[Controversy on the terminology of cervical lesions on tooth].

Hard tissue defects at cervical site of tooth has been called the wedge-shaped defect in China for a long time. Other terms, abfraction and non-carious cervical lesions have been proposed in early 1990s. These three different terms are reviewed and analyzed in the present article. The author suggests to use the term non-carious cervical lesions to replace the term wedge-shaped defect in China.

Schedule for Rating Disabilities; Dental and Oral Conditions. Final rule.

This document amends the Department of Veterans Affairs (VA) Schedule for Rating Disabilities by revising the portion of the schedule that addresses dental and oral conditions. The effect of this action is to ensure that the rating schedule uses current medical terminology and to provide detailed and updated criteria for evaluation of dental and oral conditions for disability rating purposes.

An experimental elective report examining and comparing current levels of dental anxiety and disease in child populations in Peru and the UK.

INTRODUCTION: Dental anxiety is an important factor in influencing patients' decisions to access treatment. It is crucial dental care professionals understand its causative factors in order to prevent and manage it, particularly as dentally anxious patients often have poor oral health. This report is of an elective study that tried to ascertain whether children with signs of dental neglect suffered greater dental anxiety, as existing research suggests that anxiety can stem from previous experiences. METHOD: 100 children in both the United Kingdom and Peru were examined for signs of dental neglect using the PUFA (Pulpal exposures, Ulcers, Fistulas & Abscesses) system, and their anxiety levels surveyed with the Modified Child Dental Anxiety Scale. A Spearman's rank analysis was performed. RESULTS: Both groups showed similar disease levels, but Peruvian children were significantly less anxious. The r values (United Kingdom r=-0.020 Peru r=-0.0099) were less than rc=0.165 at a significance level of P=0.05, showing that increased dental neglect does not make children more anxious. DISCUSSION: It appears that having a neglected dentition as a child does not make you more anxious, but the resultant invasive treatment procedures likely to have been experienced as a child may have a role. Ultimately, cultural background and attitude to dental care are suggested as being more important in determining the dental anxiety levels of children.

Proposal for clinical classification of multifactorial noncarious cervical lesions.

Noncarious cervical lesions often present with overlapping symptoms and have a multifactorial etiology. The dimensions of the lesion axially (depth) and occlusogingivally (width), along with the orientation of the walls of the lesion to each other (angle), are the 3 factors that can be quantified to classify the lesion and assess its progress over time. This article analyzes these factors and proposes a simple classification system based upon the clinical appearance of the lesion in order to derive simple, therapeutic, treatment-based classifications.

Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University.

BACKGROUND: Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults. METHODS: This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed. RESULTS: In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health. CONCLUSION: Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students.

A new understanding of oral and dental disorders of the equine incisor and canine teeth.

This article discusses the classification systems for dental fractures and how the assessment affects treatment options. Diagonal incisor malocclusion is discussed in relation to skull asymmetry and how this commonly relates to premolar and molar occlusion. Oral and radiographic assessment of incisive bone fracture and incisor avulsion is reviewed for determining treatment options. A summary of incisor and canine resorption and hypercementosis is presented. Clinical presentations, staging, and classifications of tooth resorption as well as canine odontoplasty are discussed. Excessive plaque and calculus formation on lower canines leading to periodontal disease and abscess is examined.

Do we really know how to evaluate tooth prognosis? A systematic review and suggested approach.

Periodontal treatment is based on tooth prognosis evaluation. Different approaches for determining tooth prognosis have been described in the literature. The vast majority are based on clinical and radiographic findings, as well as patient-related factors. The availability of various systems for assigning tooth prognosis complicates both the assignment process and the communication between clinicians regarding patient status and treatment plan. In addition, performance evaluation of several systems reveals that the accuracy of prediction differs between teeth of various conditions in most methods, as well as the factors providing significant predictive power. As a standardized prognostic classification system is still lacking, an overall evaluation based on a uniform dataset could provide an objective comparison of all methods, and help progress towards developing novel approaches. The main features of such approaches should include the selection of predictive factors, their assigned weights in accordance with different tooth conditions, and the estimated period of time applicable for reevaluation of prognosis. In this paper, we propose a different approach for prognosis evaluation, suggesting reevaluating tooth prognosis at several time points during the treatment plan, and taking into consideration some of the most important issues of patient compliance, oral hygiene, and plaque control. The suggested approach attempts to address prognosis from a different perspective, viewing the process as a dynamic and recurring evaluation embedded within each step of the treatment plan. Due to the fact that accurate tooth prognosis evaluation is still (and might forever be) unavailable, a more humble and less aggressive approach should be adopted, trying to preserve more and extract less.

Oral diagnosis and treatment planning: part 5. Preventive and treatment planning for dental caries.

The practice of operative dentistry continues to evolve, to reflect the many changes occurring in society and in dental diseases and conditions. However, the belief that all questionable and early carious lesions should be restored still persists. This belief is largely based upon the concept that the removal of all carious tissue followed by meticulous restoration of the tooth is the treatment of choice for dental caries. Yet restorations are not permanent and do not cure caries, as the causes remain. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth.

Salivary flow rate and oral findings in Prader-Willi syndrome: a case-control study.

BACKGROUND. Prader-Willi syndrome (PWS) is a rare complex multisystemic genetic disorder. AIM. The objective of this study was to provide a systematic assessment of whole saliva secretion and oral manifestations associated with PWS. DESIGN. Fifty individuals (5-40 years) with PWS and an age- and sex-matched control group were included. Whole saliva was collected. All participants underwent an anamnestic interview. Radiological and dental clinical examinations were carried out to identify hypodontia, dental caries, enamel defects and gingival inflammation. RESULTS. Mean whole salivary flow rate was 0.12 ± 0.11 mL/min in the study group compared with 0.32 ± 0.20 mL/min in the control group (P < 0.001). Hypodontia was significantly more common in PWS (P < 0.001), and dental caries in the age group >19 years was significantly lower in PWS (P = 0.04) compared with the controls. There was no significant difference in the prevalence of dental caries in the primary dentition or in the frequency of enamel defects in the permanent dentition between the two groups. Median Gingival Index was significantly higher in the Prader-Willi group compared with the controls (P = 0.02). CONCLUSIONS. Low salivary flow is a consistent finding in PWS. Nevertheless, despite dry mouth and dietary challenges, dental caries is not increased in Norwegian individuals with PWS.

Classification of extensively damaged teeth to evaluate prognosis.

The restoration of teeth with extensive structural damage is an important clinical procedure in dental practice. However, despite the availability of a variety of materials, techniques and studies in the scientific literature, the criteria for selection of such teeth for restoration need clarification. The approach to severely compromised teeth should be based on consistent scientific evidence to reduce dental error and improve the prognosis. If restoration is indicated, it must conserve and protect the remaining tooth structure. In this article, we develop and suggest clinical criteria and guidelines that clinicians may use to identify and classify extensively damaged teeth to help in the diagnosis, treatment plan and prognosis.

[An index for untreated severe caries]. / Een index voor onbehandelde ernstige cariës.

Hardly any data are available on the clinical consequences of untreated severe caries, because there is no method to quantify the prevalence of oral conditions resulting from untreated caries. In the Philippines, an index was developed which records for (the location of) each tooth whether caries has reached the dental pulp, whether ulceration is present in the surrounding soft tissues due to sharp edges of fragments of a tooth lost due to caries, or whether a fistula or abscess is present. By adding the index to the existing Decayed Missing Filled Tooth index, insight is provided on the extent and the consequences of untreated caries and research may be carried out on its possible impact on the general health and wellbeing of national populations.

Ultramicroscopy of bone at oral implant sites: a comparison of ED and control patients. Part 1-defining the protocol.

PURPOSE: The aim of this study was to develop a protocol to analyze the microstructure of mandibular and maxillary bone in association with implant placement in ectodermal dysplasia (ED) and anodontia conditions compared to patients not suffering from such conditions. MATERIALS AND METHODS: This study was not additionally invasive, since the bone harvesting was completed at the time and site of implant placement. Bone samples were allocated into two groups (ED and control patients) and specified by the site of bone harvesting. Microcomputed tomography (micro-CT) analysis at 5-Μm resolution was conducted on each bone sample. Computer analysis applying specialized CT analysis and software allowed evaluation of the three-dimensional microstructure of alveolar and basal bone samples for comparison of structural parameters. RESULTS: Ten bone samples (five alveolar and five basal) were harvested. Preliminary data confirmed the structural features and significant differences between alveolar and basal bone. Basal bone had greater absolute and percent bone volume, greater bone surface, and a lower trabecular bone pattern factor than alveolar bone. CONCLUSION: Preliminary data were derived from bone harvested from both the maxilla and mandible of control patients, while bone samples from ED patients were harvested from only the anterior mandible. Further bone samples will provide more data on whether broader areas of bone harvesting, age, or sex affect the quality and quantity of the bone and influence implant treatment outcomes.

Behavioral and socioeconomic correlates of dental problem experience and patterns of health care-seeking.

BACKGROUND: To recognize and better understand barriers to dental care, the authors studied behavioral and socioeconomic factors specific to low-income and minority populations that contribute to patterns of professional health care-seeking. METHODS: A stratified random sample of 27,002 Maryland households participated in a cross-sectional telephone survey. The authors targeted respondents who were low-income non-Hispanic white, non-Hispanic black or Hispanic who had experienced a dental problem or injury during the previous 12 months, as well as similar people with higher incomes for comparison. A total of 94.8 percent (401 of 423) of eligible people completed the survey. RESULTS: Logistic regression modeling (95 percent confidence interval) revealed that the respondents' race or ethnicity and sex were associated with the number of dental problems experienced during the previous 10 years, and that having a regular source of medical care and the type of dental problem experienced were associated with earlier health care-seeking. The first choice of treatment site (physician's office, emergency department or dentist's office) was associated with the respondents' income, pain level, number of problems experienced in the past 10 years and the degree to which their problem was a burden. CONCLUSIONS: The authors found that predisposing, enabling and need-based factors were associated with dental problem experience and patterns of professional health care service use.

Influence of lateral excursion on vestibular cervical dental abfractions

Se realizó una investigación para evaluar la influencia de los movimientos excursivos laterales mandibulares; función de grupo y guía canina sobre abfracción dentaria cervico vestibular(ADCV). Se seleccionaron 36 individuos de ambos sexos entre 20 a 45 años de edad, con dentición natural completaque presentan como mínimo un diente con ADCV, en la Clínica Universitaria de la UNMSM. Se evaluó el número de dientes con ADCV por cada lado (derecho e izquierdo), tipo de diente,y movimiento excursivo lateral (guia canina o función en grupo) que lo influye. Los resultados denotaron no significancia estadísticas (p>0,05), el tipo de diente con mayor frecuencia a presentar ADCV fue el primer premolar inferior, 30,8 por ciento del lado derecho y 36,4 por ciento del lado izquierdo. Se encontró correlación positiva moderada entre edad y ADCV(r=0,40). Se concluye que la excursion lateral función en grupo puede contribuir a la presencia de ADCV.

An evaluation of U.S. Navy Dental Corps classification guidelines.

OBJECTIVES: The aims of this research were to evaluate the effectiveness of two different sets of dental classification guidelines to differentiate dental emergency (DE) rates between deployable and nondeployable personnel. METHODS: A retrospective study of the dental records of two cohorts of Marine Corps recruits examined and treated using different classification guidelines was completed. RESULTS: Both classification systems showed significant differences between DE rates of nondeployable and deployable personnel. No statistical difference was observed when comparing the adjusted HRs of the two cohorts. CONCLUSIONS: Results of this study suggest that both guidelines are able to distinguish between deployable and nondeployable personnel and give reasonable assurance that class 1 and 2 patients will not experience a DE for a 6-month period. Incorporating factors such as caries risk, number of missing and filled teeth, and number of third molars may improve the ability of the dental classification systems in predicting DE.

Recruitment of rural and cognitively impaired older adults for dental research.

The recruitment of community-dwelling older adults, particularly those with cognitive impairment and those residing in rural areas, has been consistently challenging for researchers, especially in the dental field. This study reports on recruitment experiences from an ongoing study investigating the association between oral health and cognitive status in later life. Multiple recruitment strategies, including educational presentations and traveling to participants' homes, were used to enroll rural elderly participants with various levels of cognitive function. In general, multipronged, proactive recruitment strategies were more effective than traditional, passive methods in reaching participants with varying degrees of cognitive impairment. The outcome of this study suggests that successful recruitment of such populations involves gaining the support of staff at relevant community organizations, informing community members (including older adults and their family members) of the project and the importance of oral health, and making data collection sites accessible for older adults.

Oral health status of the visually impaired children--a south Indian study.

UNLABELLED: Oral health is an important aspect of health for all children, and is all the more important for children with special health needs. The oral health of children who are visually impaired can be disadvantaged, since they are often unable to adequately apply the techniques necessary to control plaque. PURPOSE: The purpose of the present study was to evaluate the oral health status of visually impaired children. METHOD: A modified WHO oral health assessment form was used to assess oral conditions, oral hygiene status, caries experience and gingival status. RESULTS AND CONCLUSION: The children exhibited suboptimal levels of oral health with majority of the children showing a high caries prevalence as well as moderate to severe gingivitis.