Oral Health Outcome Measures: A Feasibility Evaluation.

OBJECTIVES: Outcomes of oral health care must be measured and analysed to improve oral health care delivery, outcomes, and quality. This study aims to develop and test outcome measures for the needs of oral health organisers and explore their feasibility using clinical data. METHODS: Based on the literature review and oral health advisory board, outcome measures for oral health care were identified, developed, and tested. Data from 425,000 clinical examinations were obtained from the clinical records of 8 public oral care providers in Finland. RESULTS: The advisory board selected 7 outcome measures: 1 on oral self-care, 2 on periodontitis, 3 on caries, and 1 on missing teeth. A large variation was found in the diagnostic and data entry practices of these outcome measures. The coverage of caries and missing teeth entries was good, but the quality of initial and remineralised caries entries was questionable. The caries and missing teeth measures show statistically significant differences amongst some providers. CONCLUSIONS: The measures "new cavitated caries surfaces," "cavity-free clinical examinations," and "the change in the missing value" were evaluated as feasible. The results of these measures provided insight about the effectiveness of oral care and enabled the comparison between the providers and age groups. Statistically significant differences between the providers in the measures imply potential possibilities for providers to learn from each other.

Low reproducibility between oral radiologists and general dentists with regards to radiographic diagnosis of caries.

AIM: Early clinical and radiological diagnosis of dental caries is one of the fundamental objectives of clinical dentistry because of the high frequency of the disease and severe complications if caries remains untreated, especially among the elderly and patients with immunodeficiency. Dental panoramic tomography (DPT) is a common radiographic method for evaluating dentition when indicated, especially in an adult population. The aim of this study was to assess the reproducibility of diagnosis between specialists in oral radiology and general dentists with regards to caries lesions based on DPTs of adults. MATERIAL AND METHODS: One-hundred DPTs taken from adult patients (average age 35) and then analyzed and reported on by 42 general dentists were then analyzed independently by two specialists in oral radiology with respect to caries lesions in the premolar and molar areas using radiographic criteria established for caries diagnosis. The general dentists versus oral radiologists were not calibrated before. Level of agreement between specialists and general dentists was measured using Cohen's kappa. RESULTS: Comparison between observations of general dentists and specialists in oral radiology showed that 61% of the caries lesions on proximal surfaces of premolars and molars observed by specialists went unobserved by general dentists. Cohen's kappa value for specialists was 0.85 (p < .001) and for each specialist and general dentists 0.48 (p < .001) and 0.44 (p < .001). CONCLUSIONS: The reproducibility between specialists in oral radiology and general dentists for detecting caries in DPTs was low.

[Oral health among the elderly]. / Vanhusten suun terveys.

A large proportion of our population is ageing with own teeth in the mouth. Good oral health and an adequate number of teeth improve the functional capacity of an elderly person. Oral diseases are, however, becoming more common among the elderly population with the accumulation of risk factors such as insufficient self-care, cariogenic diet, reduced salivation, smoking and systemic diseases. Dryness of the mouth due to the adverse effects of drugs or systemic diseases makes eating and cleaning of the mouth more difficult. Prevention of oral diseases with good self-care and regular dental examinations is essential.

Periodontal health status in the elderly with different levels of education: a 5-year follow-up study.

OBJECTIVE: To assess the association between the periodontal health status and level of education over a 5-year period among the elderly aged 75 years and older. BACKGROUND: Oral health among the higher educated is known to be better than among the less-well educated. On the other hand, the prevalence and severity of periodontal disease has been found to grow with increasing age. METHODS: The participants were derived from a population-based Helsinki Aging Study, a random sample of 76-, 81- and 86-year-old elderly. The 170 dentate elderly who underwent clinical oral examinations at baseline and 71 who participated in the follow-up were included in this study. The data was collected from intraoral and radiological examinations and from a structured questionnaire. RESULTS: Subjects with a higher level of education had more retained teeth than subjects with a lower level of education. According to CPITN index, better-educated participants had more healthy sextants, but they also had more sextants with periodontal pockets. Radiographic examination showed similar results. CONCLUSION: Level of education has a clear effect on the periodontal health status in the elderly. More treatment need seems to polarise into those elderly who are better educated as they retain more teeth into old age.