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Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two data sets, one consisting of fictional dmft counts in 2 groups and the other on DMFS among schoolchildren from a randomized clinical trial comparing 3 toothpaste formulations to prevent incident dental caries, are analyzed with negative binomial hurdle, zero-inflated negative binomial, and marginalized zero-inflated negative binomial models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the randomized clinical trial were similar despite their distinctive interpretations. The choice of statistical model class should match the study's purpose, while accounting for the broad decline in children's caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. [ABSTRACT FROM AUTHOR]

Since the early 1990s, there has been heated debate critically reflecting on social epidemiology. Yet, very little of this debate has reached oral epidemiology. This is no more noticeable than in the field of oral health inequalities. One of the significant achievements of social oral epidemiology has been the persistent documentation of social patterning of oral disease. Nevertheless, where social oral epidemiology has fallen down is going beyond description to explaining these patterns. Thinking how and in what way things happen, not just in relation to oral health inequalities but also more broadly, requires a more creative approach which links to scholarship outside of dentistry, including the work from critical epidemiologists to that within the social sciences. The aim of this review study is to provide a critical commentary on key aspects of more general epidemiological debates in order to inform and develop social oral epidemiology theory and methodology. In the first section, 'Where are we now?', six key debates are reflected upon: (i) analysis of variance versus analysis of causes, (ii) the fallacy of independent effects, (iii) black box thinking, (iv) theory and the understanding of mechanisms, (v) individualization of risk and (vi) the meaning of 'social'. In the second section, 'Where to next?' we draw on a number of fundamental issues from within the social science literature in order to highlight possible channels of future inquiry. Our overriding goal throughout is to facilitate a critical engagement in order to improve understanding and generate knowledge in relation to population oral health. [ABSTRACT FROM AUTHOR]

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Copyright of CES Odontología is the property of Universidad CES and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Odonto Ciencia is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: This paper is concerned with developing methods for assessing the potential impact of healthy public policies on health outcomes, particularly on dental trauma. The hypothesis is that in deprived areas of Curitiba, Brazil, there would be a lower prevalence of dental trauma in 12-year-old schoolchildren related to different degrees of implementation of healthy public policies. Fourteen socio-environmental variables gathered from 29 deprived areas were factor-analysed and three principal components (PCA) extracted: physical environment, public social policies, and social cohesion. Individual clinical data on dental trauma were collected for 2126 children from public schools in the areas. Rank correlation indicated that the relationship between components’ scores and dental trauma was statistically significant. The PCA scores explained 42% of the variance for dental trauma. [Copyright &y& Elsevier]

Abstract – Numerous studies focus on visits to dental clinics for emergent dental problems. Many are all-inclusive, studying traumatic injuries as well as visits for infection and other causes. Epidemiologic studies have focused on the investigation of the prevalence or incidence of dental injury. The patients were evaluated at Pediatric Dentistry, Marmara University Dental School, İstanbul over a 2-year period. For these 300 patients (446 teeth), specific diagnoses were evaluated. Dental injuries that presented most frequently in permanent dentition were crown fractures of enamel only and crown fractures of enamel and dentin. The most frequently presented dental injury in primary dentition were avulsions and crown fractures of enamel. The more frequent treatments for primary teeth were examination only. Bandage restoration, space maintainer were common procedures for permanent teeth. [ABSTRACT FROM AUTHOR]

A growth in research focusing on the oral health of older adults has been evident in recent years. However, there are new and complex challenges for geriatric dental researchers studying the increasingly functionally dependent and cognitively impaired older adult population. Many geriatric dental studies have under-reported oral disease prevalence and incidence by excluding adults who are cognitively impaired and/or behaviourally difficult. To ensure representative samples of older adult populations are studied, traditional oral epidemiological protocols in studies with cognitively impaired adults, require additional components detailing: (1) communication and behaviour management strategies for cognitively impaired adults; and (2) methodologies to facilitate the completion of dental examinations. A description of such additional protocol components is presented, along with a discussion of the use of cognitive testing tools by dental researchers. [ABSTRACT FROM AUTHOR]

In Romania, systematic information on the occurrence of oral diseases in children is scarce. The purpose of the present study was to describe the prevalence and the pattern of dental caries in schoolchildren, and to USC the data to provide a baseline for planning and evaluation of oral health care. A national sample of children at grade 1 (n = 729) and grade 6 (n = 660) was chosen consistent with the WHO pathfinder principle. Clinical examinations were carried out according to the recording system for the Danish Municipal Dental Service and the following results were obtained. In children of grade 1 (7-yr-olds) the prevalence proportion of caries in primary teeth was 86% and in permanent teeth 39%. The mean caries indices were 11.4 defs and 1.3 DMFS. At grade 6 (12-yr-olds) the prevalence proportion of caries in primary teeth was 17% and in permanent teeth 90%. The mean caries experience was 0.8 defs and 6.5 DMFS, and a mean of 4.1 DMFT was observed. In both groups, the D-component of the caries index was dominant. The children were also classified by caries severity zone. At grade 1, 61% had a very severe pattern of caries in the primary teeth, i.e. caries in pits/fissures, proximal surfaces, smooth surfaces, and incisors. Forty-three percent of the children at grade 6 showed this pattern in permanent teeth. In Romanian schoolchildren the present level and pattern of dental caries are most severe and the implementation of oral health promotion and prevention at the community level is urgently needed. [ABSTRACT FROM AUTHOR]

In an epidemiologic study, the dental health status of elderly persons in Germany was investigated. A total of 458 persons aged 60 yr and over participated in the study, with 89 persons being residents of old-people's homes. With a mean DMFS score of 87.3, the mean number of manifest caries was low (1.2) and the standard of conservative and prosthetic care high. Of a mean number of 17.75 filled surfaces. 59.6% were surfaces with crowns. Dental health is a social problem. The mean number of caries cavities was 10 times higher in institutionalized elderly persons of low social class than in non-institutionalized persons of the same age. Finally, initiatives to improve oral and dental hygiene in all age groups examined in this study are urgently required. [ABSTRACT FROM AUTHOR]

The purpose of the paper is to relate standard epidemiologic and statistical methods for measures of occurrence to the description of prevalence proportions and incidence rates of dental diseases. No new concepts are introduced, but the choice of the unit of analysis of numerator and denominator is discussed, and the biological interpretation of the within-patient correlation coefficient is discussed. [ABSTRACT FROM AUTHOR]

As part of a nationwide dental survey in 1986 a caries study was executed in 3526 adults, aged 15-74 yr, living in 40 residential areas in The Netherlands. Marked differences were found between the social classes distinguished (more edentates in the lower classes) and between the different region. It is supposed that these differences relied the lack of dental manpower in the past. [ABSTRACT FROM AUTHOR]

In 1984, 1986 and 1988 a mixed-longitudinal study was carried out to determine the prevalence of plaque, calculus, gingival bleeding and type of tooth cleaning device amongst school children in Morogoro, Tanzania. The background parameters considered were age, geographical location and sex. The reproducibility of the methods of diagnosis was assessed. In general, more children possessed a chewing stick than a toothbrush, except urban children. The prevalence of visible plaque decreased and the prevalence of calculus increased with increasing age. Gingival bleeding was not age-dependent. Urban children had significantly more surfaces covered with visible plaque, but had a significantly lower prevalence of calculus, than rural children. Boys showed a significantly higher prevalence of visible plaque and calculus than girls. In the majority of those with gingival bleeding, only 1 of the 6 examined papillae was involved, most often the mesio-lingual papilla of the 3.6. The children had not been subjected to organized oral health care and professional intervention. The findings of the study indicate the need for organized school-based oral hygiene programmes in the area in order to improve the periodontal health of these children. [ABSTRACT FROM AUTHOR]

Clinically evaluated oral health outcome variables from the ICS-II USA data set were examined in the diverse ethnic groups, for two adult age cohorts (35-44 and 65-74 years). These measures were derived from epidemiological examinations and include the DMFT components, loss of attachment, and an indicator of treatment need-the ratio of decayed teeth over decayed and filled teeth. The ratio of decayed over decayed and filled teeth was used in multivariate analysis, since this measure represents an area where public policy could have an impact if determinants were understood. The most important independent variables were race-ethnicity, educational attainment, no fear of dental visits because of pain, and oral hygiene practices. Having a usual source of dental care and visiting the dentist within the past 12 months did not appear to be as important in predicting unmet needs as these other variables. To bridge the gap between the oral health status of majority and minority populations, health educators in minority communities need to become more accessible, have a pro-active interest in oral health, and also be cognizant of the various socio-cultural issues influencing oral health. The problems regarding Native American adults are more complex and require more careful study [ABSTRACT FROM AUTHOR]

Five hundred and twelve students of the Royal Dental College in Copenhagen were given a questionnaire designed to elicit information on the prevalence, debut, frequency of recurrences, and prevalence of patients treated for recurrent aphthous ulcerations. The prevalence of aphthae was 56 % (289/512). In 45 % (131/289) the disease was manifest before the age of sixteen. Fifty per cent (143/289) experienced yearly outbreak, 28 % (81/289) monthly and 3 % (9/289) weekly. The prevalence of treatment was 35 % (101/289); 18 % (51/289) received medical advice. In the present population the prevalence of recurrent aphthous ulcerations was significantly higher in females than in males. The debut, frequency of recurrences and prevalence of patients treated showed no significant differences with regard to sex. [ABSTRACT FROM AUTHOR]

The Dental Aesthetic Index (DAI) was used to evaluate malocclusion in Japanese high school students (n =409, ages 15-18 yr). The purpose of this study was to obtain basic data concerning malocclusion in Japanese high school students. This study used a sample of students from randomly selected urban and rural high schools in Japan's Kyushu district. The DAI scores for urban and rural high school students, as well as the total DAI scores from these two areas were significantly higher than that of American high school students. These results showed that the number of students with an acceptable dental appearance among Japanese high school students is significantly lower than among American high school students. This indicates a higher need for orthodontic treatment among Japanese high school students. [ABSTRACT FROM AUTHOR]

Previous epidemiological studies, performed in conjunction with compulsory lung screening examinations, showed good results in detecting oral lesions in Hungary, where the mortality rate of oropharyngeal cancer has increased by more than 30% in the past decade. Oral examinations were performed on a district population sample in Budapest, called regularly for X-ray lung examinations. Precancerous lesions and conditions were diagnosed and grouped according to internationally accepted criteria. Oral examinations of 7820 individuals were performed: 42.9% in men and 57.1% in women; 42% of all examined subjects were over 60 yr of age. Oral leukoplakia was diagnosed in 104 cases (1.3%). Histologic examination revealed squamous cell carcinoma in one case. About 70% of oral leukoplakia occurred in men and 30% in women. Oral lichen was diagnosed in six cases (0.08%). The prevalence of smokers was 86.5% in the leukoplakia group as compared with 29% in the non-lesion group. The new organizational screening model seems to function well in the "risk group" of elderly persons, especially in the early diagnosis of oral cancer and precancerous lesions. [ABSTRACT FROM AUTHOR]

A representative sample of 2020 schoolchildren, aged 6 to 15 years, was randomly selected from 85 state and private schools in Rennes and distributed in 10 groups, according to their age. Type and prevalence of dental injuries were determined in each group, using Ellis & Davey's classification, giving rise to a subset of 345 subjects. Simple enamel fracture was the predominant injury (59.4%), occuring most often on maxillary central incisors. Most time (77.1%), the trauma affected only one tooth. Mean prevalence of dental injuries was 13.6% from 2020 subjects. Boys showed a higher prevalence than girls (respectively 17% and 10.20%), but this difference was only significant for age-groups 12 and 13 (p<0.001) and for the whole group of 6-15 (p<0.001). [ABSTRACT FROM AUTHOR]

295 5-year-old children were examined in Mallow, a non-fluoridated town in North Cork to ascertain the dental status of children commencing first level education. The results were compared with those found in Baja, Hungary and in Barnsley, England. The def in Mallow was found to be 5.15 and the Met Need Index 14 %. The authors suggest that the programmes of dental care should be re-examined in the light of these findings and more emphasis placed on the prevention and treatment of caries at an earlier age. [ABSTRACT FROM AUTHOR]