Global aspects of preventive dental care

[Prevalence, clinical and morphological features of tooth root caries in the adult human]

The incidence of tooth root caries, the morphology of hard dental tissues and the clinical course of the pathology were studied in 4701 (2526 men and 2175 women) residents of St. Petersburg and the Leningrad Region aged 18 to 88 years, which were divided into age groups according to age periodization of Institute of Age Physiology RAS. The highest prevalence of tooth root caries was revealed in the older age groups making 9.88% in elderly age and 7.4% in old age. In young, 1st and 2nd mature age the tooth root caries was diagnosed relatively rare (in 0.26, 1.35 and 5.02% of cases, respectively). Morphological changes in the tooth root cement that predispose to the development of a carious process were determined. In the first adulthood the caries of the tooth root occurred against the background of gum recession in chronic generalized periodontitis especially diabetes patients. In people of the 2nd mature age, elderly and old age the caries of the tooth root was associated with poor oral hygiene, gingival recession due to periodontal disease, as well as in teeth supporting fixed or removable dentures.

Age, period, and cohort analysis of regular dental care behavior and edentulism: a marginal approach

Background

To analyze the regular dental care behavior and prevalence of edentulism in adult Danes, reported in sequential cross-sectional oral health surveys by the application of a marginal approach to consider the possible clustering effect of birth cohorts.

Methods

Data from four sequential cross-sectional surveys of non-institutionalized Danes conducted from 1975-2005 comprising 4330 respondents aged 15+ years in 9 birth cohorts were analyzed. The key study variables were seeking dental care on an annual basis (ADC) and edentulism. For the analysis of ADC, survey year, age, gender, socio-economic status (SES) group, denture-wearing, and school dental care (SDC) during childhood were considered. For the analysis of edentulism, only respondents aged 35+ years were included. Survey year, age, gender, SES group, ADC, and SDC during childhood were considered as the independent factors. To take into account the clustering effect of birth cohorts, marginal logistic regressions with an independent correlation structure in generalized estimating equations (GEE) were carried out, with PROC GENMOD in SAS software.

Results

The overall proportion of people seeking ADC increased from 58.8% in 1975 to 86.7% in 2005, while for respondents aged 35 years or older, the overall prevalence of edentulism (35+ years) decreased from 36.4% in 1975 to 5.0% in 2005. Females, respondents in the higher SES group, in more recent survey years, with no denture, and receiving SDC in all grades during childhood were associated with higher probability of seeking ADC regularly (P < 0.05). The interaction of SDC and age (P < 0.0001) was significant. The probabilities of seeking ADC were even higher among subjects with SDC in all grades and aged 45 years or older. Females, older age group, respondents in earlier survey years, not seeking ADC, lower SES group, and not receiving SDC in all grades were associated with higher probability of being edentulous (P < 0.05).

Conclusions

With the use of GEE, the potential clustering effect of birth cohorts in sequential cross-sectional oral health survey data could be appropriately considered. The success of Danish dental health policy was demonstrated by a continued increase of regular dental visiting habits and tooth retention in adults because school dental care was provided to Danes in their childhood.