Dental status in a group of adult diabetic patients

The aim of this study was to determine the prevalence of dental caries, DMFT score and treatment needs in a group of diabetic patients (n = 222), mean age 46.9 yr, and to compare them to those recorded in a control group (n = 189), mean age 43.9 yr, using WHO criteria. Relations between the type and duration of diabetes mellitus, diabetic complications (retinopathy and neuropathy), diabetic control, and the subjects' DMFT status were separately studied. The results obtained revealed no difference in the prevalence of caries between the group of diabetics and the control group. Neither was any difference found in the mean numbers of teeth with fillings, but the number of extracted teeth per subject was significantly higher in the group of diabetics (12.3) than in the control group (9.7) (P less than 0.01). Type I diabetics were found to have a significantly higher number of teeth with fillings (4.05 vs. 2.22) than the non-insulin dependent diabetics (P less than 0.001). Type II diabetics, however, had a significantly higher number of extracted teeth (14.1 vs. 10.4) (P less than 0.001). There was no difference in the caries experience regarding duration of diabetes, diabetic control, or diabetic complications.

The prevalence of orthodontic extractions

The controversy regarding extractions for orthodontic treatment continues and today is invoked by some as a feature of the "standard of care." For this and other reasons, it is necessary to have contemporary data on the general prevalence of orthodontic extractions and the interpractice range of extraction rates in current specialty practice and, if possible, also to establish possible reasons for, and consequences of, the extraction versus nonextraction decision. Although all treatment decisions are made on a case-by-case basis, practitioners appear to have personal preferences for or against extractions and hence adopt policies with different degrees of aversion to or bias toward extraction therapy. A number of factors enter into the extraction decision. These include features of the malocclusion, objectives of treatment, and the technique selected to accomplish desired results. The present study does not address such issues but merely serves to provide epidemiologic data to estimate extraction frequency in contemporary orthodontic practice. Accordingly, a telephone survey of all licensed orthodontists in Michigan was conducted to determine their subjective estimates of extraction rates for patients in their practices. There were 238 respondents, for a response rate of 90.2%. Reported rates range from 5% to 87%. We then selected five practices from the extremes of the reported extraction rates. Three practices from the high end and two from the low end were included for an examination of patient records. Records of a total of 438 patient whose treatment had been completed were reviewed. The actual extraction rates for these practices ranged from 25% to 85%, which differed considerably from the clinicians' subjective estimates.(ABSTRACT TRUNCATED AT 250 WORDS)

Trends in tooth loss due to caries and periodontal disease by tooth type

Although the patterns of dental disease is gradually changing, caries and periodontal disease still account for the most important reason for extractions in most countries. However their relative contributions towards overall tooth mortality figures varies. The aim of this study is to investigate the types of teeth usually associated with extractions due to caries or periodontal disease and its relation to the age at which the tooth was lost. The highest proportion of extractions due to caries occurred between 21 to 30 years of age while that for periodontal disease occurred between 41 to 50 years. For caries, the greatest proportion of extractions involved the posterior teeth. The most frequently extracted teeth due to caries are the molars, in particular the first permanent molar. However, for periodontal disease a slightly greater proportion of anterior teeth were lost than the posteriors. This trend is more marked in the lower jaw than the upper. Overall, extractions related to caries tend to increase posteriorly, while that for periodontal disease tend to increase anteriorly.

[Frequency and causes of extraction of permanent teeth. A ten-year (1968-1977) clinicostatistical investigation]

The purpose of this clinical investigation was to analyze the frequency and the causes of mortality (loss) of 50493 permanent teeth, extracted, during a ten-year (1968-1977) period, in Clinic Exodontia of Dental School University of Athens, at 27804 population of Greece (13140 males and 14664 females). The following conclusions were drawn from the statistical analysis and the interpretation of the results: The mean value of extracted teeth per person was 1.84 and was lower in females (1.70) from males (1.94). Independently of the sex and the jaws (maxillamandible) the greater percentage (60.69%) of extractions was to posterior teeth. The extracted teeth were more in maxilla (52.42%). The more per cent extracted teeth, independently of the sex, were the maxillary central incisors (9.51%) and lateral maxillary incisors (8.61%) and the lower, the mandibular canines (3.41%). Caries and periodontal diseases were responsible for 80.37% of extracted teeth, independently the sex and the age. Caries was the major cause of extraction until 40 years old (71.03%) and after this age the periodontal disease was the major cause of extraction (51.61%).

[Prognosis of periodontally reduced abutment teeth under removable dentures]

The extraction rate was studied in a group of 151 patients treated for periodontal and prosthodontic reasons. 29 of 588 abutments had to be extracted due to periodontal problems within a period of 6 years after prosthodontic treatment. The initial findings of the extracted teeth are correlated with the initial findings of all abutments. It can be shown that periodontally reduced teeth involve a higher risk of extraction; nevertheless, in the majority of the cases, they could be successfully used as abutments.

The relationship between fluoridation, social class and caries experience in 5-year-old children in Newcastle and Northumberland in 1987

The dental health of 457 5-year-old children who have lived continuously in fluoridated (at 1.0 mg F/litre) Newcastle and 370 children of the same age in non-fluoridated (less than 0.1 mg F/litre) South Northumberland has been reported. This paper examines in detail the caries prevalence in social class groups I + II, III, IV + V, and the social class/fluoridation relationship in 1987. The prevalence of dental caries in the three social class groupings I + II, III, and IV + V (and the mean dmft), respectively, was 35% (1.1), 46% (1.7) and 67% (2.4) in the fluoridated area, and 59% (2.2), 67% (3.7) and 77% (5.0) in the non-fluoridated area. Fluoridation was effective in all social class groupings and, because caries levels were higher in social classes IV + V, fluoridation brought about greater savings for these children than for those in social classes I + II. Fluoridation reduces but does not eliminate social inequalities, leaving social disadvantage/social background/social class as the major factors in caries prevalence for this age group. Further research into the fluoridation/social class relationship is required, particularly since the understanding of occupational class, now considered an imperfect representation of social class, is being superseded by other criteria which have stronger associations with measures of poor health.

[Reasons and factors which are causing tooth loss in the population of Greece]

The aim of this study was to determine the reasons for tooth loss among the population of Greece and the factors which contribute to it. A total of 600 individuals, ages 18-50, was included in this study. During the examination the following were recorded: 1) The number of teeth which had already been lost and the number of teeth which had to be extracted. 2) The dental disease which was responsible for tooth loss. 3) The age, the socioeconomic status, the oral hygiene habits and the dental care of the individual. For the entire age group the percentages of teeth which had to be extracted due to caries, periodontal disease or other reasons were 68.7%, 12.3% and 19.0% respectively. The percentages of teeth which had been lost due to caries, periodontal disease or other reasons were 56.5%, 10.8% and 32.8%. The mean number of extractions of individuals was inversely related to their oral hygiene habits and frequency of visits to their dentist. Tooth loss was greater among the rural population than the urban population. People of the higher socioeconomic class tend to have a lower number of extractions.

Tooth mortality in an adult rural population in Kenya

This paper reports on the pattern of tooth loss in a random sample of 1131 adults aged from 15 to 65 years in a rural area of Kenya in which access to formal dental care is minimal. We found that the majority of the population retained most of their dentition in a functional state even up to the age of 65 years: In all age groups, more than 50% had at least 26 teeth present, and more than 90% had at least 16 teeth present. The prevalence of edentulousness was less than 0.3%. The principal cause of tooth loss in all age groups was caries, and this was true for all tooth-types except incisors, for which periodontal disease was the main cause of tooth loss. The cultural practice of removing lower central incisors was observed only in those over 40 years of age. More teeth were lost due to caries among women than among men, while the reverse was true for teeth lost due to periodontal diseases. In view of the fact that most people retain most of their teeth throughout life, it is suggested that the most appropriate strategies for dental health care in this population should be those promoting self care, rather than the introduction of a formal treatment-oriented approach provided by dentists.

Forty-year review of extraction frequencies at a university orthodontic clinic

In a review of consecutive charts at 5-year intervals from the orthodontic clinic at the University of North Carolina, the number of patients with extraction of all four first premolars increased from 10% in 1953 to 50% in 1963, remained at 35% to 45% until the early 1980s, then declined sharply to the 1950s level by 1993. Extraction for camouflage of Class II malocclusion (maxillary first premolars alone or maxillary first-mandibular second premolars) reached 16% in 1968, then declined, but not as dramatically, and presently is as frequent as the extraction of four first premolars. The rate of extraction of other teeth, done for a variety of individual reasons, has remained almost constant at about 15% for the past 40 years. Thus the total extraction percentage was 30% in 1953, peaked at 76% in 1968, and declined again to 28% in 1993, with almost all the change in the percentage of four first premolar extractions. The increase in first premolar extractions occurred primarily in a search for greater long-term stability; the recent decline seems due to a number of factors. Greater concern about the impact of extraction on facial esthetics, data to suggest that extraction does not guarantee stability, concern about temporomandibular dysfunction, and changes in technique all seem to have played a role. With appropriate orthodontic mechanics, many patients with Class I crowding can be treated satisfactorily with or without premolar extraction.