Subgingival glycine powder air-polishing as an additional approach to nonsurgical periodontal therapy in subjects with untreated chronic periodontitis.

BACKGROUND AND OBJECTIVE: Glycine powder air-polishing (GPAP) is an alternative approach to removing subgingival plaque biofilms for effective periodontal therapy. This study aimed to investigate the effect of subgingival GPAP as an additional approach to nonsurgical periodontal treatment in subjects with chronic periodontitis. MATERIAL AND METHODS: Twenty-seven nonsmoking subjects were recruited. Two quadrants in each subject were randomly assigned, according to a split-mouth design, to receive scaling and root planing (SRP) and GPAP (Test group) or SRP and air flushing with water (Control group) at sites with probing depth ≥5 mm. Clinical parameters, gingival crevicular fluid volumes and the concentrations of interleukin-1ß and interleukin-1ra in gingival crevicular fluid were measured at baseline and 1, 3 and 6 months after the treatments. RESULTS: At baseline, no statistically significant difference in periodontal and gingival crevicular fluid parameters was found between the Test and Control groups. Overall, the periodontal conditions of all subjects showed significant improvement after the treatments. Notably, the Test group showed greater reduction in gingival crevicular fluid volume (0.37 ± 0.26 µL) than the Control group (0.23 ± 0.30 µL) at 3 months (P < .05). The gingival crevicular fluid levels of interleukin-1ß and interleukin-1ra showed a significant decrease in both groups at 6 months, and no significant difference was found between the groups. CONCLUSION: These preliminary results suggest that GPAP, as an additional approach to nonsurgical periodontal treatment, may be beneficial for the short-term improvement of subclinical inflammation when measured by gingival crevicular fluid volume. Further longitudinal studies with larger sample sizes are required to clarify the exact benefits of GPAP treatment for controlling inflammation and maintaining long-term periodontal health.

Moderate- to long-term therapeutic outcomes of treated aggressive periodontitis patients without regular supportive care.

BACKGROUND AND OBJECTIVE: Risk for deterioration in treated aggressive periodontitis (AgP) individuals remained unclear. This retrospective cohort study investigated 7-26 years of periodontal outcomes and oral health-related quality of life (OHRQoL) of young adults with advanced periodontitis. MATERIAL AND METHODS: Eighty-nine previously treated patients with AgP were re-examined. Clinical and radiographic parameters before treatment discontinuation and at re-examination were compared. OHRQoL at re-call was assessed with the short-form Oral Health Impact Profile (OHIP-14S). RESULTS: None of the subjects adhered to suggested periodontal therapy and maintenance after discharge. Mean percentage of sites with probing pocket depth (PPD) ≥6 mm at re-examination was 4.5 ± 5.9%. A total of 182 teeth had been lost over time. Tooth loss rate was 0.14/patient/year. From 68 subjects with documented favorable treatment outcomes, higher percentage of sites with PPD ≥6 mm at re-examination and higher radiographic proximal bone loss was associated with current smoking status. Patients with AgP with <20 teeth at re-call had worse OHRQoL than those with ≥20 teeth. Patients with higher full-mouth mean PPD also reported poorer OHRQoL. CONCLUSION: Treatment in patients with AgP who smoke and neglect proper supportive care, risk periodontal disease progression. Substantial tooth loss and higher full-mouth mean PPD led to poorer OHRQoL in this cohort.

Self-perceived preparedness for dental practice amongst graduates of The University of Hong Kong's integrated PBL dental curriculum.

OBJECTIVES: To determine how prepared for dental practice graduates from the integrated problem-based learning (PBL) dental undergraduate curriculum at The University of Hong Kong (HKU) perceive themselves to be and to identify factors associated with self-perceived preparedness. MATERIALS AND METHODS: A postal questionnaire was sent to five cohorts of dentists who had graduated from HKU's integrated PBL curriculum between 2004 and 2008. Using a 4-point Likert scale, the questionnaire assessed the self-perceived level of preparedness in 59 competencies grouped in nine domains. Responses were dichotomised into 'poorly prepared' and 'well prepared'. RESULTS: The response rate was 66% (159/241). The mean proportion (±standard deviation) of respondents indicating well-preparedness was 72.0±15.1% overall, and for each domain was as follows: general patient management, 93.1±12.1%; practice management, 81.0±22.2%; periodontology and dental public health, 73.5±19.3%; conservative dentistry, 92.5±13.1%; oral rehabilitation, 62.8±24.0%; orthodontics, 23.0±32.9%; managing children and special-needs patients, 64.8±28.9%; oral and maxillofacial surgery, 52.2±25.2%; and drug and emergency management, 84.7±22.6%. The odds of self-perceived well-preparedness were increased for cohorts graduating in 2004 and 2005 and graduates working in a non-solo dental practice. CONCLUSIONS: Dental graduates of HKU's integrated PBL curriculum felt well prepared for the most fundamental aspects of dental practice. However, apparent deficiencies of training in orthodontics and oral and maxillofacial surgery will need to be addressed by continuing education, postgraduate training and planning for the new 6-year undergraduate curriculum in 2012.

Combined photodynamic and low-level laser therapies as an adjunct to nonsurgical treatment of chronic periodontitis.

BACKGROUND AND OBJECTIVE: In recent years, there has been a growing interest in the use of dental lasers for treatment of periodontal diseases. The purpose of this short-term clinical trial was to evaluate the effects of a combination of photodynamic therapy with low-level laser therapy as an adjunct to nonsurgical treatment of chronic periodontitis. MATERIAL AND METHODS: Twenty-four nonsmoking adults with untreated chronic periodontitis were randomly assigned in a split-mouth design to receive scaling and root debridement with or without one course of adjunctive photodynamic therapy and low-level laser therapy within 5 d. Plaque, bleeding on probing, probing depth and gingival recession were recorded at baseline, 1 and 3 mo after the treatment. Gingival crevicular fluid was collected for assay of interleukin-1ß levels at baseline, 1 wk and 1 mo. RESULTS: The test teeth achieved greater reductions in the percentage of sites with bleeding on probing and in mean probing depth at 1 mo compared with the control teeth (p < 0.05). A significant decrease in gingival crevicular fluid volume was observed in both groups at 1 wk (p < 0.001), with a further decrease at 1 mo in the test sites (p < 0.05). The test sites showed a greater reduction of interleukin-1ß levels in gingival crevicular fluid at 1 wk than the control sites (p < 0.05). No significant differences in periodontal parameters were found between the test and control teeth at 3 mo. CONCLUSIONS: The present study suggests that a combined course of photodynamic therapy with low-level laser therapy could be a beneficial adjunct to nonsurgical treatment of chronic periodontitis on a short-term basis. Further studies are required to assess the long-term effectiveness of the combination of photodynamic therapy with low-level laser therapy as an adjunct in nonsurgical treatment of periodontitis.

Periodontal conditions of essential hypertension attendees to a general hospital in Hong Kong.

BACKGROUND: Periodontal infection may induce systemic vascular/endothelial dysfunction signifying a potential link between hypertension and periodontitis. METHODS: A convenience sample of 204 adults attending a university teaching hospital without (C: control) or with essential hypertension [EH; n = 102, duration (mean ± SD) 11.4 ± 6.9 years] was surveyed in this cross sectional study. Patients with concomitant systemic conditions were excluded. Dental history, oral hygiene habits and blood pressure were recorded. Plaque score (Pl%), bleeding on probing (BOP%), probing pocket depth (PPD) and probing attachment level (PAL) were noted and periodontitis severity was determined according to AAP/CDC case definition guidelines. RESULTS: Both groups exhibited poor oral hygiene. EH group had higher mean full-mouth PAL/PPD (3.16/2.73 vs. 2.51/2.40, P < 0.001). 51.0%/30.4% of the EH/C participants had severe periodontitis (P < 0.001). Regression analysis indicated systolic blood pressure, age, smoking and BOP% were associated with more severe periodontitis (r2  = 0.207, P < 0.05) while BOP%, PAL and fewer missing teeth were associated with worse mean PPD (r2  = 0.612, P < 0.05). CONCLUSIONS: Within the limitations of this study, the majority of hospital attendees surveyed exhibited poor plaque control, while periodontitis severity was found to be associated with EH, and smoking.

Moderate- to long-term periodontal outcomes of subjects failing to complete a course of periodontal therapy.

BACKGROUND: The current retrospective cross-sectional study investigated 5-18-year treatment outcomes in subjects who did not complete a recommended course of periodontal therapy. METHODS: Sixty-five subjects who voluntarily discontinued therapy were recalled. The subjects' demographic data and dental history since discontinuation of periodontal treatment were collected via questionnaires. The subjects' periodontal condition, radiographic data and individual tooth-based prognosis at pre-discontinuation and recall were compared. RESULTS: A total of 229 teeth had been lost over time, mainly due to periodontal reasons. Upper and lower molars were most frequently lost. Rate of tooth loss (0.38/patient per year) was comparable to untreated patients. Deterioration in periodontal health in terms of increased percentage of sites with bleeding on probing (BOP) and sites with probing pocket depths (PPD) of 6 mm or more at re-examination was observed. Positive correlations were found between tooth loss and: (i) years since therapy discontinued; (ii) percentage of sites with PPD of 6 mm or more at pre-discontinuation; and (iii) at re-examination. Percentage of sites with PPD of 6 mm or more at recall was positively correlated with periodontal tooth loss and negatively correlated with percentage of sites without BOP. CONCLUSIONS: Patients not completing a course of periodontal therapy are at risk of further tooth loss and deterioration in periodontal conditions over time.

ART and conventional root restorations in elders after 12 months.

Successful use of atraumatic restorative treatment (ART) in children has been reported, but little information is available regarding its use in older adults. The hypothesis of this study was that survival rates of root restorations placed by both ART and the conventional technique were similar. Root-surface caries lesions in 103 institutionalized elders in Hong Kong were treated randomly by either: (1) the conventional approach-caries removed by dental burs, and the cavity filled with light-cured resin-modified glass ionomer; or (2) the ART approach-caries removed by hand instruments, and the cavity filled with chemically cured high-strength glass ionomer. In total, 84 conventional and 78 ART restorations were placed. After 12 months, 63 conventional and 59 ART restorations were reviewed, and the respective 12-month survival rates were 91.7% and 87.0% (p > 0.05). It is concluded that the survival rates of both types of root restorations were high and similar.

Periodontal conditions in adult Southern Chinese.

Periodontal diseases remain a concern in adult populations, but there have been no systematic descriptions of periodontal conditions, which have included periodontal attachment loss, among Southern Chinese. The main aim of this report is to describe the periodontal conditions in adult Chinese and to investigate factors that may have influenced periodontal attachment loss. Subjects were recruited from urban and rural survey sites throughout Guangdong. In total, 1,572 35- to 44-year-old subjects and 1,286 65- to 74-year-old subjects completed a structured interview and underwent a periodontal examination, which included the Community Periodontal Index (CPI) and periodontal Attachment Loss (ALoss) recordings. Calculus was found as the highest CPI score in 61-68% of the 35- to 44-year-old subjects and in 54-57% of the 65- to 74-year-olds. Shallow pockets were found as the highest CPI score in about one-third of both the urban and the rural subjects in both age groups, and deep pockets in 3-7% of the subjects. ALoss was more prevalent than pockets in both age groups. On the basis of the ALoss recordings, about one-third of the subjects in both age groups were categorized as exhibiting considerable ALoss for their age. In both age groups, logistic regression analysis indicated that being male, wearing partial dentures, and reporting less frequent toothbrushing were found to be associated with considerable ALoss.

Oral mucosal lesions in adult Chinese.

The objectives of this analysis were to determine the prevalence of oral mucosal lesions (OML) among adults in Southern China and to determine possible associations between OML and reported tobacco-smoking and alcohol-drinking habits. The sample consisted of 1,573 35- to 44-year-old and 1,515 65- to 74-year-old Chinese from both urban and rural areas of Guangdong Province. The subjects were interviewed by trained interviewers and underwent a clinical examination of the oral mucosa performed according to WHO guidelines. A specially prepared color atlas of OML was used for lesion recognition and confirmation during the survey. Among the 35- to 44-year-old subjects, the overall prevalence of OML was found to be 13% in urban men, 6% in urban women, 15% in rural men, and 4% in rural women. The corresponding figures for the 65- to 74-year-olds were 22%, 12%, 26%, and 19%. Tongue lesions and white lesions were relatively common, but denture-related lesions were not. No malignancies or erythroplakia was observed. Age and gender were found to relate to the occurrence of OML. In elderly men, smoking was significantly (p < 0.05) associated with some white lesions and tongue lesions, and alcohol drinking was also associated with some white lesions. In conclusion, tongue lesions and white lesions were relatively common in men, but pre-cancerous lesions were not prevalent.

Tooth loss, occluding pairs, and prosthetic status of Chinese adults.

The objectives of this analysis were to describe the numbers of teeth lost and those indicated for extraction, dental prosthetic status, and occluding tooth pairs among adults in Southern China and to investigate factors affecting tooth mortality. A sample consisting of 1,573 35- to 44-year-old and 1,515 65- to 74-year-old urban and rural Chinese was examined clinically by calibrated examiners. Teeth not present for any reason were defined as missing (MT). The sum of MT and teeth indicated for extraction (IMT) was defined as adjusted missing teeth (AMT). Only 4.4% of the urban and 3.4% of the rural 65- to 74-year-olds were edentulous. MT were not significantly different between urban and rural residents, but more IMT were found in rural residents. Women, those who had a lower education level, and those who were less wealthy had more AMT in both age groups. Smoking was found to be associated with AMT in the 35- to 44-year-olds. Eighteen percent of the urban and 27% of the rural elderly had no occluding tooth pairs after IMT were accounted for, and only 38% and 30%, respectively, had 10 or more occluding pairs. Fifty-one percent of the urban and 43% of the rural elderly were found to have some form of dental prostheses in either jaw. A partial denture was more common in urban residents in both age groups.

An Oral Health Survey in Southern China, 1997: background and methodology.

Relatively limited information is available about the oral health in the Guangdong Province of Southern China, the closest neighbor to Hong Kong. The study intended to explore the oral health status, knowledge, attitudes, and dental care utilization in the Guangdong population as a basis for formulating strategies for oral health prevention and treatment. Through multi-stage stratified and quota-sampling, individuals from urban as well as rural communities were selected (5- to 6-; 12-; 35- to 44-; and 65- to 74-year-olds; total N = 6251). Structured interviews and clinical examinations were performed. Inter-examiner reliability was high (kappa = 0.60-0.96). Samples of community water were taken for fluoride assessment. Overall, the sample surveyed was acceptably representative of the population, with some under-representation of rural residents and agricultural workers. Re-weighting was performed in appropriate analyses. The data analysis model used in the Second International Collaborative Study was used as a guide for the present data analysis. This approach has not previously been used on a Mainland Chinese population.

Interleukin-8 and granulocyte elastase in gingival crevicular fluid in relation to periodontopathogens in untreated adult periodontitis.

BACKGROUND: This study aimed to determine the relationships among interleukin (IL)-8 and granulocyte elastase levels in gingival crevicular fluid (GCF) and the concomitant presence of periodontopathogens in untreated adult periodontitis. METHODS: GCF and subgingival plaque samples were collected from 16 patients with untreated adult periodontitis and 10 healthy control subjects. IL-8 levels were determined by enzyme-linked immunosorbent assay (ELISA). Granulocyte elastase was analyzed with a neutrophilic granulocyte-specific, low molecular weight and chromogenic substrate, L-pyroglutamyl-L-prolyl-L-valine-p-nitroanilide, and the maximal rate of elastase activity (MR-EA) was calculated. Five DNA probes were used to detect the presence of A. actinomycetemcomitans (A.a.), B. forsythus (B.f.), P. gingivalis (P.g.), P. intermedia (P.i.), and T. denticola (T.d.). RESULTS: Lower IL-8 concentrations and higher granulocyte elastase activities were found in patients than in healthy controls as well as in diseased conditions co-infected with B.f., P.g., P.i., and T.d. as compared to healthy conditions without the target species (P <0.05). IL-8 concentrations were positively correlated with MR-EA levels in the periodontitis conditions co-infected with B.f., P.g., P.i., and T.d. (P <0.05). A wide range of IL-8 concentrations was found among 15 patients when the periodontitis condition was characterized by co-infection with B.f., P.g., P.i., and T.d. MR-EA levels in the high IL-8 group of subjects were significantly higher than those in the low IL-8 group of subjects (P <0.01). CONCLUSIONS: The present study shows that the local host-bacteria interactions in untreated periodontitis are diverse in terms of the intensity of inflammatory responses measured by IL-8-related granulocyte elastase activity in GCF. This might reflect different phases of the inflammatory response due to shifts in host-bacteria interactions and therefore be indicative of a range of periodontal disease activity levels.

Periodontal implications of furcation entrance dimensions in Chinese first permanent molars.

Narrow dimensions of the entrance to furcations of multi-rooted teeth can complicate the periodontal management of furcation involvements. The objectives of this study were to measure the furcation entrance dimensions of first permanent molars from Hong Kong Chinese, and to compare these dimensions with those of the blade widths of periodontal instruments generally advocated for root surface instrumentation. A total of 363 first permanent molars, of which 185 were maxillary, were examined under 1.5 x magnification. Furcation entrance dimensions were measured using calibrated test gauges ranging from 0.3 mm to 1.5 mm. Furcation entrance dimensions equal to or less than 0.75 mm (the blade width of a new Gracey curet being 0.76 mm) in maxillary first molars were found in 79% of buccal entrances, 39% of mesial entrances, and 43% of distal entrances. In mandibular first molars, entrance dimensions equal to or less than 0.75 mm were encountered in 36% and 47% of buccal and lingual furcation entrances respectively. One-half of all furcation entrance dimensions of these first molars were less than the blade width of new Gracey curets. This high prevalence of narrow furcation entrances should be considered in the periodontal management of furcation involvement of first molars in Chinese.

Oral colonisation by aerobic and facultatively anaerobic Gram-negative rods and yeast in Tibetans living in Lhasa.

Sample groups of children (n=50) and adults (n=38) were selected from pools of 207 children, (11-13-year olds from two primary schools) and 94 adults (25-44-year olds from four governmental agencies) who were the subjects of an oral health survey among Tibetans living in Lhasa, Tibet Autonomous Region. Mean ages of the study groups of children (38% females) and adults (61% females) were 11.6+/-0.9 and 37.1+/-6.1 years, respectively. All had lived in Tibet since birth. Oral rinse samples were selective cultured to isolate, quantify and speciate aerobic and facultatively anaerobic Gram-negative rods (using the API 20E kit) and yeasts (using API 20C AUX and API ZYM kits). For children, the isolation rates for oral coliform bacteria and yeasts were 84 and 14%, respectively, for adults, the respective rates were 26 and 40%. The corresponding quantities of coliforms/yeasts for children and adults were 0.4+/-1.6 x 10(3)c.f.u./15.8+/-72.3 and 0.2+/-0.6 x 10(3)c.f.u./57.2+/-137.5c.f.u. per millilitre oral rinse, respectively. Aerobic and facultatively anaerobic Gram-negative rods and Stenotrophomonas maltophilia, a free-living saprophytic and ubiquitous bacterial species of wide geographic distribution, were significantly more frequently recovered from the children's oral rinses. The isolation rates of facultatively anaerobic Gram-negative rods in adults and yeasts in both groups were similar to those found in similar cohorts from southern China in earlier studies. Randomly amplified polymeric DNA analysis showed that the S. maltophilia spp. isolated from children were of several different clonal types and were school specific. This study shows that the colonisation rate of facultatively anaerobic Gram-negative rods in adults and yeasts in both groups are similar to those in populations living at lower altitudes, the native young, urban Tibetans appear to exhibit a high oral carriage rate of S. maltophilia spp.

Tooth spaces in and prosthetic treatment received by the middle-aged and the elderly in Hong Kong.

The purpose of this study was to describe the state of the dentition of middle-aged and elderly Chinese in Hong Kong in terms of teeth present, tooth spaces, and prosthetic treatment received. In an oral health survey conducted in 1991 in Hong Kong, a sample of 372 35-44-yr-olds and 537 noninstitutionalized 65-74-yr-olds was interviewed and clinically examined. In all dentate subjects, each tooth was scored for the presence/absence of that tooth, a tooth space of 5.5 mm which had not been treated, or the presence of a denture or pontic replacing that tooth. Each denture was assessed according to a set of criteria. None of the 35-44-yr-olds were edentulous and the mean number of teeth present was 27.5. About 40% of the third molars and about 35% of the mandibular first molars were missing. For only 1% of the missing teeth had space closure resulted in missing teeth not being recorded as tooth spaces or treated tooth spaces. Overall, 72% of the 35-44-yr-olds had no prosthesis, 17% had a bridge or bridges, 12% had a denture or dentures, and 1% had both. Of the 65-74-yr-olds, 12% were edentulous, and the dentate subjects had a mean number of 17 teeth present. About 70% of the molars were missing. Overall, only 29% of the elderly had no prosthesis, 52% had a denture or dentures, 33% had a bridge or bridges, and 13% had both. Only 35% and 28%, respectively, of the middle-aged and elderly denture wearers had no complaint about their dentures.(ABSTRACT TRUNCATED AT 250 WORDS)

Periodontal conditions among the middle-aged and the elderly in Hong Kong.

The aim of this study was to describe the periodontal conditions in 372 35-44-yr-old and 537 noninstitutionalized 65-74-yr-old Hong Kong Chinese who were examined clinically for loss of attachment, recession, probing depth, calculus, and bleeding after probing. Community Periodontal Index (CPI) data and treatment need indications were compiled from index teeth or their substitutes. The prevalence of loss of attachment varied considerably in both cohorts according to the definition of the threshold (> or = 6, > or = 9, and > or = 12 mm, respectively). The mean numbers of teeth with loss of attachment at the > or = 6-mm threshold and at higher thresholds were small. In both age cohorts, about one-fifth of subjects had probing depths > or = 6-mm, while at the > or = 9-mm threshold only 2-3% were so affected. Although recession was an important component of loss of attachment in the younger cohort, in the older cohort the prevalence and extent of recession were greater than for probing depths at thresholds > or = 4 mm. All subjects had one or more teeth with calculus, bleeding, or both, most teeth being so affected. Eighty-four of the 537 65-74-yr-old subjects were excluded either because of edentulousness or because extractions indicated for the remaining teeth would have rendered the subjects edentulous. The distribution of subjects according to their highest CPI score was remarkably similar for the two cohorts. No subjects in either age group were assessed as "healthy" (CPI code 0) or had "bleeding only" (code 1) as their highest score. While most subjects scored CPI code 2 or 3 as their highest score, only 17% of the younger and 15% of the older cohort scored Community Periodontal Index of Treatment Needs (CPITN) code 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral mucosal lesions in 65-74-year-old Hong Kong Chinese.

There have been no reported surveys of oral mucosal lesions among the elderly in Asian countries. Therefore, the purpose of this study was to determine the prevalence of oral mucosal lesions among 65-74-yr-old, community-dwelling elderly Chinese in Hong Kong and to determine the prevalence of lesions in denture wearers, tobacco smokers, and alcohol drinkers. A total of 537 noninstitutionalized 65-74-yr-olds were interviewed and clinically examined in an oral health survey conducted in 1991. In the survey, the elderly underwent a systematic examination of their oral mucosa by one of the three examiners with the aid of an overhead light. The examiners were trained and calibrated before and during the survey, and a specially prepared colour atlas of oral mucosal lesions was used for lesion recognition. No mucosal lesions were detected in 64% of the elderly. In the 193 elderly subjects with lesions, 80% exhibited only one lesion. There was no difference in prevalence between men and women. The more common lesions, each being found in 5-7% of the elderly, were lingual varicosities, frictional keratosis on the buccal mucosa, denture stomatitis on the palatal mucosa, and denture-induced hyperplasia in the maxillary and mandibular buccal sulcus. Denture wearers had a higher prevalence of lesions (40%) than nonwearers (32%). There was no difference in the prevalence or number of oral mucosal lesions between those defined as users of tobacco and alcohol and those defined as nonusers in this study. No confirmed oral malignancies were found.

Oral health care needs among the middle-aged and the elderly in Hong Kong.

A sample of 372 35-44-yr-olds and 537 noninstitutionalized 65-74-yr-olds were clinically examined in an oral health survey of Hong Kong Chinese conducted in 1991. The examination procedures and diagnostic criteria for assessing restorative and extraction treatment need followed those recommended by the World Health Organization. The Community Periodontal Index-based periodontal treatment needs involving index teeth or their replacements were computed from separate clinic scores for maximum probing depth, presence of calculus, and bleeding after probing. A set of criteria for assessing prosthodontic treatment need was specially laid down for this survey. Examiners were calibrated before the survey, and the interexaminer reliability was found to be generally good. Besides reporting the various individual normative treatment need items in the traditional way, the present analysis used some holistic treatment-need categories which may have manpower-requirement implications for the classification of subjects. All dentate subjects surveyed required some treatment. Only 6% of the elderly, all edentulous, required denture work only. Of the 35-44-yr-olds, 42% needed scaling and oral hygiene instruction only, which could be provided by dental hygienists. The treatment needs of the vast majority of the middle-aged and the elderly (mainly scaling; simple fillings; and extractions, dentures, or both) could be easily handled by general dentists. Only about one-fifth of the subjects in both age groups required some complex care such as endodontics, crowns, and advanced periodontal treatment, which could be delivered by senior dentists or dentists with specialist training.

The Hong Kong adult oral health survey--1991: background, study population, and methods.

This second adult oral health survey was conducted with the following main aims: 1) to describe the oral health conditions and to analyse the oral health care needs and demands of 65-74-yr-olds in Hong Kong, and to propose appropriate strategies for meeting their needs in the light of societal obligations; 2) to describe the oral health conditions and to analyse the oral health care needs and demands of 35-44-yr-olds in Hong Kong with special emphasis on assessment of changes in this age group since 1984 (when the first adult oral health survey was conducted); 3) to assess the impact of sociodemographic and dental care system factors on the oral health status of selected adult age groups: and 4) to utilize survey data to refine curriculum development and research strategies in the Faculty of Dentistry, as well as in the proposal of appropriate action to governmental committees on dental health policy. For enhanced comparability with the previous study, the 35-44-yr-olds were selected from the same geographic areas of Hong Kong Island. Multistage cluster sampling was used to recruit the study population, defined geographic units and addresses being used as the starting-point. A sample of 398 subjects was selected, of whom 93% were both interviewed and clinically examined. The 65-74-yr-olds were recruited from housing estates in all principal areas of Hong Kong, yielding a sample of 559 subjects, of whom 96% were both interviewed and clinically examined.(ABSTRACT TRUNCATED AT 250 WORDS)

Reasons given for tooth extraction in Hong Kong.

Two hundred and seventy dentists, systematically selected from the membership lists of the Hong Kong Dental Association, were sent forms on which they were invited to record the reasons for tooth extraction in all patients aged 16 years and above over a period of five to six weeks. Third molars were excluded. Fifty-five per cent of the recording sheets dispatched were returned with usable data. Data were provided on 8516 extractions performed for 6331 patients. Overall caries was the reason given for 60 per cent of extractions; periodontal disease for 28 per cent; prosthetic indications for six per cent; trauma (which included tooth wear) for four per cent; and orthodontic and other reasons for two per cent. Extractions for periodontal reasons were more common in those aged 40 years and above, but periodontal disease did not exceed caries as a reason for extraction even in those aged 60 years and over. The tooth type most frequently extracted was the first molar. Mandibular incisors were the teeth most commonly extracted for periodontal reasons. In this community, which has benefited from water fluoridation since 1961, caries was the dominant reason given by dentists for tooth extractions in all age groups of the subjects studied.