Mechanisms of accidental fall injuries and involved injury factors: a registry-based study.

BACKGROUND: Falls are the leading cause of injury-related morbidity and mortality worldwide, but fall injury circumstances differ by age. We studied the circumstances of accidental fall injuries by age in Shenkursk District, Northwest Russia, using the data from the population-based Shenkursk Injury Registry. METHODS: Data on accidental fall injuries (hereafter: fall injuries) occurring in January 2015-June 2018 were extracted from the Shenkursk Injury Registry (N = 1551) and categorized by age group (0-6, 7-17, 18-59, and 60+ years). The chi-square test and ANOVA were used to compare descriptive injury variables across age groups, and a two-step cluster analysis was performed to identify homogeneous groups of fall injuries by preceding circumstances. RESULTS: Half of recorded fall injuries in the 0-6 year age group occurred inside dwellings (49%). The largest cluster of falls (64%) mainly included climbing up or down on home furnishings. In the 7-17 year age group, public outdoor residential areas were the most common fall injury site (29%), and the largest cluster of falls (37%) involved physical exercise and sport or play equipment. Homestead lands or areas near a dwelling were the most typical fall injury sites in the age groups 18-59 and 60+ years (31 and 33%, respectively). Most frequently, fall injury circumstances in these groups involved slipping on ice-covered surfaces (32% in 18-59 years, 37% in 60+ years). CONCLUSION: The circumstances of fall injuries in the Shenkursk District varied across age groups. This knowledge can be used to guide age-specific preventive strategies in the study area and similar settings.

Denture wearer's perception of ambient care. Part 2. Analyses of data.

OBJECTIVE: The aim was to investigate to what extent denture wearers were satisfied with the ambient care (care) received. MATERIALS AND METHODS: A study sample of 117 completely edentulous and 56 partially edentulous patients, who had received their dentures in the period 1997-2005 at Bergen School of Dentistry, completed a questionnaire containing eight specific items regarding different aspects of care, each with two positive (a and b) and two negative (c and d) categories, and four global items. The care items, including confidence in the dental team, information, waiting time and cost, constitute the Ambient Care Scale; the global items were concerned with overall care, satisfaction with dentures, self-reported oral and general health. RESULTS: Between 91-100% of Ambient Care Scale responses were in the two positive categories. The completely edentulous group was significantly more satisfied than the partially edentulous group regarding several Ambient Care Scale items and oral health. Also, ratios between categories b and a showed systematic higher degrees of satisfaction for the completely edentulous group than the partially edentulous group. Fifty-six per cent in the completely edentulous group and 36% in the partially edentulous group were very satisfied, i.e. with ≥ 6 of 8 possible responses in category a. Analysis of the very satisfied showed that the highest degrees of satisfaction for both groups were found regarding students and staff, the lowest regarding cost and waiting times. CONCLUSIONS: Patient satisfaction with care was very high. Completely edentulous patients were systematically more satisfied than partially edentulous ones.

Randomized clinical trial comparing dietary intake in patients with implant-retained overdentures and conventionally relined denture.

PURPOSE: This study compared the dietary intake of edentulous subjects dissatisfied with their existing mandibular complete dentures following two different prosthodontic management interventions. MATERIALS AND METHODS: A convenience sample of 60 subjects was randomly allocated into two equal treatment modalities: relined conventional denture (RCD) or converted implant-retained overdenture (IOD). Two-year data incorporating demographics and food avoidance were recorded using a self-administered questionnaire at baseline and regular follow-up intervals. Twenty-four-hour dietary intake assessments were obtained by telephone interviews at three spaced intervals. Dietary analyses were based on nutrient values from the Norwegian Food Composition Table. RESULTS: Twenty-seven patients in the IOD group and 26 in the RCD group completed the protocol. There were no statistical differences regarding dietary intake and energy distribution. Intake of protein and fat, especially saturated fat, were above Nordic recommendations, and carbohydrate intake was below. Vitamin D intake was at the recommended level, but that of vitamin C, folate, and fiber were lower than recommended. The IOD group reported significantly less avoidance of certain food items at 3 and 24 months (P < .001), better chewing ability (P < .001), and greater willingness to eat more of some food items (P < .001). CONCLUSION: There were no significant differences regarding food choices and nutrient intake between the IOD and RCD groups. However, the IOD group reported significantly better chewing ability, less food avoidance, and greater willingness to eat more of certain food items.

Denture wearer's perception of ambient care, part 1: validation of a preliminary scale.

OBJECTIVE: The aim of the present study was to investigate if a preliminary Ambient Care Scale (ACS), intended to measure ambient care in complete denture wearers, had acceptable reliability and validity. MATERIALS AND METHODS: A sample of 117 patients who had received complete dentures in both jaws in the period 1997-2005 at Bergen School of Dentistry completed a questionnaire containing eight items regarding the patients' relationship with the student and clinical personnel, to what extent they were informed and consulted during treatment, waiting times and cost. In addition, information was gathered regarding demographics, The Psychological General Well-Being index (WHO-5), global ambient care, satisfaction with dentures and how patients viewed their oral health. RESULTS: Cronbach's alpha coefficient was 0.76 for the ACS, indicating acceptable internal consistency. From principle component analysis, three factors were extracted, correlating with ACS with coefficients of 0.72, 0.58 and 0.59, respectively. Acceptable construct validity was indicated by the fact that items were formulated by common agreement among three experienced prosthodontists, the extremely low frequency of missing data (<2%) and that ACS, as expected, was able to discriminate between patients satisfied and dissatisfied with their dentures (p = 0.005) and oral health (p = 0.042), but not between those who had high or low WHO-5 scores (p = 0.77). CONCLUSIONS: The ACS appears to have acceptable psychometric properties.

Patients' perceptions of improvements after bilateral sagittal split osteotomy advancement surgery: 10 to 14 years of follow-up.

INTRODUCTION: The aims of this study were to determine reasons for orthodontic-surgical treatment, to quantify the perceptions of possible improvement 10 to 14 years after treatment, and to assess factors that affect treatment satisfaction and socio-dental impacts on quality of life. METHODS: The participation rate was 36 of 78 patients; their mean age was 45.7 years (SD, 10.7 years; range, 29-62 years). The presurgical anatomic occlusions were measured on dental casts. Visual analog scales allowed the participants to rate their perceived treatment outcome on 7 oral health-related items. A 3-point scale rated satisfaction with orthodontic-surgical treatment. The oral impact of daily performances index was included to assess socio-dental impacts on quality of life. RESULTS: Most responders reported improvements on the 7 items. The most significant change was reported for chewing. "Very satisfied" with the treatment was reported by 13 responders; 19 of 36 persons were "reasonably satisfied." Reporting "very satisfied with treatment" was 8 times more likely when peers had noticed a changed in the participant's appearance after surgery. Sex was significantly associated with quality of life. CONCLUSIONS: The most frequently reported reason for treatment was to improve chewing, and the item that showed the most pronounced improvement was also chewing. Most responders were only reasonably satisfied with the treatment. Whether peers noticed a change in appearance after treatment was a significant factor affecting both treatment satisfaction and reporting a good quality of life.

Oral health status of 12-year-old school children in Khartoum state, the Sudan; a school-based survey.

BACKGROUND: Few studies have investigated the prevalence of dental caries among school children in the past decades in Sudan rendering it difficult to understand the status and pattern of oral health. METHODS: A school-based survey was conducted using stratified random cluster sampling in Khartoum state, Sudan. Data was collected through interviews and clinical examination by a single examiner. DMFT was measured according to WHO criteria. Gingival index (GI) of Loe & Silness and Plaque index (PI) of Silness & Loe were used. RESULTS: The mean DMFT for 12-year-olds was found to be 0.42 with a significant caries index (SiC) of 1.4. Private school attendees had significantly higher DMFT (0.57) when compared to public school attendees (0.4). The untreated caries prevalence was 30.5%. In multivariate analysis caries experience (DMFT > 0) was found to be significantly and directly associated with socioeconomic status. The mean GI for the six index teeth was found to be 1.05 (CI 1.03 - 1.07) and the mean PI was 1.30 (CI 1.22 - 1.38). CONCLUSION: The prevalence of caries was found to be low. The school children with the higher socioeconomic status formed the high risk group.

Developing a scale for measuring expectancy of retaining natural teeth for life and comparison of results obtained using a global item and a multi-item scale of measurement.

OBJECTIVE: To develop and test a scale for measuring expectancy of retaining teeth for life and to compare the estimates when using a global item with those obtained with a multi-item scale of measurement. MATERIAL AND METHODS: The design of the study was cross-sectional selected and random sample surveys using a self-administered questionnaire or interview. There were two groups of patients and a national sample aged 16-79 years (n=1274); response rate 64%. The main results pertain to dentate subjects in a global group (n=615) and in a scale group (n=609). The outcome measure was expectancy of retaining natural teeth for life. Results. When using the global item, 92% (95% CL 89.8, 94.1) of the respondents believed they would definitely or possibly retain their natural teeth for life, significantly higher than the 81% (95% CL 77.6, 84.0) obtained with the 4-item conditional scale. Cronbach's alpha was 0.89 for the 4-item scale and the test-retest reliability moderate (kappa = 0.51; 0.77 for +/-1). The adults' belief in retaining teeth for life was significantly associated with having a live-in partner (p = 0.009) when the global question was the dependent variable; and sex (p = 0.000) and education (p = 0.004) when the 4-item scale was the dependent variable. Explained variance was 3.8% and 4.5%, respectively. Conclusions. The internal reliability of the 4-item scale was high. A significantly lower proportion of people reported belief in retaining natural teeth for life when employing the 4-item conditional scale than when the unconditional global question was used.

Level and predictors of agreement between patients and their dentists concerning need for replacement of teeth at the time of extraction.

The aims were to determine the level of agreement between patient and dentist about the need for a replacement of teeth at the time of extraction, and to identify and assess the effect of predictor variables on the level of agreement. Data were obtained from questionnaires. A systematic random sample of 1,500 Norwegian general dental practitioners were contacted, 67% of them responded and 75% of their patients. The final sample consisted of 427 patients (16-92 years old) and 224 dentists. Overall agreement was 62% of the cases and agreement about replacement 26%. Multiple logistic regression analysis with overall agreement as dependent variable identified tooth type (OR = 2.7 for anterior teeth versus molars, 95% CI: 1.3; 5.6 and OR = 1.9 for molars versus premolars, 95% CI: 1.2; 3.2), service sector, dentist's age and patient gender as significant predictors. Tooth type (OR = 36.0 for anterior teeth versus molars, 95% CI: 12.5; 104.0 and OR = 5.8 for premolars versus molars, 95% CI: 2.7; 12.3), service sector (OR = 7.0, 95% CI: 2.3; 21.1), the number of teeth extracted and the number of remaining natural teeth affected the likelihood of agreement about the need for replacement of extracted teeth. Predictors of no need for replacement were tooth type (OR = 6.7 for molars versus premolars, 95% CI: 3.3; 13.7) and the dentist's age (OR = 2.1, 95% CI: 1.2; 3.6). Clinical factors were the most important predictors of patients' and dentists' likelihood to agree about replacement, but service sector, dentist's age and patient's gender had also a significant impact on the level of agreement.