An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students.

OBJECTIVE: To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students. DESIGN: Cross-cultural survey of dental students. SETTING: 18 cultural areas. PARTICIPANTS AND METHODS: 904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions. RESULTS: The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001). CONCLUSIONS: Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.

Reduction of plaque formation and gingivitis by a dentifrice containing triclosan and copolymer.

A 6-month, single-blind and parallel clinical study was conducted to compare the effects of dentifrice containing 0.3% triclosan and 2.0% of copolymer (methoxyethylene and maleic acid) with a customary oral hygiene procedure on supragingival plaque formation and gingivitis. The 124 subjects were stratified into two balanced groups on the basis of their baseline plaque and gingivitis scores. After complete oral prophylaxis, subjects were assigned to use either a triclosan/copolymer dentifrice or to practice their customary oral hygiene care for 6 months. Plaque formation and gingivitis were scored at 3 and 6 months. After 3 and 6 months, triclosan/copolymer produced 7.17% and 12.07% significantly greater reduction of plaque formation than the customary oral hygiene group, respectively. Triclosan/copolymer significantly reduced gingivitis by 5.20% at 3 months, while no significant differences between the two groups were observed at 6 months. Likewise, triclosan/copolymer provided 8.70% and 16.33% significantly greater reduction of plaque severity index at 3- and 6-month evaluation, respectively. Gingivitis severity index was significantly reduced by 25% at 3 months, but there were no differences between the two groups at 6 months. These results indicate that the triclosan/copolymer dentifrice was better than the customary oral hygiene care in preventing supragingival plaque formation up to 6 months and in reducing gingivitis up to 3 months.

Number of teeth and nutritional status in Thai older people.

OBJECTIVE: To assess the association between the number of natural teeth and nutritional status in older Thai people aged 60-74 years. RESEARCH DESIGN: A cross-sectional study. METHOD: Stratified purposive sampling from senior citizen centres, households in sub-districts and municipal communities in Chiang Mai metropolitan area. MAIN OUTCOME MEASURES: The number of natural teeth and underweight status. RESULTS: Mean Body Mass Index was 22.1 (+/- 4.0) kg/m2 in the whole sample; 29.4% of the total sample were underweight. After controlling for confounders (personal income and age), there was a significant association between BMI and number of teeth. The crude odds ratio of underweight were 2.42 for 19 or less natural teeth and 2.84 for no natural teeth compared to 20 teeth or above (P < 0.001). A significant association was also found between number of natural teeth and being underweight (< 20 kg/m2) in the older age group (68-74 years) after controlling for personal income, gender, education and current smoking (odds ratio = 2.27, 95% CI = 1.25, 4.13). CONCLUSIONS: The results support the association between the number of natural teeth and being underweight.

The effectiveness of the newly designed 'Concept 45 degrees' toothbrush for removal of dental plaque in primary schoolchildren.

A single-blind, two-period cross-over study involving 36 primary schoolchildren, grade 6, aged 11-12 years, was conducted to evaluate the effectiveness of the newly designed 'Concept 45 degrees' toothbrush. This toothbrush, with straight, multi-tufted bristles and a specially designed handle, was compared with a control toothbrush with straight, multi-tufted bristles and a conventionally designed handle for removing dental plaque. All subjects were instructed to brush their teeth using the Bass technique. The subjects were asked to refrain from brushing for 24 hours before the study, to provide an indication of which subjects had the greatest potential for plaque development. Dental plaque was scored before and after brushing for 2 minutes. Results indicated that the use of the 'Concept 45 degrees' toothbrush removed significantly more dental plaque when compared to a standard, conventional toothbrush.

Dental plaque removal in adults using a newly developed, 'Concept 45 degrees' toothbrush.

A two by two factorial designed study was conducted to compare the effectiveness of the newly designed 'Concept 45 degrees' toothbrush on removal of dental plaque, to a standard conventional toothbrush using either the roll technique or the Bass technique of toothbrushing. One hundred male soldiers, aged 21-22 years were stratified into four balanced groups according to baseline plaque scores obtained from a pretest period. They received oral prophylaxis and were randomly assigned into one of the four experimental groups: (a) standard conventional toothbrush with the roll technique, (b) standard conventional toothbrush with the Bass technique, (c) the 'Concept 45 degrees' toothbrush with the roll technique, and (d) the 'Concept 45 degrees' with the Bass technique. The results showed that the 'Concept 45 degrees' toothbrush using the Bass technique removed dental plaque more effectively than the standard conventional toothbrush with either technique.

Comparison of the efficacy of a dentifrice containing 1.5% arginine and 1450 ppm fluoride to a dentifrice containing 1450 ppm fluoride alone in the management of early coronal caries as assessed using Quantitative Light-induced Fluorescence.

OBJECTIVE: To compare the efficacy of a new dentifrice containing 1.5% arginine, an insoluble calcium compound, and 1450 ppm fluoride to a matched, positive control dentifrice containing 1450 ppm fluoride in arresting and reversing early coronal caries lesions in children using Quantitative Light-induced Fluorescence (QLF). STUDY DESIGN: 331 children from Chiang Mai, Thailand, aged 7-14 years, with one or more visible early enamel caries lesions on the upper anterior teeth, completed the study. The new dentifrice contained 1.5% arginine, an insoluble calcium compound, and 1450 ppm fluoride, as sodium monofluorophosphate; the matched positive control contained 1450 ppm fluoride only. Subjects brushed twice daily at home and additionally once on school days under teacher's supervision. Digital images of the upper six anterior teeth were captured at the baseline, 3- and 6-month examinations using a custom apparatus for reproducible acquisition of Quantitative Light-induced Fluorescence data. RESULTS: At the 3-month examination, the ΔQ (representing lesion volume) for the test group decreased from a mean of 28.62 at baseline to 20.53 mm(2)% and for the positive control group to 23.38 mm(2)%. The difference between groups was not statistically significant (p=0.055). At the 6-month examination, the ΔQ decreased for the test group to 15.85 mm(2)% and for the positive control group to 20.35 mm(2)%. The difference between groups was statistically significant (p<0.001). CONCLUSION: A new dentifrice containing 1.5% arginine, an insoluble calcium compound, and 1450 ppm fluoride, as sodium monofluorophosphate, provided statistically significant superior efficacy in arresting and reversing active coronal caries lesions in children than brushing with a matched positive control dentifrice containing fluoride alone.

Assessing the difference between sociodental and normative approaches to assessing prosthetic dental treatment needs in dentate older people.

OBJECTIVE: To illustrate differences in assessed need using normative and sociodental approaches to assess prosthetic treatment needs of dentate older people. DESIGN: A cross-sectional study using non-random sample. SETTING: Metropolitan area of Chiang Mai, Thailand. SUBJECTS: 707 older individuals, 549 of the total sample were dentate, living independently, aged 60 to 74 years. RESULTS: The dentate population examined consisted of 289 classified as 'normal health' and 44 with a nutritional problem. Of the total population, 60% (333) had a normative need for partial dentures. Excluding the 44 with a nutritional problem, 50% (146) of the NTM group had 'impact-related treatment need' and of the latter 146, 69% (102) had a high propensity for health behaviour. 41% of the 102 who had 'impact-related' and 'propensity related treatment need' had 'accessible treatment need'. That is 14.5 per 100 of those with normative need. The gap between normative and 'accessible need' was greater among those with 'general health related treatment need' due to underweight. Of the 44 with a NTM and had a health problem, 45% (20) had a 'propensity related treatment need'. 40% of the group with a 'propensity related treatment need' had 'accessible treatment need'. Overall of the 44 older people with a normative need for a prosthesis and who had a health problem, only 2.4% had 'accessible treatment need' mainly due to lack of finance. If the treatment were subsidised then 45% of those with 'propensity related treatment need' would be eligible for treatment. CONCLUSION: Large differences of estimated treatment need were found between a sociodental and a normative approach to assess prosthetic dental treatment needs of older Thai people.

The prevalence of dental impacts on daily performances in older people in Northern Thailand.

OBJECTIVE: To assess the prevalence of oral related impacts on the quality of daily life in older Thais. DESIGN: A cross-sectional study on a non-random sample. SETTING: Metropolitan area of Chiang Mai, Thailand Subjects: 707 older individuals living independently, aged 60 to 74 years, 549 were dentate, 158 were edentate. METHODS: Clinical examination and questionnaire for the Oral Impacts on Daily Performances (OIDP) index and on dental behaviours. RESULTS: About one half of the older people interviewed (52.8%) had at least one OIDP oral impact. The most common performance affected was eating (47.2%). The two main symptoms that caused oral impacts in the total sample were functional limitation and pain. The majority of older people had low OIDP scores below 8.0 (76.4%). Almost one in 10 had OIDP scores above 16.0. Individuals with a high income were more likely to have lower OIDP score (p<0.001). Subjects who had attended a dentist were more likely to have no oral impacts (p=0.02). There was a significant difference between OIDP scores related to some clinical variables; dental status (p=0.002), having mobile teeth (p=0.005), periodontal attachment loss (p<0.001), missing anterior and posterior teeth (p<0.001). CONCLUSIONS: Oral impacts that affected quality of life of older people were relatively common but not severe. The impacts were related to some social and clinical variables.

Number of teeth and risk of root caries.

OBJECTIVE: This study aimed to investigate the association between number of natural teeth and prevalence of root caries. DESIGN: A cross-sectional design was adopted. A stratified multi-stage purposive sampling method was used to select a wide range of elderly people from all social classes, educational levels and sexes. Data was collected through interviews and clinical examinations. SETTING: Urban area in Chiang Mai-Thailand. PARTICIPANTS: 549 elderly dentate aged 60-74 years. MAIN OUTCOME MEASURES: Teeth with decay and filled roots (DF-T). RESULTS: The prevalence of root caries was 18.2% with a mean DF-T of 0.58 (S.D. 2.02). Results of multiple logistic regression showed that number of teeth, DMF-S scores, sex, and socio economic factors were statistically significantly associated with root caries (P < 0.05). Adjusted odds ratios demonstrated a 14% increase in the chance of having root caries when the number of teeth increased one unit. Similarly, a 3% increase was observed for each unit increase in the DMF-S scores (p < 0.001). Being male, having more than four years of education and earning more than 1500 baht/month increased the chances of root caries by 76%, 139% and 85% respectively (p < 0.001). Recession and age were not statistically significantly associated with root caries. CONCLUSIONS: Having more teeth, higher DMF-S scores, earning more than 1500 baht/month, having more than 4 years of education and being male increased the likelihood of having root caries.