[THE INTERDEPENDENCE BETWEEN SMOKING, ALCOHOL, TOOTH PATHOLOGY AND PREVALENCE OF HELICOBACTER PYLORI AMONG ETHNIC GROUPS IN KYRGYZSTAN]

The main aim was to study the ethnic and social characteristics of the prevalence of certain risk factors among Kyrgyz ethnic population infected with Helicobacter pylori without clinical signs of the disease of upper gastrointestinal tract. The study involved 116 healthy individuals (57 and 49 Kyrgyz, Russian) who were tested on H. pylori infection, taking into account risk factors such as smoking, alcohol consumption, low or serious teeth damage. The identified H.pylori infection was independent from ethnic affiliation. Significant relation between absence or high damage of the teeth and H. pylori contamination was revealed in surveyed Kyrgyz group.

Perceptions of oral health, preventive care, and care-seeking behaviors among rural adolescents

BACKGROUND

An asymmetrical oral disease burden is endured by certain population subgroups, particularly children and adolescents. Reducing oral health disparities requires understanding multiple oral health perspectives, including those of adolescents. This qualitative study explores oral health perceptions and dental care behaviors among rural adolescents.

METHODS

Semistructured individual interviews with 100 rural, minority, low socioeconomic status adolescents revealed their current perceptions of oral health and dental care access. Respondents age ranged from 12 to 18 years. The sample was 80% black and 52% male.

RESULTS

Perceived threat from dental disease was low. Adolescents perceived regular brushing and flossing as superseding the need for preventive care. Esthetic reasons were most often cited as reasons to seek dental care. Difficulties accessing dental care include finances, transportation, fear, issues with Medicaid coverage and parental responsibility. In general, adolescents and their parents are in need of information regarding the importance of preventive dental care.

CONCLUSIONS

Findings illuminate barriers to dental care faced by low-income rural adolescents and counter public perceptions of government-sponsored dental care programs as being "free" or without cost. The importance of improved oral health knowledge, better access to care, and school-based dental care is discussed.

Pathological findings in a sample of Mexican pediatric patients. Clinical and radiographic survey

AIM

The findings of a clinical-radiological review of 467 children attending the Oral Diagnosis Clinic of the Facultad de Odontología, UNAM, Mexico, are presented.

METHODS

All patients were clinically reviewed, clinical history was taken, and an orthopantomogram obtained by last year dentistry students. Patients and radiographs were then reviewed by the panel and all alterations in teeth, soft tissues and bone were recorded.

RESULTS

Clinical and/or radiographic alterations were found in 132 (28.26%) children. The main alterations were developmental (75%) and inflammatory/infectious and traumatic (6.06% each). The most common entities were: supernumeraries (30.77%); hypodontia (29.7%); osteosclerotic lesions and microdontia (4.4% each).

CONCLUSION

The data on the frequency of alterations in the pediatric population attending at our institution reinforce the importance of this kind of study in efforts to improve the quality of stomatologic services in the pediatric population.

Experimental encounters: Filipino and Hawaiian bodies in the U.S. imperial invention of odontoclasia, 1928-1946

Through extensive dietary and dental surveys among infants and children living in Hawai'i starting in the late 1920s, medical researchers transformed immigrant and indigenous children's mouths into objects of pathological comparison, establishing sites of alternative empirical and epistemological contact that are endemic to U.S. Pacific empire. These studies resulted in the extension of odontoclasia, a veterinary diagnosis, from dogs to humans. As a dietary antidote, researchers recommended the wider consumption of poi, a starchy Hawaiian staple. Although this appears to be a novel endorsement of indigenous foodways predating contemporary activist efforts to reinstate traditional food cultures to support indigenous health, narrow technocratic specificity and the biomedical emphasis on the cultural rather than structural etiology of odontoclasia marginalized Hawaiian health by reducing morbidity to failures to conform to U.S. imperial modernity, which included industrial medical surveillance on plantations. Conversely, doctors credited plantations for saving Filipinos through successful imperial and hygienic assimilation.

Dental status of victims from Batajnica's mass graves

The aim of this paper is to present the post mortem dental evidence and dental health of the victims interred during 1999 in five grave pits at Batajnica near Belgrade. The investigated sample comprised 32 individuals with only maxillae preserved, 80 with mandible, and 260 individuals with both jaws. We have found high degree of enamel hypoplasia (25.89%), frequent signs of the severe forms of periodontal disease (18.55%), very high percent of antemortem tooth loss (31.48%), and evidence of edentate jaws in an early age of individuals. Amalgam was predominant material for tooth fillings; implants and non-metal ceramic crowns were not found, and three quarters of edentate individuals were found with full prostetic dentures. Despite the detailed postmortem dental analysis, antemortem dental charts were not collected. These individuals were identified by other forensic methods.

Hmong adults self-rated oral health: a pilot study

Since 1975, the Hmong refugee population in the U.S. has increased over 200%. However, little is known about their dental needs or self-rated oral health (SROH). The study aims were to: (1) describe the SROH, self-rated general health (SRGH), and use of dental/physician services; and (2) identify the factors associated with SROH among Hmong adults. A cross-sectional study design with locating sampling methodology was used. Oral health questionnaire was administered to assess SROH and SRGH, past dental and physician visits, and language preference. One hundred twenty adults aged 18-50+ were recruited and 118 had useable information. Of these, 49% rated their oral health as poor/fair and 30% rated their general health as poor/fair. Thirty-nine percent reported that they did not have a regular source of dental care, 46% rated their access to dental care as poor/fair, 43% visited a dentist and 66% visited a physician within the past 12 months. Bivariate analyses demonstrated that access to dental care, past dental visits, age and SRGH were significantly associated with SROH (P < 0.05). Multivariate analyses demonstrated a strong association between access to dental care and good/excellent SROH. About half of Hmong adults rated their oral health and access to dental care as poor. Dental insurance, access to dental care, past preventive dental/physician visits and SRGH were associated with SROH.

3-year results of a collaborative school-based oral health program in a remote First Nations community

INTRODUCTION

Surveys of dental health among Aboriginal children in Canada, using scales such as the Decayed, Missing, and Filled Teeth (DMFT) score, indicate that Aboriginal children have 2 to 3 times poorer oral health compared with other populations. A remote First Nations community approached requested assistance in addressing the health of their children. The objective was to work with the community to improve oral health and knowledge among school children. The hypothesis formulated was that after 3 years of the program there would be a significant decrease in dmft/DMFT (primary/permanent) score.

METHODS

This was a cross-sectional study of all school-aged children in a small, remote First Nations community. Pre- and post- intervention evaluation of oral health was conducted by a dentist not involved in the study. The intervention consisted of a school-based program with daily brush-ins, fluoride application, educational presentations, and a recognition/incentive scheme.

RESULTS

Twenty-six children were assessed prior to the intervention, representing 45% of the 58 children then in the community. All 40 children in the community were assessed following the intervention. Prior to the intervention, 8% of children were cavity free. Following 3 years of the intervention, 32% were cavity free. Among the 13 children assessed both pre- and post-intervention, dmft/DMFT score improved significantly (p <0.005). The visiting hygienist noted increased knowledge about oral health.

CONCLUSION

A community- and university-supported, school-based, collaborative oral health program improved oral health and knowledge among children in a remote First Nations community.

Racial and Ethnic Differences in Health and Health Care

This study describes differences in health care utilization and recorded diagnoses in a racially and ethnically diverse sample of 1175 out-of-treatment patients who screened positive for heroin and cocaine use during an outpatient visit to a drop-in clinic at an urban hospital. Blacks averaged more ED visits than Whites and higher average yearly ED charges than Hispanics (1,991 dollars vs. 1,603 dollars). Charges over two years totaled 6,111,660 dollars. Blacks were most likely to be diagnosed with injury, hypertension, cardiac disease, alcohol abuse/dependency, and sexually transmitted disease, and least likely to be diagnosed with psychiatric disease. Hispanics were most likely to be diagnosed with HIV, dental disease and drug overdoses, and least likely to be injured. Only 34% of this group of drug users was identified with a diagnosis of drug abuse or dependency.

Dental abnormalities in children preparing for pediatric bone marrow transplantation

The purpose of our study was to describe the types and frequencies of altered dental development in pediatric patients preparing for bone marrow transplantation (BMT). Retrospective review of the medical records and panoramic radiographs of all patients who underwent BMT at St Jude Children's Research Hospital between 1990 and 2000 for whom pre-BMT dental examination and panoramic radiography records were available. All patients were treated on institutional protocols. We recorded patient demographics and radiographic evidence of microdontia, hypodontia, taurodontia, root stunting, caries, enamel pearls, and pulpal calcifications. The 259 patients identified (150 male and 109 female) had a median age of 12.82 years (range, 3.18-25.93 years) at the time of BMT. In total, 203 were Caucasian, 38 were African-American, and 18 were of other races. In all, 150 (57.9%) had abnormal dentition. The most common dental abnormalities were caries (n=84), pulpal calcifications (n = 34), and dental extractions (n = 33). Developmental abnormalities occurred less frequently: taurodontia (n = 8), hypodontia (n = 10), microdontia (n = 11), and root stunting (n = 11). Dental abnormalities are prevalent in children undergoing BMT. Pre-transplant oral hygiene and dental examination should be standard care in order to minimize potential sites of infection.

Racial and socioeconomic disparities in health from population-based research to practice-based research: the example of oral health

Oral health serves as an excellent model for understanding social disparities in health. Associations among race, socioeconomic status, oral health, and dental care are strong. Multiple points along the dental care process allow investigation of disparities and mechanisms; and there are multiple types of treatment services (ranging from those that all patients and clinicians would likely agree on, to multiple treatment options, to discretionary treatments). Florida Dental Care Study (FDCS) data are used to provide examples of these concepts. Without regard to whether the dental care system was ultimately entered, the FDCS found substantive social differences in 1) incidence of need; 2) responsiveness to this need; and 3) propensity to seek preventive services. Once the dental care system had been accessed, substantive social differences were still evident with regard to 1) clinical condition; 2) awareness of treatment options; and 3) treatment discussions and recommendations. Once differences in clinical condition were taken into account, and once analysis was limited to persons who had entered the dental care system, social differences in receipt of care were still evident. Findings suggested that although dental care was effective at treating and preventing certain oral conditions, social differences in treatment effectiveness were evident.

Improving the oral health of Alaska Natives

There is a high prevalence of oral disease in the Alaska Native population, much of which goes untreated, creating a large discrepancy between the level of their oral health and that of the general population. The causes of this discrepancy are multiple--a major cause being the lack of access to care, especially in remote Alaska Native villages. Improving the oral health status of Alaska Natives will require treatment of current disease and initiation of an effective program to prevent oral disease. Cooperation between the Alaska Native organizations, dental health aides, the dental profession, and the government will be important. A strategy that combines addressing the disease currently present and preventing the occurrence of disease in the long run is the only strategy that offers a sustainable solution.

Addressing oral health disparities in settings without a research-intensive dental school: collaborative strategies

Research suggests that oral health is linked to systemic health, and those with poor oral health are potentially at greater risk for important diseases, including cardiovascular disease, stroke, diabetes mellitus, and adverse pregnancy outcomes. Asians and Pacific Islanders (APIs) in Hawaii have high rates of many such diseases. Studies in children in Hawaii have revealed disparities in dental health; for example, API children have significantly higher rates of cavities than other groups. Hence, conducting further study is vital in adults, particularly APIs, to assess oral health and its correlation to overall health outcomes. Given the lack of a dental school and the lack of fluoridated water in the state, the University of Hawaii's John A. Burns School of Medicine (ABSOM) has identified the need to assume a leadership role in creating effective community-based oral health research and treatment programs. With the support of the National Institute of Dental and Craniofacial Research, JABSOM fostered a collaborative relationship with the University of North Carolina at Chapel Hill School of Dentistry, a premiere research-intensive dental school, the Waimanalo Health Center, and the Hawaii State Department of Health. This partnership has worked together to implement a community-based approach to performing research designed to illuminate disparities and develop innovative strategies to promote oral health in Hawaii's diverse populations. We hope that this collaborative, culturally competent approach may serve as a model for use in other settings without a research-intensive dental school.

Oral disease burden and dental services utilization by Latino and African-American seniors in Northern Manhattan

Although oral diseases are among the most common chronic conditions affecting older adults, utilization of dental services by the elderly, especially minority elderly is low. This pilot study determined whether there are racial/ethnic differences in oral disease burden, perceived oral health-related quality of life, perceived need for dental services and dental services utilization between African-American and Latino seniors in Northern Manhattan. Subjects received an oral examination and a face-to-face survey to assess oral health status, perceived need, perceived oral health-related quality of life, and utilization of dental services. The data suggest that in both populations, oral disease burden is high and utilization of dental services is problematic--34.0% of the subjects were edentulous and average time since last dental visit was 40.1 months. The average DMFT was 23.8; 81.6% of the dental caries experience was accounted for by Missing Teeth, and there were significant differences in total caries experience, and Missing and Filled Teeth between African-American and Latino seniors. Although there were no racial/ethnic differences in the utilization of dental services, dentate individuals were more likely to have had a more recent dental visit (31.0 months) than edentulous individuals (57.7 months). The high proportion of Missing Teeth suggests that interventions aimed at improving the oral health of this population must target individuals at a younger age.

Dental health and treatment needs among a sample of Bangladeshi medical users aged 40 years and over living in Tower Hamlets, UK

AIM

To assess the dental health status and treatment needs of Bangladeshi medical care users aged 40 years and over and to explore the relationship of oral disease status, tobacco usage and paan (betel quid) chewing.

DESIGN

Multi-centre cross-sectional study.

SETTING

General medical practitioners' waiting areas in Tower Hamlets, UK.

SUBJECTS

185 Bangladeshi adults aged 40 years and over.

INTERVENTION

A clinical examination and an interview schedule.

MEASURES

Dental status, periodontal status, dental plaque, calculus and denture status. Tobacco smoking and paan chewing behaviour.

RESULTS

The response rate was 74%. 85% of participants were dentate with an average number of 24 (SD +/- 5.4) standing teeth. The mean DMFT score was 5.38, with missing teeth (3.81) being the major component. The decayed component was 0.43 and the filled was 1.14. 46% of participants were assessed as being free from gingivitis. Significant relationships between chewing paan and aspects of dental and periodontal status were found. Impacts of oral health were reported by 45% of the respondents. The normative need for dental treatment was 96% with a perceived need of 48%.

CONCLUSION

There was considerable normative dental need. Whilst caries experience was low, there were high levels of periodontal treatment needs. Paan chewing was related to aspects of dental and periodontal status.

Occlusal and oral health status of a group of 3-8-year-old South African black children

This study determined the oral health status of a group of 3-8-year-old South African black children, comprising a total of 214 children from the townships of Garankuwa, Shosanguwe, Mabopane, Hebron and Erasmus who attended a school in Akasia, Greater Pretoria Metropolitan Substructure. The decayed, missing and filled teeth (dmft), oral hygiene status, dental IQ and malocclusion status were determined. The study found that the children's oral health status and occlusal status were unacceptable. The level of their dental IQ scores was low, their oral hygiene poor, and they were in urgent need of primary and secondary dental care. In addition they were in need of both preventive and interceptive orthodontic care. A national strategy to address primary dental health care is recommended.

Does the ethnicity of teenage children influence oral self perception and prevalence of dental disease?

AIM

The primary aim was to evaluate the effect of ethnicity, social deprivation and oral health on oral self perceptions of 14-15-year-old Asians and Whites. A secondary aim was to assess the influence of ethnicity and social deprivation on oral treatment need in the same sample.

DESIGN

A cross-sectional epidemiological study.

DATA SOURCE

A stratified, random sample of 408 14-15-year-old Asian and White children from schools in Manchester.

METHOD

Information was collected on oral self perceptions using a questionnaire and on oral treatment need with a clinical examination.

RESULTS

Multivariate data analysis revealed that oral treatment need, but not ethnicity or social deprivation, was an important predictive variable with respect to oral self perceptions. Ethnicity was the only variable to influence periodontal treatment need. Social deprivation influenced the level of untreated caries.

CONCLUSIONS

1. Socially deprived children have higher caries levels than their more affluent counterparts and this is evident regardless of ethnic background. 2. Although Asian 14-15-year-old children have a higher periodontal treatment need than Whites, there was no ethnic influence on how they perceive their oral health. 3. Oral treatment need is an important factor with respect to oral self perceptions.

Dental caries, restoration and tooth conditions in U.S. adults, 1988-1991. Selected findings from the Third National Health and Nutrition Examination Survey

This article provides estimates of dental caries experience and selected restorative and tooth conditions among U.S. adults, obtained from Phase 1 (1988-1991) of the Third National Health and Nutrition Examination Survey. Between 1988 and 1991, 94 percent of adults in the United States showed evidence of past or present coronal caries. Based on the data collected, the authors estimate that about 40.5 percent, or 61.6 million, dentate adults had at least one tooth or tooth space that could potentially benefit from professional treatment. Minimally, it is estimated that 135.6 million tooth or tooth spaces among U.S. adults may benefit from professional treatment. These estimates supplement information available from the DMF index to provide a broader profile of the impact of dental caries on permanent tooth of U.S. adults.

Children's dental health under the capitation scheme

A study was undertaken of the dental health of 7870 eight-year-old children resident in the City of Birmingham, using the standard British Association of Community Dentistry epidemiological procedures. There were variations in the dental health of children from different ethnic backgrounds. Asian children had the poorest dental health and Afro-Caribbean children, the best. There were also variations in the dental health of children from different ACORN Categories. Children from the highest ACORN Category 'Thriving' had better dental health than those from the lowest, 'Striving' Category. Positive consent was obtained from every parent or guardian to link the findings with the Dental Practice Board's records as to whether each child was registered under the NHS capitation scheme for the provision of primary dental care to children. The dental state of those who were registered in the capitation scheme, (54.5 per cent), was compared with those who were not, (45.5 per cent). The highest proportion of children registered with a dentist were Caucasian and from a high social class i.e. ACORN Category 'Thriving'. In order to ensure that differences were due to their capitation status and not to other differences within the groups, analyses were undertaken according to the ethnic background and ACORN Category of the children. Overall, there were only very small differences between the caries state of the registered and non registered children. However 32 per cent of those children registered in the scheme still had active decay which was not restricted to the primary dentition. The greatest reduction in the average number of decayed teeth together with the greatest increase in the average number of fillings in registered children when compared to their non registered colleagues was observed in the lowest ACORN Category. Unfortunately this group had the lowest proportion of children who were registered in the capitation scheme and 40 per cent of them, both registered and non registered, still had active decay. Overall, oral hygiene was good, and there was little difference between registered and non-registered children in the ACORN Category 'Thriving'. However, in the ACORN Category 'Striving', there was a higher proportion of children with good oral hygiene amongst those who were registered than amongst those who were not. Provision of preventive treatment was low in all registered and non registered groups, but lowest in those groups of children with the poorest dental health. It would appear that, for a proportion of children registered in the capitation scheme, the practitioners were failing to achieve the requirement of "securing and maintaining their oral health".

Selected restoration and tooth conditions: United States, 1988-1991

The DMF index provides one source of information on past and present dental caries experience; however, important limitations hinder its ability to characterize fully the impact of dental caries. The purpose of this paper is to describe a measure of selected restoration and tooth conditions that supplements information from the DMF index and to report on the application of this measure as part of the Third National Health and Nutrition Examination Survey, Phase 1, conducted between 1988 and 1991. Data from this survey were used to estimate the prevalence and severity of selected disaggregated physical and biological oral conditions among dentate adults aged 18 to 74 years. Trained, standardized, and calibrated dentist examiners assessed 28 permanent teeth or tooth spaces for each of 6,767 subjects. Teeth or tooth spaces were classified based on criteria for: defective intracoronal restorations, crowns, or bridges; gross loss of tooth structure associated with a restoration; pulpal involvement; or retained roots. Approximately 40.5%, or 61.6 million, dentate adults had at least one tooth or tooth space that met the criteria. Among all persons, an average of 0.9 teeth or tooth spaces met the criteria for at least one category. Adults with at least one scored tooth or tooth space had an average of 2.2 such teeth or tooth spaces. Data from this assessment supplement information available from the DMF index to provide a broader profile of the impact of dental caries on permanent teeth of US adults.

Social factors and self-assessed oral health in South Africa

The question of what determines the dental needs of a population has been widely debated in the dental literature. Although there is no full agreement, the consensus is that substantial consideration should be given to the people's perceptions of what their needs are, based on self-assessment of their oral health and satisfaction with the appearance of their teeth. These perceptions (self-assessments) are likely to be shaped by their previous experiences with the dental service, their understanding of "normally" and knowledge of oral care, which are determined by social factors such as culture, class and race. The purpose of this paper is to examine self-assessed oral health in South Africa according to relevant social factors. In 1988/89 a National Oral Health survey, which included a social survey, was conducted. The data were collected by means of a structured interview, based on a questionnaire, with a sample of 4652 adults aged 20-64 yr. The variables examined in this paper formed part of the items in the questionnaire. There is a higher level of identification that "something is wrong with teeth" in (a) lower educational levels (53%-no formal education; 20%-standard 10+); (b) lower income categories (43%-lowest; 16%-highest); (c) among Xhosa (66%), S. Sotho (58%) and Zulu (53%) speaking groups and (d) among Black people (54%). Similar trends are evident in the degree of satisfaction with the appearance of teeth. The results reveal differences in self-assessed oral health among people with different educational standards, income levels, linguistic/cultural characteristics as well as racial groups as defined by the Population Registration Act of 1950.(ABSTRACT TRUNCATED AT 250 WORDS)

Trends in the perceived need for dental care for children: 1982-1990

A review is provided of the national surveys of parents and guardians on the dental status and associated difficulties of their children. Although fewer in number, complaints of acute dental problems in children continue to be made.

Oral disease beliefs, behaviors, and health status of Korean-Americans

Previous research with other ethnic minorities has shown that culture and age cohort, as well as language and economic limitations, act as barriers to obtaining dental care and maintaining good oral health. This study compared self-reported oral health attitudes, self-efficacy, and dental practices of 20 younger and 23 elderly Korean-Americans. Oral assessments were also conducted to determine plaque and gingival status, and root and coronal caries. Significant differences emerged in health self-efficacy (P less than .01) and preventive health orientation (P less than .002). Elderly had fewer teeth (P less than .0001), more decayed and filled root surfaces (P less than .05 and P less than .004, respectively), and more decayed and filled coronal surfaces (P less than .001 and P less than .03). Both groups showed higher levels of distal and mesial plaque than occlusal and cervical plaque; however, the elderly had higher rates of both (P less than .0001). Gingival status was also worse for the elderly, on distal and mesial (P less than .01), facial (P less than .01), and lingual (P less than .01) surfaces. These differences are striking, since the elderly reported visiting the dentist more recently (P less than .0001); but most of these visits were for prosthodontic and emergency care. Better preventive dental care and education are necessary for elderly immigrants who have not been exposed to preventive dentistry in their home countries.

Oral health in preschool children living in Sweden. Part II--A longitudinal study. Findings at three years of age

Scientific epidemiological studies of dental health in children three years of age are relatively few in Sweden. The aim of this study was to describe the oral health of three-year-old children living in Sweden, with special reference to immigration and failure to attend health examinations. All of 671 children requested to take part in an earlier investigation (Wendt et al. 1991) were invited for a new dental examination at three years of age. A total of 632 children were examined. At the age of three years 71.7 per cent of the children were caries free. Of the children with caries, 33.5 per cent were immigrants and of the total number of immigrants, 50.5 per cent had caries compared to 21.9 per cent of the non-immigrant children. Among those children, who failed to attend the earlier investigations at one or two years of age, 61.5 per cent had caries at the age of three. Compared to studies on dental health in three-year-old children from the 70's and 80's (Hugoson et al. 1986), this study shows that dental health in three-year-old children has not improved significantly during the last decade. Furthermore, this study supports the suggestion that special preventive dental programmes should be developed for immigrant children and that extra attention should be paid to children who fail to attend health examinations and their families.