologic traits of malocclusion was recorded in 977 Danish adolescents who did not have access to organized orthodontic care. Fifteen years later, 841 (86%) of these subjects responded to a questionnaire screening for tooth loss, symptoms involving the temporomandibular joints and muscles, and some other symptoms of dysfunction. The occurrence of malocclusion was related to the symptoms of the temporomandibular joints and muscles and other functional symptoms. Only a few significant coefficients of correlation were observed. Extreme maxillary overjet (greater than 9 mm) and frontal open bite showed significant correlations with unsatisfactory biting ability. Crossbite was correlated positively with speech defects but negatively with tenderness or fatigue of the cheeks; unilateral crossbite was associated with locking of the mandible. It was concluded that the untreated morphologic traits of malocclusion did not seem to predispose to tooth loss or functional disorders of the masticatory system as reported at the age of 30 years.

Decrease in menarcheal age from 1966 to 1983 in Denmark

Mean age at menarche was estimated by the status quo method in the same region of Denmark in 1965-66 and 1982-83 in 983 and 1 591 girls, respectively. During that period menarcheal age decreased by 4 months from 13.40 to 13.03 years, subsequent to a similar decrease from 1949-50 (2) to 1965-66. Comparison with recent data from the other Nordic countries, except Norway, indicates that age at menarche is now close to 13 years, and a halt in the trend towards earlier menarche is not evident.

A 15-year follow-up study of 30-year-old Danes with regard to orthodontic treatment experience and perceived need for treatment in a region without organized orthodontic care

It was the aim to study orthodontic treatment experience and past and present perceived need for treatment in 30-year-old Danes who, at adolescence, had no access to organized orthodontic care. In order to identify the malocclusion traits which elicited treatment or need for treatment, the findings were related to the occurrence of various traits which had been registered in the same individuals 15 years earlier. From questionnaires (response rate 86%, n = 841) it appeared that 10% had received treatment and 20% perceived need for treatment either in childhood or at present. At adolescence, the subjects who had subsequently received treatment, displayed relatively high frequencies of ectopic eruption, anterior cross-bite, extreme maxillary overjet, deep bite, and crowding; among those who perceived need for treatment, extreme maxillary overjet, mandibular overjet and crowding were relatively prevalent.

Orthodontic treatment priorities in the Danish Child Dental Health Services

In 1980, the population of Danish schoolchildren in grade 9 formed the first cohort which, throughout all school grades, had been covered by the Child Dental Health Services, including free orthodontic care. National statistics on prevalence of malocclusion for this cohort of about 60 000 children in grades 3, 6, and 9 (approximate ages: 9, 12, and 15 years) were compared with corresponding frequencies in a population of schoolchildren in the 1960s among whom orthodontic treatment was rare. From the comparison it is inferred that treatment priority, based on professionally defined need, had been given to occlusal anomalies of the incisor segment, transverse anomalies of the lateral segments, and crowding.

Juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis, the most common connective tissue disease occurring during childhood, is characterized by chronic arthritis and may be associated with disability and blindness. The presentation, laboratory findings and prognosis of the disease differ significantly from those of adult rheumatoid arthritis. Current classification includes systemic, pauciarticular and polyarticular types, each having different therapeutic and prognostic implications.