1
|
How Phantom Networks, Provider Qualities, and Poverty Sway Medicaid Dental Care Access: A Geospatial Analysis of Manhattan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312383. [PMID: 34886108 PMCID: PMC8656799 DOI: 10.3390/ijerph182312383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/03/2021] [Accepted: 11/12/2021] [Indexed: 11/17/2022]
Abstract
Access to general dental care is essential for preventing and treating oral diseases. To ensure adequate spatial accessibility for the most vulnerable populations, New York State mandates a ratio of one general dentist to 2000 Medicaid recipients within 30 min of public transportation. This study employed geospatial methods to determine whether the requirement is met in Manhattan by verifying the online directories of ten New York managed care organizations (MCOs), which collectively presented 868 available dentists from 259 facilities. Our survey of 118 dental facilities representing 509 dentists revealed that significantly fewer dentists are available to treat Medicaid recipients compared to MCO directories. The average dentist-to-patient ratio derived from the MCO listings by the Two-Step Floating Catchment Area (2SFCA) method was 1:315, while the average verified ratio was only 1:1927. “Phantom networks”, or inaccurate provider listings, substantially overstated Medicaid dental accessibility. Surprisingly, our study also discovered additional Medicaid providers unlisted in any MCO directory, which we coined “hidden networks”. However, their inclusion was inconsequential to the overall dental supply. We further scrutinized dental care access by uniquely applying six “patient-centered characteristics”, and these criteria vastly reduced accessibility to an average ratio of merely 1:4587. Our novel evaluation of the spatial association between poverty, dental care access, and phantom networks suggests that Medicaid dental providers wish to be located in wealthier census tracts that are in proximity to impoverished areas for maximum profitability. Additionally, we discovered that poverty and phantom networks were positively correlated, and phantom providers masked a lack of dental care access for Medicaid recipients.
Collapse
|
2
|
Lima RB, Buarque A. Oral health in the context of prevention of absenteeism and presenteeism in the workplace. Rev Bras Med Trab 2019; 17:594-604. [PMID: 32685760 PMCID: PMC7363255 DOI: 10.5327/z1679443520190397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 09/26/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Oral health is an important factor of human morbidity worldwide. Yet is often neglected in occupational health despite its direct impact on the quality of life and health of workers. OBJECTIVE To discuss the role of oral health in sickness absence and presenteeism, as well as in development and work efficiency improvement processes involving governments, companies and the workers themselves. METHODS Review of full-text articles on oral health, occupational health, sickness absence and presenteeism published in English or Portuguese in the last 10 years and included in scientific databases. RESULTS Oral problems accounted for 9 to 27% cases of sickness absence and 28 to 50% of presenteeism, with toothache and temporomandibular joint pain as the most frequent reasons. About 50% of workers prefer company-provided dental care, while 40% visit public and 10% other types of facilities. Despite high, the prevalence of oral diseases and orofacial pain was not associated with high rates of absenteeism, but mainly with presenteeism, this is to say, workers do not tend to miss work days, but their performance is reduced and become susceptible to more serious health problems in the future. CONCLUSION Oral health is not dissociated from general and occupational health, and as such it must be enhanced and duly promoted in an integrated manner. Effective and comprehensive oral health promotion and prevention public policies and private sector actions in the workplace can enhance the quality of life of workers.
Collapse
Affiliation(s)
- Roberto Brasil Lima
- Specialization in Occupational Medicine, Universidade de São Paulo - São Paulo (SP), Brazil.Universidade de São PauloSpecialization in Occupational MedicineUniversidade de São PauloBrazil
| | - Alexander Buarque
- Specialization in Occupational Medicine, Universidade de São Paulo - São Paulo (SP), Brazil.Universidade de São PauloSpecialization in Occupational MedicineUniversidade de São PauloBrazil
| |
Collapse
|
3
|
Do Patients With More Education Receive More Subsidized Dental Care? Evidence From a Natural Experiment Using the Introduction of a School Reform in Norway as an Instrumental Variable. Med Care 2018; 56:877-882. [PMID: 30113421 DOI: 10.1097/mlr.0000000000000976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND In Norway, for several dental conditions, a substantial part of treatment costs are reimbursed by the National Insurance Scheme. Ideally, the probability of receiving subsidized dental care (SDC) should be independent of social determinants of health, such as education, so that dental services are accessible to everyone independent of their social status. OBJECTIVE The main objective of this study was to estimate the causal effect of education on the probability of receiving SDC in the adult Norwegian population. RESEARCH DESIGN During the period 1960-1972, all municipalities in Norway were required to increase the number of compulsory years of education from 7 to 9 years. This education reform was used to create exogenous variation in the education variable. Since municipalities implemented the reform at different times, we have both cross-sectional and time series variation in the reform instrument. Thus we were able to estimate the effect of education on the probability of receiving SDC by controlling for municipality fixed effects and trend variables. SUBJECTS This study included all Norwegian adults, born during the period of 1947-1958. MEASURES Information about education (number of years), whether the individuals had received SDC, place of residence (municipality) was collected. RESULTS The probability of receiving SDC was found to increase by 2 percentage points per additional year of education. CONCLUSION People with the most resources benefit the most from a universal welfare scheme that is addressed to reach everybody. We suggest providing information about the subsidy scheme in a way that is easily available and understandable to all individuals, independent of their level of education.
Collapse
|
4
|
Carasol M, Llodra JC, Fernández-Meseguer A, Bravo M, García-Margallo MT, Calvo-Bonacho E, Sanz M, Herrera D. Periodontal conditions among employed adults in Spain. J Clin Periodontol 2016; 43:548-56. [DOI: 10.1111/jcpe.12558] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Miguel Carasol
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | | | | | - Manuel Bravo
- Faculty of Odontology; University of Granada; Granada Spain
| | | | | | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
- Spanish Society of Periodontology (SEPA); Spain
| |
Collapse
|
5
|
Abstract
Assessment of the periodontium has relied exclusively on a variety of physical measurements (e.g., attachment level, probing depth, bone loss, mobility, recession, degree of inflammation, etc.) in relation to various case definitions of periodontal disease. Periodontal health was often an afterthought and was simply defined as the absence of the signs and symptoms of a periodontal disease. Accordingly, these strict and sometimes disparate definitions of periodontal disease have resulted in an idealistic requirement of a pristine periodontium for periodontal health, which makes us all diseased in one way or another. Furthermore, the consequence of not having a realistic definition of health has resulted in potentially questionable recommendations. The aim of this manuscript was to assess the biological, environmental, sociological, economic, educational and psychological relationships that are germane to constructing a paradigm that defines periodontal health using a modified wellness model. The paradigm includes four cardinal characteristics, i.e., 1) a functional dentition, 2) the painless function of a dentition, 3) the stability of the periodontal attachment apparatus, and 4) the psychological and social well-being of the individual. Finally, strategies and policies that advocate periodontal health were appraised. I'm not sick but I'm not well, and it's a sin to live so well. Flagpole Sitta, Harvey Danger
Collapse
|
6
|
Tarkkila L, Furuholm J, Tiitinen A, Meurman JH. Oral health in perimenopausal and early postmenopausal women from baseline to 2 years of follow-up with reference to hormone replacement therapy. Clin Oral Investig 2008; 12:271-7. [PMID: 18299902 DOI: 10.1007/s00784-008-0190-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Accepted: 02/01/2008] [Indexed: 01/09/2023]
Abstract
Female sex hormones also affect the mouth but there are little data on oral health of menopause age women. This 2-year follow-up study investigated oral health of perimenopausal and early postmenopausal women. Because hormone replacement therapy (HRT) users have been reported to be more health conscious than nonusers, we expected differences between women using and women not using HRT. Of 3,173 women, a random sample of 400 (200 using and 200 not using HRT) was examined. Of them, 161 case-control pairs of women using/not using HRT were reexamined 2 years later. Dental and periodontal status was recorded according to the WHO criteria and resting and stimulated saliva flow was measured. Panoramic tomography of the jaws was taken at baseline and at follow-up. The patients also filled in a structured questionnaire on their systemic health, medication, and health habits. The results were analyzed statistically between and within the groups. No difference was observed in any dental parameters or salivary flow rates between the groups. However, during the follow-up, women in HRT group had received more dental restorations (p<0.05) and they also reported more often recent dental appointments (p<0.05). Although no difference in oral health status or salivary flow rates between women using or not using HRT was found, the observation on dental restorations may indicate a more health conscious attitude in the HRT group.
Collapse
Affiliation(s)
- L Tarkkila
- Institute of Dentistry, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland.
| | | | | | | |
Collapse
|
7
|
Okamoto Y, Tsuboi S, Suzuki S, Nakagaki H, Ogura Y, Maeda K, Tokudome S. Effects of smoking and drinking habits on the incidence of periodontal disease and tooth loss among Japanese males: a 4-yr longitudinal study. J Periodontal Res 2007; 41:560-6. [PMID: 17076782 DOI: 10.1111/j.1600-0765.2006.00907.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We investigated the risk of periodontal disease and tooth loss, associated with habits of smoking and alcohol consumption, in a longitudinal study. SUBJECTS AND METHODS The subjects were 1332 Japanese males, 30-59 yr of age, who were free from periodontal disease at the baseline check-up, and who underwent a second check-up 4 yr later. Periodontal disease was diagnosed using the community periodontal index score, based on the clinical probing of pocket depth (> or = 4 mm). Smoking and alcohol consumption patterns were evaluated using a self-administered questionnaire. RESULTS A dose-response relationship was observed between the amount of smoking and the incidence of periodontal disease in each age group. The overall odds ratios (95% confidence intervals), adjusted for age and alcohol, were 1.51 (0.95-2.22), 1.58 (1.13-2.22) and 2.81 (1.96-4.03), among smokers consuming 1-19, 20 or 21 or more cigarettes per day, respectively, with a significant linear trend (p < 0.0001). A similar association was found between smoking and tooth loss, except for the 50-59-yr-old age group. The adjusted odds ratios were 1.26 (0.60-2.64), 2.01 (1.21-2.32) and 2.06 (1.23-3.48), respectively. A significant linear trend between smoking and tooth loss was also observed (p = 0.01). Ex-smokers showed no significant difference compared with nonsmokers. We also found a significant linear trend between alcohol consumption and tooth loss among 30-39-yr-old subjects, while no relationship was observed between alcohol consumption and periodontal disease. CONCLUSION Cigarette smoking was found to be an independent risk factor for periodontal disease and tooth loss. Alcohol consumption was a limited risk factor for tooth loss in the younger age group, but was unrelated to periodontal disease. To prevent periodontal disease and tooth loss, health practitioners need to encourage people to stop smoking or not to start.
Collapse
Affiliation(s)
- Y Okamoto
- Department of Health Promotion and Preventive Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | | | | | | | | | | |
Collapse
|
8
|
Bernhardt O, Gesch D, Look JO, Hodges JS, Schwahn C, Mack F, Kocher T. The Influence of Dynamic Occlusal Interferences on Probing Depth and Attachment Level: Results of the Study of Health in Pomerania (SHIP). J Periodontol 2006; 77:506-16. [PMID: 16512766 DOI: 10.1902/jop.2006.050167] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study was to investigate potential associations between dynamic occlusal interferences and signs of periodontal disease in posterior teeth based on dental and medical measurements obtained from a population-based sample in the cross-sectional epidemiological study entitled, "Study of Health in Pomerania" (SHIP). METHODS Medical history and dental and sociodemographic parameters of 2,980 representatively selected dentate subjects, 20 to 79 years of age, were collected. The analysis was performed on posterior teeth only using a mixed linear model that considers the clustered structure of the data. The model also was adjusted with respect to known risk factors for periodontal disease. RESULTS The presence of non-working side contacts only was significantly related to probing depth (P<0.0001) and attachment loss (P=0.001). The presence of non-working side contacts and working side contacts on the same tooth was significantly related to increased probing depth (P=0.004) but not attachment level. The effect magnitude was a mean increase of 0.13 mm for probing depth and 0.14 mm in attachment loss. Known risk factors for periodontal disease that also showed significant associations with probing depth and attachment loss included male gender, age, smoking, education, and plaque score. Other factors significantly related to probing depth and/or attachment loss were tilted teeth, restored occlusal surfaces versus sound surfaces, elongated teeth, and tooth type (molar versus premolar). CONCLUSION The effect of non-working contacts on periodontal disease status was discernible, but weak in terms of magnitude and specificity.
Collapse
Affiliation(s)
- Olaf Bernhardt
- Department of Restorative Dentistry, School of Dentistry, University of Greifswald, Greifswald, Germany
| | | | | | | | | | | | | |
Collapse
|
9
|
Almeida TFD, Vianna MIP. O Papel da epidemiologia no planejamento das ações de saúde bucal do trabalhador. SAUDE E SOCIEDADE 2005. [DOI: 10.1590/s0104-12902005000300010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este é um estudo de revisão que sistematiza achados de pesquisas sobre exposições ocupacionais e seus efeitos na saúde bucal, destacando a importância dos dados epidemiológicos no planejamento de programas de saúde bucal do trabalhador. Existem relatos de associação potencial entre exposições ocupacionais e alterações bucais; entretanto, são escassos os estudos sobre as condições de saúde bucal dos trabalhadores em países em desenvolvimento como o Brasil. Entre as exposições ocupacionais presentes na literatura odontológica, observa-se uma predominância de estudos sobre substâncias ácidas e também exposições relacionadas com o açúcar, como a poeira de açúcar. As alterações bucais podem manifestar-se tanto nos tecidos duros (cárie, erosão dental, etc.) como nos tecidos moles (lesões da mucosa oral, doenças periodontais, etc). Por outro lado, observa-se que os programas de saúde bucal do trabalhador, quando existem, muitas vezes não consideram as especificidades dessa parcela da população que, além de exposta aos fatores de risco mais conhecidos das principais doenças bucais, está submetida a outros fatores relacionados ao ambiente de trabalho. Assim, considera-se relevante a discussão sobre a necessidade de maior produção de conhecimento nessa área, de capacitação de recursos humanos e de implementação de programas mais efetivos, baseados nos princípios da vigilância em saúde do trabalhador.
Collapse
|
10
|
Morishita M, Sakemi M, Tsutsumi M, Gake S. Effectiveness of an oral health promotion programme at the workplace. J Oral Rehabil 2003; 30:414-7. [PMID: 12631166 DOI: 10.1046/j.1365-2842.2003.01047.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of the study was to evaluate the effectiveness of an oral health promotion programme at the workplace. The programme was given once a year at offices or factories, which was voluntary and free for all employees. The programme consisted of clinical examinations followed by oral health guidance, oral hygiene instruction and oral prophylaxis of anterior lower teeth. Oral health status was compared by the times of participation in the programme. It was shown that three times or more participants in the programme had fewer decayed, missing and filled teeth (DMFT) and lower percentage of Community Periodontal Index (CPI) sextants 3 and 4. The oral health promotion programme was effective in keeping or maintaining good oral health among workers. In addition to current activities, the programme should include education to motivate subjects to receive regular check-ups.
Collapse
Affiliation(s)
- M Morishita
- Department of Preventive Dentistry, Faculty of Dentistry, Hiroshima University, Hiroshima, Japan.
| | | | | | | |
Collapse
|
11
|
|
12
|
Karikoski A, Murtomaa H, Ilanne-Parikka P. Assessment of periodontal treatment needs among adults with diabetes in Finland. Int Dent J 2002; 52:75-80. [PMID: 12013254 DOI: 10.1111/j.1875-595x.2002.tb00604.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES People with diabetes have a high risk for periodontal disease, which can be considered one of the complications of diabetes. We evaluated periodontal treatment needs using the Community Periodontal Index of Treatment Needs (CPITN) in relation to diabetes-related factors and oral hygiene. DESIGN The sample consisted of 120 dentate diabetics, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic. The nurses, who interviewed the patients, collected data on duration and type of diabetes, complications, and HbA1c level. Clinical periodontal examination included identification of visible plaque, the presence of calculus and use of the CPITN. RESULTS The CPITN score 3 was the most prevalent. According to the logistic regression model, poor metabolic control was significantly related to pathologic pockets. No significant association was found between diabetes-related factors and the highest individual CPITN score of 4, which was, in turn, significantly associated with extensive calculus. CONCLUSIONS Excessive periodontal treatment needs found, indicate that current dental care may be insufficient in adults with diabetes. Oral health among high-risk groups, especially those with poor metabolic control, should be promoted by collaboration between dental and health care professionals involved in diabetes care.
Collapse
Affiliation(s)
- A Karikoski
- Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Finland
| | | | | |
Collapse
|
13
|
Kinane DF, Chestnutt IG. Smoking and periodontal disease. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2001; 11:356-65. [PMID: 11021635 DOI: 10.1177/10454411000110030501] [Citation(s) in RCA: 189] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Numerous investigations of the relationship between smoking and periodontal disease have been performed over the last 15 years, and there now exists a substantial body of literature upon which this current review is based. From both cross-sectional and longitudinal studies, there appears to be strong epidemiological evidence that smoking confers a considerably increased risk of periodontal disease. This evidence is further supported by the data emanating from patients who stop smoking. These patients have levels of risk similar to those of non-smokers. Numerous studies of the potential mechanisms whereby smoking tobacco may predispose to periodontal disease have been conducted, and it appears that smoking may affect the vasculature, the humoral immune system, and the cellular immune and inflammatory systems, and have effects throughout the cytokine and adhesion molecule network. The aim of this review is to consider the evidence for the association between smoking and periodontal diseases and to highlight the biological mechanisms whereby smoking may affect the periodontium.
Collapse
Affiliation(s)
- D F Kinane
- Periodontology and Oral Immunology, University of Glasgow Dental Hospital and School, Scotland, UK
| | | |
Collapse
|
14
|
Ahlberg J, Tuominen R, Murtomaa H. A 5-year retrospective analysis of employer-provided dental care for Finnish male industrial workers. Community Dent Oral Epidemiol 1997; 25:419-22. [PMID: 9429814 DOI: 10.1111/j.1600-0528.1997.tb01732.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The treatment-mix, treatment time, and dental status of 268 male industrial workers entitled to employer-provided dental care were studied. The data were collected from treatment records of the covered workers over the 5-year period 1989-93. Treatment time was based on clinical treatment time recorded per patient visit, and the treatment procedure codes were reclassified into a treatment-mix according to American Dental Association categories, with a modification combining endodontics and restorative treatment. The mean number of check-ups followed by prescribed treatment (treatment courses) during the 5 years was 3.7 among those who had entered the in-house dental care program prior to the monitored period (old attenders). Their treatment time was stable, 57-63 min per year, while the first-year mean treatment time (170 min) of those who had entered the program during the study period (new attenders) was significantly higher (P < 0.01) than the 5-year mean of the old attenders (61 min). Over the first 2 years, the treatment-mix of the new attenders showed a rise in diagnostic and preventive procedures from one-third to about one-half of all procedures, as it was for the old attenders. The new attenders' mean number of carious teeth (2.7), registered at the initial check-up visit, paralleled the mean recently demonstrated in the similar non-covered population. It was significantly higher than the 5-year mean of the old attenders (0.5) (P < 0.001), but declined to the same level after the first year of treatment. It was concluded that the studied program seemed to contribute to a stabilization of treatment-mix, and to the establishment of a shorter annual treatment time within the first 2 years of treatment.
Collapse
Affiliation(s)
- J Ahlberg
- Department of Dental Public Health, University of Helsinki, Finland.
| | | | | |
Collapse
|
15
|
Murtomaa H, Ahlberg J, Metsäniitty M. Periodontal awareness among adult Finns in 1972 and 1990. Acta Odontol Scand 1997; 55:49-52. [PMID: 9083576 DOI: 10.3109/00016359709091941] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Surveys were conducted in 1972 and 1990 to analyze conceptions among Finns of their own periodontal status. The interview samples, drawn to represent the Finnish population, aged 15 years and more, comprised 965 persons in 1972 and 1,006 in 1990. After excluding edentulous individuals, a total of 732 in 1972 and 853 in 1990 were accepted for the interview study. In 1990, 2% of the respondents stated that they currently had gingivitis, the percentage being highest in the youngest age group (6%). In both years there were no statistically significant differences between the age, education, and residence subgroups with regard to gingivitis: nearly 60% of those in all subgroups claimed that they had never had gingivitis. The proportions of those who had never experienced gingival bleeding were 54% in 1972 and 50% in 1990. During the first observation period the youngest age group (15-24 years) was the only one in which the increment in self-recognized gingivitis was accompanied by a higher proportion experiencing gingival bleeding. The overall low prevalence of self-recognized gingivitis is at variance with the estimated periodontal treatment need according to Finnish clinical epidemiologic data. Our results indicate that knowledge concerning periodontal disease is still poor in Finland.
Collapse
Affiliation(s)
- H Murtomaa
- Department of Dental Public Health, University of Helsinki, Finland
| | | | | |
Collapse
|