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The second congress of the European Association of Dental Public Health, EADPH, was held in Santander, Spain on September 25th and 26th.. The Co-President of the congress was Professor Javier Goiriena de Gandarias. The abstracts were referreed by the Programme Committee consisting of Professor Gert-Jan Truin (Editor), Nijmegen, the Netherlands; Dr. Cynthia Pine (President), Dundee, Scotland; Dr. Roberto Ferro (Vice President), Cittadella, Italy; Professor Klaus Pieper (Treasurer) Marburg, Germany.
Professor M Garcilazo Ambriz
University of Mexico
Professor Montserrat Barranquero
Head of the Department of Stomatology of the University of the Basque Country, Spain
Executive Officer – Membership of EADPH
Dr David Barmes, PhD
Special Expert for International Health, Office of International Health, National
Institute of Dental Research, National Institutes of Health, Bethesda, Maryland, USA
Dr Dominique Declerck, PhD
Professor of Paediatric and Preventive Dentistry, School for Dentistry, Oral Pathology and
Maxillofacial Surgery, Catholic University, Leuven, Belgium
Professor Giuliano Falcolini
Professor and Chairman of Paediatric Dentistry, Dean of the Dental School, University of
Sassari, Italy
Professor F J Goiriena de Gandarias
Dean of the Faculty of Medicine and Odontology of the University of the Basque Country,
Spain
Professor Franklyn Garcia-Godoy
Chairman of Investigation of the University of San Antonio, Texas, USA.
Professor K W Stephen, DDSc
Professor of Dental Public Health, University of Glasgow Dental School, Glasgow, Scotland,
UK
Professor W Werteleckyj M.D.
Chairman of the Department of Medical Genetics of the University of South Alabama, USA
Dr Miguel Pellón Ortega
President of the Spanish Society of Prevention and Community Dentistry (SEOEPYC) and Chief
of Cantabrian Dental Health Service, Spain
Abstracts are Grouped under the following headings:
| Group | Invited Speakers | |
| Title | Odontology and law | |
| Author | M Barranquero, University of the Basque Country, Spain | |
| Between oral health professionals and the Law there is more confrontation in some countries such as the United States. The Law sees in the practice of odontology, an activity that is profitable and even lucrative; but at the same time potentially harmful, in that the health and life of the patient are at stake. Therefore, it seeks guarantees that treatment is properly performed. Given this situation, the health professional finds himself at times with a normative, formalistic duty where the Law is concerned, without sufficient flexibility to apply it in accordance with the complex circumstances and the biological reality of the disease, and this state of affairs may run counter to the patient's real interests in the area of health. We have to create a framework to help show that odontology does not have to fear the Law, and that the Law may be sure of the collaboration of odontologists and stomatologists to define acceptable practice. Malpractice should not be based only on deviations from legal norms, but particularly, from accepted odontological practice. It is difficult to deal with ethical and legal subjects without introducing dialogue and reasoning, giving voice to all the parties making up the odontologist-patient process. The establishment of this dialogue in odontological problems entails not only approaching them from the point of view of general practical-operating criteria via a method of abstraction and deduction. It is also necessary to install therapeutic relationality so that the patient and the professional recognise themselves and each other on the basis of this relation and not that mediated by extrinsic judgements. The moral problems that confront us vary from routine to important. Often they are highly complex and require that we take decisions. Interventions are carried out in accordance with ethical norms with the use of appropriate technology. The mere fact that an intervention can be performed does not mean that it ethically should be. We have to establish bridges between one another so that we can arrive at a synthesis between different religious, cultural and health beliefs that can impact on odontological care. | ||
| Group | Invited Speakers | |
| Title | International collaborative research in oral health – new opportunities | |
| Author | D Barmes, Office of International Health, National Institute of Dental Research, National Institutes of Health, Bethesda, Maryland, USA | |
| Since the late 80s and early 90s when the ICOHR initiative developed, first through collaboration between NIH/NIDR and WHO and later with involvement of international dental associations, there has been a vigorous renewal of interest in International Health. That element of the NIDR's work has been strengthened by creation of the Office of International Health (OIH). Within the OIH, resides the International Collaborative Research initiative, broad in scope, but with origins in oral health ideas. This renewed initiative uses the acronym ICR both to differentiate it from the former ICOHR and to emphasise the intention to address cross-cutting issues which will require multi-disciplinary, multi-partner and multi-country approaches. The priority list of five items from the ICOHR has been retained in the ICR. However, a rigorous approach has been taken towards setting targets and expected outcomes which will break new ground and notably improve community health. There is also scope for addition of other items provided that criteria to support the international approach are fulfilled. The OIH is reviewing a broad range of international links and also mechanisms for supporting international co-operation and research, not the least being the network(s) of WHO Collaborating Centres. | ||
| Group | Invited Speakers | |
| Title | The Signal TandmobielR-project – A unique epidemiological study | |
| Author | D Declerck, Catholic University of Leuven School for Dentistry, Oral Pathology and Maxillofacial Surgery, Capucijnenvoer 7, B-300 Leuven, Belgium | |
| The Signal TandmobielR-project, an epidemiological survey in primary schoolchildren in Flanders (Belgium) is in many ways a unique project. It is the results of the collaborative efforts of different partners, including the dental schools of 3 different Flemish universities, the Flemish Dental Association, school health care services, university youth health care department and biostatistical centre and an industrial partner (LeverElida). The project was constructed in such a way that the participation of each partner resulted in an extra dimension. The aim of this project is not only the collection of epidemiological data, but also a screening of the oral health condition of children in Flanders (with referral to their own dentist) and oral health promotion and education. The project consists of a longitudinal follow-up (1996–2002) of more than 5000 school children (stratified cluster sample) between the age of 7 and 12, with yearly clinical examinations. These examinations are performed by trained dentists with calibration at regular intervals, using standardised criteria and techniques. The clinical examination takes place at school in a mobile dental clinic (bus) especially designed for this project. On each occasion a wide variety of variables is recorded (oral health habits, oral hygiene, gingival condition, caries experience, tooth eruption stage, fluorosis, enamel developmental defects, trauma) and advanced statistical techniques are developed for analysis of the data. Oral health education and counselling receives much attention, with especially developed educational material and the long-term outcome of this will be evaluated over the 6 year study period (control group included). Partners in the Signal TandmobielR-project are: Catholic University of Leuven (Prof D Declerck, Prof E Lesaffre, Dr K Hoppenbrouwers), University of Gent (Prof L Martens), Free University of Brussels (Prof P Bottenberg), Flemish Dental Association – Section Oral Health Promotion (J Vanobbergen), Association for Youth Health Care (Dr G Mertens) and Unilever (LeverElida). | ||
| Group | Invited Speakers | |
| Title | Prevention in dental public health | |
| Author | G Falcolini, University of Sassari, Italy | |
| Public Dental Health Services should be concerned with the prevention of dental diseases, especially of dental caries, not only for ethical reasons, but also for economical ones. However, prevention can not exclude active therapy; since, although dental decay is a disease in decline, it is still prevalent in many groups within the population. Prevention is of greater benefit when it is applied early with childhood being the optimum time. As caries has declined, a total population approach to caries prevention is inappropriate and should be targeted. Therefore, it is useful to be able to identify risk-patients to deliver more intensive prevention. Criteria for early diagnosis of risk and diagnosis of initial lesions to trigger interceptive therapy are discussed. Preventive measures as carbohydrate intake, fluoride therapy and plaque removal are examined from a modern point of view. Other factors such as salivary flow and immunity status are considered in the genesis of caries and in preventive strategies. Experience from outside Europe and from Northern European and Southern European countries are considered to study the organisation of prevention in a Public Dental Health Service. | ||
| Group | Invited Speakers | |
| Title | Genetics and prevention of oral cancer | |
| Author | F J Goiriena de Gandarias, University of the Basque Country, Spain | |
| Neoplastic pathologies have increased considerably in this century. Cancer is a multifactorial genetic disease in which there appear accumulative multiple mutations with from three to six mutations being necessary for it to be manifested. These variations can be hereditary, familial, spontaneous, etc. They are influenced by a variety of risk and protective factors. Gene mutations are relatively frequent, but it is clear that on most occasions they do not alter the significance of the gene, and lead to no pathology. The genes that have been associated with carcinogenesis are the following: oncogenes that are encountered in the form of protooncogenes, which have a positive effect on the cell cycle; suppressor genes, which function as a brake to growth; genes responsible for the correction of errors in DNA replication. In oral cancer studies, oncogenes have been detected that are associated with these processes, such as C-myc, N-myc, N-ras, and Ki-ras. The myc act on the nucleus, the ras on the plasmatic membrane. In India, there are high percentages of the population exhibiting the N-myc gene. The main problem in the early detection of cancer lies in the difficulty of searching for the isolated mutation. The American Society of Clinical Oncology has pointed out that when genetic tests are performed on the population at risk, it is necessary to report first of all to the oncologists so that tumours can be detected early. It will be necessary concurrently to assess the effect of this information, above all on patients, since it may be highly beneficial or damaging psychologically and sociologically, both for the patient and for the family. It is also necessary to determine the limits of the tests, since there are still many tumours for which screening methods are inadequate. At the same time, genetics is providing new therapeutic weapons. Most promising is the gene-transfer method involving the use of a virus into which a therapeutic gene is inserted to replace part of the viral genome. At this time, they constitute the preferred gene- transfer method for the long-term treatment of gene defects. In spite of the brilliance of this idea, there are still a lot of questions surrounding the technique. | ||
| Group | Invited Speakers | |
| Title | Salt fluoridation cessation in Hungary – caries and fluorosis data 12 years later | |
| Authors | K Stephen(1), L Macpherson(1), I Gorzo(2) and W Gilmour(1) (1)University of Glasgow, Scotland, UK (2)Albert-Szent Gyorgyi University, Szeged, Hungary |
|
| From 1976–85, domestic salt for 4 villages near Szeged had 350 mg F-/kg added and, by 1983, 53% dmft & 68% DMFT reductions were noted, compared to non-F- Szeged subjects, but no fluorosis data were scored. Hence, 14-year-olds from each F- (N=49) and non-F- (N=59) area were examined by KS and had blind clinical (+ 10% repeat), X-ray and photographic recordings completed at one site. Fluorosis was scored by TF and TSIF indices on teeth 13–23. In Scotland, data were processed, X-rays read blind (+ 10% repeats) and 35 mm slides projected randomly, viewed by a 'jury' of 2 lay and 4 dental personnel, and scored for aesthetic acceptability (+ 10% repeats). Mean DMFS scores were 9.18 (+/– 10.7 SD) and 4.51 (+/– 6.2 SD) for previous F- salt and non-F- salt users respectively (clinical reliability =0.99; X-ray reliability =0.95; P<0.01). Clinically, 3 Test children had fluorosis (6 teeth @ TF=1; 4 @ TF=2; 6 @ TSIF=1; 2 @ TSIF=2 & 2 @ TSIF=3), with 8 teeth @ TF & TSIF=1 in 2 Controls. Photographic scoring by KS gave 97.2% clinical match, while 'jury' photo agreements for all 4 dentist pairs were from 92.5%–97.2%, with lay observers' agreement at 89.8%. For both groups, 10% repeats gave 98.5% agreements. In only 1 Test case was fluorosis photographic unanimity found, and "possible fluorosis" in only 3 other Test and 2 Control subjects. Thus, no significant fluorosis resulted from exposure to F- salt up to age 3 years. Lack of caries-benefit seemed socio-economically related, the city-based Controls having less caries than rural Test subjects, even with identical F- tablet regimens from 1987 until 1991, when subjects were 8–10 years old. However, the data suggest sub-optimal tablet usage and emphasise, yet again, the superiority of community-delivered fluoridation. Funded by SODoH grant K/OPR/15/9/F13. | ||
| Group | Invited Speakers | |
| Title | Public dental services; methods, mechanisms of payment and incentives | |
| Author | D M Pellón Ortega, Spanish Society of Prevention and Community Dentistry and Service of Oral Health in Cantabria, Spain | |
| The basic forms of organising dental services are: first, via a public care system which is administered by state employees, and is found to a greater or lesser extent in most European countries. This is the ideal form of organisation to carry out massive preventive programmes or integral odontological assistance (education, prevention, care). Second, Health Maintenance Organisations (HMO's), which may be financed either publicly or privately and can be an efficient alternative to controlling costs. A third example is the contaction of services individually with private sector professionals. Each one of the organisation types generate their own incentives regarding cost minimisation, with its own pros and cons that affect the quality of care and efficient use of resources. Payment mechanisms determine the amount and cash flow that goes from a third party or the patient or both, to the suppliers in exchange for their services, defining the service item or combinations which are being paid for and the price, and likewise defining a complex series of behavioural incentives to the professionals that influence their relationship with the payers, either patients or a third party. Experience shows that if the providers are rewarded by a payment mechanism relying on a certain work indicator, then there is an incentive for them to concentrate their service provision on this indicator alone. The most frequently used payment mechanisms are reported first, in their "pure" form , secondly, as the incentive structure concerning the suppliers behaviour towards the amount of services provided (number of patients and items) and the gross indicators of the "intensity" of care provided. Finally, as these payment mechanisms are a very important method of regulation and a common element in the patient/payer/ provider relationship, and because of their influence on total expenses of the systems and financial viability of health care, we suggest that this field of research be developed. | ||
| 1 | Group | Epidemiology |
| Title | Normative, perceived oral health and consumer satisfaction among adult | |
| Author(s) | A Borutta*, A Je and M Brocker. Department of Preventive Dentistry, Friedrich-Schiller-University of Jena, Germany | |
| A sub-objective of a cross-sectional study (1995) was to examine the influence of political changes in Eastern Germany on changes in socio-environmental characteristics, oral health care system and behavioural practices in relation to objective and perceived oral health, and consumer satisfaction among adults. The methodology of the ICS-II was applied. A random sample of 1000 subjects in Thuringia, a new Federal State in Germany, was selected. All subjects had to fill in a questionnaire and to undergo a clinical examination. The oral health status parameters used were caries status (DMFT), periodontal status (CPITN) and prosthetic status (bridges, dentures). The adults had on average 24.6 teeth. Caries prevalence was moderate (16.1 DMFT). Regarding the periodontal status, the majority of subjects had shallow pockets (50.6%). The percentages of those wearing bridges was 14%. Very few adults had full dentures. Overall, the adults rated their general health better than their oral health. 85.7% of subjects perceived their general health as "better than OK", whilst only 52.3% of individuals indicated this level for their oral health. Most symptoms were related to gum problems (23%) compared to tooth problems (10%). The levels of satisfaction with the oral health care system were extremely high in terms of the quality of care (99%) and of the quality and modernity of the equipment (99%). It can be concluded that the changes in socio-environmental factors did not show any negative effect on the three outcomes, which revealed an acceptable oral health and a high consumer satisfaction. | ||
| 2 | Group | Epidemiology |
| Title | Dental health in two groups of working communities in Kazakhstan | |
| Author(s) | E Mossessyants* and L Zazulevskaya. Republican Scientific and Research Centre Stomatology, Kazakhstan | |
| Concern has been expressed of possible environmental influences on both general and dental health. The aim of this epidemiological study was to compare the dental health of two groups of adults in a working community in Kazakhstan. The methodology followed that described by WHO in Basic Methods of Oral Health Surveys and involved the examination of a group (n=301) of adults working entirely in chemical production facilities and of a adults control group (n=511), working in a neighbouring community without contact with chemical production. Both groups had lived and worked in the community for an average of 10–15 years. In both communities, filled teeth were the lowest component of the DMFT score. The highest F-component was 1.9. The mean DMFT ranged from 5.0 to 13.3. Many teeth were found extracted. Workers in the chemicals producing factories had lower mean DMFT values. The mean DMFT of 35–44-year-olds in the chemicals producing factories comprised of 1.9 DT, 5.3 MT and 0.8 FT compared to the non-chemical group with 2.2 DT, 7.2 MT and 1.0 FT. The majority of adults working in chemical production factories had lower levels of caries experience than their age-mates working in general production. This finding may be related to the greater availability and need to follow higher general hygiene and preventive measures by those working in chemical factories. | ||
| 3 | Group | Epidemiology |
| Title | A comparative study of the dental health of children living in a highly industrialised region and a neighbouring village community in Kazakhstan | |
| Author(s) | G Nurasheva. Republican Scientific Research Centre Stomatology, Kazakhstan | |
| It is well documented that living in highly industrialised regions with excessive levels of environmental pollutants can have harmful effects on human health. This situation often exists in regions of gas and oil exploration but their effects may be compounded by deprivation. The aim of this study was to compare the dental health of children aged 2 to 15 years living in the region of the Karashaganac gas field with same aged children living in a village community 45 km away from the gas field. WHO criteria were used and 997 children were examined in the industrial area and 728 in the village community. Caries was experienced by 77% of all children with 81% affected in the industrial area and 73% in the village. The mean DMFT score was 3.6 and 2.9, respectively. Poor oral hygiene was a common feature for most children. Periodontal disease was recorded in 49% of children in the industrial area and 47% in the village children. It was clear that deprivation, poor living conditions and poor oral hygiene of the children living in the gas field contributed to poorer levels of dental health. Conclusion: a programme of preventive measures is needed for children in both areas with a greater effort needed in the more deprived industrial community. | ||
| 4 | Group | Epidemiology |
| Title | Relationship among socio-economic determinants, habits and malocclusion in pre-school children in Bauro, Brazil | |
| Author(s) | N Tomita, A Sheiham, V T Bijella and L J Franco. School of Dentistry of Bauru-USP, University College London, Paulista School of Medicine-UNIFESP | |
| In order to evaluate how particular social determinants affect occlusion in pre-school children, this cross-sectional study was developed in three steps: occlusion assessment, anthropometric measures and socio-economic questionnaire. The survey was carried out from October 1994 to December 1995. A random sample of 2139 children aged 3–5 years old was selected. The children were enrolled from private or state institutions in the Municipal District of Bauru-SP, Brazil. The occlusal anatomic-functional characteristics assessment was realised according to ANGLE classification. A sub-sample of 618 children responded the socio-economic questionnaire. The prevalence of malocclusion and some variables of exposition were tested by bivariate analysis (Chi-square). The prevalence of malocclusion was 51.3 % for the male group and 56.9 % for the female group. There were no differences related to ethnical group or type of educational institution. In relation to age, a higher prevalence of malocclusion was present in the three year old group, decreasing significantly with age (P<0.05). Among the environmental factors evaluated, the dummy- sucking habit was the most important in the association with malocclusion. Some social determinants, like mother's employment and parents' job, were related to oral habits that were strongly associated with malocclusion. These findings point to the importance of developing a longitudinal study in order to confirm how socio-economic status can influence the process of growth and development of the child. | ||
| 5 | Group | Epidemiology |
| Title | Oral health among 6-to 12-year-old schoolchildren in the El Bierzo district | |
| Author(s) | M Esteban Quiros* and L Mallo Pèrez. C/Monasterio de Carracedo 3, 1111, 2440 Ponferrada, Spain | |
| A cross-section epidemiological study was carried out on children of ages 6 to 12 year in the El Bierzo Health District (Spain). The number of subjects examined was 8143. Each child was given a complete oral examination, with particular attention to caries, periodontal condition and oral habits. We followed the WHO criteria and used the WHO card. The prevalence of caries ranged from 46.9% at six to 61.6% at 12 years. The DFMT index ranged from 0.06 in children of 6 years to 1.1 in those of 12. Most of the children were in need of minimal periodontal treatment (TN1). The absence of any need for treatment (TN0) was lowest at 8 years (1.9%) and highest at 6 years (11.4%). Type-2 needs ranged from 20.2% at 6 years up to 39.2% at 12. Most of the children consumed refined carbohydrates. The percentages of children who brushed their teeth more than once a day ranged from 40.4% at age of 6 to 46.1% at age of 12 years. | ||
| 6 | Group | Epidemiology |
| Title | Oral health status among 21-year-old recruits | |
| Author(s) | M Boss*, A Barbato, A M Onali, G Campus and G Falcolini. University of Sassari, Italy | |
| The objective of this investigation was to collect clinical data for monitoring oral diseases (caries, periodontal and malocclusion) in recruits of a naval base in Italy (La Maddalena). 1001 subjects (mean age 21.1 years) were examined using the DMFT, CPTIN and IOTN index according to WHO instructions by calibrated examiners. The mean DMFT was 4.6±3.8. 35.6% of the recruits had a healthy gingival status, bleeding/visible plaque and calculus was observed in 64.25 of the recruits and 0,2% had one or more pockets with a depth of more than 4 mm. The IOTN score 'no or minor' need of orthodontic treatment (grade 1 and 2) was 46.4%, 'borderline' need (grade 3) was observed in 28.5% of the recruits, 'definite' need (grade 4 and 5) was scored in 24.0% of the sample. The study showed a low level of dental decay and periodontal diseases and a medium level of treatment need for orthodontic practice in young recruits. | ||
| 7 | Group | Epidemiology |
| Title | Oral hygiene habits in a university population at the University of the Basque Country, UPV/EHU | |
| Author(s) | L A Cerecedo, E Diez, I Tabernero and J Rodriguez. Urbanizacion J M Herrera, Mioo, Cantabria, Spain | |
| The purpose of this study was to determine the level of oral hygiene in university students aged 20 to 23 years. A survey was carried out on a group of 200 university students registered for the 3rd year of studies on different degree programmes in the current academic year (1997–1998). The data gathered were processed with the statistical program SPSS and database V. The research questions were answered as follows: (a) it is important to brush the teeth, answered yes by 81.3–84.4%, 62.5–95.5% and 71.4–93.9% of the students in dentistry, medicine and biology respectively; (b) 'brushing 3 times per day' answered yes by students in dentistry (68.7–72.1%), medicine (37.5–61.4%), biology (57.1–69.7%); (c) 'toothbrush changed every 3–6 months', yes answered by students in dentistry (50.0–55.8%), medicine (18.8–56.8%), biology (28.0–48.5%); (d) 'refined sugars are the main cause of tooth and gum disease', yes answered by students in dentistry (56.3–65.1%), medicine (62.5–79.5%), biology (57.1–84.8%). Independently of the degree course taken, students considered it important to brush the teeth, male students in medicine being the least concerned. In most cases they believed in brushing three times a day, except for male students in medicine, who brushed less frequently. Students in medicine and biology considered refined sugars to be the main cause of tooth and gum disease, while dental students also blamed acid foodstuffs. In the population studied, female students took more care and exhibited better oral hygiene. | ||
| 8 | Group | Epidemiology |
| Title | Prevalence of dental caries in schoolchildren of ages 6–10 years in the geographic area of Rosas (Gerona) | |
| Author(s) | C Climent Vallejo. ICS-ABS Roses – Odontology Service, Girona, Spain | |
| The aim of this study was to establish the prevalence of dental caries in schoolchildren aged 6–12 years in the Rosas area (Gerona), to compare these with the prevalence data of children from other areas of Catalonia, and to determine the influence of the immigrant population on the dental caries index. The study involved all 6-to 12-year-old children receiving check-ups in the academic year 1996–1997 and attending schools in the municipalities of Rosas, Castello d'Empuries, Cadaques, Pau, or Palau Saverdera. 42.7% and 70.5% of the 6- and 12-year-old children had dental caries. The percentage of caries amongst 6-year olds was 39.5% (Spain), 56.3% (Magreb countries) and 68.8 (rest of Europe). Amongst 12-year olds, caries prevalence was 67.3 (Spain), 09% (both Magreb and non-Spain European countries). The current data showed a higher percentage of 6- and 12-year-old children with dental caries compared to children from other areas of Catalonia. Children from the Magreb and European countries had the highest percentages of non caries free children. | ||
| 9 | Group | Epidemiology |
| Title | Can the phone method be used for oral health surveys in England? | |
| Author(s) | R C Craven* and A S Blinkhorn. Oral Health and Development Group, University of Manchester, England, UK | |
| The aim of this study was to compare the mail and phone methods in a survey of the subjective oral health of adults. A well established questionnaire for measuring subjective oral health (SOHSI – Subjective Oral Health Status Indicators) was administered to 784 subjects randomly selected from the adult population of Stockport, in North West England. Sixty seven of them received both methods within a 4 week period. Twenty respondents took part in the mail survey first, the remainder did the phone interview first. Logistic regression was applied to control for other differences between the groups. In the cross-over study there was an interaction for three scales between the methods and the order in which they were used. However these three scales showed a strong association, suggestive of a method effect, between the mail survey method and more reports of pain and worry about the dentition. A systematic bias was shown in two further scales: reports of problems with chewing were more likely by phone and problems with social relations by the mail method. The two methods of administration give different results and cannot be used interchangeably. The instrument was developed as a self-administered questionnaire and this study was its first documented use with a phone methodology. These results suggest that such use cannot be recommended until its performance is better understood. | ||
| 10 | Group | Epidemiology |
| Title | Dental health and treatment needs of 7- and 12-year-old Polish children from the Gdansk region | |
| Author(s) | K Emerich-Poplatek* and B Adamowicz-Klepalska. Department of Pedodontics Medical University of Gdansk, Gdansk, Poland | |
| Epidemiological dental examinations carried out in Poland in collaboration with the WHO have resulted in representative data on dental caries in permanent teeth of 7 and 12-years-old from the Gdansk region. In 1987 and 1995, 360 and 365 children in urban and rural areas were examined. Amongst 7-year olds, the data showed an increase in DMFT from 0.73 to 0.84 between 1987 and 1995. The mean DMFT score of 12-year olds was 4.1 in 1987 and 4.4 in 1995. Between 1987 and 1995 the D-component in 12-year-old children from urban areas increased significantly. In both years the M-component was low in children of urban and rural areas. The mean number of DMFT was significantly higher in girls than in boys in both age groups. In 1995, 23.9% and 12.8% of the teeth in 7- and 12-year olds, respectively needed dental treatment. These percentages were substantially higher than in 1987. | ||
| 11 | Group | Epidemiology |
| Title | Prevalence of dental caries in Italy – A survey co-ordinated by the Working Group of Preventive Dentistry of SIOI. | |
| Author(s) | G. Falcolini, G.A. Favero, *R. Ferro, C. Ghirlanda, F. Olivi, L. Stohmenger, G. Saran, M. Ggagliani. (Italian Society of Pediatric Dentistry). | |
| Historically Italy has had no epidemiological data on a national basis about the severity of dental disease. Within the Italian Society for Pediatric Dentistry (SIOI) a working group was created to carry out the first epidemiological survey on the prevalence of caries in collaboration with the WHO Collaborating Centre for Prevention and oral Epidemiology in Milan. Method In 1994–95, 12 year old children were randomly selected attending private and public schools throughout the Italian regions. They were examined in a dental chair inside a mobile dental van. Data were collected according to the WHO oral health assessment form by 20 trained and calibrated dentists as in a national pathfinder survey. Results Data was collected from 10 of the 20 Italian regions. However, beaurocratic problems excluded the collection of data from the Southern regions of Italy. In total 5,064 children were examined, 2,679 boys and 2,385 girls. Mean DMFT was 2.12 and 36.5% were caries free. The mean number of sealants was 0.44. Discussion: The prevalence of dental caries in Italy is similar to most European countries (as shown in the 1995 ORCA Symposium) even though the lowest values were found in the Northern European countries. Data collected in the Veneto region over the last 20 years show a declining trend in caries from a mean DMFT of 4.4 in the early 80s to 2.2 in 1994. This is similar to the trend in other Southern European countries for example, Spain and France. These data suggest that the decline in caries occurred later than in the North. This difference may depend on the different dental health care delivery systems (public v. private). However, nowadays caries levels are similar in both regions, despite the different systems. | ||
| 12 | Group | Epidemiology |
| Title | Dental caries prevalence in relation to socio-economic status of nursery school children in Goiania-GO, Brazil | |
| Author(s) | M Freire*, R Barbosa Melo, R and S Almeida e Silva. Faculty of Dentistry, Federal University of Goias, Brazil | |
| The study was carried out to assess dental caries experience in the primary dentition of pre-school children in Goiania-GO, Brazil, and to assess the influence of socio-economic status. The study population comprised 0–6 year old pre-school children (n=2267) attending public (low SES children) and private (higher SES children) nursery schools. Mean dmft and percent caries free were 0.1 (96.4%) at 1 year and younger, 0.4 (87.3%) at 2 years, 1.1 (69.9%) at 3 years, 2.2 (49.5%) at 4 years, 3.1 (36.1%) at 5 years and 3.9 (29.4%) at the age of 6 years, respectively. Caries prevalence was higher in those attending public nursery schools than in those attending private schools (P<0.05). Amongst children from public nursery schools the highest dmf component was untreated decay while in private nurseries it was filled teeth. The results indicate that social inequalities exist which influences dental caries experience. It was concluded that oral health programmes for pre-school children, emphasising preventive measures and dental health education, should be developed mainly in areas of social deprivation. | ||
| 13 | Group | Epidemiology |
| Title | A comparison of two descriptive indices used for measuring enamel opacities | |
| Author(s) | S Y L Kwan* and S A Williams. Community Dental Health, Leeds Dental Institute, University of Leeds, Leeds, UK | |
| The use of different indices complicates historical and concurrent comparisons between studies of dental enamel opacities. The recent introduction of the DDE Index leaves limited opportunities for comparison over time (Holloway and Ellwood, Comm Dent Health 1997; 14:148–155). This study explores to what extent the components of two descriptive indices, DDE and Al-Alousi, are equivalent. 759 12-year-old children resident in North Yorkshire were dentally examined by a trained and calibrated examiner, firstly using the Al-Alousi Index and later, under double blind conditions, the DDE Index. Data of labial surfaces of upper incisors were used for comparison. For Al-Alousi Index, the prevalence was 33% compared with 35% according to the DDE index, with a Kappa score 0.93. When DDE and Al-Alousi were cross-tabulated: of 214 demarcated defects, 64% were Type A, 26% Type B & 2% Type E. Corresponding values for 315 diffuse lesions were, 26% A, 27% B & 38% E. Further investigation examined symmetry of defects on upper central incisors, where both teeth were affected by the same type of defect. More diffuse than demarcated defects were symmetrical. Thus 61 pairs of diffuse defects produced 33 pairs type E, and 34 pairs of type E yielded 33 diffuse defects. It is concluded that there is close agreement for prevalence data for upper incisors between the two indices. However, while Type A corresponds more often to demarcated defects and Type E to diffuse, Type B is more difficult to categorise. Thus there appears to be no clear cut way of transposing the data sets beyond standardising for prevalence values. Funded by the Yorkshire Regional Health Authority, UK. | ||
| 14 | Group | Epidemiology |
| Title | Possible risk indicators of periodontitis using CPITN in an Saxonian population | |
| Author(s) | A Lehman*, M Walter and T H Hoffman. Medical Faculty of TU Dresden, Departments of Prosthodontics and Periodontology, Germany | |
| The aim was to study the periodontal status as well as possible risk indicators for periodontitis in a Saxonian (Germany) population. 714 subjects from all age groups were randomly, non stratified, included in the study. Questionnaires included age, gender, oral hygiene habits and significance of tooth-brushing, number of dental visits/year, education, as well as social status. All clinical parameters, probing pocket depth (PD), plaque accumulation (OHI) and bleeding on probing (BOP) were recorded on a partial mouth basis and documented according to CPITN. Additional missing teeth were documented. For each age group, we calculated CPITN-index, as well as the mean value of each parameter. Correlation significance was determined using Spearman-Rho correlation analysis. The results showed that with increasing age, there was a corresponding increase in the number of teeth missing, an increase in the number of deep pockets as well as an increase of average pocket depth. A three-fold increase in the number of deep pockets was observed in the 35–44 years age group; this was followed by an increase in the number of missing teeth in the 45–54 years age group. Significant correlations (P<0.01) were observed between increasing CPITN and increasing OHI (plaque as well as calculus) only. A weak correlation between education and CPITN was found in the age group of 15–24 years. All other data obtained by questionnaire had no influence on periodontal health. It is concluded that, in this Saxonian population, dental plaque and calculus are possible risk indicators for periodontal disease. Further studies using additional parameters (microbiologic and biochemical) are necessary to identify additional risk indicators and to clarify which of these are true risk factors for this population. | ||
| 15 | Group | Epidemiology |
| Title | Periodontal status of army-recruits in Tenerife | |
| Author(s) | G Gomez-Santos*, N Garcìa-Herranz, M Lopez-Bermejo and P Martìn-Santiago. Institution of General Directorate of Health, Canary Islands Health Service, Spain | |
| The purpose of this study was to assess the periodontal status of army recruits, as well as to determine the treatment needs. The field work was carried out in October and November of 1995. The sample consisted of 290 young people aged 18 and 19 years. The assessment of the periodontal status was carried out by one single investigator, using the extra-light periodontal probe designed by the WHO for measuring the CPITN index and following the diagnostic criteria described in the manual Oral Health Surveys, 1987. A healthy periodontium was observed in 21.1% of those examined. 10% displayed bleeding on probing. Plaque, whether or not accompanied by bleeding, was seen in 44.4% of those examined. 24.1% displayed 4–5mm pockets, while 0.3% had pockets exceeding 5mm. The mean number of sextants healthy was 2.87, with bleeding was 0.98, with plaque was 1.14, with 4–5mm pockets was 0.48, and with pockets of depth greater than 5 mm was 0.003. The results show the importance for awareness of good oral hygiene amongst army-recruits and the need for military institutions to facilitate this. | ||
| 16 | Group | Epidemiology |
| Title | Oral status of 6 and 12 year old Polish children and European oral health goals for the year 2000 | |
| Author(s) | P E Petersen(1) , M Wierzbicka(2), F Szatko(3), B Adamowicz(4),
M Salinger(2), K Rucinska(2), M Zawadzinski(2) (1)WHO Regional Office for Europe, Copenhagen (2)Dept. Conservative Dentistry, The Medical University of Warsaw (3)Dept. Hygiene Medical Academy of Lodz (4)Dept. Pedodontics Academy of Medicine Gdansk), Poland |
|
| With transformation of the health care system in Poland, the need for information on oral health status has increased. It was decided therefore to apply the Oral Status Euro programme, as a simple tool for collecting data. This system was designed to help monitor and evaluate oral health goals at various levels of oral health care organisation. The criteria for recording dental caries are consistent to those of the WHO of 922 6 year old and 1743 12 year olds from 9 districts were examined. Examinations were preceded by collected data. Reliability of clinical diagnosis of the dentist was ensured by comparing with scores obtained by a calibrated epidemiologist who examined 7% of children. An analysis of data obtained showed that 17% of 6 year olds (19% from towns, 15% from rural areas), and 11% of 12 year olds with (11.5% from towns, 10.1% from rural areas) were caries free. DMFT at age 12 ranged from 2.6–6.3, mean value 4.0 (mean 3.7 in towns, 4.2 in rural areas). Mean MT was 0.2. The percentage of 12 year olds with missing teeth reached 13%, ranging from 7.5 to 18.4%, depending on the district. Conclusion: With the oral status observed in 1997, WHO/EURO goals cannot be reached in Poland by the year 2000. National goals for oral health shall be formulated to aid the adjustment of policy and planning or oral health services in Poland. | ||
| 17 | Group | Epidemiology |
| Title | Maxillo-facial fractures in persons under sixteen years of age | |
| Author(s) | I Arteagoitia*, R Martin, L Barbier, P Cearra, S Landa and J Santamarìa. Department of Stomatology, University of the Basque Country, UPV/EHU; Hospital de Cruces, Hospital de Basurto, Servicio Vasco de Salud, Osakidetza, Spain | |
| Maxillo-facial fractures occur less frequent in children than in adults. In the Basque Country, there exist no data on the prevalence of maxillo-facial fractures. In order to determine the profile of the children diagnosed with maxillo-facial fractures, the etiological factors involved, their characteristics and treatment required, a retrospective and multi-centre descriptive study was carried out. The study was performed between 1991 and 1996 in the Cruces and Basurto hospitals. The sample included 246 fractures in 224 patients (average age 11.2 ± 3.3). The highest prevalence was found in boys (68.8%) and children living in cities (79.0%). The prevalence of maxillo-facial fractures was low in children younger than 6 years (6% of the total). Most fractures occurred in July. Falling down was the most frequent cause (44.6%) and the nasal isolated fracture (61.2%) was the most common location. In 182 patients (81.3%) there were associated lesions. Two hundred and four patients were surgically operated, of whom six exhibited immediate complications. | ||
| 18 | Group | Epidemiology |
| Title | Diagnostic validity study of approximal caries in 15- and 19-year-old individuals from an area with low caries prevalence | |
| Author(s) | L G Petersson*, H Andersson, K Magnusson K and P Herrstrom. Medical and Dental Health Centre, Halmstad, Sweden | |
| Low caries prevalence has recently been reported from the County of Holland. To confirm these results we aimed to test the validity of yearly reported epidemiological data by sampling 464 15-year-old and 431 19-year-old individuals from 5 different Public Dental Health Clinics (PDHC) situated in an area with natural optimal F concentration in the drinking water (Kungsbacka). Bitewing radiographs were analysed following the criteria by Grondahl (1979) including all approximal surfaces between the distal surfaces of the canine and the mesial surfaces of the 2nd molar, totally 28640 approximal surfaces. A comparison was made with yearly reported epidemiological data. The differences were tested using Students t-test. The results of the validity test showed that in 26% of the surfaces caries diagnosis could not be performed (overlapping orthodontic bands etc.). Among the 15-year-old children, the mean enamel caries score (DES) was significantly higher in the validity test, 2.7 vs. 2.1 (P<0.001). The mean score DFS-a was significantly lower (P<0.05) in the validity test (0.48 vs. 0.54). Among the 19-year-old subjects, there was a significantly higher mean score of DES recorded in the validity test (4.65 vs.3.88; P<0,005). It is concluded that the quality of bitewing radiographs should be improved and that epidemiological data often underestimate the "true" caries prevalence. | ||
| 19 | Group | Epidemiology |
| Title | Prevalence of developmental enamel defects in first permanent molars and incisors in children aged 5–9 years attending public and private schools | |
| Author(s) | S Martignon* and F Valbuena Luisa. Universidad El Bosque, Bogot, Colombia | |
| Defects in the development of enamel (DDE) predispose the patient to caries, tooth sensitivity, malocclusion, and poor appearance. In recent years, an increase in DDE has been observed at the private odontopaediatric level in the permanent teeth of schoolchildren of high economic status. There is no current information available on this phenomenon in the population of Colombia. The study was carried out to assess the prevalence of DDE in first permanent molars and incisors. 660 schoolchildren aged 5–9 years in public and private schools in the area of influence of the Universidad El Bosque, Santa Fe, Bogot, were examined. Defects were recorded with the modified DDE index. The prevalence of DDE was 74.5%; 55.5% in children attending private schools and 44.5% in children attending public schools. Diffuse hypermineralization was observed most (61.1%) which is related in the literature to the chronic ingestion of fluoride. The prevalence of white/cream localised hypomineralization was 33.2%. Hypoplasia was seen in only 0.7%. These data show high prevalence of DDE and confirm the initial clinical observation (greater prevalence of DDE in private schools). They further call for a specific determination of fluorosis in the population studied. | ||
| 20 | Group | Health Services |
| Title | Treatment needs of patients attending the Faculty of Medicine and Dentistry of the Basque Country University | |
| Author(s) | R M Granado, Y Fernandez*, L Aparicio, C Roncero and C Larrinaga. Vitoria, Alava, Spain | |
| The aim of the study was to determine the kind of treatment required by adults aged between 20 and 75 years, attending the dental clinics of the Faculty of Medicine and Dentistry of the Basque Country University (U.P.V./E.H.U.). Clinical files of 167 randomised chosen patients constituted the data base. Classification into age groups was as follows: 20–30 years, 31–40 years, 41–50 years, 51–60 years and 61–75 years. Treatment were categorized into: scaling, scaling and curettage and rootplaning, extraction, root canal treatment and prosthetic treatment. Scaling (64,4%) and extraction (55,5%) was mostly performed among 20- to 30-year olds. Prosthetic treatments were mostly performed in the 31–40-year age group (55,6%), followed by scaling, curettage and rootplaning. Crown and bridges (61,2%) and extractions (56,5%) was seen most among 41- to 50-year olds. Removable dentures and extractions were mostly performed among 61–75-year olds. It is concluded that periodontal treatments were needed most at younger ages and that the need for prosthetic treatments increased as one gets older. The need for tooth extraction was high in all age groups. | ||
| 21 | Group | Health Services |
| Title | Reasons for visiting dental clinics and treatment needs among young people | |
| Author(s) | A Lejarreta, O Basterretxea, M Martin*, N Suarez and J Zorroza. Durango, Vizcaya, Spain | |
| The aim of the study was to assess the treatment needs of young people that visited the dental clinics of the Medical and Dental School in the Basque Country University (U.P.V./E.H.U.), Spain. The sample consisted of 116 individuals below the age of 20 years. They were asked the main reason for visiting the dentist. Reasons included common treatments such as fillings, root canal treatment, extraction and periodontal, prosthetic and orthodontic treatment. The following results were obtained: the main reason for visiting the dentist were check ups (45.7%) and orthodontic consult (17.2%). 13.8% needed one filling, 21.5% a root canal treatment, 26.7% extraction, 60.3% scaling. A crown, bridge and orthodontic treatment were needed by 9.5, 2.6 and 18.9%, respectively. In conclusion: the main reason for visiting the dentist is for a check up. Most of the young people studied required scaling. The high need for extraction and root canal treatment indicate poor oral health in the group. | ||
| 22 | Group | Health Services |
| Title | Type of treatment provided in first permanent molars | |
| Author(s) | C Magunagoicoechea, E Etxeberria, J Vivar*, J Lavin, J and T Rivas. Colegio Mayor Deusto, Bilbao, Vizcaya, Spain | |
| The study aimed to assess treatments provided in first permanent molars. The study sample contained 385 individuals (47.5% men, 52.5% women) aged 6 to 79 years, who attended the dental clinics of the Medical and Dental School in the Basque Country University (U.P.V./E.H.U.). The treatment possibilities considered included fillings, root canal treatments and extraction. The most frequent treatment provided were fillings (48%), followed by extractions (45%) and root canal treatments (7%). Fillings were seen most among 10- to 19-year olds (78%), whilst extraction was the most common treatment provided amongst 70- to 79-year olds (88%). Root canal treatment was done in 15% of 10- to 19-year olds. There were no differences observed for the four quadrants. The most common type of treatment was related to the age of the individual with fillings seen in the younger and extraction in the older age groups. | ||
| 23 | Group | Health Services |
| Title | Reasons for consulting the Maxillofacial Surgery Department of the Santo Hospital Civil in Basurto (Spain) | |
| Author(s) | I Argote, A C Femandez, R Gutierrez, A Matia*, Y Oraindi and S Landa. Galdakao, Vizcaya, Spain | |
| The aim of the study was to determine the most common reasons for consulting the Maxillofacial Surgery Department of the Santo Hospital Civil in Basurto (Bilbao, Spain) and to establish a profile of patients visiting the department. The sample consisted of 113 patients (44,2% men, 55,8% women). They visited the department for the first time and were between 10 to 78 years. The majority of the patients were 21 to 30 years. Reasons for consulting the department were pathology in relation to third molar eruption (38%), mandible temporal joint problems (16.8%), ulcer of the tongue (4.4%) and white lesions of the tongue, lithiasic submaxillitis and cysts in the mandible (3.5, 3.5 and 1.7%, respectively). With regard to the profile of the patient, it is suggested that it concerns mainly women, between 11 to 30 years old, without superior studies that have impacted third molars. | ||
| 24 | Group | Health Services |
| Title | Developing a strategic framework for the development of specialised Head and Neck Cancer Services in 5 Health Authorities | |
| Author(s) | D Richards*1 and D Thomas2. 1Berkshire and Northamptonshire Health Authorities, 2Buckinghamshire and Oxfordshire Health Authorities, England, UK | |
| Survival rates for most head and neck cancers have improved little over the past 40 years. Following a Government report on Cancer Services a review of Head and Neck Cancer Services was undertaken. The remit of this review group led by Dental Public Health was to develop a strategic framework for the development of services in 5 health authorities. Data for the period 1995–7 across the 5 health authorities for 16 different Head and Neck disease sites was compared. 11 hospitals in the 5 authorities wished to continue treating head and neck cancer patients. Each site was visited by members of the Head and Neck Review Group who compared the sites against standards proposed by the British Association of Head and Neck Oncologists (BAHNOC). Following data collection a report compiled by the Review Group was discussed with a panel of national experts. In all, 414 patients were treated by 178 consultants at 40 different hospitals. Only 18 consultants were involved with more than 20 episodes of care, with 101 involved in only a single episode of care. No single site complied with all the BAHNOC standards. As a result of this it was recommended that all major treatment provision be ultimately carried out at 3 sites, that multi-disciplinary functional teams and clinical leads should be established and a process for designating clinical leads should be developed. These teams should also develop clear guidelines and undertake regular audit. | ||
| 25 | Group | Health Services |
| Title | The changing profile of patients using the Community Dental Service in Leeds, UK | |
| Author(s) | M J Prendergast(1)*, J F Beal(1) and J R Clayton(2) (1)Leeds Health Authority (2)Leeds Community and Mental Health Services Trust, Leeds, England, UK |
|
| The role and functions of the Community Dental Service (CDS) in the UK have been changed in recent years. The emphasis for patient care provision should be towards those groups unable to obtain, or unwilling to seek care form general dental practitioners. This study investigated the socio-demographic profile of CDS patients in 1996/97 and determined any changes since 1991/92. Information from routinely collected patient care activity data was used to construct a profile of patients using the service for at least one course of treatment in each year. Using their postcodes, individuals were allocated to an area deprivation quintile according to the Townsend Score of their district of residence. The CDS was used by 8021 patients in 1996/97 compared with 9372 in 1991/92. The age profile of patients changed over the period with a reduction in the proportion aged 5–15 years from 75% to 65% and an increase in the 16–64 year olds from 13% to 19%. Almost one quarter (24%) of children under 16 years old seen in 1996/97 were of South Asian ethnic origin, a much higher proportion than the 6% reported for Leeds in the 1991 census. Two thirds of the patients in 1996/97 were from districts in the two most deprived quintiles, a small but significant increase in comparison with the 60% seen previously (P<0,001). The proportion of patients with special needs increased from 19% to 29% (P<0,001) over the 5 years of the study with the greatest increase being shown in 16–64 year olds. This study indicates that the CDS in Leeds is adopting its new role in the delivery of patient care to target groups. Profiling of patient care activity data is a useful tool for monitoring the progress of these changes. | ||
| 26 | Group | Health Services |
| Title | Can glass ionomer sealants be economical? | |
| Author(s) | S Kervanto-Seppala1*, E Lavonius1, I Pietila2 and E Kerosuo2. 1Institute of Dentistry, University of Helsinki, Helsinki and 2Health Centre, Municipal of Varkaus, Varkaus, Finland | |
| Glass ionomer (GI) applied as a pit and fissure sealant has been shown to be a promising method in caries prevention but not superior on the community level when compared to the resin based (RB) material. The purpose of this study was to evaluate the factors influencing the time used to apply a sealant, and thus the cost-effectiveness of the RB and GI sealants supposing they share an equal caries preventing effect. Children born between 1980 and 1983 were examined and the appropriate second molars sealed in 1993–6. The sealant material was either RB (Delton) or GI (Fuji III). The present study was based on a sub-sample where 131 teeth were sealed, 79 with RB and 52 with GI. The whole procedure of applying a sealant, beginning from the cleaning of the tooth to a finished sealant, took 332 (± 64) seconds(s) with RB and 578 (±99) s with GI (P<0.001). There was no statistically significant difference in the time requested between the types of sealants made in the upper (409 ± 151 s) jaw. It took the dentists significantly (P<0.01) less time (351 ± 118 s) compared to the hygienists (446 ± 145 s). This is explained by the fact that the dental hygienists work alone and the dentists with a dental nurse. In an earlier retrospective study (unpublished) the need for resealing a second molar due to a completely or partly lost resin sealant was found to be 31.2%. Considered the resealing is done only to teeth previously sealed with RB and no GI sealants are resealed, RB still remains more cost-effective sealant material than GI, when the effectiveness is evaluated according to the time requested. | ||
| 27 | Group | Health Services |
| Title | Changes in the socio-professional status of dentists in Bulgaria | |
| Author(s) | L Katrova. Faculty of Stomatology, Department of Public Health, Sofia, Bulgaria | |
| The aim of this study was to determine the influence of the revolutionary social changes in Bulgaria (1989–1997) on the socio-professional identification of dentists. A sociological survey was conducted involving 842 dentists from the total of 1707 working in Sofia. The majority worked in the salaried public sector (42%) with 30% working in mixed settings: public service and private practice and 28% were entirely in private practice. The questionnaires were completed by 86% of the dentists enrolled. It obtained information on the structure of the oral health service, the status of dentists, their mobility and attitudes towards the current state of dental education and service. Almost all dentists had started their career as salaried dentists. 43% of them had left the public sector after the Changes. Now more than 50% are working under private contracts. Although more than 70% of dentists are female with an average age of less than 40 years, the private sector was characterised by younger aged males and older-aged females. Private practitioners showed higher levels of satisfaction with their profession (97%) compared to salaried dentists (80%). The majority valued the quality of undergraduate dental education (74%) but only 25% considered postgraduate education and vocational training to be very good. In conclusion, after the Changes the dental profession in Bulgaria tends to follow a pluristic model of practice based on autonomous development. The impact of these significant socio-professional changes on dental health and access to care for the population will need to be carefully monitored in the future. | ||
| 28 | Group | Health Services |
| Title | Demand for oral health related drugs in pharmacies on night duty | |
| Author(s) | M C Balanzategui*, A Rubalcaba, A Apellaniz and F J Goiriena. Department of Stomatology, Faculty of Medicine and Dentistry, University of the Basque Country, UPV/EHU, Spain | |
| A study was carried out to determine the demand for oral drugs in pharmacies on night duty, the reason for asking drugs to and the specific drug dispensed. The data regarding dispensing (medicament, pharmacological principle, and type of prescription) were collected in pharmacies on night duty (22:00–09:00) in Bilbao. In addition, the pharmacist on duty recorded the gender and age of the patient, and the particular disease. Results indicated that 3% of the medicines were related to oral diseases. Of these, 90% were given to men and 10% to women in the age 24 to 44 years. The reason for seeing the pharmacist was infection and dental pain. The drugs requested were antibiotics and analgesics. Among the former, the most handed out was Espiramicina (65%), and among the analgesics, Ibuprofen (40%). 68% of the dispensations were realised following pharmaceutical advice, while the rest were self-medication. Medical or dental prescription were not seen. It may therefore be concluded that emergency oral care place excessive demand on pharmaceutical emergency services. | ||
| 29 | Group | Health Services |
| Title | An investigation into the treatment of cleft lip and/or palate in Kent, England | |
| Author(s) | C Allen*, V Harrison and D E Gibbons. West Kent Health Authority and UMDS Guy's Hospital Dental School, England, UK | |
| A recent report by the Clinical Standards Advisory Group (CSAG 1998) suggested that there are too many centres in the UK offering cleft lip and palate services, which appear to result in poor clinical outcomes. Shaw (1996) recommends 30 new cases per operator per year as a minimum involvement for primary surgery. The aim of this study was to investigate the number of cleft lip and/or palate cases being treated in the Kent population (approx. 20,000 live births with an expected 30 cases per annum), where this treatment was taking place, by which operators and in what speciality. Cleft treatments were identified using operation codes and patient identifier. Two data sets were analysed for the three year period April 1993 to March 1996. One for children born in the survey period who would require a primary lip repair and a second for patients born before 1993 who would require revision operations or bone grafts. For the primary repair group, 67 cases were treated by five operators in 5 centres. Of these, 56 (86%) were treated in the same hospital by the same plastic surgeon. Only two (3%) were treated by an orolmaxillofacial surgeon. For the later treatment group, 191 cases were treated by 15 operators in 8 centres. The majority 135 (71%) were in the same hospital, 81 (60%) by the same plastic surgeon, 40 (30%) by four orolmaxillofacial surgeons and 14 (10%) an ENT surgeon. Conclusions From this study it can be seen that none of the operators met the suggested minimum criteria. There were no dedicated cleft lip and/or palate teams. The recording of information was poor, thus data were difficult to analyse. | ||
| 30 | Group | Health Services |
| Title | Frequency and reason for referral for dental impactions, excluding third molars, in order to plan a hospital-based service | |
| Author(s) | F Villar*, I Martín, G Santamaría, I Arteagoitia, P Cearra, J Gil, J Santamaría and S Landa. Department of Stomatology, University of the Basque Country, UPV/EHU; Hospital de Cruces, Hospital de Basurto, Spain | |
| Introduction Teeth failing to erupt and anomalies in number make up two of the most frequent pathologies in the area of stomatology. However, their study, excluding tertiary molars appears to be little considered since there are few reports in the bibliography. In order to plan the need for a hospital-based service to meet any referral requests, we carried out a retrospective, descriptive study on a randomised sample of 251 patients with these pathologies, who were diagnosed and treated in the Cruces and Basurto hospitals over the period 1987–1998. Aims To describe the relative frequency of the various dental inclusions, the reasons for visiting the dentist, their correlation with the tooth affected, the prevalence with respect to sex, and the jaw in question. Results 51% of the patients were women, and 49% men. The age mode was in the fourth decade of life. Maximum incidence was in the upper jaw (89%) and for the upper canine (52%). Of those of the lower jaw, the canine was again the most common tooth retained accounting for 5% of total retentions. The main reasons for a visit were absence of the tooth (44%) and a chance X-ray finding. The most frequent positions for the impaction was a mesoangular inclination (58%) and a palatine location (80%). The prevalence of mesiodens was 3%, distomolars 0.45%, upper canine 7%, and lower canine 0.7. Retention of a mesiodens is most frequent in men, while retention of the canines is more frequent in women. Reabsorption of adjacent teeth accounted for 3.2% of the cases. Conclusions The retention most often displayed, apart from third molars, is that of the upper canine. Cases of retention are most frequent in the upper jaw for all teeth except in lower premolars. An average of 2 to 3 patients each year have accessed this hospital service. | ||
| 31 | Group | Health Services |
| Title | The contribution of dental disorders to short term illness within a community of Bilbao (Osakidetza) over a twenty year period | |
| Author(s) | C Prado, P Cearra, M L De Orte, J A Cearra* and J Prado. University of the Basque Country, Spain | |
| Objective The aim of this study was to measure the contribution made by dental disorders to the incidence of temporary disability reported within a community of Bilbao health district. Method The database comprised clinical histories of the full range of patients attending the area's general medical practitioner with cases going off, going back on, or continuing. Results The area has 1831 persons, of whom 56% were working. Over 20 years, 1870 cases (94 per year) of temporary disability were identified. 52% of the patients were male. The majority were married and of middle age or more. The most common professions were business (14%) and health (8%). The annual average frequency of temporary illness was 11%, most often caused by infectious pathologies. The main causes of short term illness were viral infections (28%) and trauma (22%). Temporary disability caused by oral pathologies accounted for 2% of the total. The principal oral conditions were cellulitis (47%) and problems with wisdom teeth (25%). Conclusion: Dental ill health can impact on the ability to work and although a minor component it does affect the economic activity of a community. | ||
| 32 | Group | Health Services |
| Title | Dental extractions are the principal treatment provided by the public clinics of Bilbao (Oszkidetza) | |
| Author(s) | N Minguez, M L De Orte, A Blanco, P Cearra* and R Triana. University of the Basque Country, Spain | |
| Objective The purpose of this study was to consider the contribution that dental extractions make to the service provided by Osakidetza public clinic over a 10 year period (1990–1998). Method The medical attention sheets were delivered to the surgery, where we gathered the following data: time of the visit, number of patients, date, patient's personal particulars, teeth extracted, reason for the extraction, pharmacological treatment employed, complications, X-rays requested, consultation with other specialists and adverse reactions to medication. Results The results show over 98 months 17,116 surgical operations were carried out. This comprises 56% of the total service rendered in the surgery. The average number of patients seen per day was 26, each for a period of 6.2 minutes. There were 25,580 teeth extracted. The reason for extraction was caries or mobility. Conclusion: Extractions account for 56% of the cases handled at the community centre. We would like to see a change in mentality, with a switch from surgical to preventive dentistry. | ||
| 33 | Group | Health Services |
| Title | Dental attendance among 20–25-year olds adults in Sweden | |
| Author(s) | P Stenberg. Lund University, Oral Diagnostics Department, Malmo, Sweden | |
| In Sweden, the aim of health policies has been to provide an equal distribution of dental services to all children and teenagers. Thus, dental care is annually offered free of charge until the 20th year of birth. Besides providing good clinical treatment, there has also been a strong ambition to inform children/adolescents and their parents about the aetiology of oral diseases and how to prevent its onset. The outcomes of dental health services are frequently measured by clinical parameters. But little is known about the behavioural and cognitive effe | ||
