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Objectives: To assess the association between gingival recession (GR) and oral health-related quality of life (OHRQoL) in a Brazilian population of adults., Methods: A representative sample from Porto Alegre city was drawn in 2011 using a multistage probability sampling strategy. For this study, 740 individuals, 35-59 years of age and with ≥6 teeth, were included. GR was assessed by two calibrated examiners at four sites in all present teeth. The Oral Health Impact Profile (OHIP-14) was used to assess OHRQoL. OHIP-14 was dichotomized using 'fairly often' as the cutoff point for a negative impact. Multiple logistic regression models were fitted to define which descriptors of GR were associated with the dichotomous outcome of OHIP-14, including dentine hypersensitivity in separate models, adjusting for age, gender, socioeconomic status, smoking, dental care, and missing teeth., Results: Mean OHIP was significantly higher for individuals with ≥1 tooth with GR ≥2, ≥3, ≥4, and ≥5 mm. Individuals with ≥1 tooth with GR ≥2 mm had approximately two times higher chance of having a negative impact than individuals without GR of this threshold [odds ratio (OR) = 1.99, 95% confidence interval (CI) 1.05-3.78]. When buccal and proximal sites were analyzed separately, the presence of GR was significantly associated with worst quality of life only in anterior and not in posterior teeth. GR in the lower arch had no impact on OHRQoL. GR ≥2 mm affected only physical pain (OR = 2.61; 95% CI 1.06-6.42), whereas GR ≥4 mm affected functional limitation, physical pain, psychological discomfort, physical and psychological disabilities, with ORs ranging from 1.43 to 1.91. Dentine hypersensitivity alone was not associated with OHRQoL, but it modified the association between GR and OHIP when present concomitantly with GR, mainly in buccal sites., Conclusions: OHRQoL is poorer in this adult population in the presence of GR, mainly in upper and anterior teeth. Dentine hypersensitivity and esthetics were found to be factors linking GR to OHRQoL., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The objectives of this study were to describe root caries patterns of Chinese adults and to analyze the effect of selected demographic and socioeconomic factors on these patterns. A total sample of 1080 residents aged 35-44-years-old and 1080 residents aged 65-74-years-old from three urban and three rural survey sites in Hubei Province participated in both an oral health interview and a clinical oral health examination. Root surface caries prevalence rates were 13.1% in the middle-aged group and 43.9% in the elderly group. The mean number of teeth affected by caries in the middle-aged group was reported at 0.21 and 1.0 in the elderly group. Mean Root Caries Index (RCI) scores of the middle-aged were reported at 6.29 and elderly subjects were reported at 11.95. Elderly people living in rural areas reported a higher RCI score (13.24) than those living in urban areas (10.70). A significantly higher frequency of root surface caries was observed in elderly participants (P < 0.001, OR = 3.80) and ethnic minorities (P < 0.001, OR = 1.93). In addition, smokers, nontea drinkers, and those with an annual household income of 10,000 yuan or less tended to have higher caries prevalence. RCI figures for the different tooth types ranged from 1% to 16%, indicating a wide variation in attack rates. In conclusion, our study suggests that root surface caries occurrence is high among the Chinese adult population, especially older adults. With an increasing number of retained teeth in both middle-aged and elderly people, root caries is a growing disease in the People's Republic of China which deserves more attention in future research.

Objectives: To describe oral health-related quality of life (OHRQoL) among New Zealand adults and assess the relationship between clinical measures of oral health status and a well-established OHRQoL measure, controlling for sex, socioeconomic status (SES) and use of dental services., Methods: A birth cohort of 924 dentate adults (participants in the Dunedin Multidisciplinary Health and Development Study) was systematically examined for dental caries, tooth loss, and periodontal attachment loss (CAL) at age 32 years. OHRQoL was measured using the 14-item Oral Health Impact Profile questionnaire (OHIP-14). The questionnaire also collected data on each study member's occupation, self-rated oral health and reasons for seeing a dental care provider. SES was determined from each individual's occupation at age 32 years., Results: The mean total OHIP-14 score was 8.0 (SD 8.1); 23.4% of the cohort reported one or more OHIP problems 'fairly often' or 'very often'. When the prevalence of impacts 'fairly/very often' was modeled using logistic regression, having untreated caries, two or more sites with CAL of 4+ mm and 1 or more teeth missing by age 32 years remained significantly associated with OHRQoL, after adjusting for sex and 'episodic' dental care. Multivariate analysis using Poisson regression determined that being in the low SES group was also associated with the mean number of impacts (extent) and the rated severity of impacts., Conclusions: OHIP-14 scores were significantly associated with clinical oral health status indicators, independently of sex and socioeconomic inequalities in oral health. The prevalence of impacts (23.4%) in the cohort was significantly greater than age- and sex-standardized estimates from Australia (18.2%) and the UK (15.9%).

Unlabelled: In 1995, a dental survey, similar to one carried out in 1983, was performed among persons aged 25-54 in the city of 's-Hertogenbosch, the Netherlands., Objective: To describe trends in adults periodontal health between 1983 and 1995., Methods: The participants were interviewed at home and clinically examined in a dental van., Results: Average scores for plaque, calculus, bleeding after probing and number of buccal root surfaces exposed to the oral cavity were lower in 1995 than in 1983. There was no significant change in the percentage of teeth with pocket depth of 3.5 mm or more between 1983 and 1995. No difference was found between frequency of toothbrushing in 1983 and 1995., Conclusion: The results suggest that the periodontal health of Dutch adults aged 25-54 years has improved since 1983.

Unlabelled: Tooth loss diminishes oral function and quality of life, and national health targets aim to reduce population levels of tooth loss., Objectives: The purpose of this study was to determine tooth loss incidence and predictors of tooth loss among older adults in South Australia., Methods: Data were obtained from a cohort study of a stratified random sample of community-dwelling dentate people aged 60+ years. Interviews and oral examinations were conducted among 911 individuals at baseline and among 693 of them (76.1%) 2 years later. Incidence rates and relative risks were calculated for population subgroups and multivariate logistic regression was used to construct risk prediction models. A method was developed to calculate 95% confidence intervals (95% CI) for relative risks (RR) from logistic regression models using a Taylor series approximation., Results: Some 19.5% (95% CI = 15.4-23.6%) of people lost one or more teeth during the 2 years. Men, people with a recent extraction, people who brushed their teeth infrequently, smokers and people born outside Australia had significantly (P < 0.05) greater risk of tooth loss. Baseline clinical predictors of tooth loss included more missing teeth, retained roots, decayed root surfaces, periodontal pockets and periodontal recession. In a multivariate model that controlled for baseline clinical predictors, former smokers (RR = 2.55, 95% CI = 1.48-4.40) and current smokers (RR = 2.06, 95% CI = 0.92-4.62) had similarly elevated risks of tooth loss compared with non-smokers., Conclusions: The findings from this population suggest that a history of smoking contributes to tooth loss through mechanisms in addition to clinical disease processes alone.

This study aimed to provide oral epidemiological data describing periodontal destruction among older adults in South Australia. A cross-sectional survey design was employed and periodontal assessments were made among 801 persons aged 6+ drawn at random from the non-institutionalized population. Measurements of pocket depth (PD) and gingival recession (GR) were made at three sites on all teeth and used to compute loss of attachment (LOA). An average of 17 teeth per person were measured. LOA of 4+ mm at one or more sites was observed among 89.1% of persons. A mean of 78.1% of sites per person had LOA of 2+ mm (extent) and the mean LOA at sites with LOA of 2+ mm was 3.09 mm (severity). Extent and severity were greater for males and for persons aged 80+ years. Extent was virtually identical for mesio-buccal and disto-lingual sites, while severity was virtually identical for mid-buccal and disto-lingual sites. Patterns of GR and PD varied according to the jaw and type of tooth. Maxillary first and second molars had the greatest mean LOA, and the majority of LOA in the maxilla was due to PD. In the mandible there was less variation in LOA among anterior and posterior teeth, and LOA tended to be more equally divided between GR and PD. Levels of periodontal destruction of South Australia were broadly similar to results from North American studies of older adults which have used full-mouth periodontal assessments.

The present study was undertaken in response to a growing concern among clinicians about an increase in gingival recession among children and adolescents. Groups of 50 boys and 50 girls aged respectively 7, 12, and 17 yr were examined at Espoo Health Centre in 1983. Gingival recession was measured on the facial and lingual aspects of all permanent teeth. Whenever the gingival margin was located on root cementum, the distance from the gingival margin to the enamel border was measured to the nearest 0.5 mm. Recession was categorized as "slight" (0.5 or 1 mm) or "extensive" (1.5-3.5 mm). The prevalence of gingival recession was 5% at 7 yr, 39% at 12 yr, and 74% at 17 yr of age. More girls than boys had recession in the two youngest age groups. At 17 yr recession was equally common in both sexes and both "slight" and "extensive" recession was most often recorded on facial surfaces of first molars, premolars and canines. The alarmingly high prevalence of gingival recession at young age warrants further study of both the reasons and the consequences of early cementum exposure.

A study to assess the prevalence and severity of periodontal conditions among 809 adults in Tanzania was carried out in 1982 in Morogoro District. The prevalence of plaque (99.6%), calculus (95.7%) and gingivitis (93.8%) among them was high. The mean number of teeth per person with pockets between 3.5 and 5.5 mm was 3.5 for the urban and 4.2 for the rural population. Pockets of more than 5.5 mm were found on average in 0.1 (urban) and 0.2 (rural) teeth per person. In the 45+ age group on average 3.0 teeth per person were missing in urban areas and 6.9 teeth in rural areas. There were no statistically significant differences found in periodontal conditions between urban and rural adults, except for the 45+ age group. In this age group a higher mean number of teeth per person with recession, calculus, pockets, gingivitis and missing were found among the rural than the urban population. The study suggests that high prevalence of plaque, calculus and gingivitis at a young age, if untreated, does not lead for all persons to severe periodontal breakdown with ultimately tooth loss in old age in this population. Effects of the study in terms of planning primary health care teaching programs have been presented.

Ninety-seven teenagers were followed from the age of 14 1/2 to 19 yr. During that time they were given regular dental care by the Public Dental Service. Data concerning dental caries, gingival status, probing pocket depths, subgingival calculus, defective fillings, loss of attachment and additional preventive care were recorded. The prevalence and increment of caries were low and at 19 one-third of the subjects had still needed no proximal restorative care at all. However, in 26% of the 19-yr-olds subgingival calculus was diagnosed radiographically and during the study period gingival inflammation changed from being merely a result of poor oral hygiene to an indication of initial periodontal disease. There was a sex difference in dental health, which increased with age and was of clinical importance at 19. In spite of a good caries situation, most of the subjects were in need of individual care due to an initial periodontal problem. Furthermore, the change to a treatment strategy based on prevention requires regular check-ups, and an extension of intervals between dental examinations could not be justified in this study, especially as it seemed to be difficult for the regular dentist to predict future disease on a clinical basis.

Recent reports have suggested that the use of smokeless tobacco is increasing in adolescents, and is particularly high in Native Americans, causing concern about possible effects on oral health. In this study, 226 Navajo Indians, aged 14-19, were interviewed regarding their use of smokeless tobacco (ST), cigarettes, and alcohol. Midbuccal and mesiobuccal sites on all fully erupted permanent teeth (excluding third molars) were examined for the presence of gingival bleeding, gingival recession, calculus, and loss of periodontal attachment. The oral mucosa was examined for evidence of leukoplakia. 64.2% (145) of the subjects (75.4% of the boys and 49.0% of the girls) were users of ST. Of these, over 95% used snuff alone or in combination with chewing tobacco. 55.9% used ST one or more days per week. 52.2% consumed alcohol, usually beer or wine, and 54.0% smoked cigarettes. 25.5% (37) of the users and 3.7% (3) of the non-users had leukoplakia. The duration (in years) and frequency of ST use (days per week) were highly significant risk factors associated with leukoplakia. However, the concomitant use of alcohol or cigarettes did not appear to increase the prevalence of these lesions. No consistent relationship was observed between the use of ST and gingival bleeding, calculus, gingival recession, or attachment loss, either when comparing users to non-users or when comparing the segment where the tobacco quid was habitually placed to a within-subject control segment. In view of these results, there is little doubt that smokeless tobacco is significantly related to the etiology of leukoplakia. As some evidence exists that smokeless tobacco use is a significant risk factor associated with oral carcinoma, intervention programs to discourage the use of smokeless tobacco by adolescents should be a public health priority.