Risk indicators for tooth loss in Kiriri Adult Indians: a cross-sectional study.

BACKGROUND: The aim of this cross-sectional study was to evaluate the risk indicators of tooth loss in adult Kiriri Indians from Brazil. METHODS: A representative sample of 225 Indians (≥ 19 years of age) was assessed. Interviews using a structured written questionnaire were performed to collect data on demographics and socio-economic status, and health-related data. Probing depth, the distance between the cement-enamel junction and the free gingival margin, and decayed, missing or filled teeth were evaluated. Bivariate and logistic models were used to assess associations between tooth loss and age, sex, income, education, diabetic status, smoking habits, dental caries, severe periodontitis, plaque index and previous dental visit. RESULTS: Eighty per cent of subjects had lost one tooth or more, and 20% had lost eight teeth or more. Mean (± standard deviation) tooth loss was 5.09 (± 5.83) teeth. After adjustment for covariates, loss of one tooth or more was associated with older age [≥ 35 years; odds ratio (OR) = 4.06, 95% confidence interval (95% CI): 1.38-11.94, P = 0.01], severe periodontitis (OR = 3.35, 95% CI: 0.99-11.24, P = 0.05), higher dental caries (OR = 3.24, 95% CI: 1.35-7.78, P = 0.01) and previous dental visit (OR = 23.32, 95% CI: 5.75-94.63, P < 0.001). CONCLUSION: Tooth loss is highly prevalent in Kiriri Indians. Older age, severe periodontitis, higher caries index and previous dental visit were associated with tooth loss. Prevention and treatment programmes, targeting high-risk groups, are required to promote the oral health of the population.

The association between current unemployment and clinically determined poor oral health.

OBJECTIVES: The aim of this study was to assess whether current unemployment was associated with poor oral health and whether there was a difference in oral health according to the duration of the current unemployment. METHODS: As part of the Health 2000 Survey in Finland (a nationwide comprehensive health examination survey), we used its data based on interviews, questionnaires, and clinical oral examinations of the 30- to 63-year-old respondents (n = 4773). Current employment status was measured in its dichotomous form, employed versus unemployed, and length of current unemployment was classified into four categories. We measured oral health in terms of numbers of missing teeth, of sound teeth, of filled teeth, of decayed teeth, and of teeth with deepened periodontal pockets (≥4 mm, ≥6 mm). Poisson regression models were fitted for all oral health outcomes except number of decayed teeth, for which negative binomial regression model was used. Oral health-related behaviors and sociodemographic and socioeconomic factors were added to the analyses. RESULTS: The unemployed subjects had higher numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets than the employed ones. The association remained consistent even after adjustments. Oral health-related behaviors seemed to mediate the association. We found no association between unemployment and number of sound teeth. Current long-term unemployment showed stronger association with poor oral health than short-term among women. CONCLUSIONS: The unemployed can be considered as a risk group for poor oral health. Oral healthcare should be reoriented toward those who are unemployed.

Which life course model better explains the association between socioeconomic position and periodontal health?

AIM: To assess whether the relationship between socioeconomic position (SEP) and periodontal health fitted the Critical Period or the Social Mobility life course models. METHODS: A nationally representative sample of 5570 Korean adults from KNHANES IV study. Log-binomial regression models adjusting for adulthood or childhood socioeconomic (SES) variables was used to assess independent effects of socioeconomic differences for childhood, adulthood and period of transition from child to adult in periodontal health. RESULTS: In the Critical Period model, poorer periodontal status was associated with SES disadvantage in adulthood and not predicted by SES disadvantage in childhood. For the intergenerational Social Mobility model, prevalence of current periodontal disease was only different for females aged 30-39 and 40-49 years, after adjustment. Prevalence of periodontal disease in females was highest in the downwardly mobile group. CONCLUSIONS: The Critical Period model was better at explaining association between socioeconomic position and periodontal health, such as the adulthood socioeconomic variables (SEP), had a stronger effect than childhood factors on periodontal disease. The Social Mobility model explained more of the variation in the association between SEP and periodontal health among women than among men.

The Interplay between socioeconomic inequalities and clinical oral health.

Oral health inequalities associated with socioeconomic status are widely observed but may depend on the way that both oral health and socioeconomic status are measured. Our aim was to investigate inequalities using diverse indicators of oral health and 4 socioeconomic determinants, in the context of age and cohort. Multiple linear or logistic regressions were estimated for 7 oral health measures representing very different outcomes (2 caries prevalence measures, decayed/missing/filled teeth, 6-mm pockets, number of teeth, anterior spaces, and excellent oral health) against 4 socioeconomic measures (income, education, Index of Multiple Deprivation, and occupational social class) for adults aged ≥21 y in the 2009 UK Adult Dental Health Survey data set. Confounders were adjusted and marginal effects calculated. The results showed highly variable relationships for the different combinations of variables and that age group was critical, with different relationships at different ages. There were significant income inequalities in caries prevalence in the youngest age group, marginal effects of 0.10 to 0.18, representing a 10- to 18-percentage point increase in the probability of caries between the wealthiest and every other quintile, but there was not a clear gradient across the quintiles. With number of teeth as an outcome, there were significant income gradients after adjustment in older groups, up to 4.5 teeth (95% confidence interval, 2.2-6.8) between richest and poorest but none for the younger groups. For periodontal disease, income inequalities were mediated by other socioeconomic variables and smoking, while for anterior spaces, the relationships were age dependent and complex. In conclusion, oral health inequalities manifest in different ways in different age groups, representing age and cohort effects. Income sometimes has an independent relationship, but education and area of residence are also contributory. Appropriate choices of measures in relation to age are fundamental if we are to understand and address inequalities.

[Association between periodontal pockets and health-related behaviors of workers].

OBJECTIVE: Periodontal disease is a chronic disease caused by bacterial infection, and frequently develops in adulthood. As the disease is closely related to lifestyle, it is important to clarify its relationship with health-related behaviors to provide effective health instructions targeting its prevention. In this study, we focused on periodontal pockets with advanced periodontal disease to clarify the health-related behaviors associated with the presence or absence of periodontal pockets. METHODS: The subjects were 3,142 employees (male: N=2,429, female: N=713; 42.4 ± 10.5 years, Range 20-59 years) of one company, which had provided all employees with an oral health program in 2002. Participants with a Community Periodontal Index code of ≤2 and ≥3 were classified as those without and with periodontal pockets, respectively. To clarify the health-related behaviors associated with the presence or absence of periodontal pockets, we conducted multivariate logistic regression analysis, with presence/absence of periodontal pockets as the dependent variable, and items of health-related behavior investigated in 2002 as independent variables, and calculated the odds ratios (OR) and 95% confidence intervals (95%CI) adjusted for sex, age group and occupation. RESULTS: The factor most strongly correlated with the presence of periodontal pockets was non-use of dental floss (OR=1.95 (95%CI: 1.57-2.41)), followed by smoking (OR=1.71 (95%CI: 1.44-2.03)), and tooth-brushing habits (≤once a day: OR=1.33 (95%CI: 1.10-1.61)). CONCLUSIONS: Our results suggest that, to promote oral health program at the worksite, it is important to provide health education and instructions to encourage the use of dental floss, a daily tooth-brushing habit, and smoking cessation.

Risk factors for oral diseases among workers with and without dental insurance in a national social security scheme in India.

OBJECTIVES: The target population for this cross sectional study comprises subjects with and without social security in a national social security scheme. The study aimed to compare and assess the risk factors for oral diseases among insured (organised sector) and non-insured workers (unorganised sector) in New Delhi, India. METHODS: The sample comprised a total of 2,752 subjects. Of these, 960 workers belonged to the formal or organised sector with a social security and dental health insurance and 1,792 had no social security or dental insurance from the informal or unorganised sector. RESULTS: Significant differences were noted between the two groups for literacy levels, between-meal sugar consumption, tobacco-related habits and utilisation of dental care. Bleeding/calculus and periodontal pockets were present among 25% and 65.4% of insured workers, respectively. Similarly, 13.6% and 84.5% of non-insured workers had bleeding/calculus and periodontal pockets, respectively. The mean DMFT (decayed, missing, filled teeth) value among the insured workers and non-insured workers was 3.27 ± 1.98 and 3.75 ± 1.80, respectively. The association between absence of health insurance and dental caries was evident with an odds ratio (OR) of 1.94. Subjects with below graduate education were more prone to dental caries (OR = 1.62). Subjects who cleaned their teeth two or more times a day were less likely to have dental caries (OR = 1.47). Utilisation of dental care was inversely related to dental caries (OR = 1.25). CONCLUSION: The major risk factors for oral diseases in both the groups with similar socio-economic status were the lack of social security and health insurance, low literacy levels, high tobacco consumption and low levels of dental care utilisation.

Oral health of female prisoners in HMP Holloway: implications for oral health promotion in UK prisons.

OBJECTIVES: This study describes the oral health status and associated risk factors in a sample of female prisoners and compares their oral health to that of the female population from the 2009 Adult Dental Health Survey. METHOD: A random sample of prisoners was selected from HMP Holloway, London. Structured interviews were carried out to collect information on oral health behaviours and oral health related quality of life. Clinical examinations using the Adult Dental Health Survey criteria assessed the oral health needs of prisoners. RESULTS: The mean age of female prisoners (n = 103) was 30.9 ± 9.6 years. The prevalence of oral diseases was high. Seventy-five percent had decayed or unsound teeth. The mean DMFT was 12.3 ± 7.5. Compared to the general female population, prisoners had more decayed and fewer filled teeth. Sixty-six percent had periodontal pockets of 4 mm or more. A large proportion (73%) reported at least one oral impact on daily performances. Prisoners were more likely than the general female population to engage in oral health damaging behaviours such as high sugar intake and smoking. CONCLUSION: This survey has demonstrated the poor state of oral health and identified considerable levels of unmet dental treatment needs in HMP Holloway. Urgent action is required to address this major public health problem.

Oral health status and treatment need among institutionalised hearing-impaired and blind children and young adults in Udaipur, India. A comparative study.

AIM: The aim of this study was to assess and compare the oral health status and the treatment needs of the institutionalised hearing-impaired and blind children and young adults in the city of Udaipur, Rajasthan, India. METHODS: A descriptive cross-sectional study was conducted among 498 institutionalised hearing-impaired and blind people, aged 4 to 23 years, in the city of Udaipur, Rajasthan. The World Health Organization oral health assessment basic methods and form (1997) were used for data collection. Clinical examinations were carried out in the institute's medical room or classroom by single examiner with the aid of a mouth mirror, explorer and Community Periodontal Index (CPI) probe under adequate natural light (Type III examination). The resulting data were entered into statistical software and analysed by applying the chi-square test, ANOVA, t-test and stepwise multiple linear regression analysis. RESULTS: The total mean DMFT (decayed-missing-filled teeth) and mean dft scores were 1.77 and 0.27 respectively. The largest component of DMFT was the D, with a mean of 1.49. The F component of 0.08 was very low. Mean DMFT/dft was greater among hearing-impaired than among blind subjects. Overall, 159 (32%) were periodontally healthy (CPI=0), 162 (32%) had shallow pockets (CPI=3) and 36 (7%) had deeper pockets (CPI=4). A higher percentage of the blind (87; 43%) than the hearing-impaired (72; 24%) subjects were periodontally healthy (CPI score=0). One-surface fillings were the most commonly provided form of past treatment. CONCLUSION: The findings in this study highlight the lack of dental treatment for this group. Overall oral health status was poorer in the hearing-impaired than in the blind subjects.

Oral health status and reasons for not attending dental care among 12- to 16-year-old children with Down syndrome in special needs centres in Jordan.

OBJECTIVES: The objective of this study was to assess oral health status, treatment needs, soft and hard tissue findings, as well as reasons for not attending dental care among children with Down syndrome (DS) registered in special needs centres in Jordan. METHODS: The sample consisted of a total of 206 participants with a mean age of 13.66 ± 1.47 comprising 103 with DS and 103 age- and gender-matched non-DS/public school children. Clinical levels of oral hygiene were assessed using Simplified Oral hygiene index, and caries detection was carried out according to WHO caries recording criteria. RESULTS: Children who had DS had a significantly higher percentage of surfaces with severe gingival index (39.9 ± 9.1 versus 15.9 ± 8.0, P < 0.001) and a higher mean of probing pocket depth than children without DS (2.27 ± 0.2 versus 1.81 ± 0.32, P < 0.000). Significantly more peg-shaped maxillary lateral incisors and retained primary teeth (P < 0.001) were observed in subjects with DS, compared with non-DS children. Average decayed, missing and filled teeth (DMFT) was significantly lower in male children with DS compared with male non-DS children only (P = 0.034). The most common reason cited for not taking children to the dentist for DS group was 'Not aware of the dental problems of their children' and for non-DS groups 'No awareness of the importance of dental visit' (61.2% and 53%, respectively). CONCLUSIONS: While having similar caries level, Jordanian teenagers with DS had more dental anomalies, poorer periodontal health and less dental attendance than age- and gender-matched non-DS/public school children.

Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults.

BACKGROUND: Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population-based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full-mouth examination. METHODS: Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full-mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health-related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated. RESULTS: Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full-mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors. CONCLUSION: Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.

A preliminary assessment of the periodontal status of elderly pensioners in Benin City, Nigeria.

AIM: This study was to assess the periodontal status of pensioners in Benin City and obtain baseline data. MATERIALS AND METHODS: The cross-sectional descriptive study involved 250 subjects selected by systematic random sampling from three clusters of general, university and teaching hospital pensioners examined using the Community Periodontal Index index in four locations within Benin City. RESULTS: The percentages of the dentate subjects with healthy gingiva, bleeding on probing, calculus, shallow pockets and deep pockets were 2.4, 5.2, 46.8, 38.8 and 6.8%, respectively. Only 2% needed no periodontal treatment; those requiring oral hygiene instructions, scaling and polishing and complex treatment were 52, 39 and 7%, respectively. There were no significant differences in the periodontal status of the pensioners by gender, age or tooth brushing habits. CONCLUSION: The presence of calculus accounted for the most prevalent periodontal condition among the elderly pensioners followed by shallow periodontal pocketing apparently owing to poor dental attendance or lack of access to care. A comprehensive pensioner's oral health programme is recommended.

Assessment of periodontal status among dental fluorosis subjects using community periodontal index of treatment needs.

AIM: To determine the periodontal status and treatment needs among dental fluorosis subjects residing in Ennore, Chennai, using Community Periodontal Index of Treatment Needs (CPITN). MATERIALS AND METHODS: All the subjects with dental fluorosis above 15 years of age, permanent residents of Ennore, were included in the study. Subjects with known systemic diseases and subjects with other intrinsic dental stains were excluded from the study. Periodontal status was estimated using CPITN and Dental fluorosis was recorded using Dean's Dental Fluorosis Index. RESULTS: The total number of study subjects was 1075, of which 489 were males and 586 were females. Males were predominantly affected with periodontal disease than females. This was found to be statistically significant (P=0.000). The association between Degree of Fluorosis and Periodontal Status is statistically significant (P=0.000). There was statistically significant difference in mean number of sextants between the degree of fluorosis in each of the periodontal status (P=0.000). CONCLUSION: The finding that the lower prevalence of shallow pockets in the study area, where the fluoride level in the drinking water ranges from 1.83 to 2.01 ppm, indicates that the use of fluoride in water is beneficial to the periodontal tissues.

Oral health status of Vietnamese adults: findings from the National Oral Health Survey of Vietnam.

BACKGROUND: The National Oral Health Survey of Vietnam 1999 was conducted to inform policy development. AIMS: This article aims to describe the oral health status, analyze its socioeconomic distribution, and evaluate change over time in the oral health of the adult population of Vietnam. METHODS: A multistaged stratified sampling process was used. Adults aged 18+ years completed a social survey and were examined by trained and calibrated dentists. RESULTS: Oral symptoms were frequent. Dental care utilization was low and mostly problem driven. One third of adults had periodontal pockets. Calculus was highly prevalent. Caries level was moderate with a mean decayed, missing, and filled teeth score of 4.98 (SD 5.7), with most as untreated decay. Factors related to caries were gender, hygiene practices, socioeconomic status, location, and dental visiting. CONCLUSIONS: The oral health status of the Vietnamese adult population was compromised by various factors. There was indication of deteriorating oral health of this population.

Income inequality and periodontal diseases in rich countries: an ecological cross-sectional study.

UNLABELLED: There are adverse effects of income inequality on morbidity and mortality. This relationship has not been adequately examined in relation to oral health. AIMS: To examine the relationship between income inequality and periodontal disease in rich countries. PARTICIPANTS: Adults aged 35-44 years in 17 rich countries with populations of more than 2 million. METHODS: National level data on periodontal disease, income inequality and absolute national income were collected from 17 rich countries with populations of more than 2m. Pearson and partial correlations were used to examine the relationship between income inequality and percentage of 35-44-year-old adults with periodontal pockets > or = 4 mm and > or = 6 mm deep, adjusting for absolute national income. RESULTS: Higher levels of income inequality were significantly associated with higher levels of periodontal disease, independently of absolute national income. Absolute income was not associated with levels of periodontal disease in these 17 rich countries. CONCLUSION: Income inequality appears to be an important contextual determinant of periodontal disease. The results emphasise the importance of relative income rather than absoluteincome in relation to periodontal disease in rich countries.

Prevalence of periodontal disease and treatment demands based on a German dental survey (DMS IV).

AIM: We assessed the prevalence and extent of periodontitis in Germany. Furthermore, region- and gender-specific differences in periodontal disease prevalence were evaluated. MATERIAL AND METHODS: The fourth German Dental Health Survey is a national cross-sectional survey conducted in 2005. Nine hundred and twenty-five adults (35-44 years) and 1040 seniors (65-74 years) were examined. The survey comprised social- and health-related interviews and dental examinations. Probing depth (PD) and clinical attachment loss (CAL) were assessed at three sites at 12 index teeth. RESULTS: Prevalence of CAL> or =3 mm was found in 95.0% in adults and 99.2% in seniors with 68.7% and 91.4% of teeth being affected, respectively. PD> or =4 mm was prevalent in 76.9% and 87.7% in both age groups, respectively. According to the CDC definition considering mesiobuccal and distolingual sites, prevalence of periodontitis was 70.9% and 87.4% in both age cohorts, with one-fourth and one-half presenting severe forms, respectively. Periodontal prevalence was significantly higher in male subjects and East German subjects. CONCLUSIONS: Periodontitis was highly prevalent in German adults. To reduce periodontal burden, treatment of periodontal diseases and continuous maintenance should become an integral part in dental practice. Furthermore, health recommendations should be implemented at the community, professional, and individual level.

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.

Risk factors for impaired oral health among 18- to 34-year-old Australians.

OBJECTIVES: The objective of this study was to determine risk factors for a summary measure of oral health impairment among 18- to 34-year-olds in Australia. METHODS: Data were from Australia's National Survey of Adult Oral Health, a representative survey that utilized a three-stage, stratified, clustered sampling design. Oral health impairment was defined as reported experience of toothache, poor dental appearance, or food avoidance in the last 12 months. Multivariate Poisson regression models were used to evaluate effects of sociodemographic characteristics, self-perceived oral health, dental service utilization, and clinical oral disease indicators on oral health impairments. Effects were quantified as prevalence ratios (PR). RESULTS: The estimated percent of 18- to 34-year-olds with oral health impairment was 42.4 [95 percent confidence interval (CI) 37.7-47.2]. In the multivariate model, oral health impairment was associated with untreated dental decay (PR 1.38, 95 percent CI 1.13-1.68) and presence of periodontal pockets 4 mm+ (PR 1.29, 95 percent CI 1.03-1.61). In addition to those clinical indicators, greater prevalence of oral health impairment was associated with trouble paying a $100 dental bill (PR 1.37, 95 percent CI 1.12-1.68), usually visiting a dentist because of a dental problem (PR 1.46, 95 percent CI 1.15-1.86), reported cost barriers to dental care (PR 1.46, 95 percent CI 1.16-1.85), and dental fear (PR 1.43, 95 percent CI 1.18-1.73). CONCLUSIONS: Oral health impairment was highly prevalent in this population. The findings suggest that treatment of dental disease, reduction of financial barriers to dental care, and control of dental fear are needed to reduce oral health impairment among Australian young adults.

Periodontal treatment needs and prevalence of localized aggressive periodontitis in a young Turkish population.

BACKGROUND: The purpose of this study was to investigate the prevalence of localized aggressive periodontitis (LAgP) among students aged 13 to 19 years at public schools in Ankara. METHODS: A total of 3,056 students (1,563 females and 1,493 males) participated in the study. All students were examined at their schools and their mouths coded according to the recommendations of the Community Periodontal Index of Treatment Needs (CPITN) using a mirror, a World Health Organization 621 ball-tip probe, and daylight for illumination. Among the students examined, 170 had two or more sextants or teeth with code 3 or one sextant with code 4 and were scheduled for radiographs and a full clinical examination. The additional criteria for the diagnosis of LAgP were good general health, radiographically determined bone loss around the first molars bilaterally, and the bone loss must be unproportionally extensive with respect to the low levels of plaque and calculus, contrary to what is usually observed in chronic periodontitis. RESULTS: Among the 3,056 students screened, 170 were scheduled for further examination, and 18 (10 females and eight males) were diagnosed with LAgP. Of 18,336 sextants examined, 6,575 required scaling, and 63 required scaling and further complex treatment. CONCLUSION: The prevalence of LAgP was 0.6%, with a female/male ratio of 1.25:1.

Oral health-related quality of life in a birth cohort of 32-year olds.

OBJECTIVES: To describe oral health-related quality of life (OHRQoL) among New Zealand adults and assess the relationship between clinical measures of oral health status and a well-established OHRQoL measure, controlling for sex, socioeconomic status (SES) and use of dental services. METHODS: A birth cohort of 924 dentate adults (participants in the Dunedin Multidisciplinary Health and Development Study) was systematically examined for dental caries, tooth loss, and periodontal attachment loss (CAL) at age 32 years. OHRQoL was measured using the 14-item Oral Health Impact Profile questionnaire (OHIP-14). The questionnaire also collected data on each study member's occupation, self-rated oral health and reasons for seeing a dental care provider. SES was determined from each individual's occupation at age 32 years. RESULTS: The mean total OHIP-14 score was 8.0 (SD 8.1); 23.4% of the cohort reported one or more OHIP problems 'fairly often' or 'very often'. When the prevalence of impacts 'fairly/very often' was modeled using logistic regression, having untreated caries, two or more sites with CAL of 4+ mm and 1 or more teeth missing by age 32 years remained significantly associated with OHRQoL, after adjusting for sex and 'episodic' dental care. Multivariate analysis using Poisson regression determined that being in the low SES group was also associated with the mean number of impacts (extent) and the rated severity of impacts. CONCLUSIONS: OHIP-14 scores were significantly associated with clinical oral health status indicators, independently of sex and socioeconomic inequalities in oral health. The prevalence of impacts (23.4%) in the cohort was significantly greater than age- and sex-standardized estimates from Australia (18.2%) and the UK (15.9%).

Predictive values of self-reported periodontal need: National Health and Nutrition Examination Survey III.

BACKGROUND: This study assessed predictive values of self-reported periodontal need to identify periodontal conditions using clinical examinations as the gold standard. METHODS: We identified 12,370 adults > or = 18 years of age in the third National Health and Nutrition Examination Survey. Self-reported periodontal need was based on participants responding that gum treatment and/or cleaning was needed when asked: "What type of dental care do you need now?" Two periodontal conditions were at least two sites with pockets (pockets > or = 3 mm or pockets > or = 4 mm) and at least two sites with calculus. Main outcomes were: 1) positive predictive value (PPV(Clean)): proportion of those who self-reported the need for cleaning who had calculus; and PPV(Gum): proportion who self-reported the need for gum treatment who had pockets; 2) negative predictive value (NPV(Clean)): proportion of those who self-reported no need for cleaning who did not have calculus; and NPV(Gum): proportion who self-reported no need for gum treatment who did not have pockets; 3) association between predictive values and sociodemographic and behavioral characteristics; and 4) proportion of individuals with specific sociodemographic and behavioral characteristics whose self-reported periodontal need predicted periodontal conditions. RESULTS: The prevalence of periodontal conditions influenced predictive values. Calculus prevalence = 85%: corresponding PPV(Clean) = 88% and NPV(Clean) = 16%. Prevalence of pockets > or = 3 mm = 47%: corresponding PPV(Gum) = 62% and NPV(Gum) = 54%. Prevalence of pockets > or = 4 mm = 11%: corresponding PPV(Gum) = 25% and NPV(Gum) = 90%. Ninety percent of 30- to 44-year-old minority female smokers who did not visit the dentist in the past year and reported the need for gum treatment had pockets > or = 3 mm (PPV(Gum) = 90%). CONCLUSIONS: Self-reported periodontal need (cleaning/gum treatment) predicted the presence of the prevalent conditions (calculus/pockets > or = 3 mm). Not reporting a need for periodontal treatment predicted the absence of the less common condition (pockets > or = 4 mm) but not the more prevalent condition (calculus).