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Treatment Need (treatment + need)

Distribution by Scientific Domains
Medical Sciences91%
3 Other Domains9%

Kinds of Treatment Need

  • orthodontic treatment need
    		•
  • unmet treatment need
    		•

    Selected Abstracts

    Interceptive orthodontics in the real world of community dentistry

    INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2000
    K. Al Nimri
    Objective. To test the applicability and effectiveness of interceptive orthodontics in a community field trial. Design. Prospective screening for suitable malocclusions, implementation of treatment and analysis of outcomes 12 months later. Setting. Community dentistry in urban and rural areas of Northern Ireland, 1996,98. Subjects and methods. The initial sample consisted of 2002 children (1014 boys, 988 girls) who were screened in routine community dental inspections. One thousand and sixty (523 aged 9 years, 537 aged 11 years) were domiciled in the urban area of greater Belfast and 942 (479 aged 9 years, 463 aged 11 years) in the rural area of Enniskillen and Omagh, Co. Tyrone. Interventions. Interceptive orthodontic treatment. Outcome measures. Dental health component of the Index of Orthodontic Treatment Need (IOTN) and specially devised local indices of treatment outcomes. Results. With the use of an interception gauge, orthodontic screening was included in the community dental inspections without difficulty. Thirty-three per cent of children were in need of interceptive treatment. Only 20% of those in need both attended for recall and underwent treatment. Compliance was better in the rural area but the need, with particular reference to extraction of carious first molars, was greater in the urban area. The numbers of children in IOTN grades 4 and 5 fell from 69% at the beginning of the study to 42% at the end. The outcome judged by local indices was 94% in the range of complete success to minimal improvement with only 2% showing deterioration. Conclusions. One in three children screened in community dental inspections at age 9 and 11 years would benefit from interceptive orthodontics. Parents and children seem reluctant to accept offers of interceptive orthodontics and to having the treatment carried out. Among those complying fully, the interceptive measures are very successful. Not only does community interceptive orthodontics improve the condition being treated but also reduces the need for further treatment. [source]

    Objective, Subjective, and Self-Assessment of Preadolescent Orthodontic Treatment Need , A Function of Age, Gender, and Ethnic/Racial Background?

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2009
    Elizabeth A. Christopherson
    Abstract Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment. Objectives: To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES). Methods: Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need. Results: Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions. Conclusions: Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES. [source]

    Agreement between normative and perceived orthodontic need amongst deprived multiethnic school children in London

    ORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 2 2001
    Bilal Ahmed
    The Index of Orthodontic Treatment Need (IOTN) has been used in dental epidemiology and to prioritize orthodontic treatment. The aim of this paper was to use the aesthetic component (AC) of the IOTN to measure agreement between normative and perceived orthodontic need amongst school children. Three hundred and seventy-eight children aged 11,14 years, enrolled in London UK state schools participated in this survey. The study focused on three ethnic groups: white, black and South Asian. Townsend deprivation scores suggested that the children were from areas of high socio-economic deprivation. Logistic regression analysis was carried out for agreement between normative and perceived need at each threshold value. Perceived need for braces, ethnic background, social class and hours of television viewing were significant variables. Black pupils were significantly less likely to concur on normative and perceived need scores, tending to perceive less need for treatment than did the dentist. Subjects from lower social classes were significantly more likely to concur on normative and perceived need scores. In conclusion, the study showed that using the IOTN AC at various points along the scale, different influences play a significant role in agreement/disagreement between normative and perceived needs, indicating that patient,clinician agreement regards orthodontic treatment is sensitive to several cultural factors. [source]

    Levels of aspartate aminotransferase (AST) in saliva of patients with different periodontal conditions

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2003
    Ricardo de Toledo Cesco
    Abstract Objectives: The purpose of this study was to evaluate the relationship between aspartate aminotransferase (AST) levels in saliva measured by ReflotronÔ System of Diagnosis and periodontal condition indicated by Community Periodontal Index of Treatment Needs (CPITN). Material and methods: Fifteen patients were assigned to one of four groups C0, C1, C3 and C4, based on their largest CPITN code among the examined sites, totaling 60 participants. About 1.0 ml of non-stimulated saliva was collected from the individuals after a mouth rinse with water. Biochemical analyses of saliva samples were carried out using the proposed system in order to quantify their AST concentration. Results: There were no significant differences between levels (U/ml) of AST (median; interquartile range) from groups C0 (30.9; 14.7,41.7), C1 (30.3; 19.5,39.4) and C3 (35.1; 27.0,63.5). However, group C4 (106.2; 84.4,129.7) differed statistically from the others (p<0.001) and presented AST levels as high as 284.2 U/ml. Gingival bleeding and suppuration were observed in three individuals with concentrations higher than 125.0 U/ml. Conclusion: Levels of AST in saliva from patients presenting CPITN code 4 were higher than from patients coded lower and could be detected by the evaluated diagnostic system. Periodontal destruction such as periodontal pockets, gingival bleeding and suppuration seems to be related to higher AST levels in saliva. Zusammenfassung Ziele: Der Zweck der Studie war die Evaluation der Beziehung zwischen den Levels von Aspartataminotransferase (AST) im Speichel, die mit dem ReflotronÔ System gemessen wurden, und den parodontalen Bedingungen, die mit dem CPITN erfasst wurden. Material und Methoden: 15 Patienten wurden für eine der vier Gruppen C0, C1, C3 und C4 ausgesucht, was aufgrund ihres höchsten CPITN-Wertes unter den überprüften Flächen bei total 60 Teilnehmern geschah. Ungefähr 1.0 ml von nicht stimuliertem Speichel wurde von den Personen nach einer Mundspülung mit Wasser gesammelt. Die biochemischen Analysen der Speichelproben wurden unter Nutzung des vorgeschlagenen Systems durchgeführt, um die AST Konzentration zu bestimmen. Ergebnisse: Es gab keine signifikanten Differenzen zwischen den Levels (U/ml) von AST (Median, Streuung) bei den Gruppen C0 (30.9; 14.7,41.7), C1 (30.3; 19.5,39.4) und C3 (35.1; 27.0,63.5). Jedoch unterschied sich die Gruppe C4 (106.2; 84.4,129.7) signifikant von den anderen (p<0.001) und zeigte AST Level höher als 284.2 U/ml. Gingivale Blutung und Suppuration wurden bei drei Personen beobachtet mit Konzentrationen höher als 125.0 U/ml. Schlussfolgerung: Die Level von AST im Speichel von Patienten mit einem CPITN von 4 waren höher als bei den Patienten, deren CPITN niedriger war. Sie konnten mit dem evaluierten Diagnostiksystem entdeckt werden. Parodontale Destruktion wie parodontale Taschen, gingivale Blutung und Suppuration scheinen zu höheren AST Level im Speichel in Beziehung zu stehen. Résumé Objectifs: Cette étude se propose d'évaluer la relation entre les niveaux d'aspartate aminotransferase (AST) dans la salive, mesuré par le ReflotronÔ System of Diagnosis et la condition parodontale déterminée par le CPITN. Matériel & méthodes: 15 patients (60 au total) furent répartis dans un des 4 groupes C0, C1, C3 et C4, sur la base de leur plus grand code CPITN parmi les sites examinés. Environ 1.0 ml de salive non stimulée fut prélevé après rinçage à l'eau. Des analyses biochimiques des échantillons salivaires furent réalisées avec le système proposé afin de quantifier la concentration en AST. Résultats: Il n'y avait pas de différences significatives entre les niveaux (U/ml) d'AST (median; interquartile range) entre les groupes C0 (30.9; 14.7,41.7), C1 (30.3; 19.5,39.4) et C3 (35.1; 27.0,63.5). Cependant, le groupe C4 (106.2; 84.4,129.7) présentait une différence significative par rapport aux autres (p<0.001) avec des niveaux d'AST allant jusqu'à 284.2 U/ml. Le saignement gingival et la suppuration s'observaient chez trois individus avec des concentrations au dessus de 125.0 U/ml. Conclusion: Les niveaux d'AST dans la salive de patients au CPITN code 4 étaient plus importants que ceux des patients au code CPITN inférieur et pouvaient être détectés par le système de diagnostique évalué. Des destructions parodontales comme des poches parodontales, des saignements gingivaux et des suppurations semblent en relation avec des niveaux plus grands d'AST dans la salive. [source]

    Traumatic dental injuries in an urban adolescent population in Tirana, Albania

    DENTAL TRAUMATOLOGY, Issue 5 2010
    Dorina Sula Thelen
    Material & methods: A cross-sectional survey was carried out to acquire epidemiological data about TDI in the permanent incisors of Albanian adolescents. Participants (n = 2789) were adolescents of both genders, aged 16,18 years, attending public high schools in Tirana. Results: The occurrence of TDI in the incisors ranged from 8.9% of 16-year-olds to 10.5% of 18-year-olds. A greater proportion of boys (12.4%) had TDI compared with girls (7.7). The most commonly reported causes were collisions (27.5%) followed by physical leisure activities and sports (mainly cycling and swimming/diving) (14.1%) and falls (13.4%). Of the adolescents affected by TDI, 32% had unmet treatment need because of no or inadequate treatment. Adolescents living in districts with low socio-economic level had significantly more TDI with unmet treatment need than those living in districts with high socio-economic level. Conclusion: The occurrence of TDI among Albanian adolescents was moderate. Adolescents who came from low socio-economic districts had a greater probability of having TDI with unmet treatment need. [source]

    The unmet treatment need of traumatized anterior teeth in selected secondary school children in Ibadan, Nigeria

    DENTAL TRAUMATOLOGY, Issue 1 2010
    Mojirade Deborah Ajayi
    The aim of this study was to assess the prevalence of damage to permanent anterior teeth in school adolescents, the average duration of trauma and to ascertain the level of the unmet treatment need. A total of 1532 secondary school children between the ages 12 and 19 years participated in the study. They were randomly selected from public secondary schools in five local government areas in Ibadan using a multistage sampling method. Participants were examined with the aid of mouth mirrors and probes under natural light. Traumatic anterior dental injuries were recorded by the same investigator (DMA) according to WHO classification. One hundred and sixty-five participants sustained injuries to their anterior teeth. Their mean age was 15.47 ± 2.09 years, with a male to female ratio of 1.5:1. The commonest cause was fall (78.8%) with road traffic accident being the least (1.8%). The tooth most commonly injured is the upper left incisor (48.0%) closely followed by upper right central (43.1%). Enamel fracture was seen in 46.5% and enamel,dentine in 42.6% of the traumatized teeth. Most (79.4%) of the children sustained injury to one tooth only. Of the participants, only 30 (18.2%) had previous dental consultation while only nine (5.5%) consulted the dentist following the trauma; however, none of the teeth had any form of restoration. Average time elapsed between trauma and dental examination was about 3.5 years. Many participants had had injury for about 2 years before dental examination. In conclusion, there is a high unmet treatment need of traumatized anterior teeth in the study population. [source]

    Has the education of professional caregivers and lay people in dental trauma care failed?

    DENTAL TRAUMATOLOGY, Issue 1 2009
    Ulf Glendor
    This situation could seriously affect the outcome of TDIs, especially a complicated TDI. The overall aim of this study was to present a review of dental trauma care with focus on treatment and dentists and lay persons' lack of knowledge on how to manage a TDI. A further aim is to introduce the actors involved and the outcome of their education. Material and method:, The databases Medline, Cochrane, SSCI, SCI and CINAHL from the year 1995 to the present were used. Focus was on treatment need, inadequate care, lack of knowledge and poor organization of emergency care. Result:, Studies from different countries demonstrated that treatment needs were not properly met despite the fact that not all untreated teeth needed treatment. Treatment in emergency dental care was often inadequate or inappropriate. With the exception of lay people, teachers, medical personnel and even dentists performed inadequate care. Furthermore, information to the public was insufficient. Despite a low level of knowledge, lay people expressed a strong interest in helping someone with a TDI. Conclusion:, The conclusion from this review is that consideration must be given the problematic results from different studies on education or information about dental trauma care. Despite that the studies reviewed were from different countries and groups of people, the results seem to be consistent, i.e. that a large part of the educational process of professional caregivers and lay people has failed. Too much hope seems to be put on lay people to handle difficult cases such as tooth avulsion. Education of caregivers and lay people is a field where much remains to be explored. [source]

    Risk factors for relapse after remission with repetitive transcranial magnetic stimulation for the treatment of depression

    DEPRESSION AND ANXIETY, Issue 7 2009
    Roni B. Cohen M.D.
    Abstract Background: Several studies have shown that repetitive transcranial magnetic stimulation (rTMS) treatment is associated with a significant antidepressant effect that can last for several months. Methods: To investigate the mean remission time and the predictors associated with its duration; we performed a large retrospective, naturalistic study with 204 patients who underwent treatment with rTMS. During the periods from 2000 to 2006, we identified and collected the data on 204 patients who underwent rTMS treatment for major depression and who remitted their depression (defined as Hamilton Depression Rating Scores less or equal to 7). Patients were followed up to 6 months after this therapy. Results: Event-free remission with the end point defined as relapse (Hamilton Depression Rating Scores higher than 8) was 75.3% (73.7) at 2 months, 60.0% (74.5) at 3 months, 42.7% (74.8) at 4 months, and 22.6% (74.5) at 6 months. According to a multivariate analysis, only the age and number of sessions were independent predictors of outcome. Although depression severity and use of tricyclics also showed a significant relationship with remission duration, the model including these variables was not adequate to explain our data. Conclusions: The results of this study suggest that young age and additional rTMS sessions are associated with a ong duration of rTMS effects and therefore future trials investigating the effects of maintenance rTMS treatment need to explore further the implication of these factors for depression remission. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source]

    Psychotherapy of borderline personality disorder

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009
    M. C. ZanariniArticle first published online: 6 OCT 200
    Objective:, Psychotherapy is considered the primary treatment for borderline personality disorder (BPD). Currently, there are four comprehensive psychosocial treatments for BPD. Two of these treatments are considered psychodynamic in nature: mentalization-based treatment and transference-focused psychotherapy. The other two are considered to be cognitive-behavioral in nature: dialectical behavioral therapy and schema-focused therapy. Method:, A review of the relevant literature was conducted. Results:, Each of these lengthy and complex psychotherapies significantly reduces the severity of borderline psychopathology or at least some aspects of it, particularly physically self-destructive acts. Conclusion:, Comprehensive, long-term psychotherapy can be a useful form of treatment for those with BPD. However, less intensive and less costly forms of treatment need to be developed. [source]

    Patterns and correlates of substance use amongst juvenile detainees in New South Wales 1989,99

    DRUG AND ALCOHOL REVIEW, Issue 1 2003
    JAN COPELAND
    Abstract In the decade 1989,99 there have been significant changes in the patterns of substance use in the Australian community. Juvenile offenders have been a sentinel population of these emerging trends. The social and personal costs associated with adolescent substance use, especially where it leads to increased criminal offending requires urgent attention. This study was a replication of the 1989 and 1994 surveys of young people in detention in New South Wales, Australia. The 300 voluntary participants from nine detention centres had a similar demographic profile to participants of the previous surveys. They were predominantly male (90%) with a mean age of 16.5 years and an over-representation of Aboriginal and Torres Straits Islander peoples. The patterns of lifetime alcohol and tobacco use were stable over the decade, with particular increases in amphetamine, opioid and cocaine use since 1994. The more concerning pattern of at least weekly substance use revealed significant increases in cannabis, opioid and cocaine use since 1994, but a significant decrease in the frequent use of alcohol. This study also reports on high levels of negative health and psychosocial consequences of substance use, including overdose, among this group. High levels of self-reported depression and suicidal behaviours, family and gender issues are also discussed. Encouragingly, there was a relatively high level of self-recognized treatment need for substance use and mental health problems among the sample. This highlights further the growing need for the development and dissemination of novel interventions that harness this willingness and actively engage, motivate and maintain these young people in accessible, appropriate and effective interventions. [source]

    Drug use and perceived treatment need among newly sentenced prisoners in England and Wales

    ADDICTION, Issue 2 2009
    Duncan Stewart
    ABSTRACT Aims To investigate pre-custody levels of drug use among newly sentenced prisoners and factors associated with perceived drug treatment need. Design, setting and participants A sample of 1457 prisoners was recruited to a general purpose longitudinal survey of convicted prisoners starting a new sentence. Measurements Data were collected by structured interviews on reception to prison. Measures were taken of illicit drug use, drug treatment history, current treatment needs, psychological health and a range of social problems. Findings Life-time use of heroin, crack cocaine, cocaine powder, amphetamines or cannabis was reported by 79% of prisoners. Cannabis was the drug reported most commonly, but approximately a third had used heroin or crack cocaine during the year before custody. Nearly half of recent drug users reported wanting help or support with a drug problem during their sentence. Dependence on heroin and cocaine, previous drug treatment, employment, accommodation and psychological health problems were all associated positively with perceived treatment need. Conclusions The prevalence of pre-custody drug use among this sample of newly sentenced prisoners was high. Because treatment need was associated with a range of drug, health and social factors, assessment and referral to appropriate interventions should occur as soon as possible on reception. Treatment should be coordinated with other services and support. [source]

    The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children,

    FAMILY PROCESS, Issue 4 2001
    Ellen Pulleyblank Coffey Ph.d.
    This essay is based on a pilot study that examined the effects of managed care on the treatment of children and families, with special attention to community mental health. We embarked on the pilot study to test the accuracy and generalizability of our impression that family therapy and other systemic practices have been marginalized in ordinary clinics and agencies, and to understand the reasons why. We interviewed managed care providers, researchers, family therapy trainers, and clinicians in the Northeast. Our findings led to seven themes that support our impression that, even though there is a consensus about the need for coordinated family-based services, there is a disconnection between state policies, contractual requirements and what is actually occurring at the implementation level. This study suggests that our knowledge of human systems may be in danger of being disqualified and lost, with damaging consequences for the care of children. Yet, as systemic thinkers and practitioners, it is our belief that ethical and effective treatment need not be at odds with care that is cost-efficient. The direction of our future research will be to study whether the involvement of all stakeholders at all levels of planning and training leads to systemic family-based practices that consistently save costs and provide high-quality care. [source]

    A quantitative review comparing the yield of switchgrass in monocultures and mixtures in relation to climate and management factors

    GCB BIOENERGY, Issue 1 2010
    DAN WANG
    Abstract Switchgrass (Panicum virgatum L.), a US Department of Energy model species, is widely considered for US biomass energy production. While previous studies have demonstrated the effect of climate and management factors on biomass yield and chemical characteristics of switchgrass monocultures, information is lacking on the yield of switchgrass grown in combination with other species for biomass energy. Therefore, the objective of this quantitative review is to compare the effect of climate and management factors on the yield of switchgrass monocultures, as well as on mixtures of switchgrass, and other species. We examined all peer-reviewed articles describing productivity of switchgrass and extracted dry matter yields, stand age, nitrogen fertilization (N), temperature (growing degree days), and precipitation/irrigation. Switchgrass yield was greater when grown in monocultures (10.9 t ha,1, n=324) than when grown in mixtures (4.4 t ha,1, n=85); yield in monocultures was also greater than the total yield of all species in the mixtures (6.9 t ha,1, n=90). The presence of legume species in mixtures increased switchgrass yield from 3.1 t ha,1 (n=65) to 8.9 t ha,1 (n=20). Total yield of switchgrass-dominated mixtures with legumes reached 9.9 t ha,1 (n=25), which was not significantly different from the monoculture yield. The results demonstrated the potential of switchgrass for use as a biomass energy crop in both monocultures and mixtures across a wide geographic range. Monocultures, but not mixtures, showed a significant positive response to N and precipitation. The response to N for monocultures was consistent for newly established (stand age <3 years) and mature stands (stand age ,3 years) and for lowland and upland ecotypes. In conclusion, these results suggest that fertilization with N will increase yield in monocultures, but not mixtures. For monocultures, N treatment need not be changed based on ecotype and stand age; and for mixtures, legumes should be included as an alternative N source. [source]

    Dental status and dental caries in 85-year-old Danes

    GERODONTOLOGY, Issue 1 2007
    Lene Vilstrup
    Objectives:, This study reports findings on the dental status and the prevalence of dental caries among a group of 85-year-old Danes from the Glostrup 1914 Cohort, Denmark. The purpose of the study was to analyse whether caries experience was related to number of teeth and to indicators of functional ability and cognitive function. Methods:, A total of 191 individuals (78 men and 113 women) participated in a cross-sectional population study conducted in 2000. Using mobile dental equipment, a clinical oral examination and an interview were administered to all participants in their homes. Functional ability was measured by the Mob-H scale and cognitive function was assessed by the Mini-Mental State Examination. Results:, Fifty-nine per cent of the participants had their own natural teeth and for the dentate participants, the mean number of teeth was 13 (range 1,27). A high prevalence of active caries on coronal and root surfaces was observed. Older adults with few natural teeth had a higher prevalence of active coronal and root caries and a higher unmet treatment need than older adults with many teeth. Further, the study showed that 85-year-old persons with reduced functional ability and cognitive impairment tended to have more active caries than 85-year-olds with no impairment. Conclusions:, A substantial proportion of 85-year-old individuals had retained a natural dentition; however, active dental caries is a problem of concern among the most elderly. [source]

    Oral health-related quality of life in children: Part I. How well do children know themselves?

    INTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 2 2008
    A systematic review
    Abstract:, Objective:, Paediatric oral disorders are likely to have a negative effect on the quality of life. Until recently, children's oral health-related quality of life (OHRQoL) was measured using parents as informants. Instruments have now been developed, which have demonstrated that with appropriate questionnaire techniques, valid and reliable information can be obtained from children. The aim of this study was to make a systematic review of the existing literature about child perceptions of OHRQoL and their validation. Methods:, A computerized search was conducted using Medline, ISI, Lilacs and Scielo for children's perception of OHRQoL. The inclusion criteria were: the articles should contain well-validated instruments and provide child perceptions of OHRQoL. Results:, From 89 records found, 13 fulfilled the criteria. All studies included in the critical appraisal of the project suggested good construct validity of overall child perceptions of OHRQoL. However, children's understanding of oral health and well-being are also affected by variables (age, age-related experiences, gender, race, education, culture, experiences related to oral conditions, opportunities for treatment, childhood period of changes, back-translating questionnaire, children self-perceived treatment need). Conclusions:, The structure of children's self-concept and health cognition is age-dependent as a result of their continuous cognitive, emotional, social and language development. By using appropriate questionnaire techniques, valid and reliable information can be obtained from children concerning their OHRQoL. [source]

    Evaluation of spontaneous space closure and development of permanent dentition after extraction of hypomineralized permanent first molars

    INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2007
    BIRGITTA JÄLEVIK
    Aim., ,The aim of this study was to evaluate spontaneous space closure, development of the permanent dentition, and need for orthodontic treatment after extraction of permanent first molars due to severe molar,incisor hypomineralization (MIH). Subjects., ,Twenty-seven children aged 5.6,12.7 (median 8.2) years had one to four permanent first molars extracted due to severe MIH. Each case was followed up on individual indications 3.8,8.3 (median 5.7) years after extractions. The eruption of the permanent dentition, and space closure were documented by orthopantomograms, casts, photographs, and/or bitewings. Results. ,Fifteen children were judged to have a favourable spontaneous development of their permanent dentition without any orthodontic intervention. Seven children were or should be subjected to orthodontic treatment for other reasons registered prior to the extraction. Five children were judged to have a treatment at least caused by the extractions, but three of them abstained because of no subjective treatment need. Conclusion. Extraction of permanent first molars severely affected by MIH is a good treatment alternative. Favourable spontaneous space reduction and development of the permanent dentition positioning can be expected without any intervention in the majority of cases extracted prior to the eruption of the second molar. [source]

    A survey of specialist paediatric dental services in Sweden: results from 2003, and trends since 1983

    INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2006
    G. KLINGBERG
    Summary. The child population in Sweden has changed dramatically during the last 20 years. Changes have also occurred within the Public Dental Service (PDS), regarding the provision of dental care to children and adolescents. All these changes may affect the referral pattern and provision of specialist dental care for children and adolescents. Objectives., The primary aim of this study was to survey the services provided by specialists in paediatric dentistry in Sweden during 2003. A secondary aim was to compare the results with previous surveys. Methods., A Web-based survey was sent to all 34 specialist paediatric dentistry clinics and was answered by all clinics. Data were compared with results from the surveys performed in 1983, 1989, and 1996. Results., The number of paediatric dentists had been relatively constant over the last 20 years, whereas the number of children referred to paediatric dentists had increased by 28% since 1983. It was estimated that 1·3% of all children in Sweden are treated at a specialist paediatric dental clinic in 2003. Dental treatment need in combination with behaviour management problems (BMP) was the main reason for referral and occurred in 37% of all referrals. The proportion of medically compromised children/children with disabilities had increased from 6% in 1983 to 22% in 2003. The number of patients treated using sedation and general anaesthesia had increased since 1983, and particularly since 1996. Conclusions., Despite improvements in dental health among children and adolescents in Sweden during the last 20 years, an increasing number of children are referred for specialist paediatric dental treatment. There is an urgent need to increase the number of specialist paediatric dentists in Sweden in order to ensure the continuation of high quality of dental care for children and adolescents. [source]

    Prosthetic treatment need in a representative German sample*

    JOURNAL OF ORAL REHABILITATION, Issue 8 2001
    M. H. Walter
    Regarding declining resources epidemiological data on needs for oral rehabilitation are required. Within the framework of an oral health survey a non-stratified two-stage random sample was taken to represent the over 14-year-old population of Saxony/Germany. The participation rate was 55%. Normative need was determined by dental assessment and guidelines developed in a consensus process, subjective prosthetic treatment need by self-complete questionnaire. About 97% of the realized sample could be planned within the guidelines. About 81% had normative prosthetic treatment need. Compared with the rate of normative need the rate of subjective need (13%) was considerably lower (,2P < 0,01). Different predictive parameters of subjective need were identified by logistic regression. Besides other factors subjective need was associated with giving dentist's recommendation as significant reason for prosthetic restorations [odds ratio (OR)=5,43], not believing that the own teeth were all right (OR=0,17), and the existence of prosthetic restorations (OR=3,87 for fixed restorations; OR=4,05 for removable dentures). The guidelines proved their suitability to assess normative prosthetic treatment need in oral health surveys. Further research is necessary to find adequate options for including patients' preferences in an adequate need definition. [source]

    Assessment of predictors of global self-ratings of oral health among Korean adults aged 18-95 years

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2010
    Hae-Young Kim DDS
    Abstract Objectives: The aims of this study were to assess predictors of global self-ratings of oral health (GSROH) and to examine whether they varied by age among Korean adults aged 18-95 years. Methods: Data from 4,546 adults aged 18-95 years completing the Korean National Oral Health Survey 2006 were included in the analysis. Results: Subjects' mean age was 43.5 years, with 12.1 percent aged ,65 years; 47.8 percent were men; and 2.5 percent were edentulous. The predictors of GSROH in adults were number of missing teeth, concern about oral health, and difficulty in chewing. While wearing removable dentures was associated only in elders, perceived treatment need was associated in younger age groups. The number of decayed and filled teeth was significant only in the 18-44 age group. Conclusions: GSROH status was associated with measures of oral disease, oral functional problems, oral health behaviors, concerns, and perceived treatment needs, and it varied by age. [source]

    Objective, Subjective, and Self-Assessment of Preadolescent Orthodontic Treatment Need , A Function of Age, Gender, and Ethnic/Racial Background?

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2009
    Elizabeth A. Christopherson
    Abstract Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment. Objectives: To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES). Methods: Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need. Results: Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions. Conclusions: Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES. [source]

    Oral Health of Young Children in Mississippi Delta Child Care Centers: A Second Look at Early Childhood Caries Risk Assessment

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2008
    Linda H. Southward PhD
    Abstract Objectives: To identify the predictors of early childhood caries and urgent dental treatment need among primarily African-American children in child care centers in the Delta region of Mississippi. The purpose of this study was to replicate predictors of caries and urgent dental treatment needs that were identified in an earlier study conducted in Delta child care centers and to assess additional caries risk factors not collected in the original study. Methods: Children in 19 child care centers were examined by the dentists, and the parents provided data on oral health practices, oral health history, and on children's oral health-related quality of life (QOL). The dentists also assessed visible plaque and tested levels of mutans streptococci. Predictors of caries and treatment need among children 24 to 71 months of age were examined using logistic regression. Results: Two parent predictors of caries identified in the earlier study (parent flossing and soft/sugary drink consumption) were not predictive in the current study. Parent history of abscess continued to predict their child's urgent need for treatment. Young children's level of salivary mutans streptococci, maxillary incisor visible plaque, and parents' reports of child oral health-related QOL measures predicted the presence of both caries and urgent treatment need. Some expected predictors, such as frequency of child's toothbrushing, were not predictive of caries. Conclusions: Parental abscess and parent's report of the child's oral health-related QOL are risk indicators for poor oral health outcomes that could be used by nondental personnel to identify young children in need of early preventive intervention and dental referral. [source]

    Dental Caries Status and Need for Dental Treatment of Pennsylvania Public School Children in Grades 1,3, 9, and 11

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2004
    Robert J. Weyant DMD
    ABSTRACT Objectives: This cross-sectional study was designed to determine the caries status and provide a general evaluation of the level of dental treatment need of Pennsylvania public school children in grades 1, 3, 9, and 11 on a statewide and regional basis. Methods: Between September 1998 and May 2000, caries status and treatment need were assessed using a school-based dental examination, performed on a representative sample (n=6,040) of public school children in grades 1, 3, 9, and 11 (age range=6 to 21 years). Children's caries status in the primary and permanent dentition was assessed. Need for treatment was scored on a three-level categorical scale,no treatment need identified, routine treatment need, and urgent treatment need,and was based on the presence and severity of caries and other oral conditions. Population estimates of the prevalence of untreated dental caries, DMFT and dft scores, and treatment need were calculated by grade and geographically, using the six Pennsylvania health districts and the cities of Pittsburgh and Philadelphia. The inequality of caries distribution in the population was assessed for both permanent and primary caries using Lorenz curves and Gini coefficients. Results: Dental caries has remained highly prevalent among Pennsylvania's public school children. Caries levels varied considerably by health districts and city. Urgent treatment needs were significant and also varied by health district and city. Conclusions: Dental caries remains the most prevalent disease affecting Pennsylvania's schoolchildren. Caries status varies significantly by region of the state, suggesting that environmental, social, and demographic contextual factors may be important determinants of disease prevalence. [source]

    Adverse effects of tocolytic therapy

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2005
    Steve Caritis
    The rationale for using tocolytics in preterm labour is to enable transfer of the mother to a tertiary centre and to prolong pregnancy sufficiently so that glucocorticoids can be administered to the mother. There is little question that these short term objectives can be achieved with contemporary tocolytics. Whether tocolytics can maintain pregnancy for sufficient periods to enable in utero maturation to occur remains an unresolved question. When a decision is made to use tocolytics, the clinician is faced with a multitude of choices with side effects, efficacy and ease of administration generally being the most important considerations. Placebo-controlled studies suggest that the ,-agonists, prostaglandin inhibitors and atosiban are effective in prolonging pregnancy for 24,48 hours. Of these three agents, atosiban has the best safety profile. There are no placebo-controlled studies with calcium channel blockers or nitric oxide donors. However, because of their ease of use and efficacy compared with the ,-agonists, calcium channel blockers are widely used. Calcium channel blockers appear to have a better safety profile than the ,-agonists, but there are still significant cardiovascular side effects associated with their use. Indomethacin, although proven to be efficacious, has a safety profile that limits its utility for other than short courses. Magnesium sulphate is the most commonly used tocolytic in the United States, despite a lack of evidence for its efficacy. Although magnesium sulphate appears to have a good safety profile, serious side effects have been reported with its use. The choice of tocolytics is commonly based on personal preference. Whichever tocolytic is chosen, the fundamental parturitional process is not reversed by contemporary treatment, rather a reduction in uterine response to a stimulant; thus, the expectations of tocolytic treatment need to be reconsidered. [source]

    Applying Andersen's behavioural model to oral health: what are the contextual factors shaping perceived oral health outcomes?

    COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 6 2009
    S. R. Baker
    Abstract,,, Objectives:, Andersen's revised behavioural model provides a framework for understanding the factors which influence utilization of health services and key health outcomes. To date, there have been few studies that have explicitly tested the model in relation to oral health. The aim of this study was to test the model and to examine the direct and mediated pathways between social, attitudinal and behavioural factors and perceived oral health outcomes. Methods:, The model was tested in a general population sample with data from the UK adult dental health survey (N = 3815) using the two-stage process of structural equation modelling. Results:, Structural equation modelling indicated support in line with the hypotheses within the model; enabling resources (oral health education advice, type of dental service, finding NHS treatment expensive, dental anxiety) predicted need (number of decayed or unsound teeth and perceived treatment need); enabling resources and need predicted personal health practices and use of services (frequency of toothbrushing, recent dental attendance, attendance orientation) which, in turn, predicted perceived oral health outcomes (oral health quality of life). Both enabling resources and need also predicted perceived oral health outcomes. The impact of predisposing factors (social class, qualifications, income) on need, personal health practices and use of services, and oral health outcomes was indirect; that is, mediated by intervening factors. In the final model, 26%, 37%, 49% and 21% of the variance was accounted for in enabling resources, treatment need, personal health practices and use of services and perceived oral health outcomes respectively. Conclusion:, The results provide support for Andersen's behavioural model as applied to perceived oral health. Further conceptual development of the model is discussed. [source]

    Testing the effect of including oral health in general health checks for elderly patients in medical practice , a randomized controlled trial

    COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 1 2007
    C. Lowe
    Abstract,,, Aim:, To test the feasibility and effectiveness of an oral health referral process for elderly patients (aged 75 years or over) attending a preventive health check (PHC) with their general medical practitioner. Objectives:, To evaluate the effectiveness of the process in increasing dental attendance at baseline and 6 months after the intervention. To identify key characteristics of those who accepted an oral health visit (OHV). To determine the proportion of people attending the OHV who required treatment and subsequently attended a dentist. Setting:, Three general medical practices in east Cheshire, UK. Design:, A randomized controlled trial. Method:, Elderly patients attending their general medical practice for PHCs were randomly assigned to a test group, who were invited to attend for an OHV, and to a control group, who received no intervention. Six months after the PHC the effectiveness of the process was measured. Results:, Some 50% of those invited for an OHV accepted. Those accepting were more likely to be edentulous, wear dentures or have a current oral health problem, than those declining. Regression analysis showed the best predictors of acceptance to be having a current dental problem or pain and not having a regular dentist. The mean time since their last dental visit was 8.1 years which was significantly longer than those declining the OHV. 63% of individuals attending the OHV were assessed as having a realistic treatment need and 70% of those referred went on to complete the course of treatment. In the test group a highly significant increase in reported dental visiting was found at sixth month evaluation. The primary care staff were happy to include the dental checklist and felt it was a valuable addition to the PHC. Conclusions:, The offer of an OHV was taken up most readily by those with current oral problems, or pain and those with no regular dentist. The inclusion of a dental checklist within the PHC for elderly patients together with help with arranging a dental appointment shows promise as a way of ensuring the dental needs of this group are met. [source]

    Has the education of professional caregivers and lay people in dental trauma care failed?

    DENTAL TRAUMATOLOGY, Issue 1 2009
    Ulf Glendor
    This situation could seriously affect the outcome of TDIs, especially a complicated TDI. The overall aim of this study was to present a review of dental trauma care with focus on treatment and dentists and lay persons' lack of knowledge on how to manage a TDI. A further aim is to introduce the actors involved and the outcome of their education. Material and method:, The databases Medline, Cochrane, SSCI, SCI and CINAHL from the year 1995 to the present were used. Focus was on treatment need, inadequate care, lack of knowledge and poor organization of emergency care. Result:, Studies from different countries demonstrated that treatment needs were not properly met despite the fact that not all untreated teeth needed treatment. Treatment in emergency dental care was often inadequate or inappropriate. With the exception of lay people, teachers, medical personnel and even dentists performed inadequate care. Furthermore, information to the public was insufficient. Despite a low level of knowledge, lay people expressed a strong interest in helping someone with a TDI. Conclusion:, The conclusion from this review is that consideration must be given the problematic results from different studies on education or information about dental trauma care. Despite that the studies reviewed were from different countries and groups of people, the results seem to be consistent, i.e. that a large part of the educational process of professional caregivers and lay people has failed. Too much hope seems to be put on lay people to handle difficult cases such as tooth avulsion. Education of caregivers and lay people is a field where much remains to be explored. [source]

    Oral hygiene and the need for treatment of the dependent institutionalised elderly

    GERODONTOLOGY, Issue 2 2006
    Sylvie Montal
    Objective:, To assessing the oral hygiene and treatment needs of a geriatric institution in southern France. Background:, For various reasons, the care demand from elderly people is low and difficult to determine, whereas their oral status would need long and complicated treatments. Materials and methods:, From 2003 to 2004, a cross-sectional study of 321 elderly patients was conducted at several geriatric services of Montpellier, France. The clinical evaluation of dental status was recorded together with medical information. Dental and prosthetic hygiene, status of dentures, caries experience, dependence conditions and treatment needs were evaluated. Results:, The prevalence of edentulism was 27%, with no gender difference (23% of the men and 29% of the women). Among them, 16.7% (upper jaw) and 18.1% (lower jaw) were totally edentulous with no denture. The mean number of decayed and missing teeth was 3.7 for men and 2.8 for women and 21.5 for men and 21.0 for women, respectively. The mean number of filled teeth was 0.8 for men and 1.3 for women, with no statistical difference according to gender for the three indexes. Most of the subjects needed prostheses (53%), 45.1% extractions and 30.6% conservative treatments. Only 2.4% did not need any treatment. Conclusion:, The prevalence of edentulism was relatively low, while the need for prosthodontic rehabilitation, especially for men, was still very high. The dental hygiene was globally inadequate. This evaluation emphasises the care demand and the need for help in oral hygiene procedures for the dependent institutionalised elderly. [source]

    Oral health status and treatment needs among school children in Sana'a City, Yemen

    INTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 2 2010
    KA Al-Haddad
    To cite this article: Int J Dent Hygiene DOI: 10.1111/j.1601-5037.2009.00398.x Al-Haddad KA, Al-Hebshi NN, Al-Ak'hali MS. Oral health status and treatment needs among school children in Sana'a City, Yemen. Abstract:, Data on the oral health status and treatment needs among Yemeni children are lacking. Objectives:, To assess caries prevalence, treatment needs and gingival health status among school children in Sana'a City and to examine how these are affected by age, gender and khat chewing. Methods:, 1489 children (6- to 14-year old) were randomly selected from 27 schools representing all nine districts of Sana'a City. Dental caries and treatment needs were evaluated using standard WHO oral survey methods. The plaque index (PI), calculus index (CI) and the gingival index (GI), recorded at the six Ramfjord's teeth, were used to assess gingival health status. Results:, 4.1% of the study subjects were caries-free. Prevalence of these was significantly higher among the males. Overall, mean dmfs, dmft, DMFS and DMFT scores were 8.45, 4.16, 3.59 and 2.25 respectively. The decayed component accounted for >85% of the scores. The highest dmfs/dmft means were found among the 6,8 years age group, while the highest DMFS/DMFT means were scored by the 12,14 years age group. The need for restorative treatment and extractions was high; the former was significantly higher among the females. All subjects had gingivitis; the mean PI, CI and GI were 1.25, 0.3 and 1.36 respectively. Khat chewing did not affect caries experience; however, it was significantly associated with higher PI, CI and GI scores. Conclusions:, The prevalence of caries, gingivitis and treatment needs among children in Sana'a city is high. More surveys in other Yemeni cities to generate comprehensive data are required. [source]

    Dental Caries Status and Need for Dental Treatment of Pennsylvania Public School Children in Grades 1,3, 9, and 11

    JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2004
    Robert J. Weyant DMD
    ABSTRACT Objectives: This cross-sectional study was designed to determine the caries status and provide a general evaluation of the level of dental treatment need of Pennsylvania public school children in grades 1, 3, 9, and 11 on a statewide and regional basis. Methods: Between September 1998 and May 2000, caries status and treatment need were assessed using a school-based dental examination, performed on a representative sample (n=6,040) of public school children in grades 1, 3, 9, and 11 (age range=6 to 21 years). Children's caries status in the primary and permanent dentition was assessed. Need for treatment was scored on a three-level categorical scale,no treatment need identified, routine treatment need, and urgent treatment need,and was based on the presence and severity of caries and other oral conditions. Population estimates of the prevalence of untreated dental caries, DMFT and dft scores, and treatment need were calculated by grade and geographically, using the six Pennsylvania health districts and the cities of Pittsburgh and Philadelphia. The inequality of caries distribution in the population was assessed for both permanent and primary caries using Lorenz curves and Gini coefficients. Results: Dental caries has remained highly prevalent among Pennsylvania's public school children. Caries levels varied considerably by health districts and city. Urgent treatment needs were significant and also varied by health district and city. Conclusions: Dental caries remains the most prevalent disease affecting Pennsylvania's schoolchildren. Caries status varies significantly by region of the state, suggesting that environmental, social, and demographic contextual factors may be important determinants of disease prevalence. [source]