Perceived smokeless tobacco addiction among adolescents.

Although the prevalence and associated factors of smokeless tobacco (SLT) use are well-documented, there are no data on the prevalence and associated factors of SLT dependence-addiction. From a survey of 11,057 adolescents in the nonurban Southeastern United States, 3,726 reported having tried SLT, and 17% of those who had tried SLT perceived that they were addicted to it. Years of SLT use, frequency of use per day, and hours of exposure per day were strongly related to perceived addiction. Those using SLT for 1 year or longer had perceived addiction rates of 37% and were over 12 times more likely to report being addicted than were those using for less than 1 year. After controlling for level of SLT use, other factors including parental SLT use, perceived control over health, and racial-ethnic group also contributed minimally but significantly to reported SLT addiction.

Fluoride deposition in human enamel in vivo from professionally applied fluoride prophylaxis paste.

Deciduous teeth were collected from children who received professional prophylaxis with an acidulated phosphate-fluoride (APF) or placebo paste and were analyzed to determine fluoride uptake. Enamel fluoride level was increased by the APF paste approximately 300 ppm at a depth of 2.5 micrometers during the first month after the prophylaxis was administered, after which it returned to pretreatment levels.

Snack food intake of adolescents and caries development.

The relationship between the frequency of eating various snack foods, socioeconomic variables, and an increment in caries was studied in 143 adolescents. There were negative correlations between DMFT increments and the frequency of apples, fruit juice, and sugarless gum intake, and a positive association of DMFT increments with chocolate candy intake and spending money.

The role of race and ethnic status on the psychosocial correlates of smokeless tobacco use in adolescent males.

From a stratified, random sampling of non-urban high schools in the Southeast, survey data were obtained from 5374 adolescent males. Over half reported trying smokeless tobacco, and approximately one third of these reported a regular, substantial level of use. The average age at initial use was 12.2 yr. and was negatively correlated with the level of use. Factor analysis of the psychosocial items resulted in four factors: substance use/deviant style, modeling, perceived negative consequences, and health behavior. Discriminant analysis of initial use indicated that substance use and modeling influences were the strongest predictors of trying smokeless tobacco. Regression analysis of level of smokeless tobacco use indicated that substance use, modeling, and perceived negative consequences were equivalent in their contribution. Separate analyses were performed for American Indian, Black, and White males. Although predictors of initial use were similar, level of smokeless tobacco use was most associated with the use of other substances in Blacks and with modeling influences in Whites.

Comparisons of caries prevalence of children with different daily toothbrushing frequencies.

Clinical caries examinations, supplemented by bite-wing radiographs, were conducted on 290 schoolchildren. The children ranged from 12 to 15 years of age and were residents of a fluoride-deficient community in New York State. The children were divided into two groups based upon their stated daily toothbrushing frequency, namely, those brushing once or less/day and those brushing twice or more/day. Mean DMFS and DMFT scores were recorded for children in both categories. A trend was noted that more frequent brushing was associated with less caries activity. For females and male-females combined the differences in mean DMFS and DMFT scores between those children brushing once a day or less. The caries scores for males in these two brushing groups were marginally significant (P less than .05). Ninety percent of the children used fluoride-containing dentifrices. The inverse relationship between brushing frequency and caries activity may be related to the more frequent fluoride contact when the children brush.

The effect of toothbrushing frequency on oral hygiene and gingival health in school children: reassessment after two and one-half years.

An epidemiological survey of brushing frequency, oral hygiene (OHI-S), and gingival condition (GI modified) was conducted on 290, 12- to 15-year-old schoolschildren. The purpose of the survey was to compare the clinical findings with the children's states frequency of toothbrushing. Since the same children had participated in a similar study approximately 2 1/2 years earlier, it was also of interest to determine what effect, if any, a change in reported brushing habits might exert over the oral status of the children. As in a previous study, the stated level of brushing activity was high. Approximately 46 percent of the children claimed to brush twice a day, and 40 percent once a day. The poorest oral hygiene and highest level of gingivitis were associated with the group of children that claimed to brush less than once a day. In general, the children that claimed to brush their teeth more frequently had lower mean OHI-S and GI scores indicating less oral debris and gingivitis. For males-females combined the optimal effect on oral hygiene and gingival condition, on a statistical basis, was detected at the level of twice-daily brushing. Increased brushing frequency beyond this level did not produce significant improvement in OHI-S or GI scores.

The use of behavior modification techniques to successfully manage the child dental patient.

Techniques of desensitization, modeling, and contingency management that can be used in the dental office for reducing anxiety and encouraging appropriate behavior in children are discussed. The "tell, show and do" approach is one desensitization technique easily applied in the private practice. Language should be at the child's level of understanding. An older sibling will frequently serve as an excellent model for a fearful child. Social reinforcers-a handshake, a smile, or praise-should be dispensed throughout dental treatment. Rewards should only follow desired behavior.

A comparison of general dentists' and pediatric dentists' treatment recommendations for primary teeth.

A survey which included a series of demographic questions, a brief clinical history, and pictures of eight radiographs was mailed to 2000 general dentists and 1000 pediatric dentists. Usable responses were received from 1369 (45%) dentists--765 (38%) general dentists, and 604 (60%) pediatric dentists. The dentists were asked to select the optimal treatment for a specified tooth in each radiograph. The results of this survey indicate that there were differences in the treatment recommendations of general and pediatric dentists. Whether or not pulp therapy was recommended, general dentists frequently recommended restoring teeth with amalgam. Pediatric dentists more frequently recommended restoring primary teeth with stainless steel crowns. There were differences in treatment recommendations within each group of practitioners, as well as between the two groups.

Comparing treatment options for occlusal surfaces utilizing an invasive index.

The purpose of this project was to develop an invasive index to: 1) compare the treatments recommended by dentists for the occlusal surfaces of molars; 2) compare the invasive index score of each tooth with the extent of the carious lesion as determined by electrical resistance and histological examination; and 3) compare the relative extent of the total crown destruction resulting from the carious lesion and the cavity preparation. Twenty dentists examined 19 extracted permanent molar teeth using a #23 explorer and selected the most appropriate treatment from the following options: no treatment (score 0), occlusal sealant (score 1), preventive resin (score 2), occlusal amalgam (score 3). The invasive index scores determined for each dentist and each tooth were compared using an analysis of variance. The electrical conductivity of each tooth was measured with an electronic caries detector (Vanguard). Electrical resistance scores were compared to the invasive index scores and to a histological examination. The results demonstrate that the invasive index is a useful means to compare treatments recommended by different dentists. The invasive index suggests there is considerable variation among dentists in the treatment they recommend for occlusal surfaces. Electrical resistance testing did not provide helpful information for treatment planning of questionably carious occlusal surfaces.

Oxygen saturation and diffusion hypoxia in children following nitrous oxide sedation.

Oxygen saturation of arterial blood (SaO2) was assessed in children after discontinuing N2O/O2 sedation for dental procedures. Two post-treatment methods were used: breathing 100% O2 for 5 min after the procedure, and breathing room air for 5 min. Participants were 24 healthy children ages 41 to 113 months. Each child was treated twice and a crossover design was used. The mean length of procedures that were followed by O2 was 28.8 (+/- 10.9 SD) min; for those followed by room air, 28.3 (+/- 12.4 SD) min. SaO2 was monitored continuously by pulse oximetry and recorded at predetermined intervals before, during, and after N2O/O2 administration. When participants received post-treatment O2, the mean SaO2 at 1 min after N2O cessation (99.91 +/- 0.63 SD) and 5 min after cessation (99.94 +/- 0.17 SD) was statistically significantly higher than the pretreatment value of 99.28 (+/- 0.63 SD). When participants received post-treatment room air, the mean SaO2 1 min after N2O cessation (99.44 +/- 0.8) was also statistically significantly higher than the pretreatment mean (99.08 +/- 0.96). After 2 min, however, the mean SaO2 decreased and was statistically indistinguishable from the pretreatment level after 5 min (99.13 +/- 0.9 SD). Fluctuations in SaO2, though statistically significant, were less than 1%. Allowing children to breathe room air immediately after cessation of N2O/O2 inhalation did not reduce SaO2 below clinically acceptable levels. This study further documents the safety of N2O/O2 sedation, and gives the clinician additional information concerning the safe and effective administration of inhalation sedation. (Pediatr Dent 15:88-92, 1993).

An outcomes assessment of 15 years of patient care experiences in predoctoral pediatric dentistry.

The purpose of this study was to examine the trends in numbers, demographic characteristics, and treatment history of pediatric dental patients under the care of dental students over the period 1980 through 1994. Data were collected for: exams, sealants, surfaces of amalgam, composite resin surfaces, pulpotomies, stainless steel crowns, and extractions. Correlations were done across the 15-year period to determine significant trends over time. During the 15-year period, the average number of patient visits required for each student to complete the requisite number of patients, declined from 45 appointments to complete 10 patients in 1980, to 35 visits to complete 13 patients in 1994. Over time, the numbers of amalgam surfaces, pulpotomies, extractions and stainless steel crowns decreased significantly, while the number of composite resin surfaces increased (P < 0.05). Based on a previous outcome assessment that indicated declining numbers of procedures performed between 1980 and 1985, the required number of patients treated per student was raised from 10 to 13, beginning with the 1986 class.