Sheiham, Aubrey

Purpose: To assess the association between oral and general hygiene behaviours in 12-year-old Iranians and the impact of sociodemographic and educational factors on the association. Materials and Methods: A representative random sample of 550 12-year-old Iranian adolescents from two deprived tribes answered a 41-item questionnaire on sociodemographic background, education and oral and general hygiene behaviours. The association between toothcleaning frequency and other study outcome variables were tested using binary logistic regression. The sex differences in the study outcome variables were investigated using chi-square and Mann-Whitney tests. Results: The frequency of toothcleaning was significantly associated with a general hygiene behaviour: frequency of taking a bath (OR 0.5; 95% CI: 0.3, 0.7). This association remained significant when sociodemographic factors and educational factors were added to the model both separately (P 0.001) and together (P 0.001). Girls were significantly more likely than boys to clean their teeth once or more times a day (OR 2.4; 95% CI: 1.7, 3.4). Conclusion: Oral and a general hygiene behaviour were strongly associated. Oral, general and environmental hygiene programmes should use integrated approaches. Palabras clave: adolescents, general hygiene, oral hygiene

Ziel: Ziel dieser Studie war die Erstellung einer systematischen Literaturübersicht über den Zusammenhang zwischen Diabetes mellitus (DM) und destruktiver Parodontalerkrankung. Methoden: Die angewandten Methoden beinhalteten eine strategische Literaturrecherche, Ein- und Ausschlusskriterien zur Auswahl der Studien, Studieneigenschaften, Bewertung der Studienqualität und Meta-Analyse. Als Datenquellen wurden PubMed, EMBASE, SciELO und LILACS genutzt. Bei den ausgewählten Artikeln handelte es sich um Humanstudien, die untersuchten, ob Diabetes ein Risikofaktor für Parodontitis ist und ob dieser den Erfolg einer parodontalen Therapie beeinflusst. Erfasst wurden alle zwischen Januar 1980 und Juni 2007 veröffentlichten Artikel. Ergebnisse: Von den 2440 identifizierten Studien erfüllten 49 Querschnittsstudien und acht longitudinale Studien die Einschlusskriterien. 27 der 49 in dieses Review einbezogenen Querschnittsstudien stellten eine Häufung parodontaler Erkrankungen bei Diabetikern im Vergleich zu diabetesfreien Personen fest. Das größere Progressionsrisiko der parodontalen Erkrankung war mit Typ-2-DM vergesellschaftet und eine Studie assoziierte den Erfolg der Parodontitistherapie mit DM. Die methodischen Schwächen der meisten Studien lagen in einer mangelnden Berücksichtigung von Confoundern, einer unzureichenden statistischen Analyse und in fehlender Information zur Stichprobengewinnung. Das Modell mit zufälligen Effekten zeigte zwischen Typ-2-Diabetikern und Nichtdiabetikern eine signifikante Assoziation mit dem klinischen Attachmentniveau (Mittelwertdifferenz = 1,00 [CI 95 % = 0,15 bis 1,84]) und der parodontalen Taschentiefe (Mittelwertdifferenz = 0,46 [CI 95 % = 0,01 bis 0,91]). Schlussfolgerungen: Typ-2-DM kann als Risikofaktor für Parodontitis bezeichnet werden. Um die nachteiligen Auswirkungen von Typ-1-DM auf parodontale Erkrankungen belegen zu können sind weitere Studien notwendig. Palabras clave: Diabetes mellitus, Meta-Analyse, parodontale Erkrankungen, Parodontitis, systematische Literaturübersicht

Objectives: The objective of this study is to examine whether the well-known association between periodontal disease and smoking persists after adjusting for job classification. Methods: A sample of 16,110 employed Japanese males aged 20-69 years was included in the study. Periodontal examinations were conducted using the Community Periodontal Index. The association between periodontal disease and smoking status was examined using logistic regression adjusting for age, diabetes and job classification. Job classification was based on criteria of the Japanese Ministry of Health, Labour and Welfare. There are nine major job groups: (1) Professional (professionals, specialists), (2) Managers, (3) Office workers (computer operators, clerks, secretaries), (4) Skilled worker (factory workers, construction workers), (5) Salespersons (shop assistants), (6) Service occupations (superintendents, cleaners or car park attendants), (7) Security (guards), (8) Farmers and fishermen, (9) Transport and telecommunication workers (truck drivers). Results: Current and former smokers were more likely to have periodontal disease than non-smokers. Adjusting for job classification attenuated the association between smoking and periodontal disease but did not eliminate the association. The odds ratios for the association between smoking and Community Periodontal Index score 3 or 4 attenuated from 2.25 to 2.04 and from 2.62 to 2.52 for individuals aged 20 to 39 and 40 to 69 years, respectively. The effect of job classification on the association between periodontal disease and smoking was higher among younger participants aged 20 to 39 years. Conclusions: Smoking persisted as an important determinant of periodontal disease after adjusting for job classification in Japanese employed males. Palabras clave: inequality, job classification, periodontal status, smoking

Purpose: The aim of this study was to systematically review the studies on the association between diabetes mellitus (DM) and destructive periodontal disease. Methods: The methods applied include a literature search strategy, inclusion and exclusion criteria for selecting the studies, characteristics of the studies, quality assessment and meta-analysis. Data sources included PubMed, EMBASE, SciELO and LILACS. Selected papers were articles relating to human studies investigating whether or not diabetes is a risk factor for periodontitis and if it influences the response to periodontal therapy. Those papers that were published between January 1980 and June 2007 were retrieved. Results: Of the 2440 identified studies, 49 cross-sectional and eight longitudinal studies met the inclusion criteria. Twenty-seven of the 49 cross-sectional studies that are included in this review detected more periodontal disease in diabetic subjects compared with non-diabetic subjects. The greater risk of periodontal disease progression was associated with type 2 DM, and one study associated DM with response to periodontal therapy. Methodological flaws of most of the studies included inadequate control for confounders, insufficient statistical analysis and lack of information about sampling design. Random effect model showed a significant association with clinical attachment level (mean difference = 1.00 [CI 95% = 0.15 to 1.84]) and periodontal pocket depth (mean difference = 0.46 [CI 95% = 0.01 to 0.91]) between type 2 diabetics and non-diabetics. Conclusions: Type 2 DM can be considered a risk factor for periodontitis. More studies are needed to confirm the harmful effects of type 1 DM on periodontal disease. Palabras clave: diabetes mellitus, meta-analysis, periodontal disease, periodontitis, systematic review

Purpose: To assess and compare prosthodontic treatment needs and the related manpower requirements using the normative and sociodental needs approaches for adult Koreans aged 30 to 64 years. Materials and Methods: Data were obtained from 1,029 30- to 64-year-old adults who were a subsample of the 2003 Korean National Oral Health Survey. Subjects were clinically examined for normative needs and interviewed using an oral health-related quality of life (OHRQoL) measure, the Oral Impacts on Daily Performance. Their oral health behaviors were also assessed. The sociodental approach includes impact-related needs, in which normative needs are integrated with OHRQoL, and propensity-related needs, in which oral health behaviors are used to determine appropriate treatments. Prosthodontic treatment needs and number of clinicians needed to treat those needs were estimated using normative needs, impact-related needs, and propensity-related needs. Results: Compared to normative needs, significant decreases of 74.1% to 78.5% were found for prosthodontic treatment needs using impact-related needs and propensity-related needs, respectively. Differences in manpower requirements to deal with prosthodontic treatment were large; per 100,000 people, 86.5 dental clinicians would be needed using normative needs, compared to 22.4 clinicians using impact-related needs and 18.6 clinicians using propensity-related needs. Conclusions: The sociodental approach for assessing dental needs for prosthodontic treatment indicated much lower levels of treatment needs than the normative approach. The sociodental approach should be applied to dental workforce planning.

Purpose: The aim of this study was to assess the relative weights of each factor related to tooth retention identified in our previous study with an objective of developing a risk assessment tool that could be incorporated into a selfadministered oral salutogenic checklist. Materials and Methods: Oral health status and lifestyle were investigated in 777 subjects aged >= 20 years. Eleven items that had a statistically significant odds ratio of being related to the number of retained teeth in our previous study were identified. Discriminant analysis was used to calculate the scores for each item. Results: Based on the discriminant analysis, the variables affecting tooth retention, from the most to the least important, were 'gum swelling' (1.241), followed by 'toothache' (0.766) and 'do you have any hobbies' (0.691). Based on the above analysis, a total of 20 points were allocated in proportion to the ranges. The final oral salutogenic score (OSS) was swollen gums (4), toothache (3), frequency of between-meal snacks (3), having some hobbies (3), having a family clinician (2), consulting a clinician when having dental symptoms (1), bleeding gums (1), frequency of tooth brushing (1), having one's own toothbrush (1) and smoking (1). Conclusions: A self-administered checklist for the OSS was designed. The first part contains a list of questions for the participants to fill out. The second part offers comments depending on the range of score values. The suggestions include advice to decrease or to stop the behaviours for which the subject obtained zero points. Palabras clave: behaviours, checklist, salutogenic, tooth loss

To investigate the relationship between oral health-related quality of life and clinical dental measures in an elderly Greek population. A cross-sectional survey was carried out of adults aged 65 years or older living independently in Athens. Data were collected through clinical examination and interviews. Oral health-related quality of life was assessed through the Oral Impacts on Daily Performance (OIDP) indicator. The sample consisted of 681 participants. Data analysis used non-parametric tests (Mann-Whitney, Kruskal-Wallis and multiple logistic regressions). The response rate was 87.8%. Dentate participants with 1-10 teeth were 2.05 (1.25, 3.35) times and those with 11-20 teeth were 1.81 (1.11, 2.95) times more likely to report oral impacts than subjects with 21 or more teeth. Participants with anterior tooth spaces were 2.86 (1.70, 4.80) times more likely to report oral impacts than those without anterior spaces. Participants with 0-8 natural occluding pairs (NOPs) were 1.72 (1.14, 2.58) times and those with 0-3 posterior occluding pairs (POPs) were 1.57 (1.04, 2.36) times more likely to experience oral impacts than subjects with 9-16 NOPs and 4-10 POPs respectively. Decayed teeth were not significantly related to the presence of oral impacts. Edentulous participants with inadequate denture adaptation were 2.59 (1.46, 4.59) times, those with inadequate denture retention 2.41 (1.39, 4.17) times and those with denture overextension 2.51 (1.10, 5.74) times more likely to report oral impacts than subjects without the respective denture deficiencies. Clinical indicators of oral health status were significantly related to measures of oral health-related quality of life. Palabras clave: oral impacts, quality of life, elderly, dental status, teeth

To assess the evidence on the effectiveness of commercially available anticalculus dentifrices. Systematic search for published and unpublished epidemiological data in 7 electronic databases, 5 journals, and the bibliographies of retrieved papers and by making contact with subject experts in this field. Thirty-two reports were identified containing comparisons of one or more active agents with a placebo dentifrice and calculus measured using the Volpe-Manhold Index (VMI). Random effect model for 3-month studies showed an effect size of -0.6 for all comparisons. The effect sizes varied from -0.3 for dentifrices with zinc chloride 0.5% to -1.1 for pyrophosphate 1.3% and copolymer 1.5% dentifrices. Meta-analysis of all the studies with 6-month follow-up gave an effect size of -1.1 (-1.5 to -0.8) and for 12-month follow-up the effect size was -13.6 (-21.4 to -5.8). Anticalculus dentifrices containing pyrophosphates, zinc compounds and/or co-polymers were effective in significantly reducing calculus scores (VMI). Palabras clave: calculus, anti-calculus, dentifrices, pyrophosphate, zinc citrate, co-polymer, toothpaste, systematic review

This study was designed to evaluate the effectiveness of a WHO-supervised school based preventive program for Filipino children. 19 primary schools in deprived communities of rural areas in Northern Mindanao had been selected to take part in the program. By using WHO criteria (1997) one dentist examined 1574 children with an mean age of 7.1 years. The percentage of caries free children was 8.8. Caries prevalence was 1.2 DMFT (± 1.4) and 7.2 dmft (± 5.1). Fillings were not recorded in both dentitions. The mt value was 0.2 (+ 0.7). The preventive program focused on preventive (dietary control, supervised toothbrushing with a fluoridated toothpaste, professional application of fluoride varnish). In order to cope with the high treatment need invasive measures (extractions of deciduous teeth, ART-fillings in permanent teeth) had to be included too. 1162 children with a mean age of 10.2 years were re-examined after three years. The percentage of caries free children was 16.2. Caries prevalence of 1.6 DMFT (± 1.8) was distributed to 0.5 DT, 0.2 MT and 0.9 FT component. The increment of 0.4 DMFT and the distribution of the DMFT components in high caries risk Filipino children reflect the effectiveness of a comprehensive dental care approach. Extractions of carious deciduous teeth and ART-restorations in permanent teeth might be an important impact for reducing the microbial infection in the oral cavity. We conclude that invasive measures seem to be a prerequisite for the caries preventive effect of daily toothbrushing with fluoridated toothpaste in children with high caries experience, particularly in the mixed dentition. Palabras clave: caries prevalence, Philippine, preventive programme