ORCID Profile
0000-0003-0588-6843
Current Organisations
University of Leeds
,
University of Adelaide
,
University of Otago
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Publisher: Hindawi Limited
Date: 2017
DOI: 10.1155/2017/9378325
Abstract: Hypodontia, or tooth agenesis, is the most prevalent craniofacial malformation in humans. It may occur as part of a recognised genetic syndrome or as a nonsyndromic isolated trait. Excluding third molars, the reported prevalence of hypodontia ranges from 1.6 to 6.9%, depending on the population studied. Most affected in iduals lack only one or two teeth, with permanent second premolars and upper lateral incisors the most likely to be missing. Both environmental and genetic factors are involved in the aetiology of hypodontia, with the latter playing a more significant role. Hypodontia in iduals often present a significant clinical challenge for orthodontists because, in a number of cases, the treatment time is prolonged and the treatment outcome may be compromised. Hence, the identification of genetic and environmental factors may be particularly useful in the early prediction of this condition and the development of prevention strategies and novel treatments in the future.
Publisher: MDPI AG
Date: 08-06-2016
DOI: 10.3390/DJ4020020
Publisher: Wiley
Date: 25-10-2005
Publisher: Elsevier BV
Date: 04-2003
Abstract: Not only is the number of older people increasing in New Zealand, but a greater number of them are keeping their own teeth, with predictable consequences for the costs of treating (and rehabilitating) dental and maxillofacial trauma in that group. The aim of the study was to describe the occurrence of dental and maxillofacial trauma involving New Zealanders aged 65 and over during the 1990s. The investigation was a secondary analysis of routinely collected, national-level compensation and hospital treatment data. The analysis showed that: (1) there was an increase in the rate and absolute number of injuries among older people (2) the dental trauma rate was highest among males in the youngest age group, while the facial fracture rate was highest among older females and (3) there was a general increase in the contribution of falls to the occurrence of trauma. Measures which aim to reduce the occurrence of falls among older people will also reduce the oral and maxillofacial trauma rate in that age group.
Publisher: Wiley
Date: 30-05-2006
Publisher: Springer Science and Business Media LLC
Date: 04-2014
Publisher: Wiley
Date: 13-09-2006
Publisher: Wiley
Date: 09-2004
Publisher: SAGE Publications
Date: 02-03-2016
Abstract: Complex associations exist among socioeconomic status (SES) in early life, beliefs about oral health care (held by in iduals and their parents), and oral health–related behaviors. The pathways to poor adult oral health are difficult to model and describe, especially due to a lack of longitudinal data. The study aim was to explore possible pathways of oral health from birth to adulthood (age 38 y). We hypothesized that higher socioeconomic position in childhood would predict favorable oral health beliefs in adolescence and early adulthood, which in turn would predict favorable self-care and dental attendance behaviors those would lead to lower dental caries experience and better self-reported oral health by age 38 y. A generalized structural equation modeling approach was used to investigate the relationship among oral health–related beliefs, behaviors in early adulthood, and dental health outcomes and quality of life in adulthood (age, 38 y), based on longitudinal data from a population-based birth cohort. The current investigation utilized prospectively collected data on early (up to 15 y) and adult (26 and 32 y) SES, oral health–related beliefs (15, 26, and 32 y), self-care behaviors (15, 28, and 32 y), oral health outcomes (e.g., number of carious and missing tooth surfaces), and oral health–related quality of life (38 y). Early SES and parental oral health–related beliefs were associated with the study members’ oral health–related beliefs, which in turn predicted toothbrushing and dental service use. Toothbrushing and dental service use were associated with the number of untreated carious and missing tooth surfaces in adulthood. The number of untreated carious and missing tooth surfaces were associated with oral health–related quality of life. Oral health toward the end of the fourth decade of life is associated with intergenerational factors and various aspects of people’s beliefs, SES, dental attendance, and self-care operating since the childhood years.
Publisher: Wiley
Date: 28-10-2010
Publisher: SAGE Publications
Date: 10-2016
Abstract: Caries increment is affected by sugar-sweetened beverage (SSB) consumption. Taxing SSBs could reduce sugar consumption and caries increment. The authors aimed to estimate the impact of a 20% SSB sales tax on caries increment and associated treatment costs (as well as the resulting tax revenue) in the context of Germany. A model-based approach was taken, estimating the effects for the German population aged 14 to 79 y over a 10-y period. Taxation was assumed to affect beverage-associated sugar consumption via empirical demand elasticities. Altered consumption affected caries increments and treatment costs, with cost estimates being calculated under the perspective of the statutory health insurance. National representative consumption and price data were used to estimate tax revenue. Microsimulations were performed to estimate health outcomes, costs, and revenue impact in different age, sex, and income groups. Implementing a 20% SSB sales tax reduced sugar consumption in nearly all male groups but in fewer female groups. The reduction was larger among younger than older in iduals and among those with low income. Taxation reduced caries increment and treatment costs especially in younger (rather than older) in iduals and those with low income. Over 10 y, mean (SD) net caries increments at the population level were 82.27 (1.15) million and 83.02 (1.08) million teeth at 20% and 0% SSB tax, respectively. These generated treatment costs of 2.64 (0.39) billion and 2.72 (0.35) billion euro, respectively. Additional tax revenue was 37.99 (3.41) billion euro over the 10 y. In conclusion and within the limitations of this study’s perspective, database, and underlying assumptions, implementing a 20% sales tax on SSBs is likely to reduce caries increment, especially in young low-income males, thereby also reducing inequalities in the distribution of caries experience. Taxation would also reduce treatment costs. However, these reductions might be limited in the total population.
Publisher: American Public Health Association
Date: 02-2016
Publisher: Wiley
Date: 15-05-2009
Publisher: BMJ
Date: 08-2016
Publisher: Wiley
Date: 04-07-2015
DOI: 10.1111/IPD.12177
Abstract: Cost-utility analysis using the quality-adjusted life years (QALY) as an outcome measure to inform healthcare resource allocation is becoming more common. The Child Health Utility 9D (CHU9D) enables the calculation of utility values in children. Children were involved throughout its development to ensure it is child centred. To determine whether the CHU9D is responsive to the changing components of the dmfs+DMFS index score in children receiving dental care over a 1-year period. The study s le comprised children aged 6 to 9 years old who were enrolled in a split-mouth, placebo-controlled randomised controlled trial. All children had a comprehensive clinical examination including radiographs and health-related quality of life (HRQoL) was measured using the CHU9D at baseline and 1 year. Descriptive statistics was followed by bivariate analyses before effect sizes were calculated. A negative binomial model was fitted to assess whether the utility score predicted the components of decayed and filled teeth (combined primary and permanent teeth). Eighty (92%) children completed the CHU9D at baseline and follow-up. They presented with a mean baseline d3mfs+D3MFS of 6.7 (SD = 7.1), which rose to 7.3 (SD = 7.0) at follow-up. The mean CHU9D score improved from 0.88 to 0.90 from baseline to follow-up. No statistically significant relationships were found between caries status and the CHU9D score. The CHU9D was found to be unresponsive to the changing components of dental caries experience.
Publisher: Wiley
Date: 25-01-2022
DOI: 10.1111/CDOE.12726
Abstract: To compare periodontitis prevalence estimates obtained using the new classification system with those generated using other case definitions from the literature, examine the strength of the association between tobacco smoking and periodontitis (and that between periodontitis and its impact on oral‐health‐related quality of life OHRQoL) using those definitions. We conducted a secondary analysis of data from the 2009 New Zealand Oral Health Survey, a cross‐sectional dental examination survey of a representative s le of people aged 18 or over. We identified cases using 10 different periodontitis case definitions and then compared weighted prevalence estimates across those. The associations between smoking and periodontitis, and between periodontitis and short‐form Oral Health Impact Profile (OHIP‐14) scores, were then compared across the various case definitions. There was considerable variation in periodontitis prevalence estimates (range 3% to 59%). All definitions (but one) showed a higher prevalence of periodontitis in smokers than in non‐smokers. The new classification stage III definition showed the strongest association, with an adjusted prevalence ratio of 1.99 (95%CI: 1.35, 2.91). All case definitions (but one) had a higher mean OHIP‐14 score among people with periodontitis. Periodontitis prevalence estimates are greatly influenced by case definition choice. The new classification system may be more accurate than any other used to date, but questions remain about its utility for periodontal epidemiology.
Publisher: Wiley
Date: 2002
DOI: 10.1111/J.1708-8208.2002.TB00149.X
Abstract: Step-wise reduction in loading protocols is necessary to evaluate early loading of implants with mandibular overdentures. To compare the success rates of two different dental implant systems following conventional or early loading protocols in patients being rehabilitated with mandibular overdentures. Forty-eight edentulous participants were randomly allocated to two different implant systems: one with a machined titanium implant surface (Sterioss, Nobel Biocare, Yorba Linda, California, USA) and the other with a roughened titanium surface (Southern Implants, Irene, South Africa). For each system, the participants were further ided into control groups, in whom mandibular implant overdentures and their respective matrices were inserted following a standard 12-week healing period, and test groups, in whom a 6-week healing period was followed prior to identical loading. Two unsplinted implants to support implant overdentures were placed in the anterior mandible of all participants, using a standardized one-stage surgical procedure. Mobility tests and marginal bone levels, as well as peri-implant parameters, were evaluated at each baseline and 52 and 104 weeks after surgery. There was no statistically significant difference in the success rates of the two systems in either control or test groups. At the 2-year evaluation, a success rate was found of 87.5% and 70.8% for the control and test Sterioss groups, respectively, and 83.3% and 100% for the control and test Southern Implants groups were observed. For the Sterioss groups, eight implants were lost at an early stage: seven in the test group and one in the control group. For the Southern Implants control and test groups, no failures were seen at any time interval. There were no significant differences in marginal bone loss, Periotest values, and peri-implant parameters between implant systems or between any of the control or test groups. Early loading, with step-wise reductions in loading protocols, of unsplinted machined Sterioss and roughened Southern Implants fixtures with mandibular overdentures is possible for up to 2 years.
Publisher: Springer Science and Business Media LLC
Date: 2014
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.JDENT.2017.03.006
Abstract: This systematic review and meta-analysis evaluated the association between developmental defects of enamel and dental caries in the primary dentition. Electronic searches were performed in PubMed, Web of Knowledge, Scopus and Scielo for the identification of relevant studies. Observational studies that examined the association between developmental defects of enamel and dental caries in the deciduous dentition were included. Additionally, meta-analysis, funnel plots and sensitivity analysis were employed to synthesize the available evidence. Multivariable meta-regression analysis was performed to explore heterogeneity among studies. A total of 318 articles were identified in the electronic searches. Of those, 16 studies were included in the meta-analysis. Pooled estimates revealed that children with developmental defects of enamel had higher odds of having dental caries (OR 3.32 95%CI 2.41-4.57), with high heterogeneity between studies (I This systematic review and meta-analysis demonstrates a clear association between developmental defects of enamel and dental caries in the primary dentition.
Publisher: American Public Health Association
Date: 2015
Abstract: Objectives. This study aimed to clarify the relationship between community water fluoridation (CWF) and IQ. Methods. We conducted a prospective study of a general population s le of those born in Dunedin, New Zealand, between April 1, 1972, and March 30, 1973 (95.4% retention of cohort after 38 years of prospective follow-up). Residence in a CWF area, use of fluoride dentifrice and intake of 0.5-milligram fluoride tablets were assessed in early life (prior to age 5 years) we assessed IQ repeatedly between ages 7 to 13 years and at age 38 years. Results. No clear differences in IQ because of fluoride exposure were noted. These findings held after adjusting for potential confounding variables, including sex, socioeconomic status, breastfeeding, and birth weight (as well as educational attainment for adult IQ outcomes). Conclusions. These findings do not support the assertion that fluoride in the context of CWF programs is neurotoxic. Associations between very high fluoride exposure and low IQ reported in previous studies may have been affected by confounding, particularly by urban or rural status.
Publisher: Wiley
Date: 10-10-2016
Abstract: The aim of this article is to add to the literature on the sociology of oral health and dentistry by presenting the relevance of status passage to the study of complete tooth loss. The article reports on an analysis of data taken from participants residing in the Nelson region of New Zealand. In total the data include interviews from 20 participants, all of whom had their remaining natural teeth removed before 1960. In total, 12 women and eight men were interviewed. All were from a European background with an age range of 71 to 101 years. Following a narrative approach, participants were interviewed on the nature of the social factors that resulted in complete tooth loss by starting with their family history and then focusing on the factors and events leading up to their total tooth loss. Data were analysed using the methods and techniques of grounded theory. This article provides an outline of the importance of scheduling, prescribing, social factors, 'compound awareness contexts' and reversibility to the status passage into complete tooth loss. We conclude by arguing that the theory of status passage may enable a detailed analysis of the 'time-space extensionality' of trajectories into complete tooth loss.
Publisher: Springer Science and Business Media LLC
Date: 15-03-2021
Publisher: Wiley
Date: 17-12-2010
DOI: 10.1111/J.1708-8208.2010.00306.X
Abstract: Different attachment systems for mandibular two-implant overdentures could influence levels of patient satisfaction. Positive consensus of the majority of patients being satisfied does not preclude the possibility of dissatisfaction for some. To evaluate patient satisfaction and dissatisfaction before and after 5 years of wearing mandibular two implant overdentures using different attachment systems to determine the prognostic relevance of pretreatment complete denture complaints to treatment outcomes. A total of 106 edentulous participants enrolled in a clinical trial completed a preliminary self-report inventory of their original complete denture complaints.New complete maxillary dentures and mandibular two-implant overdentures were provided to each participant using one of six different attachment systems. Patient satisfaction was determined at pretreatment at baseline with mandibular two-implant overdenture insertion and then annually for 5 years, using visual analogue and Likert-type scales. Patient satisfaction with mandibular two-implant overdentures showed significant changes pre- to posttreatment(baseline) in all domains, but these were significant immediately and maintained without further significance for 5 years, other than pain with the overdenture. After 5 years, no significant differences were observed with all the attachment systems. Highly significant differences were found with some social and psychological aspects by the fifth year compared to baseline. Diagnostic and prognostic indicators from a pretreatment inventory identified 12 participants (13.5%) who were dissatisfied. These indicators revealed a maladaptive predisposition to mandibular two-implant overdentures. The provision of mandibular two-implant overdentures will, in the majority of patients, significantly enhance levels of patient satisfaction for 5 years, as compared to complete mandibular dentures, regardless of the attachment system. Careful evaluation of pretreatment complaints with conventional dentures can possibly identify patient dissatisfaction with mandibular two-implant overdentures [corrected].
Publisher: SAGE Publications
Date: 19-01-2011
Abstract: The long-term effects of poor maternal oral health are unknown. We determined whether maternal oral health when children were young was a risk indicator for caries experience in adulthood, using oral examination and interview data from age-5 and age-32 assessments in the Dunedin Study, and maternal self-rated oral health data from the age-5 assessment. The main outcome measure was probands’ caries status at age 32. Analyses involved 835 in iduals (82.3% of the surviving cohort) dentally examined at both ages, whose mothers were interviewed at the age-5 assessment. There was a consistent gradient in age-32 caries experience across the categories of maternal self-rated oral health status (from the age-5 assessment): it was greatest among the probands whose mothers rated their oral health as “poor” or who were edentulous, and lowest among those whose mothers rated their oral health as “excellent”. Unfavorable maternal self-rated oral health when children are young should be regarded as a risk indicator for poor oral health among offspring as they reach adulthood.
Publisher: Wiley
Date: 10-02-2017
DOI: 10.1111/CDOE.12285
Abstract: To conduct cross-national comparison of education-based inequalities in tooth loss across Australia, Canada, Chile, New Zealand and the United States. We used nationally representative data from Australia's National Survey of Adult Oral Health Canadian Health Measures Survey Chile's First National Health Survey Ministry of Health US National Health and Nutrition Examination Survey and the New Zealand Oral Health Survey. We examined the prevalence of edentulism, the proportion of in iduals having <21 teeth and the mean number of teeth present. We used education as a measure of socioeconomic position and measured absolute and relative inequalities. We used random-effects meta-analysis to summarize inequality estimates. The USA showed the widest absolute and relative inequality in edentulism prevalence, whereas Chile demonstrated the largest absolute and relative social inequality gradient for the mean number of teeth present. Australia had the narrowest absolute and relative inequality gap for proportion of in iduals having <21 teeth. Pooled estimates showed substantial heterogeneity for both absolute and relative inequality measures. There is a considerable variation in the magnitude of inequalities in tooth loss across the countries included in this analysis.
Publisher: Wiley
Date: 06-2006
Publisher: Elsevier BV
Date: 03-2005
Publisher: Wiley
Date: 04-11-2010
Publisher: Springer Science and Business Media LLC
Date: 29-09-2019
DOI: 10.1007/S00784-018-2652-2
Abstract: Differences in oral health perceptions complicate comparisons of self-reported oral health in countries with considerably different cultures, traditions, and dental care. We compared it in China and New Zealand (NZ), to determine whether adults in those countries differ in how self-report oral health item responses distinguish those with different clinical oral disease states. Analysis of representative data on dentate 35-44-year-olds and 65-74-year-olds from the 3rd National Oral Health Survey of China in 2005 (for Sichuan province) and the NZ Oral Health Survey in 2009. Self-rated oral health in the Chinese survey was assessed by asking "Overall, how would you rate your oral health?"(responses: "Very poor," "Poor," "Fair," "Good," and "Very good"). The NZ survey asked "How would you describe the health of your teeth or mouth?" (responses: "Excellent," "Very good," "Good," "Fair," or "Poor"). To enable comparability, these were combined to create a four-category ordinal measure of self-reported oral health. The slope index of inequality (SII) and the relative index of inequality (RII) determined the extent to which the four-category self-report item distinguished those with better or poorer oral status. A higher proportion of Chinese than NZ 35-44-year-olds rated their oral health as poor or fair, and the NZ proportion rating their oral health as very good was four times that observed among Chinese. The 65-74-year-olds differed even more in their overall responses. For most aspects of clinical disease experience, the two populations were responding similarly to the self-reported oral health item, although the SII and RII values were more pronounced among 35-44-year-olds in NZ than in China among 65-74-year-olds, both countries were more similar. Chinese and NZ adults' self-ratings reflect their oral disease experience in largely similar ways, despite considerable absolute differences. These findings support the cross-cultural applicability of self-report oral health measures.
Publisher: SAGE Publications
Date: 18-09-2020
Abstract: Dementia is a major contributor to dependence and disability in older people, with aging societies characterized by growing numbers of people living with the condition. Dementia rates are highest in those with low education early in life, midlife hypertension, midlife hearing loss, depression, obesity, loneliness, a sedentary lifestyle, or sustained exposure to smoking or diabetes. Tooth loss is a putative risk factor for dementia which has received increasing research attention, but systematic review findings are mixed. Three main mechanisms have been proposed, involving 1) tooth loss leading to compromised nutrition and then leading to poorer central nervous system (CNS) function 2) tooth loss resulting in fewer interocclusal contacts and so less somatosensory feedback to the CNS, leading to impaired cognition and (3) chronic periodontitis resulting in tooth loss, but not before the inflammation has affected the CNS, impairing cognition. None of these is supported by compelling empirical evidence. Here, we use the life course approach to propose a plausible, empirically supported explanation for the associations between missing teeth and poorer cognitive function in older people. Evidence from longstanding cohort studies demonstrates that the putative association arises from cognitive function much earlier in life, in childhood. People with better childhood cognitive function have better oral health and access to routine dental care as they go through life, losing fewer teeth along the life course. They are also much more likely to have better cognitive function in old age. Their less cognitively able childhood counterparts will experience higher disease rates and poorer access to care, resulting in greater incremental tooth loss. Comparison of the 2 groups at any age from the mid-20s on will show greater numbers of missing teeth in the group who were less cognitively able in childhood. Those differences will be most pronounced in old age.
Publisher: Wiley
Date: 22-08-2012
DOI: 10.1111/J.1600-0757.2011.00405.X
Abstract: As one of the most common chronic diseases suffered by adults, periodontitis affects sufferers' day-to-day lives and is a threat to the integrity of the dentition. An important part in the condition's occurrence is played by sociobehavioural factors, the understanding of which is facilitated by using a number of largely complementary theoretical frameworks. Differences among in iduals with respect to their periodontal status at any particular point in their life-course (and particularly once they are into early middle-age and beyond) are likely to have resulted from prolonged and differential exposure to the various protective and risk factors that determine their periodontal status. Thus, a sound understanding of the psychosocial pathways of the behaviors that are strongly linked to periodontal disease - and how such psychological factors affect the response of the periodontal tissues to pathogens - is essential for improving periodontal health, whether at the personal level or at the population level. Controlling periodontitis in populations therefore requires a number of complementary strategies. The current state of knowledge of its risk factors means that there is sufficient information to enable control of the disease, and public health officials should include it alongside their efforts to control dental caries. Controlling periodontitis has three strategies: (i) a population strategy for altering life practices, particularly those determining smoking behavior and oral self-care (plaque removal) in the community (ii) a secondary prevention strategy to detect and treat people with destructive periodontal disease and (iii) a high-risk strategy for treating existing disease and preventing further disease in those at special risk. The Common Risk Factor Approach and the health promotion approach are key aspects of these strategies.
Publisher: Springer Science and Business Media LLC
Date: 08-11-2006
Publisher: SAGE Publications
Date: 04-10-2013
Abstract: This study aimed to determine the impact of dental caries in terms of Oral Health–Related Quality of Life (OHRQoL) for Cambodian children. The Child Perceptions Questionnaires (CPQ) were cross-culturally adapted and validated for the Cambodian population using a s le of 430 Cambodian children. The participants had a high caries burden, with a mean number of decayed-missing-and-filled deciduous tooth surfaces (dmfs) of 8.8 (SD = 11.1) and a mean DMFS of 3.7 (SD = 5.5) for the permanent dentition. Two in 5 children had at least one pulpally involved tooth. There was a significant difference in mean CPQ 8-10 and CPQ 11-14 scores by caries experience and by global item response for the respective age-groups, with those in the more severe caries categories scoring higher. Similar gradients were apparent with the CPQ 11-14 in the 8- to 10-year age-group. The differences in OHRQoL scores by caries experience demonstrate the construct validity of the CPQ 11-14 for the 8- to 14-year age-group.
Publisher: Springer Science and Business Media LLC
Date: 12-2013
Publisher: SAGE Publications
Date: 24-04-2021
DOI: 10.1177/00220345211007747
Abstract: The study aimed to quantify the excess risk of interaction between high free sugars (sugars) intake and lack of exposure to water fluoridation on child dental caries. Data from the Australian National Child Oral Health Study, a population-based survey of 24,664 children aged 5 to 14 y, were collected using parental questionnaires and oral epidemiological examinations by trained examiners. Information on socioeconomic status, dental health behaviors, and dental service use was used as covariates. The number of servings of sugars-containing foods and drinks consumed in a usual day was assessed as the main exposure, categorized into 5 groups. Residential history was used to calculate lifetime exposure to fluoridated water (LEFW), categorized as low ( %), medium (25% to %), or high (75%–100%). Caries prevalence (dmfs/DMFS ) and experience (dmfs/DMFS) in the primary (ages 5–10 y) and permanent (ages 8–14 y) dentitions were the main dependent variables. The association of sugars intake and LEFW with each outcome was estimated in multivariable log-Poisson regression models with robust standard error estimation, adjusted for covariates. The relative excess risk due to interaction (RERI) between sugars intake and LEFW was estimated. Strong positive gradients in all outcomes were observed across sugars intake groups. Relative to the lowest intake group, the 3 highest intake groups had significantly higher adjusted prevalence ratios for having caries and higher adjusted mean ratios of caries experience in both dentitions, after controlling for all covariates. LEFW strongly and consistently attenuated the effects of all levels of sugars intake on the outcomes. RERI estimates indicated that a combination of lack of exposure to fluoridated water and high sugars intake resulted in greater excess risk of primary and permanent caries than if there was no interaction. Evidently, children with high sugars intakes and low exposure to water fluoridation are at disproportionately higher risk of dental caries.
Publisher: Wiley
Date: 17-03-2011
DOI: 10.1111/J.1708-8208.2010.00332.X
Abstract: Patient-based outcomes with maxillary overdentures on a minimum number of implants, opposing mandibular 2-implant overdentures are not evident in the literature. To evaluate patient's satisfaction with maxillary 3-implant overdentures, opposing mandibular 2-implant overdentures, using two different attachment systems over the first 2 years of service. Forty participants wearing mandibular 2-implant overdentures for 3 years were randomly allocated to one of two similar implant system groups to receive maxillary 3-implant overdentures. Twenty participants were allocated to splinted and unsplinted attachment system treatment groups for each system. Patient satisfaction with pre-treatment complete maxillary dentures, with maxillary 3-implant overdentures at baseline and annually for 2 years, was measured using visual analogue scale questionnaires and the oral health impact profiles. Palatal coverage of the maxillary overdentures was reduced at the first annual recall. Data showed significant improvement in pain reduction, comfort, stability, and function variables of the visual analogue scale after treatment. Analysis by prosthodontic design using visual analogue scale showed no significant difference. The total oral health impact profile-14 scores after treatment for all participants, regardless of prosthodontic design, were significantly lower (more satisfied). The overall oral health impact profile-20E score at baseline was significantly higher (more satisfied) compared with pre-treatment conventional maxillary dentures. No significant changes were observed in the first or second years compared with baseline results. Twenty-two participants (84.6%) preferred reduced palatal coverage, regardless of prosthodontic design, after 1 year. Twenty participants (76.9%) still preferred reduced palatal coverage at the end of the second year. The provision of maxillary 3-implant overdentures to oppose mandibular 2-implant overdentures significantly improve levels of patient satisfaction compared with conventional maxillary dentures.
Publisher: Springer Science and Business Media LLC
Date: 10-2013
Abstract: To describe the occurrence of dental caries at the person, tooth and tooth surface level from childhood to early mid-life. No studies have reported on age and caries experience in a population-based s le through the first half of life. Prospective cohort study of a complete birth cohort (n = 1,037) born in 1972/73 in Dunedin, New Zealand. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32 and 38, and participation rates remained high. Surface-level caries data were collected at each age (WHO basic methods). Statistical analyses and graphing of data were undertaken using Intercooled Stata Version 10. Data are presented on dental caries experience in the permanent dentition at ages 9, 15, 18, 26, 32 and 38. Percentile curves are charted and reported for person-level caries experience. Data are also presented on the number of decayed teeth and tooth surfaces, (including root surfaces at age 38), as a function of the number of teeth and surfaces present, respectively. Across the cohort, the number of tooth surfaces affected by dental caries increased by approximately 0.8 surfaces per year (on average), while the percentage of at-risk tooth surfaces affected by caries increased by approximately 0.5% per year, with negligible variation in that rate throughout the observation period. These unique data show clearly that dental caries continues as a disease of adulthood, remaining important beyond childhood and adolescence and that rates of dental caries over time remain relatively constant.
Publisher: FapUNIFESP (SciELO)
Date: 2021
DOI: 10.1590/1807-3107BOR-2021.VOL35.0135
Abstract: This study aimed to assess the association between oral health and rurality in an older Brazilian population. Population-based s les of 1,451 urban and 411 rural elders were obtained from two databases. Several oral health and related measures, including the number of teeth lost, use of dental prostheses, dental visits, self-reported oral health, and perceived need for a dental prosthesis, were compared. Oral health-related information was obtained by a trained research team with interviews conducted in the in iduals' homes. Regression models were used to verify the association between living in rural areas and oral health outcomes after adjusting for possible confounding factors. The elderly population mostly comprised of women in rural or urban areas, and the mean age was 70 years in both locations. Less-educated in iduals (without or with complete elementary schooling) were more common in rural regions than in urban areas. After adjustment for socioeconomic characteristics, living in rural areas was associated with a lower perceived need for dental prostheses (PR 0.68, 95% CI 0.56-0.84), poor self-reported oral health (OR 1.24 95% CI 1.05-1.46), and having fewer teeth (β -1.31 95% CI -2.18 to -0.45). The place of residence had a significant impact on oral health indicators, with rurality negatively influencing oral health. These findings suggest that preventive and curative strategies for dental services may be needed for the Brazilian rural population.
Publisher: Wiley
Date: 15-09-2020
DOI: 10.1111/GER.12494
Publisher: Elsevier BV
Date: 11-2002
Publisher: Wiley
Date: 02-10-2020
DOI: 10.1111/GER.12496
Publisher: Wiley
Date: 27-09-2011
DOI: 10.1111/J.1600-0579.2011.00706.X
Abstract: This study investigated associations between the performance of dental students in each of the three components of the selection procedure [academic average, Undergraduate Medicine and Health Sciences Admission Test (UMAT) and structured interview], socio-demographic characteristics and their academic success in an undergraduate dental surgery programme. Longitudinal review of admissions data relating to students entering dental education at the University of Otago, New Zealand, between 2004 and 2009 was compared with academic performance throughout the dental programme. After controlling for variables, pre-admission academic average, UMAT scores and interview performance did not predict performance as a dental student. Class place in second year, however, was a strong predictor of class place in final year. Multivariate analysis demonstrated that the best predictors of higher class placement in the final year were New Zealand European ethnicity and domestic (rather than international) student status. Other socio-demographic characteristics were not associated with performance. These interim findings provide a sound base for the ongoing study. The study found important socio-demographic differences in pre-admission test scores, but those scores did not predict performance in the dental programme, whether measured in second year or in final year.
Publisher: No publisher found
Date: 2014
DOI: 10.1016/J.JDENT.2014.02.010
Abstract: Despite improvement, dental caries is still the main public oral health problem worldwide and the major cause of pain, tooth loss and chewing difficulties in children and adolescents and it impacts negatively on oral health-related quality of life. A cross-sectional study of a multistage representative s le of 8-12-year-old Brazilian school children was carried out in order to investigate the association between enamel defects and dental caries. Children's mothers completed a questionnaire about socio-demographic and behavioural characteristics at home. Firth's bias reduced logistic regression models were undertaken to assess the association between the main exposure (enamel defects) and caries experience. The prevalence of any enamel defect was 64.0% the prevalence of diffuse opacities, demarcated opacities and enamel hypoplasia was 35.0%, 29.5% and 3.7%, respectively. The prevalence of dental caries was 32.4%, with mean DMFT of 0.6 (SD, 1.2). Dental caries experience was more common among children who had enamel hypoplasia in their posterior teeth (OR=2.79 95% CI: 1.05, 6.51) than among those with none. In anterior teeth, there was no association. Enamel hypoplasia appears to be an important risk factor for dental caries.
Publisher: MDPI AG
Date: 08-09-2020
Abstract: Empirical research critically examining the role of the corporate determinants of health has gained traction in the past few years. Many of these reports have received strong, sometimes litigious, backlash from the corporations exposed. The aim of this paper is to provide a critical commentary on existing literature, policies, procedures and observations of issues, especially regarding the use of the corporate determinants of health as a research construct, in the persistence and flourishing of oral health inequalities at a global level. We discuss theoretical frameworks that underpin the power constructs of the corporate determinants of health, including Lukes “three faces of power” theory. This theory posits that power is exercised in three ways: through decision-making, through non-decision-making and ideologically. We will demonstrate, using ex les of corporate determinants of health and oral health inequalities from several countries, how intervening at key leverage points is a crucial strategy for improving oral health inequalities at a global level.
Publisher: Wiley
Date: 27-10-2015
DOI: 10.1111/JGS.13784
Abstract: To investigate the association between lower extremity motor function and occlusion in older adults and to examine the possibility of dietary intake of protein mediating the association. Cross-sectional, population-based study. Urban and rural area in Japan. Community-dwelling septuagenarians (N = 655) and octogenarians (N = 629). Information was collected on occlusal force, protein intake, grip strength, walking speed, sociodemographic characteristics, and medical history. Multivariable logistic regression analysis was used to investigate the association between walking speed, occlusal force, and protein intake, and structural equation modeling analysis and mediation analysis were performed to investigate the validity of the hypothesized model and identify the indirect effect of protein intake in occlusal force and walking speed. The proportion of participants whose walking speed was 0.8 m/s or slower (slow walking speed) was 27.7%. Logistic regression analyses showed that slower walking speed was associated with occlusal force (odds ratio = 1.57, P = .001) after adjusting for medical history, body mass index, grip strength, and protein intake. The fit of the hypothesized model that walking speed was associated with occlusal force through protein intake was good, and the indirect effect was significant. Slower walking speed was associated with lower occlusal force. Lower protein intake mediated the association between walking speed and occlusal force. Maintaining occlusal force might prevent insufficient nutrition intake and further deterioration of motor function in older people.
Publisher: Wiley
Date: 26-08-2004
Publisher: Springer Science and Business Media LLC
Date: 15-02-2019
DOI: 10.1038/S41398-019-0430-9
Abstract: Large-scale epigenome-wide association meta-analyses have identified multiple ‘signatures’’ of smoking. Drawing on these findings, we describe the construction of a polyepigenetic DNA methylation score that indexes smoking behavior and that can be utilized for multiple purposes in population health research. To validate the score, we use data from two birth cohort studies: The Dunedin Longitudinal Study, followed to age-38 years, and the Environmental Risk Study, followed to age-18 years. Longitudinal data show that changes in DNA methylation accumulate with increased exposure to tobacco smoking and attenuate with quitting. Data from twins discordant for smoking behavior show that smoking influences DNA methylation independently of genetic and environmental risk factors. Physiological data show that changes in DNA methylation track smoking-related changes in lung function and gum health over time. Moreover, DNA methylation changes predict corresponding changes in gene expression in pathways related to inflammation, immune response, and cellular trafficking. Finally, we present prospective data about the link between adverse childhood experiences (ACEs) and epigenetic modifications these findings document the importance of controlling for smoking-related DNA methylation changes when studying biological embedding of stress in life-course research. We introduce the polyepigenetic DNA methylation score as a tool both for discovery and theory-guided research in epigenetic epidemiology.
Publisher: Springer Science and Business Media LLC
Date: 2014
Publisher: Wiley
Date: 28-09-2010
DOI: 10.1111/J.1752-7325.2010.00196.X
Abstract: This study aimed to test whether socioeconomic status (SES) in childhood may affect dental visiting patterns between ages 18 and 32 years. Using data from a complete birth cohort, childhood SES status was measured (using the New Zealand Elley-Irving index) at each study stage between birth and 15 years. Longitudinal dental visiting data were available for 833 study participants from ages 15, 18, 26, and 32, and these were analyzed by trajectory analysis. Three separate dental visiting trajectories were identified these were categorized as opportunists (13.1%), decliners (55.9%), and routine attenders (30.9%). Bivariate analyses showed low SES in childhood, male sex, and dental anxiety to be associated with membership of the "opportunist" dental visiting trajectory. Multinomial logistic regression showed that low childhood SES and dental anxiety were statistically significant predictors for membership in the opportunist or decliner trajectories after accounting for potential confounding variables. In iduals who grew up experiencing low childhood SES were less likely to adopt a routine dental visiting trajectory in adulthood than those with a high childhood SES. Dental anxiety was also an important predictor of dental visiting patterns.
Publisher: Informa UK Limited
Date: 02-01-2020
Publisher: Wiley
Date: 16-05-2016
DOI: 10.1111/GER.12227
Abstract: We explored the following research questions: (i) what challenges do dentists face when providing oral health care to dependent older adults and (ii) to overcome those challenges, what recommendations would dentists providing care give those planning and implementing oral health policy and services for dependent older adults? The dentate older population is steadily increasing, and about half will end up in residential care, where dental caries rates over time are at least twice as great as those observed elsewhere. A qualitative study was used, with semi-structured interviews conducted by a single interviewer. Dental examiners in a recent national survey of oral health in dependent older people in New Zealand were interviewed about their experiences and perspectives of that. The challenges participants identified stemmed from three areas - the patient, the care facility and the oral health sector. To address those challenges, the participants recommended actions at the patient, system and sector levels. Each of the challenges and recommendations had a number of subthemes. Overall, the dentists felt that it is a very complex situation urgently requiring policy development, cross-sectoral collaboration and upskilling of the dental profession, carers, the private sector and the State to ensure a care environment which supports achieving and maintaining oral health among frail elders. Urgent attention to frail older New Zealanders' oral health is needed. Such attention needs to focus on not only the narrow dental clinical preventive and therapeutic implications of those needs, but also on the broader health system and policy development challenges.
Publisher: American Public Health Association
Date: 04-2011
Abstract: Objectives. We assessed whether 3 models of life course socioeconomic status (critical period, accumulation of risk, and social mobility) predicted unsound teeth in adulthood among a Brazilian cohort. Methods. Life course data were collected on the 5914 live-born infants in the 1982 Pelotas Birth Cohort study. Participants' oral health was assessed at 15 (n = 888) and 24 (n = 720) years of age. We assessed family income trajectories and number of episodes of poverty in the life course through Poisson regressions, yielding unadjusted and adjusted prevalence ratios for number of unsound teeth at age 24 years. Results. The adjusted prevalence ratio for participants born into poverty was 30% higher than for those who were not. Participants who were always poor had the highest prevalence of unsound teeth those who were downwardly or upwardly mobile also had more unsound teeth than did other participants, after adjustment for confounders. More episodes of poverty were associated with greater prevalence of unsound teeth in adulthood. Conclusions. Poverty at birth and during the life course was correlated with the number of unsound teeth at 24 years of age.
Publisher: Wiley
Date: 16-02-2021
DOI: 10.1111/CDOE.12628
Abstract: To assess whether proportional contribution of unprocessed or minimally processed, processed or ultra‐processed foods to daily energy intake is associated with dental caries in US adults. This secondary cross‐sectional analysis included adults aged 20 to 59 years old with complete oral examinations, using data gathered from cycles 2011‐2012 and 2013‐2014 of the continuous National Health and Nutrition Examination Survey (NHANES). Dietary recall data were categorized according to the NOVA classification into four groups: unprocessed or minimally processed foods (Group 1), processed culinary ingredients (Group 2), processed foods (Group 3) and ultra‐processed foods (Group 4). The proportional contribution of each of these groups to mean daily energy intake was calculated and then cut into quartiles (Group 1, Group 3 and Group 4) or tertiles (Group 2). Two separate measures were used to assess dental caries: the decayed, missing, filled teeth (DMFT) index and, after exclusion of edentulous participants, prevalence of untreated caries. Poisson regression was used to model DMFT, while logistic regression was used to model the prevalence of untreated dental caries. Models were calculated for each NOVA group. All models were controlled for age, gender, race/ethnicity, level of education, income, access to oral health services, body mass index, smoking status and total energy intake. Analyses took into account NHANES s ling weights. We analysed data from 5720 in iduals, of whom 123 (2.2%) were edentulous. Mean DMFT was 9.7 (± 0.2), while the prevalence of untreated dental caries was 26.0%. Mean daily energy intake was 2170 kcal (± 17). Mean contribution to overall daily energy intake was 28.6% (± 0.5) for G1 foods, 4.3% (± 0.1) for G2 foods, 10.1% (± 0.2) for G3 foods and 56.9% (± 0.5) for G4 foods. A higher intake of G3 was associated with lower DMFT at the fourth quartile (0.89 95%: CI 0.81‐0.96), while a higher intake of G4 was associated with a higher DMFT at the fourth quartile (1.10 95% CI: 1.04‐1.16). In the adjusted models for untreated dental caries, no statistically significant associations were found with any of the NOVA groups. Higher proportional intake of NOVA groups is only weakly associated with dental caries. Widespread exposure to a highly ultra‐processed diet may explain these weak associations.
Publisher: Wiley
Date: 05-02-2020
DOI: 10.1111/GER.12464
Publisher: Wiley
Date: 27-02-2021
DOI: 10.1111/CDOE.12629
Abstract: To measure utility ratings and quality‐adjusted life‐years(QALYs) for nicotine dependence‐related health states using the standard gamble approach among a s le of dental patients investigate the possible associations of nicotine dependence, and study the influences on tobacco‐related health state utilities estimates among patients. A s le of 200 adult outpatients who were current or former consumers of tobacco were included in the cross‐sectional study. Demographic, oral health self‐rating and tobacco‐related data (Fagerstrom scale for nicotine dependence, type of tobacco consumed, frequency and duration of the habit) were collected. A standard gamble method of utility valuation was also carried out. Older age, lower educational attainment, higher frequency of consumption, increased duration of the habit, consumption of chewing tobacco, as opposed to smoking tobacco, and poor oral health were associated with higher nicotine dependence. Lower nicotine dependence, better oral health and quitting the habit were associated with better health utility estimates. QALYs lost due to the habit among the ‘low to moderate’ and ‘significant’ nicotine dependence groups were 2.7 (sd, 3.7) and 6.7 (sd, 8.0) years, respectively. Higher health utility ratings were seen among patients with ‘low to moderate’ nicotine dependence, better oral health status and quitters of the tobacco habit. Quality of life weights generated through this method could be used for cost‐utility analyses of tobacco cessation revention interventions in different settings and cultures.
Publisher: SAGE Publications
Date: 07-12-2020
Abstract: Dentistry is predominantly provided in a commercial context in Australia. Despite this, little is known about how dentists navigate potential tensions that may arise between commercial and professional obligations in private dental practice. This analysis uses a qualitative approach to explore dentists’ perceptions and attitudes toward the commercialized nature of private dental practice and how these affect their professional role in providing care. Participants were recruited by advertising on social media, as well as through a professional association and a corporate dental group’s graduate training program. Data were collected from participants through interviews and written reflections. The data were subjected to thematic analysis to reveal deeper meanings and linkages between different emergent themes. Twenty dentists who worked in private practice environments were recruited to take part. The analysis revealed the following themes within the data: dentistry devalued, commercial influences on professional behavior, the effect of advertising and competition on dentistry, ethical selling, and the impacts of commercialism on consumers of dentistry. Consumers of dentistry may only be superficially empowered by the commercialized context of private dental practice. Empowerment to decide which services to access and from whom does not address the inherent disparities that exist within the dentist-patient clinical relationship. Advertising and the active “selling” of oral health services are all designed to create dental consumers, not to empower them. While advertising might assist patients to understand available treatments, the primary objective of marketing is not health education. Increasing competition and consumer choice within dentistry may help to empower consumers of dental services but only if the dentist-patient relationship remains founded in altruistic intent, with the doctrine of “caveat emptor” (buyer beware) having no place within dentistry. This research provides novel insights into how dentists experience the commercial context of private dental practice and how this is perceived to be both beneficial and detrimental to the consumers of dental services. This work will help to guide policy development to address the commercial determinants of oral health generated by the nature of commercialized dental practice environments.
Publisher: Oxford University Press (OUP)
Date: 24-09-2021
Abstract: The demands of operational deployment mean that defense force personnel must be dentally fit. Although medical evacuation for dental causes should be avoided, dental emergencies are a major non-combat-related contributor to withdrawal from deployment. Information on the oral health status of recruits and officer cadets entering the New Zealand Defence Force (NZDF) is scarce, yet it is useful for service and workforce planning. We investigated oral health status and its associations in new recruits and officer cadets entering the NZDF over a 13-month period. This study used data from recruits’ initial dental examination (including baseline forensic charting), posterior bitewing radiographs, orthopantomograph radiograph, and a socio-dental questionnaire. The impaction status of third molar teeth was evaluated. Ethical approval was obtained from the University of Otago Ethics Committee (reference number D18/200) and the NZDF Organisational Research Committee. Of the 874 (83%) of the 1,053 recruits (age range 17-59 years) who participated, one in five were Māori. Nearly two-thirds were Army recruits. Caries prevalence was almost 70%. Mean Decayed, Missing, and Filled Teeth (DMFT) (3.0 overall) was higher among females and Māori. Few teeth were missing due to caries. Third molars were common, seen in 745 (88.3%). One in four maxillary third molars (but only one in six mandibular ones) had fully erupted. The most common type of impaction among mandibular third molars was the mesioangular type, followed by vertical, horizontal, and distoangular. Almost 60% of recruits had one or more potentially problematic third molars. The prevalence was highest in the youngest age groups, those of medium or low socioeconomic status and in Army or Navy recruits. Recruits’ oral health was acceptable, but potentially problematic third molars were common, indicating a need for careful assessment (and their possible removal) before operational deployment.
Publisher: Wiley
Date: 10-09-2007
Publisher: Springer Science and Business Media LLC
Date: 06-05-2014
Publisher: Microbiology Society
Date: 06-2013
Abstract: The prevalence of dental caries continues to increase, and novel strategies to reverse this trend appear necessary. The probiotic Streptococcus salivarius strain M18 offers the potential to confer oral health benefits as it produces bacteriocins targeting the important cariogenic species Streptococcus mutans , as well as the enzymes dextranase and urease, which could help reduce dental plaque accumulation and acidification, respectively. In a randomized double-blind, placebo-controlled study of 100 dental caries-active children, treatment with M18 was administered for 3 months and the participants were assessed for changes to their plaque score and gingival and soft-tissue health and to their salivary levels of S. salivarius , S. mutans , lactobacilli, β-haemolytic streptococci and Candida species. At treatment end, the plaque scores were significantly ( P = 0.05) lower for children in the M18-treated group, especially in subjects having high initial plaque scores. The absence of any significant adverse events supported the safety of the probiotic treatment. Cell-culture analyses of sequential saliva s les showed no differences between the probiotic and placebo groups in counts of the specifically enumerated oral micro-organisms, with the exception of the subgroup of the M18-treated children who appeared to have been colonized most effectively with M18. This subgroup exhibited reduced S. mutans counts, indicating that the anti-caries activity of M18 probiotic treatments may be enhanced if the efficiency of colonization is increased. It was concluded that S. salivarius M18 can provide oral health benefits when taken regularly.
Publisher: Wiley
Date: 03-2015
DOI: 10.1111/ADJ.12284
Abstract: Dry mouth is more common among older people than in any other age group. Appropriate definition and accurate measurement of dry mouth is critical for better understanding, monitoring and treatment of the condition. Xerostomia is the symptom(s) of dry mouth it can be measured using methods ranging from single questions to multi-item summated rating scales. Low salivary flow (known as salivary gland hypofunction, or SGH) must be determined by measuring that flow. The relationship between SGH and xerostomia is not straightforward, but both conditions are common among older people, and they affect sufferers' day-to-day lives in important ways. The major risk factor for dry mouth is the taking of particular medications, and older people take more of those than any other age group, not only for symptomatic relief of various age-associated chronic diseases, but also in order to reduce the likelihood of complications which may arise from those conditions. The greater the number taken, the greater the associated anticholinergic burden, and the more likely it is that the in idual will suffer from dry mouth. Since treating dry mouth is such a challenge for clinicians, there is a need for dentists, doctors and pharmacists to work together to prevent it occurring.
Publisher: Informa UK Limited
Date: 10-07-2020
Publisher: Wiley
Date: 04-07-2007
DOI: 10.1111/J.1600-0528.2007.00332.X
Abstract: Etiological models that predominantly emphasize current adult life styles, such as smoking, diet and lack of exercise have recently been seriously challenged by a growing body of evidence that disturbed early growth and development, childhood infection, poor nutrition, and social and psychosocial disadvantage across the life-course affect chronic disease risk, including chronic oral disease. This relatively new area of research is called life-course epidemiology. The life-course framework for investigating the aetiology and natural history of chronic disease proposes that advantages and disadvantages are accumulated throughout life generating differentials in health along the life-course, but most importantly later in life. Furthermore, its dynamic framework brings together the effects of intrinsic factors (in idual resources) with extrinsic factors (environmental factors). The aim of this paper is to give an overview of this new epidemiological approach and to discuss how the life-course framework has been applied to chronic oral conditions.
Publisher: Wiley
Date: 08-05-2002
DOI: 10.1034/J.1600-0528.2002.300302.X
Abstract: The objective was to determine whether the Dental Neglect and Dental Indifference scales measure similar constructs and have similar associations in the same population s le. A random s le of 600 residents in the Dunedin South Electorate were sent a self-report questionnaire containing the Dental Neglect scale and the Dental Indifference scale. Socio-demographic and dental service-use data were also collected. In all, 478 people (78.2%) returned the questionnaire. The mean Dental Neglect score was 12.4 (SD 4.4). The mean Dental Indifference scale score was 3.1 (SD 1.9). The association between the scales' scores was moderate (r = 0.58 P < 0.01), and there was only a moderate degree of concordance between the two. The two scales had largely similar associations with socio-demographic, oral care and self-care, and oral health impact characteristics, although slightly more associations were found with the Dental Indifference scale. The Dental Neglect scale was found to be easier to use than the Dental Indifference scale because it did not require a complex algorithm to compute scale scores. The degree of concordance between the Dental Neglect and Dental Indifference scales was not as high as expected, which suggests that the scales may measure different constructs. However, the largely similar associations with important oral health and socio-demographic variables of the scales suggest the opposite. Although the Dental Indifference scale was slightly more discriminative, the Dental Neglect scale was easier to use in practice.
Publisher: Elsevier BV
Date: 12-2004
Publisher: Wiley
Date: 05-12-2016
DOI: 10.1111/JCPE.12641
Publisher: Elsevier BV
Date: 05-2008
DOI: 10.1016/J.JDENT.2008.01.012
Abstract: To describe the working practices and level of job satisfaction of male and female dentists. A nationwide postal survey of all dentists holding an annual practising certificate in New Zealand (response rate 78.1%). The mean number of hours worked per week was 29.1 for female and 36.0 for male dentists. The main reason for part-time practice given by women was caring for children (cited by 67.2%) and for men was personal choice (cited by 63.6%). A greater proportion of females than males were employed on a salary or as an associate in practice rather than owning their own practice. Male dentists were more active in continuing education than females. The mean career satisfaction score for male respondents was 7.6 and for females 7.1 (P<0.001). Relatively more women than men had taken a career break, usually for child rearing. Two-thirds of women and one-third of men planned to retire from dentistry before 60 years of age. Male and female dentists differ in their working patterns and career satisfaction. There is a need for ongoing monitoring of the workforce, particularly as the gender distribution (and societal trends and expectations) continues to change.
Publisher: Wiley
Date: 09-03-2011
DOI: 10.1111/J.1600-9657.2010.00969.X
Abstract: Few studies have investigated how patients feel about traumatic injuries to teeth. Dentists may focus on treating an injury and neglect to address how the patient views the severity, or aesthetics. Addressing these issues may improve trauma management and communication between dentists and patients. The aim of the study was to compare children's, adolescents' and young adults' perceptions of common dental injuries to the maxillary central incisor teeth. A cross-sectional study was conducted with 138 participants selected by convenience s ling and ided into 6- to 10-year, 11- to 17-year and 18- to 24-year age groups. Participants were shown six coloured photographs of traumatic injuries to central incisors and asked four questions. Data were analysed using SPSS. Group differences were evaluated using Mann-Whitney U and Kruskal-Wallis H tests. There were statistically significant differences between the 6- to 10-year and 18- to 24-year age groups as to which traumatic injury would hurt the most (P < 0.05). Responses from younger participants appeared to be affected by the presence of blood in photographs, while young adults were more 'tooth-focused.' Younger children selected extrusion as the most painful injury, and the oldest group selected the complicated crown fracture. For the youngest age group, a missing anterior tooth was least concerning aesthetically, while young adults were most likely to choose discolouration (P < 0.05). Most in each age group thought crown fractures (particularly complicated ones) would be the most difficult for a dentist to treat. Statistically significant differences (P < 0.05) were found among the youngest and oldest age groups in their perceptions of which type of injury would hurt most and which injury was the least attractive. This study suggests that children and young adults may perceive the significance of their dental injuries quite differently than dental professionals.
Publisher: Wiley
Date: 10-01-2014
DOI: 10.1111/IPD.12091
Abstract: Oral-Health-Related Quality of Life (OHRQoL) instruments are useful outcome measures in dental health services research however, there are no reports of the use OHRQoL measures in evaluating the outcome of basic dental care in children anywhere. The aims of this study are to evaluate the responsiveness of the Khmer version of the Child Perceptions Questionnaire11-14 (CPQ11-14) and to describe changes in OHRQoL associated with the provision of basic dental care. A pre-test ost-test design, with a clinical convenience s le of children aged from 8 to 14 years of age who received basic dental care from a local nongovernmental organisation (NGO). Of the 140 children in the baseline s le, 116 (82.9%) were followed up. The mean change in CPQ11-14 overall score for those with caries was 1.7, representing a small improvement in OHRQoL. There was a moderate (one in three) statistically significant reduction in the prevalence of impacts across the whole s le (P < 0.001 McNemar test), and one in five improved by the minimally important difference (MID) of five-scale points. The Khmer version of the CPQ11-14 appears to be a valid and responsive measure for assessing treatment-associated changes in OHRQoL in children with dental caries in Cambodia.
Publisher: SAGE Publications
Date: 07-2005
DOI: 10.1177/154405910508400713
Abstract: While the use of adult oral-health-related quality-of-life (OHRQoL) measures in supplementing clinical indicators has increased, that for children has lagged behind, because of the difficulties of developing and validating such measures for children. This study examined the construct validity of the Child Perceptions Questionnaire (CPQ 11-14 ) in a random s le of 12- and 13-year-old New Zealanders. It was hypothesized that children with more severe malocclusions or greater caries experience would have higher overall (and subscale domain) CPQ 11-14 scores. Children (N = 430) completed the CPQ 11-14 and were examined for malocclusion (Dental Aesthetic Index) and dental caries. There was a distinct gradient in mean CPQ 11-14 scores by malocclusion severity, but there were differences across the four subscales. Children in the worst 25% of the DMFS distribution had higher CPQ 11-14 scores overall and for each of the 4 subscales. The construct validity of the CPQ 11-14 appears to be acceptable.
Publisher: Wiley
Date: 2004
DOI: 10.1111/J.1365-263X.2004.00512.X
Abstract: To determine the prevalence and severity of dental caries in a s le of urban Fijian school children. Cross-sectional. Children aged between 6 and 8 years who attended one of four primary schools in different localities of Suva completed self-report questionnaires and were examined for dental caries. A total of 704 children (response rate = 72.4%) returned questionnaires and were examined dentally. The prevalence of dental caries in the primary dentition was 87.6% and in the permanent dentition, 46.7%. The mean dfs and mean DFS were 8.43 (SD 7.82) and 2.38 (SD 1.37), respectively. High caries prevalence and severity were associated with infrequent brushing, snacking on sugar-containing foods, having seen a dentist before, and having last visited a dentist because of pain. The caries prevalence of the s le was comparable with findings from a national oral health survey conducted in 1985/86, but the caries severity was greater. As in other developing countries, this may be due to an increased availability of refined sugar products without a concurrent rise in oral health awareness. The study findings contribute to the overall picture of Fijian school children's dental health.
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/375407
Abstract: Historically, New Zealand has had the highest rates of edentulism in the world, but that rate has been falling quickly in recent decades. In 1997, projections were made for edentulism prevalence among 65–74-year-olds using national survey data from 1976 (where it was 72.3%) to 1988 (58.6%). That process assumed a logistic decline in edentulism, given that it would never have been 100% and will never get to 0%. This paper examines the validity of the projections using the estimate (29.6%) from the third national oral health survey, conducted in 2009 and considers the implications of this fall.
Publisher: MDPI AG
Date: 12-02-2019
DOI: 10.3390/DJ7010019
Abstract: Comparing oral health-related quality of life (OHRQoL) measures can facilitate selecting the most appropriate one for a particular research question/setting. Three child OHRQoL measures Child Perceptions Questionnaire (CPQ11–14), the Child Oral Health Impact Profile (COHIP) and the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) were used with 335 10- to 13-year-old participants in a supervised tooth-brushing programme in New Zealand. The use of global questions enabled their validity to be examined. Assessments were conducted at baseline and after 12 months. All three measures had acceptable internal consistency reliability. There were moderate, positive correlations among their scores, and all showed differences in the impact of dental caries on OHRQoL, with children with the highest caries experience having the highest scale scores. Effect sizes were used to assess meaningful change. The CPQ11–14 and the CARIES-QC showed meaningful change. The COHIP-SF score showed no meaningful change. Among children reporting improved OHRQoL, baseline and follow-up scores differed significantly for the CPQ11–14 and CARIES-QC measures, although not for the COHIP-SF. The three scales were broadly similar in their conceptual basis, reliability and validity, but responsiveness of the COHIP-SF was questionable, and the need to compute two different scores for the CARIES-QC meant that its administrative burden was considerably greater than for the other two measures. Replication and use of alternative approaches to measuring meaningful change are suggested.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.JDENT.2018.04.010
Abstract: Regular and/or preventive dental services utilization is an indicator of healthcare access and associated with improved health outcomes. We assessed the proportion of in iduals regularly reventively utilizing dental services, and how this was affected by demographic, health-related and social factors. Three electronic databases (Medline, Embase, Central) were searched (2005-2017). We included observational studies investigating the association between preventive/regular dental service utilization and age, oral and general health, edentulism, family structure and health literacy. The proportion of in iduals with regular reventive utilization overall and in different sub-groups were extracted. Random-effects meta-analyses, with subgroup analyses by region, were performed. Meta-regression was used to assess whether and how associations changed with time and countries' human developmental status (HDI). 103 studies on 7,395,697 participants from 28 countries were included. The global mean (95% CI) proportion of in iduals regularly reventively utilizing dental services was 54% (50-59%). In countries with higher HDI, more in iduals regularly reventively utilized services (p < 0.001). Age did not have a significant impact on utilization in adults (OR = 1.00 0.89-1.12). Utilization was significantly lower in younger than older children (OR = 0.52 0.46-0.59), in iduals with poorer general health (OR = 0.73 0.65-0.80) and poorer oral health (OR = 0.64 0.52-0.75), edentulous in iduals (OR = 0.32 0.23-0.41), and in iduals with less supportive family structures (OR = 0.81 0.73-0.89) or poor health literacy (OR = 0.41 0.01-0.81). The observed differences within populations did not significantly change with time and were universally present. Regular reventive utilization varied widely between and within countries. Understanding and tackling the reasons underlying this may help to consistently improve utilization. Higher developmental status of countries is reflected in greater regular reventive utilization of dental services. However, large demographic, health-related and social differences in utilization remain. These may contribute to dental health inequalities.
Publisher: Springer Science and Business Media LLC
Date: 2011
Publisher: Springer Science and Business Media LLC
Date: 02-2016
Publisher: Wiley
Date: 15-09-2012
DOI: 10.1111/CDOE.12001
Abstract: Socioeconomic disparities in oral health among adults have been observed in many countries, but it is not clear whether they exist in aspects of Oral Health-Related Quality of Life in Chile. Data were analyzed from the 1st National Health Survey (NHIS) of Chilean adults, conducted in 2003. It included questions on aspects of oral-health-related quality of life (OHRQoL), including problems ('always' or 'almost always') with speaking, eating, pain, or daily activities. These were the dependent variables. Covariates included age, sex, education level, rurality, smoking, general quality of life, the number of remaining teeth, the number of untreated decayed teeth, and the reason for the last dental visit. Multivariate modelling was used to describe disparities in aspects of OHRQoL, using education level as the marker for socioeconomic status. The s le comprised 3050 participants (54.7% female), of whom 49.0%, 40.5% and 10.5% had been educated to primary, secondary or tertiary level respectively. In the bivariate analysis, there were significant gradients in all four aspects of OHRQoL across those three categories. Covariates significantly associated with poorer OHRQoL were female gender, rurality, and poor self-reported general quality of life, and these were subsequently controlled for in the multivariate analysis. Adults with primary education (or less) were more likely than their tertiary-educated counterparts to report problems speaking (relative risk = 2.38 CI: 1.41, 4.05), trouble or pain (relative risk = 2.77 CI: 1.56, 4.91), discomfort in eating with others (relative risk = 2.35 CI: 1.34, 4.10), and interference with activities of daily living (relative risk = 2.29 CI: 1.15, 4.55). Those educated only to secondary level had relative risks which were lower than these but still significantly different from the reference category. The number of teeth with untreated caries was positively associated with impaired OHRQoL, and the number of remaining teeth was negatively associated with it. Socio-economic disparities in oral-health-related quality of life are apparent among Chilean adults, and remain after adjusting for dental status.
Publisher: Springer Science and Business Media LLC
Date: 04-2016
Abstract: The Cochrane Review on water fluoridation for the prevention of dental caries was published in 2015 and attracted considerable interest and comment, especially in countries with extensive water fluoridation programmes. The Review had two objectives: (i) to evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries, and (ii) to evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis. The authors concluded, inter alia, that there was very little contemporary evidence, meeting the Review's inclusion criteria, that evaluated the effectiveness of water fluoridation for the prevention of dental caries. The purpose of this critique is to examine the conduct of the above Review, and to put it into context in the wider body of evidence regarding the effectiveness of water fluoridation. While the overall conclusion that water fluoridation is effective in caries prevention agrees with previous reviews, many important public health questions could not be answered by the Review because of the restrictive criteria used to judge adequacy of study design and risk of bias. The potential benefits of using wider criteria in order to achieve a fuller understanding of the effectiveness of water fluoridation are discussed.
Publisher: MDPI AG
Date: 03-06-2020
Abstract: Oral health inequalities reflect social injustice. This is because oral health simultaneously reflects material circumstances, access to health services and inequities across the life course. Oral health inequalities between Indigenous and non-Indigenous populations are among the largest in the world. This paper provides a critical commentary on Indigenous oral health inequalities at an international level based on existing literature and policies. We include the role of systematic and institutionalized racism and how this enables the persistence and flourishing of Indigenous oral health inequalities. We discuss theoretical frameworks—including Shiffman and Smith’s Political Power Framework—that underpin the power constructs that contribute to those. This theory posits that power is exercised in four ways: (i) the power of ideas (ii) the power of the issue (iii) the power of the actors and (iv) the power of the political context. We will demonstrate, using ex les of Indigenous oral health inequalities from several countries, how intervening at key leverage points, acting simultaneously on multiple subsystems and counteracting the social determinants of health are crucial strategies for ameliorating Indigenous oral health inequalities at a global level.
Publisher: Informa UK Limited
Date: 2006
Publisher: Wiley
Date: 08-2016
DOI: 10.1111/CDOE.12248
Abstract: To examine the factor structure and other psychometric characteristics of the most commonly used child oral-health-related quality-of-life (OHRQoL) measure (the 16-item short-form CPQ Secondary data analyses used subnational epidemiological s les of 11- to 14-year-olds in Australia (N = 372), New Zealand (three s les: 352, 202, 429), Brunei (423), Cambodia (244), Hong Kong (542), Malaysia (439), Thailand (220, 325), England (88, 374), Germany (1055), Mexico (335) and Brazil (404). Confirmatory factor analysis (CFA) was used to examine the factor structure of the CPQ Caries experience varied, with mean DMFT scores ranging from 0.5 in the Malaysian s le to 3.4 in one New Zealand s le. Even more variation was noted in the proportion reporting only fair or poor oral health this was highest in the Cambodian and Mexican s les and lowest in the German s le and one New Zealand s le. One in 10 reported that their oral health had a marked impact on their life overall. The CFA across all s les revealed two factors with eigenvalues greater than 1. The first involved all items in the oral symptoms and functional limitations subscales the second involved all emotional well-being and social well-being items. The first was designated the 'symptoms/function' subscale, and the second was designated the 'well-being' subscale. Cronbach's alpha scores were 0.72 and 0.84, respectively. The symptoms/function subscale contained more of the items with greater impact, with the item 'Food stuck in between your teeth' having greatest impact in the well-being subscale, the 'Felt shy or embarrassed' item had the greatest impact. Repeating the analyses by world region gave similar findings. The CPQ
Publisher: S. Karger AG
Date: 29-12-2003
DOI: 10.1159/000073917
Abstract: Experience in practice has suggested that children with attention-deficit hyperactivity disorder (ADHD) tend to have higher numbers of diseased, missing and filled teeth (DMFT score) than children without the condition. To date, however, this impression has not been systematically investigated. A case-control study of children in Otago, New Zealand (case DMFT ≧ 5 control DMFT case status determined from School Dental Service dental records) was conducted by postal survey and reference to the School Dental Service records. Cases and controls were matched on age, sex, ethnicity, and school socio-economic status. The purpose of the study was to assess whether having ADHD was associated with higher odds of having high caries experience. Questionnaires were returned for a total of 128 case-control pairs. Conditional logistical regression analysis showed that, after controlling for fluoride history, medical problems, diet, and self-reported oral hygiene, children with ADHD had nearly 12 times the odds of having a high DMFT score than children who did not have ADHD (OR = 11.98 95% CI 1.13, 91.81). No other factors were significant predictors. Dental practitioners and parents should consider ADHD to be a condition that may affect children’s dental caries experience.
Publisher: Wiley
Date: 19-09-2007
DOI: 10.1111/J.1365-2842.2007.01797.X
Abstract: The aim of this study was to evaluate the provision of removable prosthodontic services, including implant-supported overdentures, by dentists and denturists. A structured questionnaire was mailed to 474 randomly chosen dentists and 156 denturists registered to practise in New Zealand. Information was sought on the range of removable prosthodontic services provided (including implant-supported overdentures) and the professional fees charged for them. From 410 respondents, there was an overall response rate of 67.43% 290 came from the dentists (males 78.6%, n = 228 females 21.48%, n = 62) and 120 from denturists (males 91.7%, n = 110 females 8.3%, n = 10). Most respondents were over 40 years of age, with one in three denturists (but only one in seven dentists) over 60 years of age. The extent of removable prosthodontic services varied. One-third of dentists referred complete denture patients and denturists referred a similar number of immediate denture cases. Denturists' complete denture, immediate denture and single reline prices were generally lower than those from dentists. Removable partial denture prices were similar. Implant-supported overdentures were recommended for edentulous patients by one-third of the dentists and three out of four denturists. Forty per cent of denturists (but only 10% of dentists) charged <NZ$1000 for complete dentures. (1NZ$ = US$ 0.75 1NZ$ = euro 0.56 1NZ$ = GBP 0.38) Implant-supported overdenture fees were predominantly in the range of NZ$1500-3000 for both groups, but one in four dentists and one in six denturists charged more than NZ$3000. Although both denturists and dentists both provide prosthodontic services, there is a professional fee differential between them. Denturists' lower fees provide a more economic option. Denturists are likely to steadily develop further inroads into the implant-supported overdenture market.
Publisher: S. Karger AG
Date: 2022
DOI: 10.1159/000527255
Abstract: Dental caries is an endogenous microbial community-based disease resulting from an ecological shift from dynamic stability to metabolic imbalance in a consortium of acidogenic and aciduric bacteria comprising the dental plaque biofilm. Participants were members of the Dunedin Multidisciplinary Health and Development Study, a longitudinal investigation of health and behaviour in a cohort born in Dunedin, New Zealand. Oral biofilm s les (collected at age 32 years) from anterior labial supragingival, posterior lingual supragingival, posterior subgingival, and the dorsum of the tongue habitats for 841 participants were analysed using checkerboard DNA-DNA hybridisation (CKB), focussing on 30 ecologically significant bacteria. Associations of CKB data with dental caries at ages 32 and 45 years were assessed using regression modelling, adjusting for potential confounders including sex, xerostomia, and oral hygiene. The putative periodontitis pathobiont i Tannerella forsythia /i (in the anterior supragingival biofilm) was associated with untreated caries at age 32 years. The percentage of total summed cell number counts for two putative periodontitis-associated species ( i T. forsythia and Micromonas micros /i ) was associated with greater caries experience at age 32 years and the development of new caries between age 32 and 45 years. Additionally, severe caries (3 + cavities) was associated with putative caries pathobionts ( i Lactobacillus fermentum, Lactobacillus plantarum /i ), periodontitis-associated species, and commensals ( i M. micros /i , i C ylobacter rectus, Streptococcus mitis /i biovar I i , Streptococcus mitis /i biovar II) in the subgingival biofilm. Participants with sustained poor oral hygiene through age 32 years not only had greater experience of caries by that age than those with good oral hygiene (fully adjusted incidence risk ratio = 5.10, 95% CI: 3.30, 7.89) but also experienced greater incidence of new caries from age 32 to 45 years (incidence risk ratio = 3.69, 95% CI: 2.62, 5.20). These findings provide evidence in support of the extended caries ecological plaque hypotheses, the polymicrobial aetiology of caries, and the integrated aetiology of dental caries and periodontal diseases. They also underscore the roles of poor oral self-care (particularly over the life course) and xerostomia in the occurrence and progression of caries.
Publisher: Wiley
Date: 26-06-2002
DOI: 10.1046/J.1445-5994.2002.00234.X
Abstract: Most descriptive pharmacoepidemiological reports are from studies of older people, and little is known about medication use by younger adults. The aim of the present study was to examine the prevalence of medication usage in the previous 2 weeks among young adults. Detailed information was collected on medications taken by 26-year-old participants in the longstanding Dunedin Multidisciplinary Health and Development Study. At age 26, 980 (96.2%) of the surviving cohort participated medication data were available for 978 in iduals, of whom 78.1% had taken one or more prescribed or over-the-counter medications. Medication use was higher among females. The most prevalent drug categories were analgesics (taken by 22.8% of the s le), hormonal contraceptives (21.9% 44.7% of females), nutrient supplements (17.6%) and anti-asthma drugs (11.1%). The prevalence and pattern of medication use among younger adults differ from those reported for older age groups. Asthma appears to be the most prevalent chronic medical condition requiring pharmacological intervention (and for which medical care has been sought) among younger adults. The low rates of use of antidepressants and anxiolytics suggest that common psychiatric disorders may currently go unrecognized or untreated among young adults, and the high prevalence of 'third generation' oral contraceptive use among females is of particular concern.
Publisher: Wiley
Date: 26-01-2012
DOI: 10.1111/J.1600-9657.2012.01114.X
Abstract: Knowledge of the impact of traumatic dental injuries (TDI) on children's quality of life is sparse. To determine the association between TDI and oral health-related quality of life (OHRQoL) among schoolchildren aged 11-14 years. A cross-sectional study was carried out involving a representative s le of 409 schoolchildren from 13 municipalities in the Midwest Region of the Brazilian Southern State of Santa Catarina. Clinical examination included the presence and type of TDI and the treatment provided (or needed) according to criteria used in the UK Children's Dental Health Survey. Dental caries in anterior teeth and malocclusion status were also collected according to WHO criteria. OHRQoL was assessed using the short form of the Child Perceptions Questionnaire (CPQ11-14), and the outcome was the prevalence of one or more adverse impacts on quality of life occurring often/very often. The prevalence of TDI was 16.6% (95% CI 13.0-20.2). The prevalence of one or more adverse impacts occurring often/very often was 46.6% (95% CI 41.7-51.5). Logistic regression modeling for the outcome indicated an independent and significant association between the prevalence of one or more adverse impacts occurring often/very often and the presence of TDI even after adjustment for gender, presence of dental caries in anterior teeth and malocclusion. A prevalence ratio of 1.79 (95% CI 1.16-2.76) of one or more adverse impacts occurring often/very often in schoolchildren with TDI was found, compared to those without TDI. Traumatic dental injuries appear to affect schoolchildren's OHRQoL.
Publisher: Wiley
Date: 09-2002
DOI: 10.1902/JOP.2002.73.9.1010
Abstract: While partial-mouth recording is often used in epidemiological studies of periodontal disease because of the efficiencies afforded in data collection, there has been no investigation of the extent to which information is lost in studies of young adults using the combined attachment loss (CAL) approach. A random s le of 25- and 26-year-olds was periodontally examined at 3 sites per tooth in all 4 quadrants. The analysis obtained full-mouth prevalence estimates for gingival recession (GR), probing depth (PD), and CAL. The half-mouth analyses took 3 forms: 1) estimates from each of the left and right sides were obtained and compared 2) estimates were obtained separately and compared for quadrants 1 and 3 (upper right and lower left), and quadrants 2 and 4 (upper left and lower right) and 3) estimates were obtained from a diagonal half-mouth count, whereby quadrants 1 and 3 were analyzed for study participants whose identification number was odd, and quadrants 2 and 4 were analyzed for the remainder. The utility of the half-mouth and full-mouth approaches in analytical epidemiology was examined by estimating the strength of the association between periodontitis prevalence and smoking, male gender, and episodic use of dental care. Of the 169 participants examined, 100 (59.2%) were female, 54 (32.0%) were smokers, and 78 (46.2%) were episodic dental visitors. The difference in prevalence estimates obtained from the different methods was considerably greater for GR than for PD and CAL. The unadjusted odds ratio (OR) for the prevalence of 1 or more teeth with > or = mm of CAL among smokers was 2.3 (95% confidence interval [CI] 1.0, 5.3) using the full data set and 2.4 (95% CI 0.9, 6.1) using the diagonal half-mouth approach. Similarly close odds ratios were observed for males and, to a lesser extent, for episodic dental visitors. Wherever possible, full-mouth data should be collected for descriptive epidemiological studies of periodontal disease, but where resource and time constraints mean that half-mouth examinations must be used, analytical studies of periodontitis should not be unduly affected by the loss of information. However, where the primary focus of the latter is upon gingival recession, the full-mouth design should be used in order to capture all relevant information, and attention should be directed to making economies in other areas of the data collection process.
Publisher: Wiley
Date: 05-2014
Abstract: Data on the periodontal status of the adult population in the Arab world are scarce. The aim of this pilot study is to assess the prevalence, extent, and severity of periodontal diseases in an adult group from Oman. This is a cross-sectional study of 319 teachers who were randomly s led from the list of teachers from the Muscat region schools in Oman. Dental caries, tooth loss, and periodontal attachment loss (AL) were recorded for each of the participants. A questionnaire collected data on participants' sociodemographic characteristics, dental-care characteristics, self-rated periodontal status, and self-rated well-being. A total of 99% of participants had at least one site with probing depth (PD) or clinical AL of ≥ 3 mm. More than one third (36%) of participants had at least one site with AL ≥ 5 mm, and 12% had at least one site with AL ≥ 6 mm for PD, the prevalence estimates were 26% and 8%, respectively, and a gradient by age group was evident across the different thresholds. Regarding the extent of disease, 17.6% of sites had PD ≥ 3 mm, and 21% of sites had AL ≥ 3 mm. The prevalence, extent, and severity of periodontitis were higher than estimates reported from industrialized countries, such as Australia, New Zealand, and the United States. This is of concern, especially when considering the relatively young age of the study population. Because of this high prevalence, investigation of periodontitis in a national s le of Omanis is desirable to confirm the findings of this study.
Publisher: Wiley
Date: 2008
DOI: 10.1111/J.1754-4505.2008.00002.X
Abstract: The purpose of this study was to examine New Zealand general dentists' beliefs about older people's oral health and to identify the important barriers that prevent dentists from treating institutionalized older adults. A postal survey was distributed nationwide to a representative s le of 700 dentists (response rate 64.5%). Dentists' beliefs were mostly consistent with current epidemiological knowledge, although most (81.5%) mistakenly believed that the root surface caries increment was greater than that for coronal caries. One in four had visited a long-term care (LTC) facility during the previous 2 years. Over three-quarters cited the inconvenience of leaving their practices as a barrier, and the lack of a financial incentive was cited by almost half. The results suggested that the areas most in need of attention were the LTC staff's oral health knowledge and attitudes, as well as government policies. Although dentists' beliefs, practices, and attitudes occasion some optimism, the increase in the dentate older population means that policymakers will need to examine efficient, dentist-acceptable ways of delivering care. The profession will need to develop and sustain an appropriate workforce.
Publisher: American Medical Association (AMA)
Date: 04-2007
DOI: 10.1001/ARCHPSYC.64.4.476
Abstract: A cardinal feature of the DSM-IV diagnostic criteria for conduct disorder is the distinction between childhood- vs adolescent-onset subtypes. Whether such developmental subtypes exist in the population and have different prognoses should be rigorously tested to inform the DSM-V. To evaluate the epidemiological validity of childhood- vs adolescent-onset conduct problems in a prospective birth cohort, and to assess whether life-course-persistent conduct problems are associated with a greater adult health burden. Our s le includes 526 male study members in the Dunedin Multidisciplinary Health and Development Study, a 1-year birth cohort (April 1, 1972, through March 30, 1973). Developmental trajectories were defined using prospective ratings of conduct problems at 7, 9, 11, 13, 15, 18, 21, and 26 years of age. Health burden was assessed as mental and physical health problems at 32 years of age measured via diagnostic interviews and physical examinations. We identified the following 4 developmental subtypes of conduct problems through general growth mixture modeling: (1) childhood-onset/life-course-persistent, (2) adolescent onset, (3) childhood limited, and (4) low. At 32 years of age, study members with the life-course-persistent subtype experienced the worst health burden. To a lesser extent, those with the adolescent-onset subtype also experienced health problems. A childhood-limited subtype not specified by DSM-IV was revealed its adult health outcomes were within the range of the cohort norm. Results support the epidemiological validity of the DSM-IV conduct disorder distinction based on age of onset but highlight the need to also consider long-term persistence to refine diagnosis. Preventing and treating conduct problems has the potential to reduce the adult health burden.
Publisher: Wiley
Date: 22-12-2003
Publisher: Oxford University Press (OUP)
Date: 17-02-2009
Abstract: Limited information is available regarding the occupational health status of dentists (particularly in New Zealand), although previous research suggests that stress, hand dermatoses and musculoskeletal symptoms are common. To determine the occupational health status of New Zealand dentists. A nationwide postal survey of a representative s le of 750 dentists. There was a response rate of 77%. Most dentists (71%) reported their general health as very good or excellent 43% rated their physical fitness as excellent or very good and 64% were happy and interested in life. Workplace bullying had been experienced by 19% and was higher for female and employee dentists and 29% had experienced a violent or abusive incident at work. Almost half of the s le (47%) had experienced at least one dermatitis-type condition in the previous 12 months. The most commonly reported sites for musculoskeletal problems experienced in the previous year were the neck (59%), lower back (57%) and shoulders (45%). Women had a higher prevalence of several occupational health problems, but were more satisfied with their overall health than male dentists. The majority of dentists had good general health, but physical fitness levels were not ideal. The prevalence of hand dermatoses and musculoskeletal problems are high and impact significantly on dentists' daily lives. Interventions such as reducing weight and training in optimal working methods to reduce musculoskeletal problems and injuries (such as eye or needlestick incidents) might improve the health of this workforce but further research is required.
Publisher: Wiley
Date: 03-2020
DOI: 10.1111/GER.12458
Publisher: Wiley
Date: 23-04-2018
DOI: 10.1111/GER.12337
Abstract: To investigate clinical oral disease and its association with cognitive function and dependency among older New Zealanders in residential aged care. National survey of oral health in aged residential care throughout New Zealand. We classified residents into 1 of 3 levels of care: "low dependency care (or assisted living)" "high dependency care" or "specialist dementia care sychogeriatric care." The Abbreviated Mental Test characterised cognitive function as "unimpaired" (scores of 7-10), "moderately impaired" (4-6) or "severely impaired" (0-3). Intra-oral examinations were conducted, along with a computer-assisted personal interview. Most of the 987 clinically examined participants were either at low or high dependency care level, with another 1 in 6 in psychogeriatric care. Almost half overall had severely impaired cognitive function. Just under half of the s le had 1 or more natural teeth remaining. Negative binomial regression modelling showed that the number of carious teeth was lower among women and higher among those who were older, those with more teeth and in those with severely impaired cognitive function. Oral debris scores (representing plaque biofilm and other soft deposits on teeth) were higher in men, those with more teeth, and in those with severely impaired cognitive function. Impaired cognitive function is a risk indicator for both dental caries and oral debris in aged residential care.
Publisher: American Psychological Association (APA)
Date: 03-2014
DOI: 10.1037/A0035687
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1111/J.1753-6405.2011.00736.X
Abstract: to systematically compare methods and some findings from two prospective cohort studies of oral health. This paper describes and compares two such population-based birth cohort studies of younger adults: the Dunedin Multidisciplinary Health and Development Study (conducted in New Zealand) and the 1982 Pelotas Birth Cohort Study (conducted in Brazil). The two cohorts showed socio-demographic similarities and differences, with their gender mixes being similar, but their ethnic compositions differing markedly. There were some important similarities and differences in methods. Overall dental caries experience was higher among the Dunedin cohort. Each of the studies has examined the association between childhood-adulthood changes in socio-economic status and oral health in the mid-20s. Both studies observed the greatest disease experience among those who were of low SES in both childhood and adulthood, and the least among those who were of high SES in both childhood and adulthood. In each cohort, disease experience in the upwardly mobile and downwardly mobile groups lay between those two extremes. There are important similarities and differences in both methods and findings. While the need for a degree of methodological convergence in future is noted, the two studies are able to use each other as replicate s les for research into chronic oral conditions.
Publisher: Wiley
Date: 07-2018
DOI: 10.1111/ADJ.12623
Abstract: Many women believe that their dental condition deteriorated during pregnancy or as a result of having children. Epidemiological studies have reported an association between higher parity and tooth loss, and higher parity and periodontal attachment loss. Several possible explanations for this association exist. First, hormonal changes during pregnancy affect the immune response to bacterial plaque and drive vascular and gingival changes that may contribute to heightened gingival inflammation. These changes are transient, without irreversible loss of periodontal attachment, and post-partum resolution can be expected for most women. For women with destructive periodontal disease, the effects of pregnancy and parity are unclear. Second, it is also plausible that parity and socioeconomic position (SEP) have shared risk factors, increasing the incidence of disease or influencing its management. Education, one aspect of SEP, is an important determining factor for women's fertility rate, with a gradient of fewer children with higher educational attainment. Higher levels of education are also favourably associated with behaviours conducive to oral health, and a lower incidence of damaging health behaviours. Thus, the potential for confounding is considerable. This review examines the literature on the association between pregnancy, parity and periodontal health, and explores sociobehavioural mechanisms for the observed association.
Publisher: Wiley
Date: 12-2000
DOI: 10.1902/JOP.2000.71.12.1840
Abstract: Most research efforts in periodontal epidemiology have focused on middle-aged or older people, giving a picture of disease occurrence at a relatively late stage in the natural history of the condition. There is a paucity of comprehensive descriptive data from younger age groups. Understanding the epidemiology and clinical presentation of the condition earlier in the disease course may enable more appropriate interventions. The aim of this study was to describe the occurrence of gingival recession, probing depth, periodontal attachment loss (AL), and gingivitis among participants at age 26 in the Dunedin Multidisciplinary Health and Development Study. Gingival recession and probing depth were measured at 3 sites per tooth in 2 randomly selected contralateral quadrants. At age 26, 980 (96.2%) of the surviving cohort participated and periodontal data were available for 914 in iduals. Over 70% of the s le had one or more teeth with > or = 1 mm of gingival recession and it was observed at over 20% of midbuccal sites. Over 15% had 1 or more sites with probing depths of > or = 4 mm and nearly 20% had 1 or more sites with > or = 4 mm of AL. The extent of gingival recession was greatest for midbuccal sites on mandibular premolars, followed by midbuccal sites on maxillary premolars and mandibular molars. In the mandible, more distolingual sites had probing depths of > or = 4 mm, but a higher percentage of mesiobuccal sites was affected in the maxilla, and molars were the most affected, followed by premolars, incisors, and canines. Bleeding after probing was more extensive in the mandible than in the maxilla. Periodontal disease appears to be well-established among a small proportion of young adults. The prevalence of gingival recession was higher than expected, with clear differences by site. Pocketing and AL were more prevalent in mesiobuccal and distolingual sites than the buccal sites, with differences between the jaws.
Publisher: American Medical Association (AMA)
Date: 06-02-2008
Publisher: Wiley
Date: 05-10-2023
DOI: 10.1111/CDOE.12910
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.ULTRAS.2013.06.015
Abstract: This paper investigates the mechanical behaviour and energy releasing characteristics of bedded-sandstone with bedding layers in different orientations, under uniaxial compression. Cylindrical sandstone specimens (54 mm diameter and 108 mm height) with bedding layers inclined at angles of 10°, 20°, 35°, 55°, and 83° to the minor principal stress direction, were produced to perform a series of Uniaxial Compressive Strength (UCS) tests. One of the two identical s le sets was fully-saturated with water before testing and the other set was tested under dry conditions. An acoustic emission system was employed in all the testing to monitor the acoustic energy release during the whole deformation process of specimens. From the test results, the critical joint orientation was observed as 55° for both dry and saturated s les and the peak-strength losses due to water were 15.56%, 20.06%, 13.5%, 13.2%, and 13.52% for the bedding orientations 10°, 20°, 35°, 55°, and 83°, respectively. The failure mechanisms for the specimens with bedding layers in 10°, 20° orientations showed splitting type failure, while the specimens with bedding layers in 55°, 83° orientations were failed by sliding along a weaker bedding layer. The failure mechanism for the specimens with bedding layers in 35° orientation showed a mixed failure mode of both splitting and sliding types. Analysis of the acoustic energy, captured from the acoustic emission detection system, revealed that the acoustic energy release is considerably higher in dry specimens than that of the saturated specimens at any bedding orientation. In addition, higher energy release was observed for specimens with bedding layers oriented in shallow angles (which were undergoing splitting type failures), whereas specimens with steeply oriented bedding layers (which were undergoing sliding type failures) showed a comparatively less energy release under both dry and saturated conditions. Moreover, a considerable amount of energy dissipation before the ultimate failure was observed for specimens with bedding layers oriented in shallow angles under both dry and saturated conditions. These results confirm that when rock having bedding layers inclined in shallow angles the failures could be more violent and devastative than the failures of rock with steeply oriented bedding layers.
Publisher: Informa UK Limited
Date: 02-01-2020
Publisher: Wiley
Date: 21-01-2013
DOI: 10.1111/CDOE.12036
Abstract: To develop short-form versions of the Parental-Caregivers Perceptions Questionnaire (P-CPQ) and Family Impact Scale (FIS). Pretest ost-test clinical studies involved parent-completed questionnaires (the P-CPQ and the FIS) before and some weeks after dental care (under general anaesthesia) for early childhood caries (ECCs) in consecutive clinical s les from Wellington and Auckland. Deriving the short-form versions used only the baseline data from the Wellington s le (N = 195), whereas their evaluation used both baseline and follow-up data from the Auckland s le (N = 144 followed up). Item impact analysis was used to identify the 8 and 16 items with the greatest impact. An eight-item short-form FIS version was obtained in the same way. In the Wellington s le, Cronbach's α for the full, 16- and 8-item P-CPQ scales was 0.92, 0.89 and 0.82, respectively, and it was 0.88 and 0.85 for the full and eight-item FIS. Cross-sectional concurrent validity in the Wellington s le was acceptable for all short forms. Examining their responsiveness in the Auckland s le, large decreases post-treatment were observed in the short-form P-CPQ scores which were similar in relative magnitude to those seen with the full version. The full and short-form FIS scale scores showed moderate decreases. The reliability, validity and responsiveness of the short-form versions were acceptable in these settings with children suffering from severe ECC however, before they can be treated as definitive measures for use in health services research to determine the effects of clinical interventions for ECC, their test-retest reliability should be examined and further validation undertaken.
Publisher: S. Karger AG
Date: 28-11-2012
DOI: 10.1159/000345078
Abstract: b i Objective: /i /b To determine whether coronal caries experience through to the 30s predicts root surface caries experience by age 38. b i Method: /i /b Prospective study of a complete birth cohort (n = 1,037) born in 1972/73 in Dunedin, New Zealand. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32 and 38. Root surface caries data were first collected at age 38. Data from ages 5 through 32 were used previously to identify low, medium and high life course trajectories of caries experience and plaque accumulation. b i Results: /i /b Of the 916 dentate in iduals examined at age 38, 23.0% had 1+ root DFS, 17.2% had 1+ root DS and 11.4% had 1+ root FS. The mean root DS, FS and DFS were 0.6 (SD 3.5), 0.3 (SD 1.1) and 0.9 (SD 3.8), respectively. The mean Root Caries Index (RCI) score was 7.2% (SD 18.0). Age 38 coronal DMFS and root surface caries DFS were only weakly correlated (r = 0.32), but root surface caries experience was strongly associated with coronal caries trajectory, with the mean RCI in the low, medium and high caries trajectory groups being 4.4, 8.0 and 13.5%, respectively (p 0.0001) their prevalence of 1+ root DFS was 14.5, 25.9 and 42.2% (p 0.0001). Those in the high coronal caries trajectory were more likely to have 1+ root surface DFS (odds ratio = 3.83 95% CI = 2.33–6.30) for the medium trajectory, the odds ratio was 1.86 (95% CI = 1.25–2.75). b i Conclusion: /i /b Lifelong coronal caries experience (represented by discrete longitudinal trajectories of caries experience) is indeed a risk factor for root surface caries experience by age 38.
Publisher: Wiley
Date: 22-12-2022
DOI: 10.1111/CDOE.12831
Abstract: The first steps towards gender equity in science are measuring the magnitude of inequity and increasing awareness of the problem. To describe trends in gender disparities in first and last authorship in the most cited dental publications and general dental literature over a 20‐year period. Articles and bibliometric data were retrieved from the Scopus database for the period 1996 to 2015. Two groups of 1000 articles each were retrieved: a random s le and another s le of top‐cited articles for each year. The gender of the first and last author of each publication was manually identified. When this was not possible, we used an online software platform ( genderize.io/ ). Descriptive analyses identified the proportion of women first and last authors in both s les, stratifying by dental discipline and geographic region. Trends were ascertained by frequency metrics across years. Gender disparity was observed in both first and last authorship, with a larger gap being observed in the top‐cited s le. Women led 28.4% and 20.3% of articles in the random and top‐cited s les, respectively. A similar pattern was observed for the last authorship group (22.1% and 16.1%, respectively). An increasing trend in the proportion of articles led by women over time was observed in both s les. This increase was larger in the top‐cited s le (from 15.0% in 1996–2000 to 25.1% in 2015) than in the random s le (from 26.3% in 1996–2000 to 33.2% in 2011). Clear gender disparities in dental research publications in the last 20 years were identified in both general and top‐cited manuscripts, across dental disciplines, across countries, across first and last authorship, and over time. It is paramount that actions are taken to attract, retain and promote women in science, as well as to monitor and ensure progress towards gender equity.
Publisher: Wiley
Date: 30-08-2005
DOI: 10.1111/J.1600-9657.2005.00319.X
Abstract: This study investigated the periodontal and dental trauma resultant from tongue and lip piercings in a convenience s le of 43 adult dental patients. Patients underwent an intra-oral examination followed by the administration of a questionnaire. Each patient was examined for lingual or buccal recession of the upper and lower incisors as well as the extent of abnormal toothwear or trauma on these teeth. Following bivariate analyses, regression analyses were conducted to test the study hypotheses and derive adjusted estimates for the dependent variables. Of the 43 in iduals who participated (93.0% females mean age 21 years age range 14-34 years) 76.7% had a tongue piercing, 34.9% had a lip piercing, and 11.6% had both. Only four had had their piercing procedure provided by a doctor or dentist. Postpiercing complications were reported by 34.9%. Most of those with a labial piercing (80.0%) had 1+ labial site with gingival recession (GR), and almost one-third of those with a tongue piercing had at least one lingual site with GR. Age was a significant predictor of the prevalence of lingual recession, with the odds of having lingual recession increasing by 1.17 (95% CI 1.01, 1.35) for every year older than 14. Age was the only significant predictor of the number of lingual sites with recession, but was not a predictor of the prevalence of labial recession or the number of affected sites. There were no significant associations between piercings and abnormal toothwear or trauma. These findings suggest that oral piercings are associated with localized gingival recession, and that the providers of such procedures should ensure that, as part of the informed consent process, prospective patients are informed of the likelihood that their periodontal health may be compromised.
Publisher: Elsevier BV
Date: 09-2006
Publisher: Wiley
Date: 20-02-2011
Publisher: Wiley
Date: 12-1995
DOI: 10.1111/J.1741-2358.1995.TB00139.X
Abstract: Medication has long been implicated as a potential risk factor for dental caries among elderly people, although epidemiological studies have reported inconsistent associations between medication usage and dental caries experience. This paper aimed to describe the frequency of medication usage, and to examine associations between medication usage and dental caries experience among non-institutionalized persons aged 60+ years in South Australia. A cross-sectional survey design was used to collect interview data about prescription medication usage from 1,650 people. Oral examinations were conducted among 848 people to obtain information about coronal and root canes experience. The number of prescribed medications taken ranged from 0 to 17, and the mean number taken was 1.8 (sd, 1.9). This was higher in older subjects and females. Four medication categories accounted for almost three-quarters of the medications taken of those, cardiovascular drugs (including diuretics) accounted for three, with analgesics the only non-cardiovascular class. Subjects taking 3 or more prescription medications had a higher Root Caries Index (RCI, mean = 14.43 P < 0.01) than those taking one or two (mean = 11.50), and those who were taking none (mean = 12.02). Examination of particular medication types revealed that people who took antidepressants and antiulcer drugs had significantly higher RCI values (P < 0.05). There was only a moderate association between medication usage and root caries experience which may be attributable to xerogenic effects of medication, or non-causal associations with underlying medical conditions.
Publisher: Wiley
Date: 30-07-2021
DOI: 10.1111/ODI.13536
Abstract: Previous studies of the nutritional status of older in iduals have used measures such as plasma vitamin and mineral levels, which can be difficult to interpret. The relationship between nutrition and dentition has been limited to studying exposures such as the number of posterior occluding pairs of teeth, edentulousness, and the number of natural teeth. To investigate the association between dentition status and nutritional status in a national survey of older New Zealanders living in aged residential care facilities. Secondary analysis of clinical oral status and nutrition data collected in 2012 in New Zealand's Older People's Oral Health Survey. The validated Mini Nutritional Assessment short format was used to categorize participants as “normal nutritional status,” “at risk of malnutrition” or “malnourished.” Just under half of older New Zealanders living in aged residential care facilities were classified as either at risk of malnutrition or malnourished (with about one in sixteen in the latter category). The prevalence of malnutrition was higher among those in hospital‐level and psychogeriatric‐level care, as well as in those of high socioeconomic status. In iduals who were at risk of malnutrition had the most untreated dental caries and untreated coronal caries. Relative to their counterparts in nursing‐home‐level care, dentate in iduals in hospital‐level care were 2.4 times—and those in psychogeriatric‐level care were 2.8 times—as likely to be malnourished or at risk of it. Just under half of the New Zealanders living in aged residential care were at risk of malnutrition or were malnourished. Greater experience of untreated dental caries was associated with a higher rate of being malnourished or at risk of it. Poorer cognitive function and greater dependency were important risk indicators for malnutrition.
Publisher: Wiley
Date: 20-05-2018
DOI: 10.1111/DDI.12777
Publisher: Wiley
Date: 02-2014
DOI: 10.1111/JOOR.12144
Abstract: Pain resulting from the application of orthodontic forces varies markedly across in iduals. The reasons of this variability are still largely unknown. To investigate factors that may be associated with orthodontic pain following the application of orthodontic separators. One hundred and seven participants were screened for pain response over 48 h following placement of orthodontic elastomeric separators. The highest (n = 10) and lowest (n = 10) pain responders were identified, and data collected on tooth pain sensitivity to electrical stimulation in conjunction with using the Pain Catastrophising Scale (PCS), Dental Anxiety Scale (DAS) and cold pressor test (CPT). There were statistically significant differences between high- and low-pain responders in catastrophising score (P ≤ 0.023). For every PCS magnification score of 1 unit higher, the relative risk of being a high-pain responder was 1.6 (P = 0.002) those scoring higher on helplessness had a lower risk of being so. DAS scores of high-pain responders were twice as high as those of low-pain responder (P = 0.043). During the first 2 min of CPT, the high-pain responders experienced more pain than the low-pain responders (P ≤ 0.029). Tooth pain thresholds did not differ between the two different pain responder groups. Pain catastrophising, dental anxiety and cold sensitivity appear to modify the pain experienced following placement of orthodontic separators. Further research is needed to determine the validity of screening questions to identify at-risk patients prior to commencing orthodontic treatment.
Publisher: Wiley
Date: 28-03-2013
DOI: 10.1111/EOS.12034
Abstract: The objective of this study was to examine, using structural equation modelling, the relationships among clinical characteristics (such as caries experience and malocclusion), oral health-related quality of life (OHRQoL), and psychological characteristics (mental health, self-esteem, somatisation, and social perception of body image) in adolescents in New Zealand. Adolescents were examined for malocclusion using the Dental Aesthetic Index (DAI) and for dental caries. Among the 353 (58.8%) 12- and 13-yr-old adolescents who took part in this cross-sectional study, the overall mean ± SD decayed, missing, or filled surfaces (DMFS) value was 1.6 ± 3.0, with slightly more than 50% of being caries-free the mean ± SD DAI was 31.5 ± 7.6, with one-quarter of subjects having a 'handicapping' malocclusion. The structural equation modelling analysis showed that the structural model was a good fit to the data. As hypothesized, the DAI score significantly predicted OHRQoL. There was no direct relationship between caries experience (DMFS) and OHRQoL, but there was an indirect effect of DMFS on OHRQoL mediated through psychological characteristics. The amount of OHRQoL variance accounted for in the model was substantial, at 62%. It appears that investigating OHRQoL in adolescents is not straightforward while malocclusion directly affects OHRQoL, the influence of dental caries experience is less direct.
Publisher: Wiley
Date: 06-08-2013
DOI: 10.1111/ADJ.12076
Abstract: Modern population based oral health management requires a complete understanding of the impact of disease in order to provide efficient and effective oral health care and guidance. Periodontitis is an important cause of tooth loss and has been shown to be associated with a number of systemic conditions. The impact of oral conditions and disorders on quality of life has been extensively studied. However, the impact of periodontitis on quality of life has received less attention. This review summarizes the literature on the impact of periodontitis on oral health-related quality of life (OHRQoL). Relevant publications were identified after searching the MEDLINE and EMBASE electronic databases. Screening of titles and abstracts and data extraction was conducted. Only observational studies were included in this review. Most of the reviewed studies reported a negative impact of periodontitis on OHRQoL. However, the reporting standards varied across studies. Moreover, most of the studies were conducted in developed countries.
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.OOOO.2014.03.001
Abstract: Xerostomia and tooth loss are major oral health problems in the elderly. The aim of this longitudinal study was to characterize the influence of xerostomia on oral health-related quality of life (OHRQoL) among elderly Japanese people. A total of 99 community-dwelling, independently living in iduals aged 60 years and older were interviewed and underwent dental examination at baseline and at a 5-year follow-up. The Oral Health Impact Profile-14 and the Xerostomia Inventory were used to assess OHRQoL and xerostomia severity, respectively. Participants whose xerostomia worsened over the 5-year period had a significantly poorer follow-up OHRQoL. Linear regression models showed that tooth loss and worsening xerostomia were significant predictors of poorer follow-up OHRQoL. Tooth loss and worsening xerostomia result in poorer OHRQoL among older Japanese people.
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.AJODO.2016.04.019
Abstract: The impact of orthodontic treatment on oral health-related quality of life (OHRQoL) in adolescents being treated in orthodontic practices has not yet been explored longitudinally. The aim of this cohort study was to describe the changes in both malocclusion and OHRQoL with orthodontic treatment. One hundred seventy-four patients (ages, 10-17 years 64.4% girls 81.6% European) underwent 2-arch, fixed-appliance treatment in a 4-year prospective study conducted across 19 specialist orthodontic practices throughout New Zealand. They were assessed before treatment, at debond (when 87.4% of the baseline s le were reassessed), and at a mean 21 months postdebond (when 59.4% of the baseline s le were reassessed). OHRQoL was measured using the Child Perceptions Questionnaire, and the Dental Aesthetic Index was used to measure occlusion. Among the 104 patients who took part in all 3 assessments, little change in OHRQoL overall was seen at the end of treatment, despite considerable improvement in malocclusion (with the mean Dental Aesthetic Index score falling from 35.9 at baseline to 21.3 at debond). The mean Child Perceptions Questionnaire 11-14 was slightly greater at debond, and this was most notable in the functional limitations subscale. By the end of the study (21 months postdebond, on average), the decreases in Child Perceptions Questionnaire 11-14 scores were all substantial, especially in the emotional well-being and social well-being subscales. Malocclusion affects orthodontic patients' OHRQoL before treatment. A temporary increase in symptomatic impacts seen by the debond stage appears to ameliorate with time, with the benefits of orthodontic treatment for OHRQoL manifesting themselves some months later.
Publisher: Elsevier BV
Date: 02-2006
DOI: 10.1016/J.AJODO.2005.10.003
Abstract: The purpose of this retrospective study was to identify (and quantify the effect of) factors that influence orthodontic treatment time. The s le consisted of 366 consecutive orthodontic patients (220 female, 146 male, aged 10-20 years, treated by 1 orthodontist) who completed treatment in a single stage with fixed appliances. Four categories of data (sociodemographic characteristics, malocclusion characteristics, treatment methods, and patient cooperation) were collected from treatment records and analyzed. Average treatment time was 23.5 months (range, 12-37 SD, 4.7). A multiple regression model explained 38% of the variance and identified 9 significant variables. Five were pretreatment characteristics: male sex, maxillary crowding of 3 mm or more, Class II molar relationships, proposed treatment plan involving extractions, and delayed extractions. The remaining variables (3 of which were associated with patient cooperation) were poor oral hygiene, poor elastic wear, bracket breakages, and brackets rebonded for repositioning. Orthodontic treatment time is influenced by a number of patient characteristics and clinical decisions. It is possible to predict estimated treatment time for a patient by using a small number of personal characteristics and treatment decisions.
Publisher: Informa UK Limited
Date: 04-05-2022
Publisher: Springer Science and Business Media LLC
Date: 24-07-2015
DOI: 10.1007/S00784-015-1526-0
Abstract: This study aims to assess the validity of four self-reported questions for measuring periodontitis in a birth cohort. Full-mouth periodontal examinations (three sites/tooth) were undertaken at age 38 in a complete birth cohort born in 1972/1973 in New Zealand. Four self-reported periodontal screening questions were included ("Do you think you have gum disease" "Has a dental professional ever told you that you have lost bone around your teeth" "Have you ever had scaling, root planing, surgery, or other treatment for gum disease" and "Have you ever had any teeth that have become loose by themselves without some injury"), and the sensitivity and specificity of those self-reported items were calculated for in idual questions and using a multivariable binary logistic regression model. Generalised linear models were used to compare relative risks for periodontitis and smoking, using the (a) clinical measures and (b) self-reported questions. Among the 895 who had periodontal examinations, the prevalence of periodontitis was 43.7, 22.8 and 12.0 %, respectively, for one or more sites with ≥4, ≥5 and ≥6 mm clinical attachment loss (AL). The specificity of the four self-reported questions was high (82-94 %), but the sensitivity was low for all, except the question: "Do you think you have gum disease". The four questions' highest combined sensitivity + specificity value was 1.33 for one or more sites with ≥4 mm AL, with the area under the receiver operating characteristic (ROC) curve being greatest for one or more sites with ≥6 mm AL, at 0.84. For the smoking-periodontitis association, the estimates of relative risk for periodontitis among smokers were as follows: (a) 1.81, 2.88 and 5.79, respectively, clinically determined to have one or more sites with ≥4, ≥5 and ≥6 mm AL and (b) 2.19, 2.17, 1.23 and 1.89, respectively, for the four self-reported questions. The four self-reported periodontal screening questions performed adequately in identifying clinically determined periodontal disease, and they showed moderate validity when used together as a set. However, the strength of the association between smoking and periodontitis was underestimated when they were used instead of clinically determined periodontal disease. These findings suggest that clinical examinations remain to be the desired approach for periodontal surveys, but where resource constraints preclude those, self-reported methods can provide useful information after all, some periodontal information is better than none at all.
Publisher: Wiley
Date: 29-07-2008
DOI: 10.1111/J.1708-8208.2007.00070.X
Abstract: There is an absence of conclusive evidence for occlusal schemes in implant overdentures. To investigate the consequences of two different occlusal schemes on levels of satisfaction for patients wearing implant overdentures. Within an existing randomized controlled clinical trial, a physiologic occlusal scheme was compared with a lingualized occlusal scheme for 18 selected participants all with implant overdentures. Nine participants had conventional maxillary complete dentures opposing mandibular 2-implant overdentures a further nine participants had maxillary 3-implant overdentures opposing mandibular 2-implant overdentures. All participants recruited had been wearing their original prostheses for 3 years with a bilateral balance occlusal scheme. The participants' existing satisfaction levels, as a baseline, were determined using visual analogue scale questionnaires. They were followed by similar assessments of two further occlusal schemes using 2-month assessment periods. On completion of the study, the participants selected their preferred occlusal scheme and semiformal interviews were conducted to assess the rationale for their choices. Baseline data showed all the participants had pre-existing high satisfaction levels. Thereafter, of those participants that received lingualized occlusion first, 55.6% reported that the physiologic occlusion was better than lingualized occlusion. For those participants who received the physiologic occlusion first, 85.7% reported that physiologic occlusion was better than lingualized occlusion. On completion of the study, 64.7% of the participants preferred the physiologic occlusion, 35.3% preferred the lingualized occlusion. However, when the two groups' satisfaction scores were modeled using the three main key indicator questions (general satisfaction, general ability to chew, or general function), there were no significant differences between them. Within the limitations of a small number of participants, the majority of them still indicated a preference for a physiologic occlusion for implant overdentures. Improved function was given as the main indicator for that preference. Having implant overdentures in one or both jaws is not a formative factor in patient's opinions on occlusal schemes.
Publisher: Wiley
Date: 12-11-2009
DOI: 10.1111/J.1600-0722.2009.00688.X
Abstract: The study investigated the association between food and drink consumption and the caries experience among young children in Ajman, United Arab Emirates. A one-stage cluster s le was used to select children who were 5 or 6 yr of age. Clinical examinations for caries were conducted. Parents completed questionnaires seeking information on dietary habits. Principal components analysis was used to derive a summary score for the dietary variables (designated 'snack consumption level') and thus overcome the multicollinearity problems associated with using multiple dietary variables. Dental examination and questionnaire data were obtained for 1,036 children (79.9% participation rate). The overall mean number of decayed, missing or filled teeth (dmft) was 4.5. Snacking three or more times per day was associated with a dmft score that was almost one-third higher than the dmft score for children who snacked only once daily. One-third of children had a low overall snack consumption level (41% moderate and 25% high). There was a consistent dmft gradient across those categories. The severity of Early Childhood Caries (ECC) in young Ajman children is high, with dietary habits being important determinants. Cariogenic snack consumption can be represented using a summary exposure variable that appears to be valid. Young children in Ajman would benefit from health-promotion strategies directed towards appropriate dietary practices.
Publisher: Wiley
Date: 07-12-2021
DOI: 10.1111/EOS.12829
Abstract: The oral microbiome is ecologically erse, complex, dynamic, and little understood. We describe the microbiota of four oral habitats in a birth cohort at age 32 and examine differences by sex, oral hygiene, and current smoking status, dental caries, and periodontal health. Oral biofilm s les collected from anterior labial supragingival, posterior lingual supragingival, subgingival, and tongue sites of 841 Dunedin Multidisciplinary Health and Development Study members were analysed using checkerboard DNA‐DNA hybridization focusing on 30 ecologically important bacterial species. The four habitats exhibited distinct microbial profiles that differed by sex. Streptococcus gordonii was more dominant in supragingival and tongue biofilms of males Porphyromonas gingivalis exhibited higher relative abundance in subgingival biofilm of females. Males had higher scores than females for periodontal pathogens at supragingival sites. The relative abundance of several putative caries and periodontal pathogens differed in smokers and non‐smokers. With poor oral hygiene significantly higher proportions of Gram‐negative facultative anaerobes were present in subgingival biofilm and there were higher scores for the principal components characterised by putative cariogenic and periodontal pathogens at each site. Distinctive microenvironments shape oral biofilms and systematic differences exist by sex, oral hygiene, and smoking status.
Publisher: Wiley
Date: 27-11-2017
DOI: 10.1111/GER.12313
Abstract: The aim of this study was to validate and determine the reliability of the Portuguese version of the Summated Xerostomia Inventory. Many conditions such as head and neck radiation, autoimmune diseases or polypharmacy are characterised by hyposalivation which can affect oral and systemic quality of life. As such, this condition must be assessed, and the English version of the Xerostomia Inventory has been increasingly used to determine the severity of dry mouth perception. This was a descriptive cross-sectional study, which employed volunteers suffering from hyposalivation after local ethical committee clearance. Each patient signed an informed consent and responded to the Portuguese version of the questionnaire in the form of an interview. This was repeated again after 2 weeks. A standard single question provided a validity check. Data were analysed using Cronbach's α to test its reliability and total and interitem correlation, and intraclass correlation to determine its internal consistency and test-retest reliability. Significance was set at .05. A s le of 103 volunteers was recruited. Cronbach's α was .84 and .87 for the first and second test administrations, respectively. The intraclass correlation coefficient value for the test-retest reliability was .93, and scores for the in idual items ranged from .79 to .90. The correlation between the total score of the questionnaire and standard single dry mouth question was .66, indicating a very good correlation. Demonstrating excellent psychometric properties, the Summated Xerostomia Inventory (Portuguese Version) is a valid tool for quantifying Xerostomia in a dry mouth-afflicted population.
Publisher: Wiley
Date: 13-02-2023
DOI: 10.1111/GER.12676
Abstract: The objective of the study was to describe the occurrence and associations of oral self‐care by dependent older New Zealanders. Dependent older adults who require some level of assisted daily care have been shown to have poorer oral health than their independent counterparts, yet national estimates are lacking. A secondary analysis was conducted of data from New Zealand's 2012 Older People's Oral Health Survey, a national survey that interviewed and examined a representative s le of 2,218 dependent older adults living in aged residential care or receiving home‐based care. Survey data were weighted for statistical analyses, and modelling was carried out using a modified Poisson approach. Overall, 59.5% (95% CI: 55.1, 63.7) of participants brushed their teeth twice a day, with this rate higher among women, Asians and those without cognitive or physical impairment. Cleaning interdentally at least once a week was less common than brushing, at 25.9% (95% CI: 21.5, 30.9), and that proportion was significantly lower among those with higher dependency or who were cognitively or physically impaired. Almost 9 in 10 (87.8% 95% CI 83.1, 91.4) used fluoride toothpaste, and adults of high socio‐economic status had lower rates of fluoride toothpaste use. Only 15.0% (95% CI 12.4, 18.0) used mouthwash, with this being most prevalent in Pasifika. More than half of those who wore dentures also wore them at night. Oral self‐care was sub‐optimal among dependent older New Zealanders. Improving the situation should be a high priority.
Publisher: S. Karger AG
Date: 2009
DOI: 10.1159/000252977
Abstract: The study aimed to determine the relative contributions of bitewing radiography and clinical examination to caries estimates for a New Zealand child population with high caries experience. An epidemiological survey was conducted of 171 12- and 13-year-old children attending schools in five communities. Examinations were conducted in dental clinics. Bitewing radiographs were taken at the time of the clinical examination. These were developed and read later, and the data from those were used at the analysis stage to adjust the caries diagnosis for the mesial, occlusal and distal surfaces of the posterior teeth. For almost all parameters, the use of radiographs resulted in higher estimates, although at the whole-mouth prevalence level the difference was not great. The percent difference between the estimates ranged from –0.1 to 166.7%. There were moderate differences between the clinical-only and radiographically adjusted whole-mouth estimates for mean DMFT, DT, DMFS and DS, but only a minor difference in caries prevalence. With the mesial and distal surfaces only, the prevalence and severity estimates were significantly greater, with a one-surface difference (on average) in mean DS being the largest difference observed, at 166.7%. The diagnostic discrepancy was much greater for approximal than occlusal surfaces. These findings support but also build upon earlier findings and again underline the need for bitewing radiographs to be a routine part of oral epidemiological surveys wherever logistics and funding permit.
Publisher: Springer Science and Business Media LLC
Date: 2004
Publisher: Springer Science and Business Media LLC
Date: 12-06-2013
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.JDENT.2015.03.011
Abstract: Dental caries is the main problem oral health and it is not well established in the literature if the enamel defects are a risk factor for its development. Studies have reported a potential association between developmental defects enamel (DDE) and dental caries occurrence. We investigated the association between DDE and caries in permanent dentition of children and teenagers. A systematic review was carried out using four databases (Pubmed, Web of Science, Embase, and Science Direct), which were searched from their earliest records until December 31, 2014. Population-based studies assessing differences in dental caries experience according to the presence of enamel defects (and their types) were included. PRISMA guidelines for reporting systematic reviews were followed. Meta-analysis was performed to assess the pooled effect, and meta-regression was carried out to identify heterogeneity sources. From the 2558 initially identified papers, nine studies fulfilled all inclusion criteria after checking the titles, abstracts, references, and complete reading. Seven of them were included in the meta-analysis with random model. A positive association between enamel defects and dental caries was identified meta-analysis showed that in iduals with DDE had higher pooled odds of having dental caries experience [OR 2.21 (95% CI 1.3 3.54)]. Meta-regression analysis demonstrated that adjustment for sociodemographic factors, countries' socioeconomic status, and bias (quality of studies) explained the high heterogeneity observed. A higher chance of dental caries should be expected among in iduals with enamel defects.
Publisher: Wiley
Date: 19-05-2022
DOI: 10.1111/GER.12558
Abstract: There have been no detailed descriptions of residual dentition patterns among older people living in the community. To describe the residual dentition and associated oral health‐related quality of life among older New Zealanders living in their own homes with government‐funded assistance. Using nationally representative data, we determined the residual dentition arrangement and Kennedy classification for each dental arch. In iduals were categorised according to their maxillary‐mandibular dental configuration and prosthesis use. Data were weighted to make the estimates generalisable to the source population. Of the 895 clinically examined participants, 47.8% were dentate. One‐quarter of those had maxillary tooth‐bound saddles opposing a partially dentate mandible. Pasifika (people of Pacific Islands ethnicity) were most likely to have retained all of their dentition, while only the Māori ethnic group had no participants with a dentate arch. Only one in three of those with partially dentate upper and lower arches wore any maxillary denture one in ten wore some form of mandibular denture. Partial dentures were common among those with an opposing edentulous jaw. Maxillary partial dentures were twice as common as their mandibular counterparts. Residual dentition patterns in older people are erse and complex, and meeting their prosthodontic needs is not straightforward.
Publisher: Wiley
Date: 03-2008
Publisher: Wiley
Date: 29-01-2013
DOI: 10.1111/JOOR.12031
Publisher: Elsevier BV
Date: 2000
DOI: 10.1016/S1079-2104(00)80013-X
Abstract: To examine the concurrent validity and temporal stability of the xerostomia inventory (XI), an 11-item summated rating scale that was developed to enable measurement of the severity of dry mouth symptoms in epidemiologic and clinical studies. A prospective cohort study design was used. Measurements of the severity of dry-mouth symptoms were made with the use of the XI and a standard dry-mouth question ("How often does your mouth feel dry?") on 2 groups of people at baseline, 2, 4, and 6 months. The 2 groups were chosen for their differing symptom trajectories: the onset group (N = 57) comprised patients who were about to undergo radiotherapy for head and neck cancer and the normal group (N = 55) was a convenience s le of middle-aged and older in iduals who were not expected to undergo changes in mouth dryness over the study period. The sex distributions of the 2 groups were similar, but the onset group was younger than the normal group overall. Baseline XI scores were higher among the onset group. The mean XI scores of the normal group did not differ over the observation period, indicating acceptable temporal stability of the XI. The scores of the onset group showed a substantial increase between baseline and 2 months, after which the 2-month level was sustained over the remainder of the study period. That these patterns were mirrored in the percentage responding "frequently" or "always" to the standard question provided further evidence for the concurrent validity of the XI. Linear regression was used to estimate the difference between the final scores after adjusting for age, sex, and initial difference in scores between the 2 groups. This was found to be 9.17 (95% CI 6.24, 12.10) and confirmed that undergoing radiotherapy for head/neck cancer was associated with a substantial increase in the severity of xerostomia symptoms. The xerostomia inventory appears to be a valid multi-item method for measuring the severity of the symptoms of dry mouth in clinical and epidemiologic studies.
Publisher: Wiley
Date: 14-07-2008
Publisher: SAGE Publications
Date: 2008
DOI: 10.1177/154405910808700112
Abstract: Dental caries is a chronic, cumulative disease, but no studies have investigated longitudinal patterns of caries experience. The objective of this study was to identify and describe developmental trajectories of caries experience in the permanent dentition to age 32. Longitudinal caries data for 955 participants in a longstanding birth cohort study were analyzed by trajectory analysis. Three caries experience trajectories were identified by the SAS macro PROC TRAJ these were categorized as "high" (~ 15%), "medium" (~ 43%), and "low" (~ 42%) DMFS (Decayed, Missing, and Filled Surfaces). All were relatively linear, although the higher trajectories were more "S-shaped". This effect disappeared following adjustment for the number of unaffected surfaces remaining at each age, suggesting that, among in iduals following a similar caries trajectory, caries rate is relatively constant across time.
Publisher: Wiley
Date: 19-09-2017
DOI: 10.1111/CDOE.12332
Abstract: Dental diseases are the most common chronic diseases worldwide. Healthy teeth are vital for quality of life, particularly diet and nutrition. However, little information exists to inform health policymakers about potentially long-lasting influences of early-life conditions. The purpose of this study was to investigate the relation between early-life socioeconomic conditions and number of natural teeth at age 50 and above. Analyses were conducted on cross-sectional data from the Survey of Health, Ageing and Retirement in Europe (SHARE wave 5), which includes information on 41 560 respondents aged 50 years or older from 14 European countries and Israel. Using SHARE life history information, a series of regression models (OLS, Tobit) were estimated to analyse the relationship between socioeconomic conditions in earlier life and the number of teeth at age 50+. Childhood socioeconomic background was associated with the number of natural teeth at age 50 and above, even after controlling for current determinants of oral health. Respondents who had had more than 25 books in their childhood household had a mean 1.4 (95% CI: 1.2-1.5) more teeth than respondents with fewer books. Respondents who reported poor financial conditions during childhood had a mean 0.6 (95% CI: 0.3-0.9) fewer teeth than respondents who reported better financial conditions in childhood. These findings substantiate the association between socioeconomic conditions in the early years of life and tooth retention to older adulthood and highlight the long-lasting relation between childhood living conditions and oral health through the lifecourse.
Publisher: Cambridge University Press (CUP)
Date: 2008
DOI: 10.1017/S0954579408000333
Abstract: This article reports on the childhood origins and adult outcomes of female versus male antisocial behavior trajectories in the Dunedin longitudinal study. Four antisocial behavior trajectory groups were identified among females and males using general growth mixture modeling and included life-course persistent (LCP), adolescent-onset, childhood-limited, and low trajectory groups. During childhood, both LCP females and males were characterized by social, familial and neurodevelopmental risk factors, whereas those on the adolescent-onset pathway were not. At age 32, women and men on the LCP pathway were engaging in serious violence and experiencing significant mental health, physical health, and economic problems. Females and males on the adolescent-onset pathway were also experiencing difficulties at age 32, although to a lesser extent. Although more males than females followed the LCP trajectory, findings support similarities across gender with respect to developmental trajectories of antisocial behavior and their associated childhood origins and adult consequences. Implications for theory, research, and practice are discussed.
Publisher: Wiley
Date: 27-02-2019
DOI: 10.1111/CDOE.12451
Publisher: Wiley
Date: 13-02-2007
DOI: 10.1111/J.1741-2358.2007.00137.X
Abstract: To examine the responsiveness to change of the Xerostomia Inventory (XI). The XI is an 11-item summated rating scale which results in a single continuous scale score representing the severity of chronic xerostomia. While the XI has been used as an outcome measure in clinical research, the magnitude of a clinically meaningful change score has yet to be determined. This study comprises a secondary analysis of data from a longitudinal study of changes in xerostomia symptoms in two groups whose symptom trajectories were likely to differ substantially: the normal group was a convenience s le of asymptomatic middle-aged and older in iduals with otherwise stable perceptions of mouth dryness and the onset group comprised patients who were about to undergo radiotherapy for head/neck cancer (and would therefore be expected to develop more severe xerostomia after the baseline measurements). Statistical analyses examined cross-sectional construct validity and internal consistency, test-retest reliability and the measure's responsiveness and longitudinal construct validity. The mean change scores of those for whom 'a little' improvement was reported were used to determine the minimally important difference for the XI. Over two-thirds of the onset group members reported dry mouth 'frequently' or 'always' at follow-up (2 months) and there was a concomitant increase in their mean XI score. Test-retest reliability was acceptable. Examination of within-in idual change among those who changed and those for whom stability was observed, showed that only those who worsened had significantly greater XI scores at follow-up. The minimally important difference to reflect deterioration in xerostomia symptoms was determined to be 6 scale points. Between baseline and 2 months, the XI scores of 32 participants (33.7%) deteriorated by the minimally important difference (7.1% and 54.7% respectively among the normal and onset groups p < 0.0001). The validity and responsiveness of the XI appear to be acceptable, and a change in XI score of 6 or more points is clinically meaningful.
Publisher: PeerJ
Date: 09-06-2016
DOI: 10.7717/PEERJ.2095
Abstract: Background. A loss of mucosal tolerance to the resident microbiome has been postulated in the aetiopathogenesis of spondyloarthritis, thus the purpose of these studies was to investigate microbial communities that colonise the oral cavity of patients with axial spondyloarthritis (AxSpA) and to compare these with microbial profiles of a matched healthy population. Methods. Thirty-nine participants, 17 patients with AxSpA and 22 age and gender-matched disease-free controls were recruited to the study. For patients with AxSpA, disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). All participants underwent a detailed dental examination to assess oral health, including the presence of periodontal disease assessed using probing pocket depth (PPD). Plaque s les were obtained and their bacterial populations were profiled using Ion Torrent sequencing of the V6 region of the 16S rRNA gene. Results. Patients with AxSpA had active disease (BASDAI 4.1 ± 2.1 [mean ± SD]), and a significantly greater prevalence of periodontitis (PPD ≥ 4 mm at ≥4 sites) than controls. Bacterial communities did not differ between the two groups with multiple metrics of α and β ersity considered. Analysis of operational taxonomic units (OTUs) and higher levels of taxonomic assignment did not provide strong evidence of any single taxa associated with AxSpA in the subgingival plaque. Discussion. Although 16S rRNA gene sequencing did not identify specific bacterial profiles associated with AxSpA, there remains the potential for the microbiota to exert functional and metabolic influences in the oral cavity which could be involved in the pathogenesis of AxSpA.
Publisher: MDPI AG
Date: 09-02-2023
DOI: 10.3390/HEALTHCARE11040515
Abstract: Quality of life varies with time, often worsening, and is affected by circumstances, events, and exposures at different stages of life. Little is known about how oral health-related quality of life (OHRQoL) changes during middle age. We investigated OHRQoL changes from age 32 to 45 years among participants in a population-based birth cohort, along with clinical and socio-behavioural associations. Generalised estimating equation models were used to investigate the association between OHRQoL (assessed at ages 32, 38, and 45 years n = 844), and the socioeconomic position in childhood (up to age 15 years) and adulthood (ages 26 through to 45 years), dental self-care (dental services utilisation and tooth brushing), oral conditions (such as tooth loss), and experiencing a dry mouth. The multivariable analyses were controlled for sex and personality traits. At each stage of life, those of a lower socioeconomic status were at greater risk of experiencing OHRQoL impacts. Those who engaged in favourable dental self-care habits (the regular use of dental services and at least twice daily tooth brushing) experienced fewer impacts. A social disadvantage at any stage of life has enduring deleterious effects on one’s quality of life in middle age. Ensuring access to timely and appropriate dental health services in adulthood may reduce the impacts of oral conditions on one’s quality of life.
Publisher: Wiley
Date: 10-2014
Abstract: Smoking is a major risk factor for periodontal disease. Conventional oral epidemiology approaches have found strong, consistent associations between chronic smoking and periodontal attachment loss (AL) through ages 26, 32, and 38 years, but those statistical methods disregarded the data's hierarchical structure. This study reexamines the association using hierarchical modeling to: 1) overcome the limitations of an earlier approach (trajectory analysis) to the data and 2) determine the robustness of the earlier inferences. Periodontal examinations were conducted at ages 26, 32, and 38 years in the Dunedin Multidisciplinary Health and Development Study. The number of participants examined at those three ages were 913, 918, and 913, respectively. A generalized linear mixed model with a quasi-binomial approach was used to examine associations between chronic smoking and periodontal AL. At ages 26, 32, and 38, smokers had 3.5%, 12.8%, and 23.2% greater AL than non-smokers. Regular cannabis use was associated with greater AL after age 32, but not at age 26. Males had more AL than females. Participants with high plaque scores had consistently greater AL those who were of persistently low socioeconomic status had higher AL at ages 32 and 38, but not at age 26. The amount of AL in anterior teeth was less than in premolars and molars. Gingival bleeding was associated with higher AL at ages 26, 32, and 38. The smoking-periodontitis association is observable with hierarchical modeling, providing strong evidence that chronic smoking is a risk factor for periodontitis.
Publisher: SAGE Publications
Date: 28-07-2016
Abstract: The objective was to compare absolute differences in the prevalence of Indigenous-related inequalities in dental disease experience and self-rated oral health in Australia, Canada, and New Zealand. Data were sourced from national oral health surveys in Australia (2004 to 2006), Canada (2007 to 2009), and New Zealand (2009). Participants were aged ≥18 y. The authors measured age- and sex-adjusted inequalities by estimating absolute prevalence differences and their corresponding 95% confidence intervals (95% CIs). Clinical measures included the prevalence of untreated decayed teeth, missing teeth, and filled teeth self-reported measures included the prevalence of “fair” or “poor” self-rated oral health. The overall pattern of Indigenous disadvantage was similar across all countries. The summary estimates for the adjusted prevalence differences were as follows: 16.5 (95% CI: 11.1 to 21.9) for decayed teeth (all countries combined), 18.2 (95% CI: 12.5 to 24.0) for missing teeth, 0.8 (95% CI: –1.9 to 3.5) for filled teeth, and 17.5 (95% CI: 11.3 to 23.6) for fair oor self-rated oral health. The I 2 estimates were small for each outcome: 0.0% for decayed, missing, and filled teeth and 11.6% for fair oor self-rated oral health. Irrespective of country, when compared with their non-Indigenous counterparts, Indigenous persons had more untreated dental caries and missing teeth, fewer teeth that had been restored (with the exception of Canada), and a higher proportion reporting fair oor self-rated oral health. There were no discernible differences among the 3 countries.
Publisher: Wiley
Date: 19-09-2012
DOI: 10.1111/EJE.12006
Abstract: Research suggests that students' perceptions should be considered in any discussion of their education. However, to date, there has been no systematic examination of New Zealand postgraduate dental students' learning processes in both the research and clinical settings. This study aimed to obtain in-depth qualitative insights into student and graduate perspectives of effective and ineffective learning experiences during their postgraduate dental education. Data were collected in 2010 using semi-structured in idual interviews. Participants included 2010 final-year students and 2009 graduates of the University of Otago Doctor of Clinical Dentistry programme. Using the Critical Incident Technique, participants were asked to describe at least one effective and one ineffective learning experience in detail. Interview transcripts were analysed using a general inductive approach. Broad themes which emerged included supervisory approaches, characteristics of the learning process and characteristics of the physical learning environment. The focus of this article is to report and discuss the learning processes that participants identified as promoting and precluding effective learning experiences in the clinical and research settings. Students and graduates in the study had largely similar perspectives of learning processes likely to result in effective clinical and research learning. These included self-directed and collaborative learning timely, constructive and detailed feedback with directions for further improvement and discreet clinical feedback. Learning processes that precluded effective learning included unsupported and isolated learning, delayed and overly critical/destructive feedback and open criticism in the clinical context. The in-depth findings of this study contribute to the scientific literature that identifies learning process characteristics which facilitate effective learning from New Zealand postgraduate students' and graduates' perspectives. Additional cross-sectional and longitudinal studies (both qualitative and quantitative) would lead to a better understanding of what constitutes effective teaching in postgraduate dental education.
Publisher: S. Karger AG
Date: 2023
DOI: 10.1159/000530614
Publisher: Wiley
Date: 18-05-2020
DOI: 10.1111/ADJ.12774
Publisher: SAGE Publications
Date: 04-2006
DOI: 10.1177/154405910608500411
Abstract: According to theory, health beliefs are related to health behaviors. We investigated whether in iduals who hold favorable oral-health-related beliefs over time have better adult oral health than those who do not. Beliefs about the efficacy of water fluoridation, keeping the mouth clean, avoiding sweet foods, visiting the dentist, using dental floss, and using fluoridated toothpaste were assessed in a birth cohort at ages 15, 18, and 26 years. At each age, the majority of participants endorsed the importance of each practice. However, there was also evidence of instability across time. In iduals who held stable favorable dental beliefs from adolescence through adulthood had fewer teeth missing due to caries, less periodontal disease, better oral hygiene, better self-rated oral health, and more restorations. Dental beliefs can change between adolescence and young adulthood, and these changes are related to oral health. In particular, unfavorable dental health beliefs are related to poorer oral health.
Publisher: Proceedings of the National Academy of Sciences
Date: 24-01-2011
Abstract: Policy-makers are considering large-scale programs aimed at self-control to improve citizens’ health and wealth and reduce crime. Experimental and economic studies suggest such programs could reap benefits. Yet, is self-control important for the health, wealth, and public safety of the population? Following a cohort of 1,000 children from birth to the age of 32 y, we show that childhood self-control predicts physical health, substance dependence, personal finances, and criminal offending outcomes, following a gradient of self-control. Effects of children's self-control could be disentangled from their intelligence and social class as well as from mistakes they made as adolescents. In another cohort of 500 sibling-pairs, the sibling with lower self-control had poorer outcomes, despite shared family background. Interventions addressing self-control might reduce a panoply of societal costs, save taxpayers money, and promote prosperity.
Publisher: Wiley
Date: 21-01-2014
DOI: 10.1111/GER.12085
Abstract: The main conditions of interest when considering the epidemiology of oral diseases among older people are tooth loss, dental caries, periodontitis, dry mouth and oral pre-cancer/cancer, along with oral-health-related quality of life (OHRQoL). This article presents an overview of what is known about the epidemiology of each of the main conditions of interest among older populations.
Publisher: Wiley
Date: 17-09-2012
Publisher: Wiley
Date: 13-02-2012
DOI: 10.1111/J.1741-2358.2010.00402.X
Abstract: Most research on older people's oral health has been quantitative. A need for more in-depth understanding of the oral health of that age group has pointed to a need for more qualitative investigations. To explore experiences and perceptions of oral health and oral health care among an ethnically-mixed s le of older New Zealanders. In-depth interviews were conducted with 24 older people in two communities in New Zealand's South Island. Thematic analysis of transcribed data was undertaken. Three main themes that emerged were: (1) the processes of negotiating a tension between cost and convenience of access (2) the experiential constraining of oral health maintenance and (3) trusting in dental professionals. These serve to organise processes such as normalising, justifying and social comparisons that create an equilibrium or tolerance and acceptance of what might otherwise be considered to be relatively poor oral health. We identified a number of shared experiences which affect older people's ability to maintain their oral health in the face of material and social barriers to oral health care. Because expectations were generally lower, there was greater concordance between experience and expectation, and people tended to be fairly satisfied with their oral health and the care they had received.
Publisher: Wiley
Date: 06-07-2017
DOI: 10.1111/CDOE.12320
Abstract: The total body of evidence finds fluoride varnish effective to prevent caries. However, most trials were conducted in high-risk populations, with more recent trials on low-risk groups finding a lower efficacy. We aimed to assess the cost-effectiveness of fluoride varnish application in clinic setting in populations with different caries risk. A mixed public-private-payer perspective in the context of German health care was performed using a lifetime Markov model. Effectiveness data were derived from an update of the most recent systematic Cochrane review and synthesized in three different risk groups according to control group caries increment via random-effects meta-analysis. Varnish was assumed to be applied twice yearly between age 6 and 18 years. Teeth with carious defects would be treated restoratively and could experience further follow-up treatments. Costs were deduced from German fee item catalogues. Monte Carlo microsimulations were used for to analyse lifetime treatment costs and caries increment (Euro/Decayed, Missing, Filled Teeth (DMFT)). In low-risk groups, fluoride varnish was nearly twice as costly and minimally more effective (293 Euro, 8.1 DMFT) than no varnish (163 Euro, 8.5 DMFT). The incremental cost-effectiveness ratio (ICER) was 343 Euro spent per avoided DMFT. The ICER was lower in medium-risk (ICER 93 Euro/DMFT) and high-risk groups (8 Euro/DMFT). Application of fluoride varnish in the clinic setting is unlikely to be cost-effective in low-risk populations. There is the need to either target high-risk groups or to provide fluoride varnish at lower costs, possibly in nonclinic settings.
Publisher: Wiley
Date: 22-06-2020
DOI: 10.1111/JCPE.13309
Publisher: Wiley
Date: 10-08-2020
DOI: 10.1111/CDOE.12568
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.AJODO.2014.12.019
Abstract: Estimating orthodontic treatment need in the permanent dentition using information from the deciduous-dentition malocclusion may assist in defining the time for appropriate orthodontic intervention. Our objective was to investigate whether malocclusion in the deciduous teeth predicts orthodontic treatment need in the permanent dentition. Two oral health studies nested in a birth cohort were carried out at ages 6 (n = 359) and 12 (n = 339) years. Open bite, crossbite, and canine malocclusion were assessed in the deciduous teeth. Orthodontic treatment need was determined in the permanent dentition using the dental esthetic index. Prevalence ratios were estimated using 2 dental esthetic index cutoff points: highly desirable/mandatory orthodontic treatment and only mandatory orthodontic treatment. We tested all combinations of the deciduous malocclusion and the outcomes, controlling for confounders. Children with only open bite and those with concurrent open bite and canine malocclusion were more likely to have either highly desirable/mandatory orthodontic treatment or only mandatory orthodontic treatment needs by age 12. The combination of crossbite and open bite in the deciduous teeth was associated with the highest risk of need for mandatory orthodontic treatment. Malocclusion in the deciduous teeth is a risk factor for orthodontic treatment need in the permanent dentition. Children with malocclusion at a young age should be monitored regularly, and caregivers may be able to better prepare for possible orthodontic treatment.
Publisher: American Medical Association (AMA)
Date: 07-2016
Publisher: Oxford University Press (OUP)
Date: 23-07-2021
Abstract: Medication-induced xerostomia is common in older people. We investigated medication use and xerostomia in dependent older New Zealanders. Medication and xerostomia data analysed from a nationally representative survey of dependent older people. Automatic interaction detection analysis identified medications combinations most strongly associated with xerostomia, and then xerostomia was modelled. Just over half were taking five to nine different medications one in five was taking 10+. Xerostomia prevalence (29.4% 95% confidence interval 26.5, 32.5) was higher among the latter and lowest in psychogeriatric patients. After controlling for age and sex, it was higher among people taking any antidepressant, and higher still with a tricyclic antidepressant and either a steroid or an anticholinergic, or among people taking a bronchodilator without prophylactic aspirin. Health practitioners should work together to ensure that those with xerostomia are managed in a timely and appropriate manner. Medication review is an important component of that.
Publisher: Wiley
Date: 24-07-2017
DOI: 10.1111/ADJ.12541
Abstract: The Index of Dental Anxiety and Fear (IDAF-4C) was introduced to overcome the theoretical and practical shortcomings of previously developed dental fear measures. This new scale has not been tested on population s les other than in its country of origin, Australia. The aim of this study was to validate the IDAF-4C in a different cultural setting and to determine the prevalence and sociodemographic associations of dental anxiety. A cross sectional study of a representative New Zealand adult population s le was undertaken. The questionnaire was mailed to 523 randomly-selected participants. Data were collected on sociodemographic characteristics, oral and general health care, and dental anxiety using both the IDAF-4C and the Dental Anxiety Scale (DAS). The response rate was 51.8%. The factor structure of the IDAF-4C was confirmed. The prevalence estimates for high dental anxiety and fear were 18.6% using the DAS and 13.0% using the IDAF-4C. Mean scores for the IDAF-4C and DAS were higher among episodic dental visitors and those without a recent dental visit. The performance of the IDAF-4C in this New Zealand community s le supports its use for dental anxiety measurement.
Publisher: Wiley
Date: 31-01-2011
Publisher: Wiley
Date: 30-05-2019
DOI: 10.1111/GER.12414
Abstract: Descriptions of the older population's dentition status are usually limited to indicators such as the edentulous proportion, the mean number of restored and missing teeth, and the proportion with a functional dentition, with very few reports describing in detail the nature of the residual dentition. This study described the residual dentition among older New Zealanders living in residential aged care facilities. Using national data from the Older People's Oral Health Survey, we determined the residual dentition arrangement and Kennedy classification for each dental arch. In iduals were categorised according to their maxillary-mandibular dental configuration. Data were weighted to make the estimates generalisable to the source population. Among the dentate 45% of the 987 clinically examined participants, the most prevalent configuration was maxillary tooth-bounded saddles against a partially dentate lower (24.7% 95% CI: 20.4, 29.7). More younger participants generally had less tooth loss experience and had higher prevalence of Kennedy Classes II, III and IV. There were few sex differences, although more females had a fully dentate arch. Marked ethnic differences were observed: Māori were up to eight times as likely to have only mandibular anterior teeth remaining. Upper dentures were worn more than their lower counterpart. Age, sex and ethnic characteristics were associated with particular residual teeth configurations. Having various degrees of tooth loss was the norm, with the upper tooth-bounded saddles against any partially dentate lower combination most common, and limited to females. An edentulous maxilla opposed by some standing teeth was observed in over one-quarter of the population, and most common among Māori and those who were older. Maxillary prostheses were much more common than mandibular ones. Caring for dentate older people in aged residential care is likely to be complicated by the wide range of dentition configurations.
Publisher: Wiley
Date: 17-07-2014
DOI: 10.1111/EJE.12112
Abstract: To examine the 'Expected' and 'Actual' educational environment experienced by a cohort of Bachelor of Dental Surgery (BDS) students at the University of Otago's Faculty of Dentistry using the Dundee Ready Educational Environment Measure (DREEM). Cohort members were asked to complete five DREEM surveys over the four-year BDS programme. Student expectations at the beginning of their first year were assessed using a modified version of the DREEM questionnaire, while following (standard) DREEM questionnaires at the end of each professional year addressed students' 'Actual' perception of the educational environment. Sixty-six students (99%) completed at least one questionnaire. Overall, the BDS students' perceptions of their educational environment tended to be positive and students identified both perceived strengths and weaknesses in the BDS programme. However, more negative than positive shifts were reported between the 'Expected' and 'Actual' in idual DREEM in idual items, suggesting that BDS students initially expected more from their educational environment than they actually experienced. In idual DREEM outcomes undergoing negative and positive shifts differed over the years and varied in number. These may be explained, in part, by changes in the curriculum focus from year to year. The students' changing DREEM responses over time revealed anticipated and perceived strengths and weaknesses of the BDS curriculum, as well as shifts in students' perceptions in response to curricular changes. However, our findings highlight the potential usefulness for dental education of a measure for use that takes the unique aspects of the dental education environment into account.
Publisher: Wiley
Date: 07-04-2010
DOI: 10.1111/J.1600-0501.2009.01890.X
Abstract: To determine the primary stability of the Southern wide diameter (8 mm) implants, Neoss regular diameter (4 mm) implants, and Southern regular diameter (3.75 mm) implants placed in the midline of edentulous mandibles for single-implant overdentures. Variables related to host site and implant characteristics were investigated to determine their influence on the primary stability of the implants. A total of 36 implants were placed in the midline symphysis of the edentulous mandibles of 36 participants. Their primary stability was then measured using the magnetic Osstell mentor device. Analysis of variance (ANOVA) was used to compare the mean implant stability quotient (ISQ) scores with one-way ANOVA for multiple comparisons. The highest measurement (ISQ) of primary stability was for the Southern 8 mm wide diameter implants (84.8, SD 9.8), followed by the Neoss 4 mm regular diameter (82.3, SD 4.8) implants and the Southern 3.75 mm regular diameter implants (75.3, SD 8.4), respectively. The Southern 3.75 mm regular diameter implants had a significantly lower mean ISQ value than the same system 8 mm wide diameter (P=0.004) and the Neoss 4 mm regular diameter implants (P=0.03). No significant differences were observed between the 8 mm and the 4 mm diameter implants (P>0.05). Host-site variables such as age, gender, bone volume, and quality do not appear to influence the primary stability of the implants. No clear correlation was established between ISQ values and implant diameter.
Publisher: Wiley
Date: 21-01-2014
DOI: 10.1111/GER.12098
Abstract: There is a need for a structured, evidence based approach to care for older dental patients. The following article describes the development of the Seattle Care Pathway based upon a workshop held in 2013. An overview is provided on the key issues of older persons dental care including the demography shift, the concept of frailty, the need for effective prevention and treatment to be linked to levels of dependency and the need for a varied and well educated work force. The pathway is presented in tabular form and further illustrated by the ex les in the form of clinical scenarios. The pathway is an evidence based, pragmatic approach to care designed to be globally applicable but flexible enough to be adapted for local needs and circumstances. Research will be required to evaluate the pathways application to this important group of patients.
Publisher: No publisher found
Date: 2002
DOI: 10.1034/J.1600-0528.2002.300309.X
Abstract: This study examined the association between chronic medication exposure and 5-year dental caries increment among older people, using a theoretical model whereby xerogenic medication is thought to lead to increased caries by either (i) chronically lowering salivary flow, thus reducing salivary buffering of plaque acids, or (ii) producing the symptoms of dry mouth, leading to symptomatic relief through the use of cariogenic drinks and foodstuffs. Data were obtained from participants remaining at the 5-year follow-up phase of a cohort study of community-dwelling South Australians aged 60 +. Medication information was available at baseline and at 5 years, enabling only those medications taken on both occasions to be included in the analyses. Dental examinations were conducted at baseline and 5 years, and a reversal-adjusted 5-year caries increment was computed. Multivariate modelling was used to control the effects of potential confounders. Of the original s le, 528 (62.3%) remained after 5 years, with those remaining tending to be younger, healthier and less medicated than those lost to follow-up. Five-year coronal caries incidence was 66.9%. The adjusted coronal caries increment (AdjCI) was higher among males and among those taking a beta-blocker or an antiasthma drug for the previous 5 years. The 5-year incidence of root surface caries was 59.3%. A lower root surface AdjCI was associated with taking daily aspirin. Of the medications shown in earlier analyses to predict dry mouth, only the antiasthma drugs were associated with higher caries experience, and they had predicted more severe xerostomia symptoms. This study offers no strong evidence for a medication-caries relationship, as only one of the observed medication-caries associations was explicable in terms of the theoretical model. However, it should be acknowledged that older people taking antiasthma drugs may be at higher risk of coronal caries, possibly through measures taken for the symptomatic relief of dry mouth.
Publisher: Springer Science and Business Media LLC
Date: 2011
Publisher: Elsevier BV
Date: 07-2001
DOI: 10.1016/S0005-7967(00)00060-7
Abstract: A longitudinal investigation of risk factors for early- and late-onset dental fear was conducted. Early-onset dental fear was related to conditioning experiences (indexed via caries level and tooth loss), service use patterns, stress reactive personality and specific beliefs about health professionals. Late-onset dental fear was related to aversive conditioning experiences, irregular service use and an external locus of control. In contrast to recent findings for dental anxiety, personality factors were not strongly related to the onset of dental fear in young adulthood. The key role played by conditioning events in the development of both early- and late-onset dental fear was confirmed. Conditioning events appear to play a different role in the development of dental fear vs dental anxiety. This may reflect important, but largely ignored differences between these two closely-related constructs. Interventions for early-onset dental fear should aim to modify both the dental fear and the personality vulnerabilities that may contribute to the development of dental fear early in the life-course.
Publisher: Informa UK Limited
Date: 03-05-2023
Publisher: Wiley
Date: 11-08-2009
DOI: 10.1111/J.1741-2358.2008.00263.X
Abstract: To determine whether home-based and clinic-based dental examinations of older people are comparable. Despite a number of studies which have examined the concordance between different examiners or examination circumstances, none has directly compared an oral examination conducted at home with one conducted in an appropriate clinical setting. Dentate participants (n = 61) aged between 65 and 74 years underwent two clinical examinations, one in a conventional dental clinic and the other in the person's home. Kappa statistics, intra-class correlation coefficients and 'Difference against mean' plots were used to determine the nature and extent of any bias. The summary estimates for missing teeth and dental caries were close, although the home-based examinations resulted in a lower estimate of the mean number of decayed teeth and of untreated coronal decay. The lowest reliability statistics were observed with respect to the prevalence of untreated coronal caries, filled root surfaces and root surface (Decayed or Filled Surfaces) DFS. The periodontitis prevalence estimates were closer, but the reliability statistics were relatively low. The extent of bleeding on probing was relatively under-estimated in the home-based examinations. 'Difference against mean' plots indicated that, overall, the clinic-based examinations detected more disease (although this was not observed for all clinical parameters which were measured). While clinic-based examinations will remain the preferred option, the potential loss of information associated with home-based examinations is unlikely to be great enough to preclude using them where required, although surveys with larger s les (and therefore more accurate estimates) should restrict their proportion of home-based examinations to no more than 10%. As they are less precise, surveys with s les of 300 or fewer can safely accommodate up to about one-third of their examinations being conducted in participants' homes.
Publisher: Springer Science and Business Media LLC
Date: 31-12-2009
DOI: 10.1007/S11096-009-9361-5
Abstract: To explore how New Zealanders aged 65 years and older manage their medicines in their own homes, and determine the problems and concerns they might have with taking them. Urban setting, Dunedin (population 120,000), New Zealand. Twenty in-depth semi-structured interviews were undertaken of community-dwelling people 65 years and older. Sixty people, from a random s le of 80 from the electoral roll, met the recruitment criteria and were invited to participate. The first ten men and ten women agreeing to participate were interviewed. Interviews were taped and transcribed verbatim. Transcriptions were thematically coded and analysed using grounded theory and constant comparison. Emerging themes were explored under the topics: accessing medicines, remembering to take medicines, following instructions, practical problems, adverse effects, concerns about medicines, and beliefs about medicines. Ten of thirteen men and 10/20 women contacted (61%) agreed to participate. The men were aged 71, 67-82 years (median, range) and women 77, 69-87 years. They were using 140 prescription medicines (median 7, range 3-16) and 34 non-prescription medicines (1, 0-6) mainly for the nervous system (28%), or the cardiovascular system (22%). Participants felt that they had good access to medicines, could afford them, managed them well, and had systems and routines to help them remember to take them. Occasional doses were missed following a change in routine. Practical problems were found such as difficulty swallowing or halving tablets. Three-quarters of participants had experienced adverse effects during their lives. These were managed by dose or drug changes or by taking practical measures. People were worried about adverse effects occurring whether or not they had experienced them previously. Beliefs about medicines were mainly positive, although some people disliked taking them. The people 65 years and over in this study felt that they could access, afford and manage their medicines well. Although many participants had experienced adverse effects, their beliefs about medicines were mainly positive. Practical problems and concerns should be routinely inquired about and addressed, and prescribing and monitoring optimised to minimise adverse effects, in order to assist older people take their medicines.
Publisher: Wiley
Date: 19-05-2004
Publisher: Wiley
Date: 24-10-2011
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.SAPHARM.2019.05.010
Abstract: Polypharmacy is associated with inappropriate medication use, and subsequently increasing older persons' risk of drug-related harm and health-related costs to in iduals and society. To examine and describe, using a national s le of patient-level medication data, the prevalence of older people's polypharmacy and medication use across dependency levels. To examine oral and general pain prevalence and associated analgesic usage. Medication data from the 2012 New Zealand Older People's Oral Health Survey, a nationally-representative, cross-sectional study of dependent older people's oral health, were analysed descriptively, comparing classes and sub-classes of drugs and nutrient supplements taken across four categories of dependency: very low (own homes receiving in-home support), low, high and psychogeriatric (all receiving aged residential care). Self-reported current general pain and frequency of orofacial pain data were cross-tabulated by sub-classes of analgesics taken. All participants were taking at least one medication overall, 53.2% (95% CI: 50.4, 56.0) took between five and nine (polypharmacy), and 13.9% (95% CI: 17.4, 22.5) took 10 or more (hyperpolypharmacy). Antihypertensives, analgesics, antiulcer drugs, aspirin, laxatives, statins and antidepressants were the most common drug classes taken, the proportions differing between psychogeriatric level care and all other dependency groups. Overall, simple analgesics were taken (34.5% 95%CI: 30.8, 38.4) more commonly than other analgesics the use of nonsteroidal anti-inflammatory drugs was low (3.6% 95% CI: 2.7, 4.7). Of those reporting experiencing extreme general bodily pain, 63.3% (95% CI: 56.6, 69.4) took an analgesic, more than those experiencing mouth pain occasionally or often. Fat-soluble vitamins were the most common vitamin supplement taken (32.0% 95%CI: 27.0, 37.4). Polypharmacy and hyperpolypharmacy are common among older people, regardless of dependency level, and pain may be undertreated.
Publisher: Wiley
Date: 08-12-2011
DOI: 10.1111/J.1600-0579.2011.00725.X
Abstract: To examine the reliability and validity of the Dundee Ready Educational Environment Measure (DREEM) amongst New Zealand students in the first professional year of the Bachelor of Dental Surgery (BDS) and Bachelor of Oral Health (BOH) programmes. In 2009 and 2010, students' perceptions of the educational environment were evaluated using a modified version of the 50-item DREEM, completed on the first and last day of their first professional year. In idual DREEM items' strengths and weaknesses were identified. The difference or dissonance between students' expectations and actual experience was determined by subtracting the Actual DREEM score (for each item or subscale) from the Expected DREEM score. Effect-size statistics were calculated, and internal consistency was tested using Cronbach's alpha. Overall, 82% of 2009 and 2010 BDS and BOH students in their first professional year completed the Expected and Actual DREEM (N = 176). Both groups identified the 'overemphasis of factual learning' as an Expected and Actual aspect and 'memorising all I need to know' as an Actual aspect of the educational environment. Internal consistency was high for the overall DREEM and the BDS and BOH Expected DREEM (0.89 and 0.88, respectively) and excellent for both the BDS and BOH Actual DREEM (0.92 and 0.90, respectively). Overall, students entering the courses anticipated a number of strengths and weaknesses and those expectations were relatively similar in the different programmes (BDS and BOH). The DREEM showed excellent internal consistency for the overall scores, and that for the subscale scores was generally acceptable. The study confirms the DREEM's utility for the NZ dental education environment.
Publisher: Wiley
Date: 11-2020
DOI: 10.1111/CDOE.12592
Publisher: Elsevier BV
Date: 03-2002
Abstract: The purpose of this study was to compare the caries preventive efficacy of a mouthrinse solution containing casein derivatives coupled with calcium phosphate (CD-CP) with that of a 0.05% sodium fluoride mouthrinse among in iduals with dry mouth. A randomized control trial design was used. Participants included in iduals who had had radiotherapy for head and neck cancer (n = 82) and others with Sjögren's syndrome (n = 56). Baseline data collection was followed by reexamination 12 months later. Posterior bite-wing radiographs were taken on both occasions. A total of 124 participants, 61 (49.2%) in the sodium fluoride group and 63 (50.8%) in the CD-CP group, completed the 12-month examination. The baseline characteristics of the 2 groups did not differ. Coronal caries incidence was higher in the sodium fluoride group than in the CD-CP group (34.4% and 27%, respectively), but the difference was not statistically significant. Similarly, the small difference in coronal caries increment between the 2 groups was not statistically significant (0.4 and 0.3 surfaces, respectively). There was insufficient root surface caries experience between the 2 groups observed for differences to be examined. Proportionately more of the CD-CP group lost 1 or more teeth, and the mean number of tooth loss was higher. The participants with the highest incidence and increment were those with Sjögren's syndrome in the CD-CP group. Some of that difference was accounted for by differences in baseline caries status. It appears that CD-CP preparations hold promise as caries preventive agents for in iduals with dry mouth, although confirmation of this study's findings in other settings is warranted before a definitive conclusion can be reached.
Publisher: Wiley
Date: 08-11-2006
DOI: 10.1111/J.1741-2358.2006.00135.X
Abstract: To describe the incidence of xerostomia among a population of older people over a 6-year period, with particular attention to medications as risk factors. Understanding the natural history of xerostomia requires longitudinal epidemiological research, but only one study has examined changes in xerostomia over time. While medication is a recognised risk factor for dry mouth, the role of particular medication categories continues to be controversial. Older South Australians (aged 60+) underwent an interview and dental examination at baseline, and these assessments were repeated 2, 5 and 11 years afterward. Medication data were collected at baseline, 5 and 11 years. Xerostomia data were collected at 5 and 11 years using the Xerostomia Inventory (XI) and a standard question. Of the 1205 dentate participants assessed at baseline, 669 remained after 5 years, and 246 were assessed at 11 years. Medication prevalence increased over the observation period, such that 94.8% of the cohort were taking at least one medication by 11 years. The prevalence of xerostomia increased from 21.4% to 24.8% between 5 and 11 years (p > 0.05), and the mean XI score increased from 20.0 (SD, 6.7) to 21.5 (SD, 7.9 p < 0.001). Some 14.7% of participants were incident cases of xerostomia, while 11.4% were remitted cases 10.1% were cases at both 5 and 11 years. After controlling for gender and 'baseline' xerostomia severity (represented by the XI score at 5 years), participants who commenced taking daily aspirin after 5 years had over four times the odds of becoming incident cases, while those who commenced taking a diuretic after 5 years had nearly six times the odds of doing so. While the overall prevalence of xerostomia increased during the observation period, there was considerable instability, with one-quarter of the cohort changing their status. Medication exposure was strongly associated with the incidence of the condition, with recent exposure to diuretics or daily aspirin strongly predicting it.
Publisher: Oxford University Press (OUP)
Date: 06-2008
Abstract: Dentistry is understood to be a stressful profession. Although there has been recent research about stress and dentistry in the UK and the Netherlands, little is known about the job stressors and coping strategies of New Zealand dentists. To investigate job stressors and coping strategies among New Zealand dentists. A nationwide postal survey of a representative s le of 700 dentists. The response rate was 65%. The most commonly reported stressors were treating difficult children (52%), constant time pressure (48%) and maintaining high levels of concentration (43%). The strategies most utilized for managing work-related stress included interactions with people (78%), sports (64%) and forgetting about work (59%). Dentists who had graduated overseas reported more sources of stress than New Zealand graduates. There were differences in the strategies used by male and female practitioners to manage stress. There is considerable variation in the number of stressors experienced by dentists. Overseas-qualified dentists appear to be under more stress than New Zealand-trained dentists and may need greater professional support. Dentists should be encouraged to make greater use of active coping strategies.
Publisher: Elsevier BV
Date: 04-1997
DOI: 10.1016/S0005-7967(96)00096-4
Abstract: Studies of dental fear and oral disease suggest that conditioning processes are important in the acquisition of dental fear. At this time, however, definitive conclusions are premature as all research on the etiology of dental fear has been retrospective in design, with most confined to analogue or clinic s les. This study redressed these limitations by prospectively investigating the relationship between oral health (i.e. caries experience) at age 5 and 15 yr and the report of dental fear at age 18 in a large, unselected birth cohort. Caries experience at age 5 was not related to the development of dental fear in late adolescence. In contrast, caries experience at age 15 was significantly, and specifically, related to the report of dental fear at age 18. A ratio of caries severity at age 15, indicating the extent of multi-surface involvement, was inversely related to dental fear at age 18. This intriguing finding suggests that relatively brief dental treatment occasioned by low levels of dental disease may result in the incubation of dental fear in some in iduals and that longer episodes of treatment may facilitate fear habituation. Theoretical and practical implications of these findings are discussed.
Publisher: SAGE Publications
Date: 21-01-2010
Abstract: To date, the evidence supporting the benefits of dental visiting comes from cross-sectional studies. We investigated whether long-term routine dental visiting was associated with lower experience of dental caries and missing teeth, and better self-rated oral health, by age 32. A prospective cohort study in New Zealand examined 932 participants’ use of dentistry at ages 15, 18, 26, and 32. At each age, routine attenders (RAs) were identified as those who (a) usually visited for a check-up, and (b) had made a dental visit during the previous 12 months. Routine attending prevalence fell from 82% at age 15 to 28% by 32. At any given age, routine attenders had better-than-average oral health, fewer had teeth missing due to caries, and they had lower mean DS and DMFS scores. By age 32, routine attenders had better self-reported oral health and less tooth loss and caries. The longer routine attendance was maintained, the stronger the effect. Routine dental attendance is associated with better oral health.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.JDENT.2019.103267
Abstract: To be fit-for-purpose, oral health-related quality of life instruments must possess a range of psychometric properties which had not been fully examined in the 16-item Short Form Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ Fit to the Rasch model was examined in 6648 8-to-15-year-olds from Australia, New Zealand, Brunei, Cambodia, Hong Kong, Malaysia, Thailand, Germany, United Kingdom, Brazil and Mexico. In all but two items, the initial five answer options were reduced to three or four, to increase precision of the children's selection. Items 10 (Shy/embarrassed) and 11 (Concerned what others think) showed an 'extra' dependency between item scores beyond the relationship related to the underlying latent construct represented by the instrument, and so were deleted. Without these two items, the CPQ was unidimensional. The three oral symptoms items (4 Food stuck in teeth, 3 Bad breath and 1 Pain) were required for a sufficient person-item coverage. In three out of 14 items (21 %), Europe and South America showed regional differences in the patterns of how the answer options were selected. No differential item functioning was detected for age. Except for a few modifications, the present analysis supports the combination of items, the cross-cultural validity of the CPQ with 14 items and the extension of the age range from 8 to 15 years. The valid, reliable, shortened and age-extended version of the CPQ resulting from this study should be used in routine care and clinical research. Less items and a wider age range increase its usability. Symptoms items are needed to precisely differentiate between children with higher and lower quality of life.
Publisher: Wiley
Date: 21-11-2008
DOI: 10.1111/J.1600-0722.2008.00579.X
Abstract: The objective of the study was to compare the performance of four short-form versions of the Child Perceptions Questionnaire (CPQ(11-14)) with that of the long-form version in a random population s le of 12- and 13-yr-old children from New Zealand in order to determine which short-form version was the most valid. Children (n = 430, participation rate 74.1%) completed the 37-item CPQ(11-14). Two separate 8- and 16-item short-form versions were previously developed using (a) item impact and (b) regression methods. The four different short-form scales were compared with the full CPQ(11-14) on their construct validity. The children were examined for malocclusion (using the Dental Aesthetic Index) and for dental caries by a single examiner (L.F.P.). All short-form versions revealed substantial variability in overall oral health-related quality of life (OHRQoL). Cronbach's alpha ranged from 0.73 (Regression Short Form [RSF]-8) to 0.86 (RSF-16). For all short-form versions, mean scores were positively associated with self-rated oral health and overall wellbeing associations with the latter were stronger. All short-form versions detected OHRQoL gradients, as hypothesized, across ascending categories of caries and malocclusion. These findings suggest that the short-form versions of the CPQ(11-14) all show acceptable properties, but that the 16-item versions perform better (and are essentially equivalent) however, the stronger theoretical underpinning of the item-impact-derived 16-item short-form version suggests that it shows the most promise.
Publisher: Informa UK Limited
Date: 29-08-2019
Publisher: Wiley
Date: 02-11-2018
DOI: 10.1111/CDOE.12348
Abstract: To use recent national survey data to compare dentition status and oral diseases in China and New Zealand (NZ), with a particular focus on differences by sex and education level. We undertook secondary analysis of representative data from oral health surveys conducted in 2009 in Sichuan (China) and NZ. Both surveys had an oral examination component and collected detailed demographic data. Socioeconomic position in this analysis was represented by the highest level of education completed. Participants were allocated to 1 of 3 comparable ordinal categories of years of education (primary, middle or tertiary). Analyses used survey weights. The proportion of Chinese who had been educated to only primary level was 3 times higher than that among their NZ counterparts, and the proportion with a tertiary education was correspondingly lower. In the 35-44 age group, the dentate proportions were similar, although the mean number of teeth was higher in China than in NZ. There were substantial differences in dental caries experience, with the mean DMFT in NZ being almost 3 times that observed in China. New Zealanders had more filled teeth, but the prevalence of 1+ missing teeth was lower. Periodontitis was more common in the NZ s le than in the Chinese one, although the extent of bleeding on probing was almost 3 times higher among the latter. For the 65-74 age group, there were significant differences in dentition status, with greater tooth retention among Chinese people. There were also significant differences in dental caries experience, with Chinese 65- to 74-year-olds having more decayed teeth but fewer filled or missing teeth, and lower DMFT scores, on average. Periodontal health was better among the New Zealanders. There were notable differences by sex and education level. The differences observed in this study provide strong support for using broader sociocultural models of oral health.
Publisher: Elsevier BV
Date: 08-2001
Abstract: The purpose of this study was to describe the presence and impaction status of people's third molars at age 18 years, as well as the observed changes in their clinical status between ages 18 and 26 years. Eight hundred twenty-one participants in a prospective cohort study were dentally examined at ages 18 and 26 years, and panoramic radiographs were taken at age 18 years but not at 26 years. For each tooth, its radiographic impaction status at age 18 years was compared with the clinical status by age 26 years. Of the 2857 third molars assessed at age 18 years, 92.8% were able to be followed up clinically at age 26 years. Approximately 54.9% of the teeth that were not impacted by age 18 had erupted by 26 years. Of the teeth that were impacted by age 18, 33.7% had fully erupted by age 26, 31.4% had been extracted, and 13.1% remained unerupted. Of the maxillary teeth that were categorized as "impacted" at age 18 years, 36.2% had fully erupted by age 26, whereas only 25.6% of the mandibular teeth had done so (P <.01). Fewer mandibular teeth than maxillary teeth remained unerupted by the time the patient was 26 years old (27.4% and 41.4%, respectively P <.01), but there was no significant difference between the jaws in the proportion of impacted teeth at age 18 years that had been extracted by age 26 years (29.6% and 30.3%, respectively). For mesioangularly impacted third molars, 39.3% of maxillary teeth and 20.4% of mandibular teeth had fully erupted by age 26. Of the third molars that were mesioangularly impacted at age 18 years, 39.3% of maxillary teeth and 20.4% of mandibular teeth had fully erupted by age 26 years, whereas almost one-third of each had been extracted. Of the distoangularly impacted third molars, 20.4% of the maxillary teeth and one-third of the mandibular teeth had erupted by age 26, with 21.6% of the maxillary teeth and 31.6% of the mandibular teeth having been extracted. Other than horizontally impacted third molars, a substantial proportion of other impaction types do erupt fully, and radiographically apparent impaction in late adolescence should not be sufficient grounds for their prophylactic removal in the absence of other clinical indications.
Publisher: Wiley
Date: 14-08-2020
DOI: 10.1111/EDT.12505
Abstract: Little is known about adult dental trauma experience at the population level. The aim of this study was to estimate the prevalence and associations of dental injuries in New Zealand (NZ) adults. Information about dental and orofacial trauma in a representative s le of NZ adults (aged 18-94) was collected in a national oral health survey. As well as self-reported information, the maxillary six anterior teeth were examined for signs of dental trauma. Survey weights were used. Of the 40.9% (95% CI: 37.6, 44.2) who reported previous orofacial trauma, 69.1% (95% CI: 64.3, 73.5), or just over one-quarter of the s le, reported that this included a dental injury. More males than females had experienced orofacial trauma (51.3% [95% CI: 45.8, 56.8] and 31.4% [95% CI: 27.9, 35.1], respectively). The most common injury was a "chipped or broken tooth" (66.6%, 95% CI: 60.6, 72.1). Almost three-quarters had sought treatment. Clinical examination revealed an overall trauma prevalence of 23.4% (95% CI: 21.0, 26.0) with more males than females affected. Some 14.9% (95% CI: 12.8, 17.2) had one injured tooth, while 6.5% (95% CI: 5.2, 8.1) had two injured teeth. The maxillary central incisors were the most frequently affected. Most participants with clinical signs of trauma had only one of the six maxillary teeth affected. The most common clinical dental trauma observation was evidence of "treatment" or an "untreated enamel fracture", and these were more common among males and those aged 35-44 years. Traumatic dental injuries constitute an important public health issue. More emphasis on preventing them in the NZ adult population is warranted, and public awareness of State-funded cover for dental injuries may need to be bolstered to enable equitable access for injury care. Overall, a greater emphasis on prevention and the importance of initial care for dental injuries could reduce the in idual and societal burden.
Publisher: Wiley
Date: 10-05-2017
DOI: 10.1111/JOOR.12514
Abstract: The objectives of this study were to test the hypothesis that self-reported TMJ clicking sounds in adolescents are positively associated with non-specific somatic symptoms, self-perception of body image and care-seeking behaviour. A cross-sectional study was carried out in 353 young adolescents (48·4% females) recruited from community (N = 272) and orthodontic clinic (N = 81) settings. Assessments included self-reported TMJ clicking, non-specific physical symptoms, body image concerns and for the clinic s le only, the source of motivation for treatment. TMJ sounds were self-reported by 19% of the s le and were associated with higher scores for non-specific physical symptoms and body image concerns (P < 0·001). Adolescents who were self-motivated to seek orthodontic treatment had greater scores for non-specific physical symptoms, more body image concerns and tended to report TMJ sounds more often (26·3% and 7·7% respectively P = 0·41) than those who were solely parent/family-motivated to seek treatment. Self-reported TMJ sounds in adolescents were associated with a propensity to somatisation and concerns with body image. Care-seeking adolescents have greater non-specific physical symptoms and body image concerns and tend to report more frequent TMJ sounds.
Publisher: Wiley
Date: 20-01-2004
Publisher: Wiley
Date: 10-10-2017
DOI: 10.1111/ADJ.12565
Abstract: Since the pioneering work of van Leeuwenhoek in 1684, subsequently built upon by other renowned microbiologists Robert Koch, Willoughby Miller and GV Black, oral microbiology has developed innovative techniques to study the oral microflora (now termed the 'oral microbiome'). The advent of molecular techniques such as DNA-DNA hybridization, polymerase chain reaction and DNA sequencing has created an array of opportunities to construct a comprehensive picture of the ersity and composition of the oral microbiome. Approximately 700 oral bacterial species have been identified, of which 50% have yet to be cultivated, and some of these are known only by their signature DNA sequences. The synergism of ever-evolving culture-based and state-of-the-art culture-independent molecular techniques has facilitated in-depth understanding of the dynamics, acquisition and transfer of oral bacteria, along with their role in oral and general health and disease. Further research is needed to not only analyse but also to make sense of the ever-increasing volumes of data which these molecular techniques (especially high-throughput DNA sequencing) are generating, as well as why particular bacteria are present and what they are 'actually doing' there. This review presents a comprehensive literature search of oral microbiology-related methods currently used to study the oral microbiome.
Publisher: Wiley
Date: 2001
DOI: 10.1111/J.1708-8208.2001.TB00124.X
Abstract: Prospective evaluation of the early loading of unsplinted Brånemark implants with mandibular overdentures opposing conventional dentures is not evident in the implant-related literature. To clinically evaluate progressive and early loading of 20 unsplinted conical Brånemark implants in edentulous mandibles with overdentures. Ten edentulous patients all had two conical Brånemark implants placed in the anterior mandible with mandatory primary stability with bicortical anchorage. Ball abutment connection was performed simultaneously. Previously constructed conventional mandibular dentures were temporarily relined with tissue conditioner postoperatively and worn with moderation for the first 2 weeks to allow progressive loading. Early loading of the implants followed after 2 weeks, with inclusion of the respective matrices in the mandibular dentures, using a definitive reline procedure. All patients successfully functioned with their mandibular implant overdentures from 2 to 52 weeks postoperatively. Mean marginal bone loss was within established criteria for success: 0.22 mm (SD = 0.48 mm) mesially and 0.30 mm (SD = 0.39 mm) distally on the conical implants. Mobility tests using the Periotest instrument became more negative, although not at statistically significant levels. Difficulties in the management of the peri-implant mucosa between surgery and loading at 2 weeks were observed in 40% of the patients. These preliminary 1-year results show that successful early loading of unsplinted conical Brånemark implants with mandibular overdentures is possible.
Publisher: Wiley
Date: 17-10-2011
Publisher: Wiley
Date: 04-2002
Publisher: Wiley
Date: 06-2006
DOI: 10.1111/J.1752-7325.2006.TB02564.X
Abstract: To describe adult oral health inequalities using an area-based and household-based measure of socioeconomic status (SES). Self-report questionnaires (seeking information on sociodemographic, oral health and oral self-care) were sent to a random s le of adults from the Dunedin South Electorate, New Zealand. Household- and area-based SES measures were collected. The main outcome measures were edentulism prevalence, average-poor self-rated oral health and not having visited a dentist for 2+ years. Data were weighted to produce population-based estimates. The response rate was 78.2% the s le mean age was 47 years (sd, 17 range 18-92 years) and females comprised 54.0%. Edentulism was most prevalent among those from low-SES households who were resident in high-deprivation areas (P<0.0001). Poor self-rated oral health (P<0.0001) and 2+ years since the last dental visit (P<0.0001) were also most prevalent among these same in iduals. In contrast, respondents from high-SES households located in the least deprived areas had the lowest prevalence of edentulism, poor self-reported oral health or 2+ years since their last dental visit. Those from the other household/area SES combinations occupied intermediate positions. There may be added value to dental public health in using a dual socio-economic measurement approach to population research, with greater oral health gains perhaps being possible by concentrating resources and clinical effort on people living in low-SES households in highly-deprived areas, rather than those living in low-SES households in areas that are not deprived.
Publisher: Wiley
Date: 25-06-2007
DOI: 10.1111/J.1600-0528.2007.00374.X
Abstract: To estimate the nature and magnitude of changes in oral health-related quality of life (OHRQoL) among children having dental treatment under general anaesthetic (GA) and to examine the evaluative properties of the Child Oral Health-related Quality of Life Questionnaire (COHQOL). Data from a consecutive clinical s le of the parents/caregivers of children receiving dental treatment under GA at Wellington and Kenepuru Hospitals were collected from parents using the Parental-Caregivers Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS), which both form part of the COHQOL Questionnaire. The first questionnaire was completed before treatment or while the participant's child was undergoing treatment. The follow-up questionnaire was completed 1-4 weeks afterward. Treatment-associated changes in OHRQoL were determined by comparing baseline and follow-up data for the mean scores and the prevalence of impacts. The discriminative properties of the instrument were confirmed and then its evaluative properties were assessed (by examining its test-retest reliability, responsiveness and longitudinal construct validity). The minimally important difference was determined for the overall scale and subscales. Complete baseline and follow-up data were obtained for 202 and 130 participants, respectively (64.4% follow-up rate). The evaluative properties of the P-CPQ and FIS were acceptable. There were substantial and highly statistically significant reductions in mean P-CPQ and FIS scores after treatment, with effect sizes ranging from moderate to large, depending on the subscale being examined. The minimally important difference was shown by almost two-thirds of the children treated. The provision of dental treatment under GA for young children with severe dental caries experience is associated with substantial and highly significant improvements in both their OHRQoL and in the impact on their families. The P-CPQ and the FIS show promise as evaluative measures for use in dental health services research.
Publisher: Wiley
Date: 23-09-2015
DOI: 10.1111/CID.12159
Abstract: Titanium (Ti) implants have been used in the last four decades to replace missing teeth. Alternatives to Ti such as zirconia (Zr) may offer aesthetic advantages and be more acceptable to patients and clinicians concerned about Ti allergy but must show equivalent biological acceptability to Ti. The research aimed to investigate soft and hard tissue response to Ti and Zr implants in edentulous patients. The research included 24 participants (Ti = 12, Zr = 12) restored with one-piece ball-abutment implants to support overdentures. Participants received four maxillary implants (two in the premolar alveolus, one off center in the alveolar midline, and one wide-diameter implant in the anterior median palate) and three mandibular implants (one in the midline and bilateral posterior implants). Success rates for both Ti and Zr implants were low, 67.9% for all alveolar implants and a survival rate of 50.0% for the palatal implants. Only 11 (52.4%) of 21 palatal implants survived the follow-up period. Peri-implant health was equivalent for Ti and Zr implants and showed no statistically significant changes from loading to the 1-year follow-up. Statistically significant differences were noted in radiographic bone level between Ti and Zr implants (p = .02), with Zr showing greater bone loss. Although the failure rates with the one-piece Zr implants were higher than with the Ti ones, suggesting that the former's clinical usage as in this study cannot be recommended, it should be borne in mind that the fault may also lie with the novel prosthodontic design which was used.
Publisher: Wiley
Date: 24-08-2022
DOI: 10.1111/CDOE.12772
Abstract: This study aimed to investigate whether childhood dental caries was associated with self‐reported general health in midlife. We used data on childhood oral health (caries experience) and adult self‐reported general health from two New Zealand longitudinal birth cohorts, the Dunedin Multidisciplinary Health and Development Study ( n = 922 and n = 931 at ages 5 and 45 years, respectively), and the Christchurch Health and Development Study ( n = 1048 and n = 904 at ages 5 and 40 years, respectively). We used generalized estimating equations to examine associations between age‐5 dental caries and self‐rated general health and the number of self‐reported physical health conditions at ages 45/40 (diagnosed by a doctor or health professional, n = 14 conditions among both cohorts). Covariates included known risk factors for poor health (SES, IQ, perinatal complications), and personality style, which is known to affect subjective health ratings. Incidence rate ratios for ‘Excellent’ self‐rated health were lower among those who had high experience of dental caries as children than those who had not in both, the Dunedin (IRR, 0.76 95% CI, 0.50, 1.14) and Christchurch studies (IRR, 0.69 95% CI, 0.47, 1.00). Childhood dental caries was not associated with the number of self‐reported physical health conditions in midlife, in either cohort. Dunedin Study members who at age 5 were not caries‐free or whose parents rated their own or their child’s oral health as poor were less likely to report ‘Excellent’ self‐rated general health at age 45 than those who were caries‐free and whose parents did not give a ‘poor’ rating (IRR, 0.69 95% CI, 0.49, 0.97). Five‐year‐olds with greater caries experience were more likely to have poorer self‐rated general health by midlife. Beyond this longitudinal association, future research should examine whether childhood dental caries is associated with objective/biological markers of physical health and whether it may have utility as an early indicator for poor general health in adulthood.
Publisher: Wiley
Date: 26-05-2010
DOI: 10.1111/J.1741-2358.2009.00306.X
Abstract: The aim of this study was to obtain a deeper understanding of the social factors driving New Zealand's historic 'epidemic of edentulism' and how they operated. In-depth, semi-structured interviews with 31 older New Zealanders were analysed using applied grounded theory. Universal factors present in the data were: (a) the way in which New Zealand society accepted and indeed encouraged edentulism without stigma for those who had a 'sub-optimal' natural dentition (b) how the predominant patterns of dental care utilisation (symptomatic and extraction-based) were often strongly influenced by economic and social disadvantage and (c) the way in which lay and professional worldviews relating to 'calcium theory' and dental caries were fundamental in decisions relating to the transition to edentulism. Major influences were rural isolation, the importance of professional authority and how patient-initiated transitions to edentulism were ultimately facilitated by an accommodating profession. The combined effects of geography, economics, the dental care system and the professional culture of the day, in the context of contemporary (flawed) understandings of oral disease, appear to have been the key drivers. These were supported (in turn) by a widespread acceptance by the profession and society alike of the extraction/denture philosophy in dealing with oral disease.
Publisher: Wiley
Date: 14-06-2021
DOI: 10.1111/JPHD.12466
Abstract: Many believe women's oral health deteriorates as a result of having children. If so, such associations should exist among women but not among men. The aims of this study were to investigate whether number of children is associated with experience of dental disease and tooth loss among both men and women and to examine whether this association is affected by other variables of interest. This study used data from the Dunedin Multidisciplinary Health and Development study, a longitudinal study of 1037 in iduals (48.4% female) born from April 1972 to March 1973 in Dunedin, New Zealand, who have been examined repeatedly from birth to age 45 years. Data were available for 437 women and 431 men. Those with low educational attainment were more likely to have more children and began having children earlier in life. Having more children was associated with experiencing more dental caries and tooth loss by age 45, but this association was dependent on the age at which the children were had. Those entering parenthood earlier in life (by age 26) had poorer dental health than those entering parenthood later in life, or those without children. There was no association between number of children and periodontal attachment loss (PAL). Low educational attainment, poor plaque control, never routine dental attendance, and smoking (for PAL) were associated with PAL, caries experience, and tooth loss. Social factors associated with both the timing of reproductive patterns and health behaviors influence the risk of dental disease and its management.
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.ORALONCOLOGY.2011.04.023
Abstract: To assess the cross-sectional construct validity of the Malay-translated and cross-culturally adapted FACT-H&N (v 4.0) for discriminative use in a s le of Malaysian oral cancer patients. A cross-sectional study of adults newly diagnosed with oral cancer. HRQOL data were collected using the FACT-H&N (v 4.0), a global question and a supplementary set of eight questions ('MAQ') obtained earlier in pilot work. Of the 76 participants (61.8% female 23.7% younger than 50), most (96.1%) had oral squamous cell carcinoma two-thirds were in Stages III or IV. At baseline, patients' mean FACT summary (FACT-G, FACT-H&N, FACT-H&N TOI, and FHNSI) and subscale (pwb, swb, ewb, fwb, and hnsc) scores were towards the higher end of the range. Equal proportions (36.8%) rated their overall HRQOL as 'good' or 'average' fewer than one-quarter rated it as 'poor', and only two as 'very good'. All six FACT summary and most subscales had moderate-to-good internal consistency. For all summary scales, those with 'very poor oor' self-rated HRQOL differed significantly from the 'good/very good' group. All FACT summary scales correlated strongly (r>0.75). Summary scales showed convergent validity (r>0.90) but little discriminant validity. The discriminant validity of the FHNSI improved with the addition of the MAQ. The FACT-H&N summary scales and most subscales demonstrated acceptable cross-sectional construct validity, reliability and discriminative ability, and thus appear appropriate for further use among Malaysian oral cancer patients.
Publisher: Wiley
Date: 18-07-2011
Publisher: Wiley
Date: 30-08-2018
DOI: 10.1111/CDOE.12414
Publisher: SAGE Publications
Date: 25-09-2009
Abstract: Socio-economic variations in health exist for a wide range of health outcomes, including oral health and oral-health-related quality of life (OHRQoL). Less is known regarding how socio-economic trajectories may influence oral health and OHRQoL. This study examined whether social mobility is related to the number of teeth retained by age 50 years and OHRQoL measured at the same time, using data from the Newcastle Thousand Families Study, a birth cohort established in 1947. Women remaining in the non-manual class had the greatest tooth retention. While promotion of a healthier lifestyle and continued improvements in oral hygiene throughout life appear to be the public health interventions most likely to improve oral health into middle age, there may be sub-groups of the population on which different approaches in terms of public health interventions need to be focused.
Publisher: MDPI AG
Date: 10-2021
Abstract: With a reported prevalence between 20% and 30%, dry mouth is more common among older people than any other age group. The major risk factor for dry mouth is polypharmacy. Older people take more medications than any other age group, not only for symptomatic relief of various age-associated chronic diseases, but also to reduce the likelihood of the complications that may arise from those conditions. Most aged care residents take even more medications than older people who are living in their own homes. The greater the number of medications taken, the greater the associated anticholinergic burden, and the more likely it is that the in idual will suffer from dry mouth. The condition not only affects the dentition and ability to wear dentures, but also the sufferers’ quality of life. Treating dry mouth is a considerable challenge for clinicians. As medication use is by far the most important risk factor, there is a need for pharmacists, doctors and dentists to work together to prevent this from occurring. Medication review and deprescribing is a key strategy, but there have not yet been any randomised control trials of its efficacy in reducing the occurrence of dry mouth.
Publisher: SAGE Publications
Date: 03-2005
DOI: 10.1177/154405910508400310
Abstract: The notion that caries in primary teeth causes developmental defects of enamel in permanent teeth has been recently revived. The research objective was to test this hypothesis through analysis of data from the Dunedin Multidisciplinary Health and Development Study, a longstanding prospective cohort study. The maxillary incisors of 663 children were assessed for existing restorations and dental caries at age five and for developmental defects of enamel at age nine. Where a primary tooth had been carious, the permanent successor was more likely to have a demarcated opacity after adjustment for gender, family socio-economic status, years of exposure to water fluoridation, trauma to primary teeth, and early loss of primary teeth (unadjusted OR = 2.3, 95% CI 1.3, 4.1 adjusted OR = 2.2, 95% CI 1.1, 4.3). These findings support a time-ordered association between dental caries in primary maxillary incisors and demarcated opacities in their permanent successors.
Publisher: Springer Science and Business Media LLC
Date: 21-12-2010
Publisher: Elsevier BV
Date: 2003
Publisher: Wiley
Date: 12-08-2012
DOI: 10.1111/J.1600-0579.2012.00774.X
Abstract: Research suggests that students' perceptions should be considered in any discussion of their education, but there has been no systematic examination of New Zealand postgraduate dental students' learning experiences. This study aimed to obtain in-depth qualitative insights into student and graduate perceptions of effective and ineffective learning in postgraduate dental education. Data were collected in 2010 using semi-structured in idual interviews. Participants included final-year students and graduates of the University of Otago Doctor of Clinical Dentistry programme. Using the Critical Incident Technique, participants were asked to describe atleast one effective and one ineffective learning experience in detail. Interview transcripts were analysed using a general inductive approach. Broad themes which emerged included supervisory approaches, characteristics of the learning process, and the physical learning environment. This paper considers students' and graduates' perceptions of postgraduate supervision in dentistry as it promotes or precludes effective learning. Effective learning was associated by participants with approachable and supportive supervisory practices, and technique demonstrations accompanied by explicit explanations. Ineffective learning was associated with minimal supervisor demonstrations and guidance (particularly when beginning postgraduate study), and aggressive, discriminatory and/or culturally insensitive supervisory approaches. Participants' responses provided rich, in-depth insights into their reflections and understandings of effective and ineffective approaches to supervision as it influenced their learning in the clinical and research settings. These findings provide a starting point for the development of curriculum and supervisory practices, enhancement of supervisory and mentoring approaches, and the design of continuing education programmes for supervisors at an institutional level. Additionally, these findings might also stimulate topics for reflection and discussion amongst dental educators and administrators more broadly.
Publisher: Wiley
Date: 08-2008
Abstract: The prevalence of diabetes in New Zealand is reaching epidemic proportions, with serious implications for oral health. We investigated the attitudes, beliefs, and practices of New Zealand (NZ) general dental practitioners (GDPs) with respect to the management of patients with diabetes and contrasted the NZ findings with those from a similar survey of GDPs in the Northeast United States (NE US) conducted in 2002. A nationwide postal survey was conducted of NZ dentists. A random s le was selected from the 2005 New Zealand Dental Register. Responses were received from 437 dentists (response rate: 64.5%). The s le was representative. Most GDPs participated in the assessment and discussion phases of managing patients with diabetes, but the prevalence of more hands-on activities (such as testing) was considerably lower. Three-quarters of dentists asked new patients about their type of diabetes. Just over two in five respondents believed that their evaluation and/or management of the patient with diabetes were hindered by the lack of continuing education opportunities. Almost one-third of dentists were unwilling to screen for diabetes using a finger-stick test, and only 2.6% overall had ever done so. There were only minor differences between NZ and NE US dentists. Given the increasing numbers of patients with diabetes (known and unknown), there is a need for NZ and US dentists to be more involved in their active management.
Publisher: Elsevier BV
Date: 09-2011
Publisher: Wiley
Date: 28-05-2016
DOI: 10.1111/EJE.12209
Abstract: Currently, there is a lack of studies focusing on professional doctoral students' and graduates' perceptions of their learning environment, in particular, using a qualitative approach to elicit in-depth information. This article aims to contribute to the existing body of knowledge by systematically exploring, critically analysing and getting a deeper understanding of professional doctorate dental students' and graduates' insights into effective and ineffective clinical and physical learning environment characteristics. The study included a total of 20 participants. Participants included 16 final-year Doctor of Clinical Dentistry (DClinDent) students and four dental specialists (graduates of the DClinDent programme). Semi-structured, in idual interviews were used. Participants were asked to reflect upon and describe in detail their effective and ineffective learning environment experiences. The critical incident technique was used to guide the data collection. Data were analysed using a general inductive qualitative approach. Learning environment characteristics which participants associated with effective learning included the following: sufficient opportunities for comprehensive treatment planning introduction to a number of patient treatment philosophies a sufficient number of complex cases clinically oriented research and assignment topics a focus on clinical training in the programme generally a research topic of a realistic depth and breadth, suitable for their 'specialist training' degree and a well-resourced and updated physical infrastructure. On the other hand, most participants indicated that the absence of an adequate number of clinical cases, an overemphasis on research (as opposed to clinical practice) in the DClinDent programme and an 'outdated' physical infrastructure in the dental school clinics could h er effective clinical learning. These findings contribute to the meaningful advancement of the literature on learning environment strategies through the exploration of (and in-depth qualitative insights into) what facilitated effective learning by New Zealand professional doctorate candidates and graduates. These findings provide a starting point for reflection by international academic directors, educational developers, curriculum planners, programme managers and clinical teachers in respect of the further development of the learning environment. Although the findings from this study may not be directly transferable to all international contexts, they have the potential to contribute to the further development of theory in this area.
Publisher: Wiley
Date: 21-11-2012
DOI: 10.1111/IPD.12011
Abstract: OHRQoL comprises an apparently complex array of biological and psychological aspects of oral health. To determine the relative contribution of sociodemographic, psychosocial, or clinical characteristics to OHRQoL in adolescents. A cross-sectional study of Dunedin adolescents was carried out. Each participant completed a self-administered questionnaire and underwent a clinical examination. Information collected included sociodemographic characteristics (sex, ethnicity, and household deprivation), psychosocial characteristics (self-esteem, psychological well-being, somatisation, and self-perception scores for body image), and clinical measures (DMFS and Dental Aesthetic Index). OHRQoL was measured using the 16-item impact short-form CPQ₁₁₋₁₄ questionnaire. Linear regression analyses used the CPQ₁₁₋₁₄ as the dependent variable, with independent variables entered in related groups. Three hundred and fifty-three children (48.4% females) took part, representing a 58.8% response rate. Linear regression modelling of the CPQ₁₁₋₁₄ score showed that sociodemographic characteristics were predictors, but the model's overall explanatory power was low (R(2) = 0.05). This increased slightly with inclusion of the clinical variables. When the psychosocial variables were added, however, the R(2) increased to 0.50 all psychosocial variables (except self-esteem) were strongly associated with the CPQ₁₁₋₁₄ score. Psychological well-being was the strongest predictor. Psychosocial characteristics are important contributors to OHRQoL in adolescents and appear to be more important than sociodemographic or clinical characteristics.
Publisher: S. Karger AG
Date: 22-05-2023
DOI: 10.1159/000530378
Abstract: Dental caries is a chronic and cumulative disease but little has been reported on the continuity of the disease and its treatment through life. Group-based multi-trajectory modeling was used to identify developmental trajectories of untreated carious tooth surfaces (DS), restored tooth surfaces (FS), and teeth extracted due to caries (MT) from ages 9 to 45 years in a New Zealand longitudinal birth cohort, the Dunedin Multidisciplinary Health and Development Study ( i n /i = 975). Associations between early-life risk factors and trajectory group membership were examined by specifying the probability of group membership according to a multinomial logit model. Six trajectory groups were identified and labeled: “low caries rate” “moderate caries rate, maintained” “moderate caries rate, unmaintained” “high caries rate, restored” “high caries rate, tooth loss” and “high caries rate, untreated caries”. The two moderate-caries-rate groups differed in count of FS. The three high-caries-rate groups differed in the relative proportion of accumulated DS, FS, and MT. Early childhood risk factors associated with less favorable trajectories included higher dmfs scores at age 5, lack of exposure to community water fluoridation during the first 5 years of life, lower childhood IQ, and low childhood socioeconomic status. Parent self-ratings of their own or their child’s oral health as “poor” were associated with less favorable caries experience trajectories. Children who had clinical signs of dental caries together with a parent rating of child’s oral health as poor were more likely to follow a less favorable caries trajectory. Higher deciduous dentition caries experience at age 5 years was associated with less favorable caries trajectories, as were children whose parents gave “poor” ratings of their own or their child’s oral health. These findings highlight the considerable intergenerational continuity in dental caries experience from early childhood to midlife. Subjective measures of child oral health are informative and might aid as predictors of adult caries experience in cases where childhood dental clinical data were not available.
Publisher: American Public Health Association
Date: 04-2015
Publisher: Wiley
Date: 10-2001
DOI: 10.1111/J.1708-8208.2001.TB00140.X
Abstract: Evidence-based reports are needed to support the application of a one-stage surgical protocol for unsplinted implants supporting mandibular overdentures. To examine the feasibility and success of using two different dental implant systems (originally designed for two-stage operative technique) using a one-stage operative procedure in patients being rehabilitated with implant mandibular overdentures. The study s le involved 24 edentulous subjects (aged 55-80 yr) randomly allocated to two different implant systems, one with a machined titanium implant surface (Steri-Oss, Nobel Biocare, Göteborg, Sweden) and the other with a roughened titanium surface (Southern Implants, Ltd., Irene, South Africa). Two unsplinted implants to support implant overdentures were placed in the anterior mandible of all patients, using a standardized one-stage surgical and prosthodontic procedure. Primary stability and bicortical anchorage of the implants was mandatory before healing abutments were connected at the time of implant placement. Implant overdentures and their respective matrices were inserted following a standard 12-week healing period. Data relating to mobility tests, radiographs, and peri-implant parameters were documented at 12, 16, and 52 weeks after surgery. A success rate of 95.8% for the Steri-Oss and 100% for the Southern Implants was found, without any statistically significant differences in the marginal bone loss. Significant changes in Periotest values were observed for both types between 12 and 52 weeks (p < .001). Minor changes were observed in the peri-implant parameters evaluated. These preliminary findings show a successful application of this one-stage approach for unsplinted implants supporting mandibular overdentures with Steri-Oss and Southern Implant Systems.
Publisher: Wiley
Date: 27-09-2010
DOI: 10.1111/J.1600-0501.2010.02004.X
Abstract: To determine surgical and prosthodontic outcomes of mandibular single-implant overdentures, opposing complete maxillary dentures, using a wide diameter implant and large ball attachment system compared with different regular diameter implants with standard attachment systems. Thirty-six edentulous participants (mean age 68 years, SD 9.2) were randomly assigned into three treatment groups (n=12). A single implant was placed in the mandibular midline of participants to support an overdenture using a 6-week loading protocol. The control group received Southern regular implants and standard ball attachments. One group received Southern 8-mm-wide implants and large ball attachments. Another group received Neoss regular implants and Locator attachments. Parametric and non-parametric tests of a statistical software package (SPSS) were used to determine between groups differences in marginal bone loss, implant stability, implant, and prosthodontic success (P<0.05). Implant success after 1 year was 75% for Southern regular implant (control) group and 100% for the Southern wide and Neoss regular implant groups (P=0.038). Mean marginal bone loss at 1 year was 0.19 mm (SD 0.39) without significant differences observed. Implant stability quotient (ISQ) at baseline was significantly lower for the Southern regular (control) group than the other two groups (P=0.001 P=0.009). At 1 year, no significant difference in implant stability was observed (mean ISQ 74.6, SD 6.1). The change in implant stability from baseline to 1 year was significant for the control group (P=0.025). Prosthodontic success was comparable between the groups but the maintenance (41 events overall, mean 1.2) was greater for the Locator and the standard ball attachments. Mandibular single-implant overdentures are a successful treatment option for older edentulous adults with early loading protocol using implants of different diameters and with different attachment systems.
Publisher: Wiley
Date: 16-04-2012
DOI: 10.1111/J.1752-7325.2012.00336.X
Abstract: To examine dental caries experience among New Zealand adolescents and determine the nature of caries-associated differences in oral-health-related quality of life (OHRQoL) among adolescents. Follow-up was conducted of a random s le of 430 children first examined in 2003 at age 13, when they completed the Child Perceptions Questionnaire (CPQ(11-14) ). At age 16, 255 (59.3% of the baseline s le) were re-examined and again completed the CPQ(11-14) . Caries prevalence (1 + DMFS) rose from 68% to 79.2% mean DMFS rose from 2.9 (SD 4.7) to 3.6 (SD 4.8), and the prevalence of high caries experience (5 + DMFS) rose from 20.0% to 40.8%. The 3-year mean net caries increment of 0.5 surfaces (SD 2.6) was dominated by occlusal surfaces. At both ages, overall CPQ(11-14 ) scores, as well as emotional well-being subscale scores, were significantly higher for those with DMFS values of 5 or more. Caries experience increased over the three years this age group is caries-active. Dental caries affects adolescents' OHRQoL, although not as strongly as maybe expected.
Publisher: Wiley
Date: 08-06-2023
DOI: 10.1111/CDOE.12887
Abstract: That no study has investigated oral health‐related quality of life (OHRQoL) through the transition from adolescence to young adulthood is partly due to no OHRQoL index having been validated in both adult and child populations. Having separate measures for adolescence and young adulthood has meant that the different measures cannot be compared directly. Accordingly, the study objectives were: to determine whether the CPQ 11–14 is a valid and reliable OHRQoL measure in young adults and to compare its performance with the OHIP‐14 in young adults. A cross‐sectional study was undertaken of a convenience s le of 968 young New Zealand adults aged 18–30 years (83.1% female) using RedCap. Two separate measures of OHRQoL were used (the CPQ 11–14 and OHIP‐14), along with Locker's global oral health item. Internal consistency reliability was high for the CPQ 11–14 and the OHIP‐14, with Cronbach's alpha scores of .87 and .92, respectively. Mean scale scores were 15.8 (SD = 9.7) for the CPQ 11–14 and 24.1 (SD = 10.1) for the OHIP‐14. The scale scores were strongly and positively correlated (Pearson's r = .8). Both demonstrated acceptable construct validity, represented by ascending gradients in mean scores across the ordinal response categories of Locker's global oral health item. Ordinal logistic regression modelling of Locker's item showed the CPQ 11–14 to have a slightly better fit and explain more variance than the OHIP‐14. The CPQ 11–14 was valid and reliable in this young adult population. Further epidemiological validation studies should confirm the findings in representative s les.
Publisher: S. Karger AG
Date: 2001
DOI: 10.1159/000047463
Abstract: It has been suggested that asthmatic children may have a higher caries risk, both as a result of their medical condition and the physical and physiological effects of their pharmacotherapy. By examining the association over time between asthma and caries increment, this study tested the hypothesis that childhood asthma is associated with an increased caries increment. In a long–standing New Zealand cohort study, participants’ long–term asthma histories and the 3–year net caries increment between the ages of 15 and 18 years were examined. Of the 781 who were examined at 15 and 18 years, 39 participants were consistently taking anti–asthma medication at the ages of 9, 11, 13 and 15 years (and were labelled in this study as ‘medication–determined asthmatics’), 56 were identified as consistent wheezers at the ages of 9, 11, 13 and 15 years (‘wheeze–determined asthmatics’) and 36 were members of both groups. A smaller group (n = 9) was identified as being very–long–term asthmatics (asthma at 5 years of age and at the ages of 9, 11, 13 and 15 years). Some 206 study members were identified as having no history of asthma, asthma medication or significant wheeze at any time up to and including 18 years. The overall mean net caries increment between the ages of 15 and 18 years was 2.06 surfaces (SD, 3.76). There were no significant differences in caries increment between the 206 asthma–free participants and any of the asthma groups. This study provides little evidence for an asthma–caries causative relationship.
Publisher: Wiley
Date: 02-2016
DOI: 10.1111/JCPE.12499
Publisher: Elsevier BV
Date: 06-1998
DOI: 10.1016/S0005-7967(98)00030-8
Abstract: The relation between dental, blood and injection fear and oral health was examined in 936 New Zealand 18-year-olds. Of the approximately ten percent (n = 96) of the s le who reported a dental fear, 1 in 10 also reported a fear of blood and 53% a co-morbid fear of injections. Study members with dental fear alone or co-morbid dental and blood or injection fear had significantly worse oral health (i.e. greater caries experience) than a no-fear comparison group or in iduals with blood-injection fear only. Further, in iduals with dental and blood or injection fear had a significantly higher level of recent tooth decay than in iduals with dental fear alone. Time since last dental treatment also tended to be highest in this group. Implications for dental health and practice were discussed.
Publisher: Wiley
Date: 20-11-2016
DOI: 10.1111/JOOR.12452
Abstract: The relationship between facial morphology and jaw function remains controversial. The purpose of this study was to investigate differences in self-reported oral behaviour habits between in iduals with normo ergent and hyper ergent facial types. Some 80 cases and controls were in idually matched on age, sex ethnicity and treatment stage. The participants were recruited from an orthodontic clinic, and included both adolescents and adults. Habitual oral activity was assessed using the Oral Behaviour Checklist (OBC) based on their experiences in the past 4 weeks. Univariate and bivariate analyses were performed. The s le had a mean age of 17·2 years (SD = 4·6 range = 12-49 years), and was predominantly female (65·0%) and of New Zealand European origin (91·3%). The prevalence of reporting one or more frequently performed habitual muscular behaviour in either study group was over 85% (P > 0·05). There was no difference in total OBC score between the hyper ergent (25·6 SD: 9·0) and normo ergent group (25·3 SD: 9·9). Moreover, there was no difference in the prevalence of either nocturnal or daytime oral behaviours between the two groups. While this study did not include any objective measures of functional or habitual activity, we found no differences in self-reported oral behaviour habits between normo ergent and hyper ergent in iduals. The findings do not support an association between vertical facial form and habitual muscular activity.
Publisher: SAGE Publications
Date: 13-11-2014
Abstract: Dental caries is the most prevalent disease worldwide, with the majority of caries lesions being concentrated in few, often disadvantaged social groups. We aimed to systematically assess current evidence for the association between socioeconomic position (SEP) and caries. We included studies investigating the association between social position (determined by own or parental educational or occupational background, or income) and caries prevalence, experience, or incidence. Risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies. Reported differences between the lowest and highest SEP were assessed and data not missing at random imputed. Random-effects inverse-generic meta-analyses were performed, and subgroup and meta-regression analyses were used to control for possible confounding. Publication bias was assessed via funnel plot analysis and the Egger test. From 5539 screened records, 155 studies with mostly low or moderate quality evaluating a total of 329,798 in iduals were included. Studies used various designs, SEP measures, and outcome parameters. Eighty-three studies found at least one measure of caries to be significantly higher in low-SEP compared with high-SEP in iduals, while only 3 studies found the opposite. The odds of having any caries lesions or caries experience (decayed missing filled teeth [DMFT]/dmft 0) were significantly greater in those with low own or parental educational or occupational background or income (between odds ratio [95% confidence interval] = 1.21 [1.03–1.41] and 1.48 [1.34–1.63]. The association between low educational background and having DMFT/dmft 0 was significantly increased in highly developed countries ( R 2 = 1.32 [0.53–2.13]. Publication bias was present but did not significantly affect our estimates. Due to risk of bias in included studies, the available evidence was graded as low or very low. Low SEP is associated with a higher risk of having caries lesions or experience. This association might be stronger in developed countries. Established diagnostic and treatment concepts might not account for the unequal distribution of caries (registered with PROSPERO [CRD42013005947]).
Publisher: Wiley
Date: 16-04-2007
Publisher: Wiley
Date: 09-05-2013
DOI: 10.1111/JCPE.12108
Publisher: Wiley
Date: 26-12-2019
DOI: 10.1111/ODI.13251
Abstract: To investigate the impact of gustatory stimulants of salivary secretion (GSSS) on Sjögren's syndrome patients' self-perception of xerostomia, oral health-related quality of life (OHRQoL) and salivary secretion. A total of 110 Sjögren's syndrome patients were randomly allocated to be treated with either a malic acid lozenge or a citric acid mouthwash and then crossed over. Before and after the interventions, the Xerostomia Inventory 5 (SXI-5-PL) and the Oral Health Impact Profile (OHIP-14-PT) questionnaires (both in the Portuguese language) were administered to patients. Unstimulated, mechanical and gustatory-stimulated salivary flows were determined. Repeated measures and between-subject analyses were performed. Statistical significance was set at 5%. After the intervention and within each group, both GSSS elicited a reduction in the SXI-5-PL and OHIP-14-PT scores and an increase in salivary output, significant in the malic acid lozenge group. The malic acid treatment resulted in a greater effect size and percentage improvement than citric acid mouthwash. The malic acid lozenge also produced a significant greater salivary output than the citric acid rising solution. In Sjögren's syndrome patients, lozenges containing malic acid increased saliva production and xerostomia relief, resulting in improved quality of life.
Publisher: Wiley
Date: 10-10-2011
DOI: 10.1111/J.1752-7325.2011.00281.X
Abstract: Previous studies have shown variation in long-term dental visiting but little is known about the oral health outcomes of such variation. The objective of this study is to determine the association of different dental visiting trajectories with dental clinical and oral health-related quality of life (OHRQoL) indicators. This study utilized data from the Dunedin Multidisciplinary Health and Development Study, a continuing longitudinal study of 1,037 babies born in Dunedin (New Zealand) between April 1, 1972 and March 31, 1973. Data presented here were collected at ages 15, 18, 26, and 32 years. Three categories of dental attendance were identified in earlier research, namely: regulars (n = 285, 30.9 percent of the cohort), decliners (441, 55.9 percent), and opportunistic users (107, 13.1 percent). There was a statistically significant association between opportunistic dental visiting behavior and decayed missing and filled surfaces score (Beta = 3.9) as well as missing teeth because of caries (Beta = 0.7). Nonregular dental visiting trajectories were associated with higher Oral Health Impact Profile (OHIP-14) scores (Beta = 2.1) and lower self-rated oral health scores (prevalence ratio = 0.8). Long-term, postchildhood dental attendance patterns are associated with oral health in adulthood, whether defined by clinical dental indicators or OHRQoL. Improving dental visiting behavior among low socioeconomic status groups would have the greatest effect on improving oral health and reducing oral health impacts.
Publisher: Wiley
Date: 26-10-2023
DOI: 10.1111/CDOE.12799
Abstract: Injuries to permanent teeth are common and can have lasting effects, but knowledge of their consequences is deficient because there is a lack of information from longitudinal follow‐up studies of adult populations. The aim of this study was to use routinely collected adult dental trauma data from New Zealand's no‐fault, Government‐run social insurance scheme—the Accident Compensation Corporation—to investigate the presentation and subsequent care of dental injuries sustained by adults. Cross‐sectional analysis of all new dental injuries recorded during 2008 was followed by prospective analysis of all treatment claimed in the following five years for all new injuries recorded in June 2008 for adults aged 18+ years. Those injuries were categorised into five clinically meaningful, ordinal groups of dental injuries, ranging from least severe ( Minor injury ) to most severe ( Severe displacement ). The prospective post‐injury treatment information was summarised as (1) restorations (2) crowns and veneers (3) completed root canal treatment (preparation and obturation of root canal[s]) (4) extraction (extraction surgical removal) and (5) implant placement. Orofacial trauma details were recorded for 32 110 in iduals (of all ages) in 2008 males predominated in all age groups, except for those aged 65+ years. Of the 68 890 separate injuries to permanent teeth recorded, 74.9% involved maxillary teeth, with almost 50% involving teeth 21 and 11. Some 66.9% of the dental injuries were classified as Minor 21.7% involved Fractures or loosening , and 8.2% were Severe fractures . Displacement and Severe displacement injuries comprised 1.8% and 2.5% respectively. During June 2008, dental injuries were recorded for 1325 adults. More than 80% of those dental injuries underwent treatment during the subsequent five years, and more severe initial trauma required more complicated treatment. Minor injuries accounted for 33.5%, fractures/loosening for 50.8%, severe fractures for 1.2%, displacements for 8.8%, and severe displacements for 5.8% of the total cost of treatment provided over that five‐year period. Although most injuries sustained were minor, their subsequent treatment burden is not only high but also greater with more severe initial trauma. The ongoing societal cost of orofacial trauma appears to be high.
Publisher: Informa UK Limited
Date: 18-05-2022
Publisher: Elsevier BV
Date: 02-2013
DOI: 10.1111/IDJ.12002
Publisher: Hindawi Limited
Date: 31-01-2021
DOI: 10.1155/2021/6619123
Abstract: Self-rated oral health and oral health-related quality of life is known to be influenced by various personality characteristics. The aim of this study was to understand how personality characteristics affect oral health-related quality of life ratings in an Iranian adult population. The study included 443 adult participants recruited from a public dental clinic in Kerman, southeast of Iran. The Oral Health Impact Profile-14 questionnaire was used to assess oral health-related quality of life. Personality traits were determined using the 20-item Positive Affectivity Negative Affectivity Scale. Locker’s single-item global self-rating of oral health was used to obtain information on self-rated oral health. Pearson correlation and negative binomial regression were used for data analysis. A higher negative affectivity score was associated with worse oral heath related quality of life, and a higher positive affectivity score was associated with better rating of oral health-related quality of life. On average, in iduals who described their oral health as worse scored higher on Oral Health Impact Profile-14. Negative affectivity and positive affectivity influence in iduals’ perceptions of their oral health and quality of life. If possible, investigations of oral health-related quality of life measures should also include a brief personality assessment.
Publisher: Wiley
Date: 12-08-2012
DOI: 10.1111/J.1600-0579.2012.00773.X
Abstract: Although much published school and higher education research have established a strong conceptual foundation for eliciting student feedback, this element is relatively poorly developed in dental education research. This paper examines 'student voice' as a conceptual/theoretical framework and justification for attending to students' perspectives in dental education. The aims of this review paper were: to explore the concept of student voice, including some pragmatic considerations and key critiques of listening to student feedback to critically analyse key debates about the importance of a research focus on student perceptions using themes from the seminal and contemporary educational literature on student voice from the school, higher and dental educational sectors to identify gaps in the dental education literature in relation to students' perceptions of their learning, and highlight some practical implications drawn from the 'student voice' literature for dental education and to assist dental educational researchers in developing a strong rationale for listening to student voice in dental educational institutions. This paper is intended to assist dental educational researchers in justifying future research projects which require eliciting dental student feedback erceptions.
Publisher: Wiley
Date: 24-07-2015
DOI: 10.1111/ADJ.12238
Abstract: We investigated the prevalence, associations and impact of xerostomia in a nationally representative s le of dentate adult community-dwelling New Zealanders aged 18 years and over. The data were collected from a representative s le of 2209 adults, as part of the 2009 New Zealand Oral Health Survey (NZOHS). Data were collected using face-to-face interviews, dental examinations and the short-form Oral Health Impact Profile (OHIP-14). Data analysis used appropriate weighting for all procedures to account for the complex survey design. The overall prevalence estimate for xerostomia was 13.1% (95% CI 11.7, 14.7), and it was more common among females. Those in the 75+ and 25-34 age groups were more likely (odds ratios of 6.5 and 4.0, respectively) to have xerostomia. After controlling for sociodemographic characteristics and clinical oral disease, the mean OHIP-14 score among xerostomics was 50% higher than among those who did not have the condition. These data indicate that xerostomia is a common condition which can affect quality of life among people of all ages.
Publisher: Informa UK Limited
Date: 07-02-2011
DOI: 10.3109/00016357.2011.554862
Abstract: To examine the properties, validity and responsiveness of the Family Impact Scale in a consecutive clinical s le of patients undergoing dental treatment under general anaesthesia. A consecutive clinical s le of parents/caregivers of children receiving dental treatment under general anaesthesia provided data using the Family Impact Scale (FIS) component of the COHQOL(©) Questionnaire. The first questionnaire was completed before treatment, the follow-up questionnaire 1-4 weeks afterward. Treatment-associated changes in the FIS and its components were determined by comparing baseline and follow-up data. Baseline and follow-up data were obtained for 202 and 130 participants, respectively (64.4% follow-up). All FIS items showed large relative decreases in prevalence, the greatest seen in those relating to having sleep disrupted, blaming others, being upset, the child requiring more attention, financial difficulties and having to take time off work. Factor analysis largely confirmed the underlying factor structure, with three sub-scales (parental/family, parental emotions and family conflict) identified. The parental/family and parental emotions sub-scales showed the greatest treatment-associated improvement, with large effect sizes. There was a moderate improvement in scores on the family conflict sub-scale. The overall FIS showed a large improvement. Treating children with severe caries under general anaesthesia results in OHRQoL improvements for the family. Severe dental caries is not merely a restorative and preventive challenge for those who treat children it has far-reaching effects on those who share the household and care for the affected child.
Publisher: SAGE Publications
Date: 13-09-2012
Abstract: With clinical oral examinations not always possible in health surveys, researchers may instead be invited to add questions to a wider health survey. In such situations, an item is needed which adequately represents both clinical and self-reported oral health. This study investigated the clinical validity of Locker’s global self-reported oral health item among young middle-aged adults in populations in New Zealand and Australia. Clinical examination and self-report data (including the OHIP-14) were obtained from recent national dental surveys in NZ and Australia, and from age-38 assessments in the Dunedin Multidisciplinary Health and Development Study. National dataset analyses involved 35- to 44-year-olds. Caries and tooth-loss experience showed mostly consistent, statistically significant gradients across the Locker item responses those responding ‘Excellent’ had the lowest scores, and those responding ‘Poor’ the highest. Periodontitis experience gradients in the NZ national s le were mainly as hypothesized those rating their oral health as ‘Poor’ had the highest disease experience. OHIP-14 gradients across the Locker item responses were consistent and as hypothesized. The proportion of disease in the population borne by those ‘Fair’ or ‘Poor’ ranged from 26% to 72%. These findings provide preliminary support for the measure’s validity as a global self-reported oral health measure in young middle-aged adults.
Publisher: Wiley
Date: 16-05-2017
DOI: 10.1111/CDOE.12307
Abstract: To compare the magnitude of relative oral health inequalities between Indigenous and non-Indigenous persons from Brazil, New Zealand and Australia. Data were from surveys in Brazil (2010), New Zealand (2009) and Australia (2004-06 and 2012). Participants were aged 35-44 years and 65-74 years. Indigenous and non-Indigenous inequalities were estimated by prevalence ratios (PR) and their corresponding 95% confidence intervals (CI), adjusting for sex, age and income. Outcomes included inadequate dentition, untreated dental caries, periodontal disease and the prevalence of "fair" or "poor" self-rated oral health in Australia and New Zealand, and satisfaction with mouth/teeth in Brazil (SROH). Irrespective of country, Indigenous persons had worse oral health than their non-Indigenous counterparts in all indicators. The magnitude of these ratios was greatest among Indigenous and non-Indigenous Australians, who, after adjustments, had 2.77 times the prevalence of untreated dental caries (95% CI 1.76, 4.37), 5.14 times the prevalence of fair oor SROH (95% CI 2.53, 10.43). Indigenous people had poorer oral health than their non-Indigenous counterparts, regardless of setting. The magnitude of the relative inequalities was greatest among Indigenous Australians for untreated dental decay and poor SROH.
Publisher: MDPI AG
Date: 19-11-2019
DOI: 10.3390/NU11112828
Abstract: We examined associations between dietary patterns at 12 months, characterised using multiple methodologies, and risk of obesity and early childhood caries (ECC) at 24–36 months. Participants were Australian toddlers (n = 1170) from the Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE) birth cohort. Principal Components Analysis (PCA) and the Dietary Guideline Index for Children and Adolescents (DGI-CA) were applied to dietary intake data (1, 2 or 3-days) at 12 months, and regression analysis used to examine associations of dietary patterns with body mass index Z-score and presence of ECC at 24–36 months. Two dietary patterns were extracted using PCA: family diet and cow’s milk and discretionary combination. The mean DGI-CA score was 56 ± 13 (out of a possible 100). No statistically significant or clinically meaningful associations were found between dietary pattern or DGI-CA scores, and BMI Z-scores or ECC (n = 680). Higher cow’s milk and discretionary combination pattern scores were associated with higher energy and free sugars intakes, and higher family diet pattern scores and DGI-CA scores with lower free sugars intakes. The association between dietary patterns and intermediate outcomes of free sugars and energy intakes suggests that obesity and/or ECC may not yet have manifested, and thus longitudinal investigation beyond two years of age is warranted.
Publisher: Wiley
Date: 08-2015
Abstract: This study aims to investigate the association between diabetes and periodontitis in the New Zealand (NZ) adult population. Data from two NZ national surveys (N = 2,048) were analyzed to compare estimates of the strength of the association between diabetes and periodontitis using two multivariate epidemiologic approaches (cohort and matched case-control studies). This was possible because the first survey provided participants for the second survey. Periodontitis cases were identified using 14 case definitions, including six severe definitions. The cohort study identified those with diabetes in 2006/07 and those with periodontitis in 2009 to determine the patients with diabetes odds of having periodontitis, using logistic regression modeling (adjusting for smoking status, sociodemographic, and dental characteristics). The matched case-control study identified cases of severe periodontitis in 2009 and compared their 2006/07 diabetic status with that of controls (in idually matched on age group, sex, and socioeconomic status). Conditional logistic regression modeling was used for the case-control study, adjusting for ethnicity, smoking status, and dental characteristics. Overall, 3.6% of the periodontally examined adults reported having diabetes. There was no sex difference in diabetes prevalence, but it was greater in older age groups. Depending on the definition of periodontitis used, there were different estimates of risk for periodontitis, with odds ratios ranging from 1.91 (P = 0.01) to 3.51 (P = 0.22) using the cohort study approach. Diabetes was associated with a greater risk of having periodontitis using only two of the 14 periodontitis case definitions. No association was observed using the matched case-control study. The diabetes-periodontitis association in the NZ population remains unclear. This study demonstrates that the determination of the strength of a putative association is method dependent.
Publisher: Elsevier BV
Date: 02-2011
DOI: 10.1016/J.AJODO.2010.01.032
Abstract: The purpose of this study was to identify the demographic characteristics of students completing certificate programs in orthodontics, and the curriculum and financial characteristics of orthodontic programs in the English-speaking world. An online survey was used to question orthodontic students studying in the 93 programs worldwide in countries where the first language is English. The questionnaire was built by using the online survey tool www.surveymonkey.com, and the students were predominantly contacted directly via e-mail. Of the 301 respondents (an estimated response rate of 33%), the majority were men, had an average age of 29.8 years, and were mostly from programs in the United States. The mean program durations were 31.0 months in the United States and 37.1 months in the Commonwealth, with mean total patient loads of 84 and 106, respectively. Various treatment modalities were used in both groups. The mean annual tuition fee was considerably higher in the United States. The overall mean debt at graduation was $118,200, and the mean expected income 5 years after graduation was $283,200. Private practice was the most popular career path (90.3%), with fewer than a third of the respondents stating that they would consider an academic career. This study indicates that the demographic characteristics of orthodontic students are similar to those most recently reported, with the proportion of female students continuing to increase. The numbers of transitional dentition patients and total patient case loads are increasing, and students are being exposed to an increasingly wide range of treatment techniques. A continuing increase in tuition fees was reported, along with increased levels of debt at graduation, and fewer students intend to have an academic career.
Publisher: Wiley
Date: 09-2006
DOI: 10.1111/J.1752-7325.2006.TB02578.X
Abstract: To describe the current working practices and level of job satisfaction of dental hygienists in New Zealand. Postal survey of all dental hygienists on the New Zealand Dental Council's database. An initial mailing was followed by a 3-week follow-up. Information was sought on respondents' demographic characteristics, current occupation and working practice, history of career breaks, continuing education and career satisfaction. 213 responses were received (73.2%) 90.6% were currently working as hygienists, mostly in private practice. Many worked part time, particularly those with children. Almost 50% of respondents had taken at least one career break, most frequently for childrearing. The mean time taken in career breaks was 3.6 years. Overall, dental hygienists reported high levels of satisfaction with their careers and their income. Older hygienists had higher career satisfaction scores. Most respondents were actively involved in continuing education. Almost half were interested in expanding the range of procedures they perform. Over one-third plan to retire within the next 10 years. While many hygienists take career breaks and work part time, most have a high level of career satisfaction, actively participate in continuing education, and are satisfied with their remuneration.
Publisher: S. Karger AG
Date: 2006
DOI: 10.1159/000095643
Abstract: The majority of what is known of the experience of dental caries among adults is from cross-sectional studies, and there are surprisingly few population-level longitudinal studies of dental caries among adults. Dental examinations were conducted at age 26 and again at age 32 among participants in a longstanding prospective study of a birth cohort born in Dunedin (New Zealand) in 1972/1973. Some 901 in iduals (88.8%) were dentally examined at both ages. The mean number of remaining teeth and tooth surfaces fell between 26 and 32, reflecting ongoing tooth loss. The overall prevalence of caries rose from 94.9 to 96.8%, while there were greater increases in the proportion with caries-associated tooth loss (from 10.8 to 22.8%). Caries experience was greatest in the molar teeth and upper premolars, and was lowest in the lower anterior teeth. The mean crude caries increment (CCI) was 5.0 surfaces (SD 6.6) 681 (75.5%) experienced 1+ CCI, and the mean CCI among those in iduals was 6.6 surfaces (SD 6.9). Substantial dental caries and tooth loss experience occur as people move from the third into the fourth decade of life.
Publisher: Elsevier BV
Date: 2016
Publisher: Wiley
Date: 11-03-2010
DOI: 10.1111/J.1600-0528.2009.00525.X
Abstract: To determine whether a Portuguese language version of the Child Perceptions Questionnaire for 11-14-year-olds (CPQ(11-14)) showed differential item functioning (DIF) when compared with the original English language version. CPQ(11-14) data from a school-based Brazilian study (n = 138) was compared with CPQ(11-14) data collected as part of a school-based study conducted in New Zealand (n = 322). In order to detect DIF, ordinal logistic regression analysis was performed with each CPQ(11-14) item as the dependent variable. The independent variables were language group (English versus Portuguese), the CPQ(11-14) sub-scale score of which the item was a part, and an interaction term for language*sub-scale score. Nonuniform DIF was deemed to be present if the interaction term was significant. Moderate to large uniform DIF was deemed to be present if after removing the interaction term the beta coefficient (log odds ratio) for language group was significant and numerically greater than 0.64. Analyses were also undertaken to detect pseudo-DIF. Nonuniform DIF was found in five items and moderate to large uniform DIF in an additional four items. Analyses using 'purified' sub-scale scores indicated that little of the DIF detected was pseudo-DIF. A comparison of the language groups using DIF affected and DIF-free overall and subscale CPQ(11-14) scores revealed that the DIF detected had only a marginal effect on the differences between language groups in scores. Oral health-related quality of life questionnaires, particularly those that have been translated, need to be assessed for DIF and its likely impact on group comparisons.
Publisher: Wiley
Date: 09-2010
DOI: 10.1111/J.1752-7325.2010.00186.X
Abstract: To compare the Dean's and DDE indices in examining dental fluorosis and diffuse opacities. Survey of a random s le of 9-year-old children in Southland, New Zealand. Dental fluorosis was measured using Dean's index. Enamel defects were recorded using the DDE index. A total of 436 children (74.5 percent) were examined: 24.1 percent had diffuse opacities, and 10.8 percent of children had fluorosis (P < 0.001). At tooth level (using the score for the same tooth), the indices were more similar, but 9 percent of the 33 with diffuse opacities showed no visible signs of fluorosis. We found relatively little concordance between the DDE and Dean's indices in determining person prevalence of defects among children. At the tooth level, concordance between the two was greater, and suggests that little maybe lost in fluorosis studies which use the DDE index, particularly as it enables collection of a wider and more comprehensive range of information. Although the use of Dean's index is important for historical comparisons, investigators should appreciate its limitations.
Publisher: American Medical Association (AMA)
Date: 21-05-2008
Publisher: MDPI AG
Date: 23-10-2017
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-041185
Abstract: The long-term goal of the Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) birth cohort study is to identify and evaluate the relative importance and timing of critical factors that shape the oral health of young children. It will then evaluate those factors in their inter-relationship with socioeconomic influences. SMILE is a single-centre study conducted in Adelaide, Australia. All newborns at the main three public hospitals between July 2013 and August 2014 were eligible for inclusion. The final recruited s le at birth was 2181 mother/infant dyads. Participants were followed up with questionnaires when the child was 3 and 6 months of age, and 1, 2 and 5 years of age. Oral epidemiological examinations and anthropometric assessments were conducted at age 2 and 5 years. SMILE has contributed comprehensive data on dietary patterns of young children. Intakes of free sugars, core and discretionary foods and drinks have been detailed. There was a sharp increase in free sugars intake with age. Determinants of dietary patterns, oral health status and body weight during the first 5 years of life have been evaluated. Socioeconomic characteristics such as maternal education and household income and area-level socioeconomic profile influenced dietary patterns and oral health behaviours and status. Funding has been obtained to conduct oral epidemiological examinations and anthropometric assessments at age 7–8 years. Plans are being developed to follow the cohort into adolescent years.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.PSYCHRES.2018.05.048
Abstract: This cross-sectional study aims to describe the dental caries experience, treatment needs, and experience of dry mouth of 191 long-term psychiatric inpatients in Singapore. Medical history, dental caries experience [represented by the Decayed Missing or Filled Teeth index (DMFT)], salivary flow, and treatment needs were recorded. Information on brushing, pain (when eating), and xerostomia was gathered. Bivariate analysis was used to examine the associations of DMFT, saliva flow, the presence of salivary gland hypofunction (SGH), and xerostomia. Simple linear regression was used to examine the association between SGH and DMFT. The s le comprised 143 men (74.9%) and 48 women (25.1%), aged 24 to 80 years old. 169 patients (88.5%) had schizophrenia. DMFT ranged from 0 to 32, with a mean of 21.6 (SD 9.7). Mean DMFT scores were significantly higher among males and older patients. 77 of 176 patients (43.8%) were found to have SGH. SGH was associated with a higher mean DMFT. Those taking classical antipsychotics and anticholinergics had significantly lower mean saliva flow and tended to have SGH. 107 of 165 patients (64.8%) were found to experience xerostomia. Long-term psychiatric inpatients in Singapore have poor oral health, unmet treatment needs, and suffer from dry mouth.
Publisher: SAGE Publications
Date: 17-07-2020
Abstract: Birth cohorts are those among observational studies that provide understanding of the natural history and causality of diseases since early in life. Discussions during an International Association for Dental Research symposium in London, United Kingdom, in 2018, followed by a workshop in Bangkok, Thailand, in 2019, concluded that there are few birth cohort studies that consider oral health and that a broader discussion on similarities and differences among those studies would be valuable. This article aims to 1) bring together available long-term data of oral health birth cohort studies from the low, middle, and high-income countries worldwide and 2) describe similarities and differences among these studies. This work comprises 15 studies from all 5 continents. The most studied dental conditions and exposures are identified findings are summarized and methodological differences and similarities among studies are presented. Methodological strengths and weaknesses are also highlighted. Findings are summarized in 1) the negative impact of detrimental socioeconomic status on oral health changes over time, 2) the role of unfavorable patterns of dental visiting on oral health, 3) associations between general and oral health, 4) nutritional and dietary effects on oral health, and 5) intergenerational influences on oral health. Dental caries and dental visiting patterns have been recorded in all studies. Sources of fluoride exposure have been documented in most of the more recent studies. Despite some methodological differences in the way that the exposures and outcomes were measured, some findings are consistent. Predictive models have been used with caries risk tools, periodontitis occurrence, and permanent dentition orthodontic treatment need. The next steps of the group’s work are as follows: 1) establishing a consortium of oral health birth cohort studies, 2) conducting a scoping review, 3) exploring opportunities for pooled data analyses to answer pressing research questions, and 4) promoting and enabling the development of the next generation of oral health researchers.
Publisher: Wiley
Date: 06-12-2012
DOI: 10.1111/IDH.12011
Abstract: To investigate the association between oral hygiene and dental caries in young children in the Emirate of Ajman, United Arab Emirates. A one-stage cluster s le was used to randomly select children. Clinical examinations were conducted by a single examiner. Parents completed questionnaires seeking information on child and family characteristics, dietary habits and oral hygiene practices. The total number of children s led was 1297. Dental examination and questionnaire data were obtained for 1036 (79.9%). Frequency of eating per day and snack consumption level were both significantly associated with plaque score. Children who brushed their teeth more often had lower plaque scores. The observed association between mean plaque score and mean decayed, missing, filled teeth suggests that children with high plaque scores are more likely to experience caries. Brushing with fluoride toothpaste was under-utilized in Ajman. Tooth brushing therefore needs better promotion and reinforcement.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for William Murray Thomson.