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In 1949, the American Graves Registration Service Pacific Zone proposed the identification of 27 sets of remains (skulls/crania/mandibles) based on comparisons with written dental records. All were denied, and the remains were buried as unknowns. In 2003 and 2015, the remains were exhumed by the DPAA. Currently, 26 individuals previously recommended for identification have been positively identified. The DPAA Science Director's opinion corresponded with 24 of their recommendations, while DNA excluded three. Caution should be taken by the forensic scientist when building assemblages through skeletal and dental articulation. The forensic odontologist must always consider variations in restorative care/extraction patterns and the possibility of documentation errors when reviewing/interpreting historical and current day dental records used for AM/PM comparisons. The odontologist should base their opinion on the strength of the antemortem/postmortem comparison, number and type of concordances, and distinct dental care and extraction patterns., (Published 2019. This article is a U.S. Government work and is in the public domain in the USA.)

Introduction: The use of objective criteria is essential to uniformly quantify and measure the severity of malocclusions and the efficacy of different treatment modalities. The Peer Assessment Rating (PAR) index and, more recently, the American Board of Orthodontics Objective Grading System (OGS) were developed to fulfill this need., Aim: The aim of this retrospective study was to assess and compare treatment outcomes using the UK and US weighted PAR and the OGS., Materials and Methods: The sample consisted of randomly selected records of 50 patients treated by residents in one postgraduate orthodontic clinic. UK and US weightings for the PAR index were applied and compared with OGS., Results: There was no statistically significant association between the OGS and the PAR index grading systems. Neither the UK nor the US PAR weightings showed statistically significant correlation with the OGS. All cases were 'greatly improved' or 'improved' according to the PAR index, while most cases (62%) failed according to OGS. There was a statistically significant correlation between the unweighted PAR index and the OGS (r = -0.32, p = 0.024). The US and the UK weightings for the PAR were highly correlated (r = 0.90, p < 0.001). Both weighting systems were also highly correlated with the unweighted PAR (p < 0.001). There were no gender differences found in any of the scoring systems., Conclusions: The current PAR index cannot replace the OGS for evaluating treatment outcomes. The current OGS cannot detect the improvement achieved in a treated case.

Rubber dam use during operative dentistry procedures has been quantified based on questionnaires completed by dentists. However, based on the knowledge of the authors of the current study, there are no reports based on use during actual clinical procedures other than in dental materials studies and none based on routine care. The objectives of the current study were to: 1) quantify how commonly the rubber dam is used during operative dentistry procedures; 2) test the hypothesis that certain dentist, restoration and patient-level factors are associated with its use. A total of 229 dentist practitioner-investigators in The Dental Practice-Based Research Network (DPBRN) participated. DPBRN comprises five regions of the USA: Alabama/Mississippi, Florida/Georgia, Minnesota, Permanente Dental Associates and Scandinavia. Practitioner-investigators collected data on 9,890 consecutive restorations done in previously unrestored tooth surfaces from 5,810 patients. Most dentists (63%) did not use a rubber dam for any restoration in this study. A rubber dam was used for only 12% of restorations, 83% of which were used in one DPBRN region. With regions accounted for, no other dentist characteristics were significant. A multi-level multiple logistic regression of rubber dam use was done with restoration and patient-level variables modeled simultaneously. In this multi-variable context, these restoration-level characteristics were statistically significant: tooth-arch type, restoration classification and reason for placing the restoration. These patient-level characteristics were statistically significant: ethnicity, dental insurance and age. These results, obtained from actual clinical procedures rather than questionnaires, document a low prevalence of usage of the rubber dam during operative dentistry procedures. Usage varied with certain dentist, restoration and patient-level characteristics.

The distribution of caries among homologous surfaces can exhibit three possible patterns: random, aggregated, or regular. In a random caries pattern, caries lesions are randomly distributed among homologous surfaces. An aggregated caries pattern is distinguished by the aggregation of lesions on one side of the mouth or the other to a greater extent than would be expected by chance alone. For a regular caries pattern, the left-right distribution of lesions is more homogenous than would be expected by chance alone. A test statistic based on the left-right distribution of caries lesions among discordant homologous pairs was developed to investigate which of these three caries patterns is present in a representative sample of the adult United States population. The data originated from the National Survey of Oral Health in the US (Employed Adults), 1985-1986. Of the 15,132 subjects studied, 12,776 subjects had 2 or more decayed or filled teeth. (At least 2 carious or filled teeth are required for detection of patterns.) Approximately 50% of these subjects (n = 6,439) had two or more discordant homologous tooth pairs. With these tooth pairs, the hypothesis of a random caries pattern was rejected in favor of an aggregated caries pattern (p < 0.0001). Similar findings were obtained with discordant homologous surface pairs. This aggregation of caries on one side of the mouth or the other may be due to genetic, infectious, and/or environmental factors.

The 1979-1980 and the 1986-1987 National Institute of Dental Research (NIDR) surveys of school-aged children revealed that virtually all tooth surfaces experienced a decrease in caries prevalence during the inter-survey period. Overall, there was a 28% decrease in the proportion of tooth surfaces attacked by caries for the primary dentition between the two surveys. The decrease for primary incisors was numerically small (5 surfaces per thousand surfaces at risk) and not statistically significant, whereas decreases in the canines and primary molars were considerably larger (23 surfaces per thousand) and statistically significant. For the permanent dentition, the overall decrease in the proportion of surfaces attacked was 35% during the 1979-87 period. Differences between the two surveys in the proportions of surfaces with caries were largest for pit and fissure surfaces (56 surfaces per thousand), followed by those for posterior approximal surfaces (14 surfaces per thousand) and all other smooth surfaces (5 surfaces per thousand). Almost all of these differences were statistically significant, except for some surfaces which experienced very few caries.

A National Survey of the Oral Health of U.S. children aged 5 to 17 was conducted by the National Institute of Dental Research during the 1986-87 school year. Eleven thousand and seven adolescents aged 14 to 17 years received a periodontal assessment. Their patterns of loss of periodontal attachment as assessed by probing at mesial sites were used to classify adolescents as cases of early onset periodontitis. Approximately 0.53% of adolescents nation-wide were estimated to have localized juvenile periodontitis (LJP), 0.13% to have generalized juvenile periodontitis (GJP), and 1.61% to have incidental loss of attachment (LA) (greater than or equal to 3 mm on 1 or more teeth). The total number of adolescents affected were not trivial. Close to 70,000 adolescents in the U.S. were estimated to have LJP in 1986-87. More destructive GJP affected an estimated 17,000 adolescents. Another 212,000 adolescents were estimated to have incidental LA. Blacks were at much greater risk for all forms of early onset periodontitis than whites. Males were clearly more likely (4.3 to 1) to have GJP than females when other variables were statistically controlled. Gender associations were more complicated for LJP because gender interacted with race. Black males were 2.9 times as likely to have LJP as black females. In contrast, white females were more likely than white males to have the disease by about the same odds. When interactions among demographic variables exist, caution must be taken in comparing results from different studies.

Dental examinations were conducted on 1,878 adolescent schoolchildren native to seven US cities in five states, where the water was fluoride-deficient, fluoridated, or contained approximately 5 ppm of naturally occurring fluoride. Dental caries experience was considerably lower in all the communities with fluoridated water than in Boston, which had water deficient in fluoride, and ranged from 38% to 83% fewer mean DMF for the children in the regions with fluoridated water than for the children in Boston. Moreover, dental caries experience was significantly lower in Midland, Tex (5 to 7 ppm fluoride) than in each of the four cities with fluoridated water, and approximately 50% of the children in Midland had no caries. This report provides strong evidence that a much greater protection against human dental caries can result from a higher concentration of fluoride than is customarily recommended as best for prevention of caries. Fluoridating community waters to concentrations higher than 1 to 2 ppm fluoride, however, is not suggested because of the high risk of producing unesthetic enamel fluorosis.

Prevalence, severity, and extent of periodontal diseases as well as the role of periodontal diseases in tooth mortality are described for persons 19 years and older in the U.S. in 1981. The data were collected with a household probability sample of non-institutionalized persons living in the contiguous 48 states. Plaque and calculus scores were collected for six index teeth. All permanent teeth present and capable of being assessed were scored for gingivitis; pocket depths were measured on the mesial of each tooth with a periodontal probe. Examinations were conducted by trained dentists calibrated on specific criteria. Only 15% of persons in the U.S. in 1981 were free from any sign of periodontal diseases. Periodontitis (pockets greater than or equal to 4 mm) affected approximately 36% of the population. Advanced periodontitis (pockets greater than or equal to 6 mm) was present in 8% of the population and was usually found on only one or two teeth when present. End-stage periodontal destruction requiring extraction of teeth was found in only 4% of all persons while less than 20% of all missing teeth were listed as missing due to periodontal disease.

Analysis of surface and tooth-specific data from NHANES I and HHANES shows that the pattern of dental caries differs greatly from tooth to tooth and surface to surface. Occlusal caries precedes all other types, and increases most rapidly and to the highest levels in the molars. Caries on the proximal surfaces comes later. For sealants to be of value, they must reduce the need for restorations. Therefore, the value of sealants will be determined by the balance between high enough levels of potential caries on occlusal surfaces to give them something to prevent, and low levels of, or sufficiently delayed, proximal lesions to prevent the loss of the otherwise saved occlusal surface. The data presented demonstrate that as of the time of NHANES I, the number of permanent molars that could have had surfaces saved from restoration, at least for a number of years, appears to be sufficient to warrant widespread use of sealants on those teeth. More recent data (HHANES) suggest that the current decline in caries prevalence is likely to reduce the value of sealants in the short run because there are fewer occlusal lesions in young children, but may increase the value of sealants in the long run because proximal caries in older children and adults is also declining.