The prevalence of xerostomia in patients with removable prostheses.

PURPOSE: The objective of this study was to determine the prevalence of xerostomia among patients attending a dental clinic for provision of dentures and to investigate the oral cleanliness in those patients. MATERIALS AND METHODS: Denture-wearing patients who reported dry mouth completed a questionnaire related to xerostomia. Dryness of the mouth was determined by clinical observation. Dental and denture cleanliness was determined using the Modified Debris Index. RESULTS: One hundred twenty patients had xerostomia. Oral cleanliness was generally poor. CONCLUSION: There was a high prevalence of xerostomia in the patient population. A high proportion of subjects had poor oral cleanliness.

Dental disease prevalence among methamphetamine and heroin users in an urban setting: a pilot study.

BACKGROUND: Researchers have reported rampant caries among methamphetamine users. The authors investigated the prevalence of dental disease and associated risk behaviors in methamphetamine users compared with those in heroin users. METHODS: This pilot project was a cross-sectional study of an ongoing cohort of young adult injection-drug users (IDUs) in San Francisco. Participants completed an oral health questionnaire administered by a research assistant, and dentists performed clinical examinations to record the participants' data in terms of scores on the decayed-missing-filled surfaces (DMFS) index, presence of residual roots, scores on an oral hygiene index and whether any salivary hypofunction was observed. RESULTS: The prevalence of dental disease among 58 young adult IDUs was strikingly high compared with that in the U.S. general population; however, the authors found no difference in the level of dental disease between users of methamphetamine and users of heroin. The mean DMFS score and number of decayed surfaces exceeded 28 in both groups. CONCLUSIONS: Although the authors detected no difference in dental disease between methamphetamine and heroin users, they found a high prevalence of caries and caries-associated behaviors in the sample of young adult IDUs. CLINICAL IMPLICATIONS: Given the high level of dental disease observed in this population of young adult IDUs, one next step may be to explore the feasibility and effectiveness of providing low-intensity preventive measures (such as distribution of chlorhexidine rinses or xylitol gum or application of fluoride varnishes) through outreach workers.

Oral hygiene and periodontal status among detainees in a juvenile detention center, India.

PURPOSE: To assess the oral hygiene and periodontal status and analyse the influence of age, education, institutionalization, type of visit and oral health behaviour on oral hygiene and periodontal status among detainees in juvenile detention center in Udaipur city, Rajasthan, India. MATERIALS AND METHODS: The total sample comprised 223 subjects (67.7% male and 32.3% female) aged 6 to 18 years. Clinical examination included assessment of oral hygiene and periodontal status using OHI-S (Oral Hygiene Index-Simplified) and CPI (Community Periodontal Index), respectively. Analysis of variance (ANOVA), chi-square, Student t-test and stepwise multiple linear and multiple logistic regression analysis were carried out to find the relation between oral hygiene/ periodontal status and different independent variables. RESULTS: The results showed that the oral hygiene status of detainees was poor, with only 28.1% of the subjects having good oral hygiene. Mean OHI-S scores were significantly associated with all independent variables. Overall periodontal disease prevalence was 80.2% with bleeding and calculus contributing a major part (71.9%). Stepwise multiple linear and logistic regression analysis revealed that oral hygiene practice and type of visit in the detention center were the best predictors for the oral hygiene index, and for periodontal disease it was oral hygiene practice alone. CONCLUSION: The findings confirmed that detainees in the juvenile detention center have poor oral hygiene and an increased prevalence of periodontal disease compared to that of similarly ages in the general population.

Oral disease and social class in a random sample of five-year-old preschool children in a Brazilian city.

PURPOSE: The objective of the present study was to determine the association between oral disease, access to dental care and social class in a random sample of five-year-old preschool children in Belo Horizonte, Minas Gerais, Brazil. MATERIALS AND METHODS: A cross-sectional study was carried out on a sample of 551 five-year-old children who were randomly selected from preschools. Oral health status was assessed using the decayed, missing or filled teeth (dmft) index as well as the presence of visible plaque, gingivitis and supragingival calculus. Oral examinations were performed by two examiners (j > 0.80). The clinical outcome variables were dental caries, filled and missing teeth, dental pulp exposure due to caries, dental root fragment, visible plaque, gingivitis and supragingival calculus. Social class was assessed using the City Hall database. RESULTS: Children without caries represented 63.9% of the sample. Mean overall dmft was calculated to be 1.56, and the decayed teeth component was the highest in all of the social classes. Missing teeth, caries with pulp involvement and dental root fragment had higher proportions and the filled teeth component had the lowest proportion in children from the lowest social class. Visible dental plaque was present in 45.4% of the children. Except for the filled teeth component, all of the clinical outcome variables had a significant association with social class status (P < 0.001), regardless of child's gender. CONCLUSIONS: Oral disease in the primary dentition and access to dental treatment are affected by social and cultural factors.

Periodontal status and associated factors in 15-year-old Sri Lankans.

AIM: The aim of the present study was to determine the periodontal status and associated factors in 15-year-old Sri Lankans. METHODS: This was a cross-sectional study where the data were collected by means of a self-administered questionnaire and a clinical examination. A total of 400 15 year olds were selected using a two-stage cluster sampling technique from schools in the Nattandiya education division of the Puttalam district of Sri Lanka. RESULTS: The prevalence of gingival inflammation was 86%, and nearly 7% of the adolescents had chronic periodontitis. The mean gingival index, debris index, calculus index, and oral hygiene index scores of the sample were 0.47±0.3, 0.31±0.2, 0.46±0.3, and 0.78±0.5, respectively. A multiple logistic regression analysis revealed that the debris level, calculus level, frequency of toothbrushing, and the level of education of the mother were significantly associated with gingival status. CONCLUSION: The prevalence of gingival inflammation was high, and both the debris and calculus levels were strongly associated with gingival status in these adolescents.

Oral cleanliness of 12-13-year-old and 15-year-old school children of Sunsari District, Nepal.

The aim of the study was to evaluate the oral cleanliness of school children in the District of Sunsari, Nepal. A multi-stage random sampling oral epidemiological survey was conducted in private and government, urban, rural town and rural village schools in 15 illakas of Sunsari District, Eastern Nepal. A total of 600, 12-13-year-old and 600 15-year-old school children were examined by trained examiners using the simplified oral hygiene index (OHI-S). The average age-group, debris and calculus index scores were combined to obtain the simplified oral hygiene index (OHI-S). The mean OHI-S scores were compared and evaluated using the parametric t-test for two independent samples. The mean OHI-S for urban 12-13-year-old school children was 0.98 compared to 1.34 for school children of rural towns and 1.44 for school children of rural villages and these differences in mean OHI-S were statistically significant (P < 0.005). In the 15-year-old age group, urban school children had a mean OHI-S score of 1.00 compared to 1.37 for rural towns and 1.43 for rural villages. The variance in the mean OHI-S scores were statistically significant (P < 0.005). The overall level of cleanliness in the school children surveyed was good. Children of urban schools had the lowest scores followed by school children from rural towns and then rural villages. When the mean OHI-S scores were compared with the DMFT scores, there was an inverse relationship between oral cleanliness and dental caries. Frequency of sugar consumption and the availability and affordability of fluoridated toothpaste may be important factors in the development of dental caries than oral cleanliness.

Oral health status in Greek children and teenagers, with disabilities.

Nowadays there is a sharp increase of population with disabilities. The aim of this investigation was a) to survey the dental health status, estimate the treatment requirements of children and adolescents with cerebral palsy, mental retardation and visual disorders and b) to compare the oral health status of these groups of individuals. The investigation entailed the clinical examination of 170 individuals, between 6 and 15 years old, who were attending four special schools in Athens, Greece. In conclusion, our investigation documented the following: The treatment needs regarding both dentitions are extremely high in all groups of individuals. The oral hygiene status is in general, moderate to low-grade, especially in the individuals with mental retardation. The highest rate of malocclusion is observed in the group of individuals with cerebral palsy.

Oral health status and dental service use of adults with learning disabilities living in residential institutions and in the community.

OBJECTIVE: To investigate the oral health status of adults on Sheffield's Learning Disability Case Register, and their reported use of dental services. DESIGN: A short questionnaire interview of subjects with learning disabilities or their carers followed by a standardised epidemiological examination, by one trained and calibrated examiner. SETTING: Residential homes, day centres or community homes of people with learning disabilities in Sheffield. SUBJECTS: A 20% random sample of adults (18-65 years) on the register. RESULTS: A response rate of 209 (67%) was achieved, 62% (n=130) of whom were living in the community. People living in residential care were significantly older (43.2 years) than those based in the community (36.3 years) (P<0.05). Both groups had similar mean DMFT scores; however, adults living in the community had significantly more untreated decay (DT = 1.6) and poorer oral hygiene than their counterparts in residential care (DT = 0.7). Adults in residential care had significantly more missing teeth (MT = 10.1) than those in community care (MT = 7.5). General and community dental services were the main providers of dental care. Subjects living in the community were significantly less likely to have a dentist and to use community dental services than their residential counterparts; they were more likely to attend only when having trouble. CONCLUSIONS: Adults with learning disabilities living in the community have greater unmet oral health needs than their residential counterparts and are less likely to have regular contact with dental services. Commissioners and providers of dental services have a responsibility to ensure that the health of adults with learning disabilities is not compromised by 'normalisation'.

Dental caries and oral hygiene status of 13-14 year old school children of Davangere.

2,007 children from 11 schools, selected through stratified random sampling were examined for dental caries and oral hygiene status. The Mean DMFT was found to be 2.85 and 3.40, mean DMFS 3.76 and 4.56 in 13 and 14 year olds, respectively. Females recorded higher mean values of DMFT (3.37) than males (2.94). There was no significant difference in the mean values of OHI (S). The overall prevalence of dental caries was found to be higher among 14-year-old children compared to 13 year children.

Results of a seniors' oral health survey in rural Alberta.

A questionnaire and oral screening were conducted with seniors in a rural Alberta health authority to determine their oral health needs. Both the dentate and the edentulous had high levels of treatment need. Of the dentate respondents, 41.8 percent had coronal caries, averaging .88 caries per dentate person. All dentate respondents had calculus and/or pocketing as measured by the Community Periodontal Index of Treatment Needs (CPITN). Among denture wearers, 64.4 percent were found to have calculus on one or both dentures, and 61.2 percent of lower dentures exhibited poor retention. In assessing their own oral health, 76.4 percent rated themselves somewhere between good and excellent. Among the dentate, 83.6 percent brushed daily; however 57 percent never flossed. Although 40.6 percent had been to a dentist/denturist within the last year, 70.1 percent saw a dentist/denturist only when they experienced pain or problems. Of those who had not been to a dentist/denturist within a year, 83.9 percent said the primary reason was because there was nothing wrong. Although treatment needs in this group were high, lasting change in the oral health status of this group requires more than immediate treatment. Enduring effects can only be facilitated by educating seniors as to what optimal oral health is, appropriate preventive behaviours, and the effective use of available professional services. Unless these issues are addressed there is not likely to be a great deal of improvement within each cohort.

Oral health status of Canadian-born and immigrant adolescents in North York, Ontario.

Studies from a number of countries, including Canada, have demonstrated that the oral health status of immigrants is worse than that of their native-born counterparts and that they make less use of dental services. To date, however, little information is available which documents changes in immigrant oral health following immigration. This paper reports the results of a study conducted in the City of North York, Ontario, that examined the oral health status of Canadian-born and immigrant adolescents aged 13 and 14 years. The former had better oral health than the latter on all parameters assessed and made more use of dental services. Within the immigrant population, there was a significant association between oral health and time since immigration. Those who had been in Canada 6 or more years were significantly healthier than those who had arrived within the preceding 2 years. While changing patterns of immigration may account for part of these differences, the data suggest that access to dental public health programs, delivered to students between the ages of 4 and 14 years, have been effective in improving the oral health of those born outside Canada. Since these programs cease at age 13 or 14 years, barriers to accessing the private dental care sector may mean that the residual inequities and inequalities evident in the data widen as these individuals age.

Oral health condition of 12-year-old handicapped children in Flanders (Belgium).

The dental condition of 626 12-year-old handicapped children with mild mental or moderate to severe mental retardation or learning impairment, being 25% of the population of each of these groups, was examined in Flanders. An evaluation of oral cleanliness showed poor oral hygiene in 31.8% of the children. No significant differences were found in oral cleanliness among types of handicapping conditions. The mean DMFT score was 2.9 (s: 2.6) and DMFS score was 5.4 (s: 5.6). Almost 21% of the children were free of caries or fillings. No significant differences were found among groups of handicapped children. Handicapped children presented a low level of restorative care (restorative index score: 48.7%). Mildly mentally retarded children demonstrated the lowest restorative index (43.9%). The caries experience of first permanent molars represented the largest part of the DMFT score (64.1%). Sealants were present in 7.9% of children examined. A considerable percentage of mildly mentally retarded children and learning impaired children did not brush daily (22.1% and 20.9%) and did not receive help with toothbrushing from their parents or carers (91.0% and 94.7%, respectively).

Oral hygiene index simplified of high and low socioeconomic levels (9-13 years) school children.

A total of 1600 Egyptian school children from primary and preparatory schools aged from 9 to less than 13 years were included in the study. Oral hygiene was assessed in high and low socioeconomic levels among boys and girls using the simplified oral hygiene index simplified (OHI-S) recommended by green and vermillion. The results showed that all children has debris scores (DI-S), the mean (DI-S) increases by age with the exception of age group 12 < 13 years. No significant difference in the mean (DI-S) scores between high and low socioeconomic level. The least scores were reported in low socioeconomic groups of girls. The mean (DI-S) scores were higher in boys than in girls. Calculus was scarce among 9- < 13-years-old children.

Examiner agreement on caries detection and plaque accumulation during dental surveys of elders.

Indices used to evaluate plaque accumulation and coronal caries have been widely accepted in epidemiological studies, yet their reliability cannot be guaranteed. The aim of this study was to evaluate the reliability of clinical criteria used in coronal and root caries diagnosis and oral hygiene evaluation as applied in elders. Nineteen elderly subjects, 73 years old on average, were examined at a first appointment by two independent examiners. They were re-examined two weeks later. Plaque accumulation was evaluated using the Plaque Index (PI) and coronal and root caries were detected according to the WHO criteria and Fejerskov et al. (1991), respectively. Recurrent caries was recorded as recommended by WHO and by probing at the interface tooth-restoration. Inter- and intra-examiner agreement was evaluated using kappa statistics. The PI score showed good reliability except for examiner b, for whom a simplification of the 4-point scale in 3-point scale improved significantly the reliability. The prevalence of coronal caries was very low and intra- and inter-examiner agreement was poor. Most of the root caries lesions were covered by plaque and the kappa values indicated only poor agreement. Recurrent caries were found with good agreement using WHO criteria but the detection with the probe was not reliable. In conclusion, it seems that examiners should be trained carefully to maximise their reliability and that plaque should be removed to obtain reliable diagnoses of caries. Retraining and calibration may be necessary for surveys continuing over a long period.

Periodontal treatment needs and oral hygiene among Ethiopian immigrants.

Periodontal disease studies in developing countries over the past four decades indicate periodontitis to be a major problem, even in populations with relatively low caries rates. The aim of this study was to document levels of periodontal treatment needs, as well as oral hygiene levels for a large sample covering all ages of an Ethiopian Jewish population recently immigrated into Israel. Over 800 subjects from the total of 15,000 Ethiopians who immigrated were examined utilising the PTNS Index and the OHI-S Index. Results indicate that all the examined population was in need of oral hygiene instruction. Almost 80 per cent are in need of scaling and approximately 20 per cent are in need of more complex treatment such as surgery. Significant differences were found according to age. This could be attributed to the high OHI-S scores, ranging from 2.53 at age 0-12 to 4.82 at the 51+ age group, with a mean Debris Index of 2.12 for the total population. It is suggested that this population should be exposed immediately to preventive and treatment programmes to improve oral hygiene and decrease needs for future, costly periodontal treatment.

Dental caries changes between 1982 and 1991 in children aged 6-12 in Athens, Greece.

The aim of this study was to compare dental caries and oral hygiene status in children aged 6-12 years in the Athens area between 1982 and 1991. Dental examinations were carried out by the same examiners in 773 children attending the same randomly selected schools sited in areas of different socioeconomic levels. The findings concerning the deciduous dention showed that the percentage of caries-free children increased in 1991 compared to 1982 by 38%. The mean deft scores were reduced by an amount ranging from 21 to 34%. Changes in caries prevalence were also observed in the permanent dention. The percentage of caries-free children for the total examined population increased by 94% while the reduction in DMFT index ranged between 38 and 70%. Treatment need was significantly lower in 1991 compared to 1982 in both dentitions. Debris index scores were similar while oral hygiene habits had slightly improved by 1991. The decline in caries levels may be attributed to the increased use of various forms of fluoride. Furthermore, dental health awareness of the population has improved.

Oral hygiene practices, oral cleanliness and periodontal treatment needs in 12-year old urban and rural school children in Ghana.

The aim of the present study was to inquire into oral cleaning practices, and to determine levels of oral cleanliness and periodontal treatment need among 12-year-old Ghanaian school children living in urban and rural areas. Of the 985 children examined, 38 per cent claimed to use a toothbrush, 31 per cent chewing sticks, 17 per cent plantain and 14 per cent the chewing sponge. In rural areas, traditional methods were preferred, and only 8 per cent used a toothbrush. On examination, oral debris was present in 84 per cent of the sample, and more than three quarters had calculus deposits. Children in urban areas, and particularly those attending private schools, had the cleanest mouths and the lowest periodontal treatment need. Multiple regression analysis showed that the social class background of the child, which reflects motivation and awareness for good oral health, was the most significant predictor for levels of oral cleanliness and CPITN, whereas the method or frequency of cleaning employed were not significant variables.

Dental health of disabled children in Singapore.

The oral health status of the disabled has generally been poorer than the general population as the treatment and care afforded to them has been minimal. This paper examines the relationship of the various types of disabilities to dental health status. The dental status of a random sample of 322 disabled children aged between 6 and 18 years was assessed. The children had various disabilities: intellectual, hearing, visual, and musculo-skeletal. Most differences in the prevalence and severity of the dental conditions assessed among the children in the various disability groups were not significant. However, in comparison with normal schoolchildren aged 6 to 18, the disabled children had higher levels of disease and received less dental attention.

Dental health of children and adults in Guinea-Bissau, West Africa, in 1986.

The aim of the present study was to assess the dental health situation of a relatively urban population in Guinea-Bissau, West Africa. A total of 312 persons aged 12, 30-39 and 50-59 years, respectively, were examined for dental caries, oral hygiene, periodontal pockets, gingival recession and mobility of the teeth present. The state of their oral hygiene was very poor. Although most persons examined had a relatively high number of teeth present a substantial number of these teeth had carious lesions, many of which were rather deep. Teeth with increased mobility were seen in a number of individuals but it appeared that periodontal breakdown was not the major cause of tooth mortality in the majority of the population. The results suggest that future dental health care strategies should focus on the development of a new type of dental health worker. This health worker should be capable of performing simple extractions, simple restorative treatment and intercepting early ongoing carious lesions using modern biologically-founded principles and appropriate technology.