Community dentistry and oral epidemiology
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Community Dent Oral Epidemiol · Oct 2004
Perception of general and oral health in White and African American adults: assessing the effect of neighborhood socioeconomic conditions.
This study investigates the independent and joint effects of family income and neighborhood socioeconomic status (SES) on general health and oral health before and after controlling for traditional risk factors in a representative sample of adults aged 18+ years residing in the Detroit tri-county area, Michigan. ⋯ SES conditions at the neighborhood-level, independently or jointly with individual-level income, appear to be important in evaluating racial/ethnic differences in self-rated oral health. Neighborhood conditions could tap into constructs not captured by individual-level variables on self-rated oral health.
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Community Dent Oral Epidemiol · Oct 2004
Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach.
Despite great improvements in the oral health of populations across the world, problems still persist particularly among poor and disadvantaged groups in both developed and developing countries. According to the World Oral Health Report 2003, dental caries remains a major public health problem in most industrialized countries, affecting 60-90% of schoolchildren and the vast majority of adults. Although it appears that dental caries is less common and less severe in developing countries of Africa, it is anticipated that the incidence of caries will increase in several countries of that continent, due to changing living conditions and dietary habits, and inadequate exposure to fluorides. ⋯ Such reviews concluded that water fluoridation and use of fluoride toothpastes and mouthrinses significantly reduce the prevalence of dental caries. WHO recommends for public health that every effort must be made to develop affordable fluoridated toothpastes for use in developing countries. Water fluoridation, where technically feasible and culturally acceptable, has substantial advantages in public health; alternatively, fluoridation of salt and milk fluoridation schemes may be considered for prevention of dental caries.
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Community Dent Oral Epidemiol · Feb 2004
Assessing the responsiveness of measures of oral health-related quality of life.
This paper illustrates ways of assessing the responsiveness of measures of oral health-related quality of life (OHRQoL) by examining the sensitivity of the oral health impact profile (OHIP)-14 to change when used to evaluate a dental care program for the elderly. ⋯ OHIP-14 appeared to be responsive to change. However, the magnitude of change that it detected in the context described here was modest, probably because it was designed primarily as a discriminative measure. The psychometric properties of the global transition judgements that often provide the "gold standard" for responsiveness studies need to be established.
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Community Dent Oral Epidemiol · Dec 1998
ART restorations and glass ionomer sealants in Zimbabwe: survival after 3 years.
Atraumatic restorative treatment (ART) consists of removing demineralised tooth tissues with hand instruments only, restoring the prepared cavity and sealing the adjacent pits and fissures with an adhesive filling material. This relatively painless, no-handpiece, minimal intervention approach to controlling dental caries is described. ART was applied in an oral health care programme in Zimbabwe that was carried out amongst secondary school students from 1994 to 1997. ⋯ Experienced operators placed better ART restorations than inexperienced operators. This study has demonstrated that ART with a glass ionomer restorative material and sealants provided high quality preventive and restorative dental care to this student population. ART has become one of the treatment modalities available to oral health workers in managing dental caries.
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Oral disadvantage can be defined as the avoidance of certain daily activities because of decrements in oral health. These decrements include oral disease and tissue damage, pain, and functional limitation. The Florida Dental Care Study (FDCS) is a longitudinal study of changes in oral health, which included at baseline 873 subjects who had at least 1 tooth, were 45 years old or older, and who participated for an interview and clinical examination. ⋯ In multivariate analyses that accounted for differences in clinical measures of disease/tissue damage, self-reported disease/tissue damage, oral pain, and oral functional limitation, females were more likely to report disadvantage due to disease/tissue damage, and middle-aged persons and irregular dental attenders were more likely to report oral disadvantage due to pain. In these same regressions, differences in disadvantage due to race, poverty status, socioeconomic status, and rural/urban area of residence were not evident. These results have implications regarding the use of oral disadvantage to assess the long-term effectiveness of dental care.