Tooth-surface distribution of caries in Greek schoolchildren, using ICDAS-II index. A national pathfinder survey

AIM

The objective of this cross-sectional nationwide study was to assess the caries status of Greek children, in regard to the severity and the distribution pattern of the lesions in the primary and permanent dentition at a tooth-surface level, based on ICDAS-II criteria.

METHODS

Study Design: A national survey was conducted in 15 urban and 9 rural sites and about 50 subjects were examined at each location across the country. Caries data, based on ICDAS-II index, were recorded on 4,410 children aged 5, 12, and 15-years by 10 calibrated dentists. The rankings of the most affected tooth-surfaces, the most vulnerable teeth found cavitated, the right-left symmetry of caries stages and its pattern of distribution shown per jaw or dentition were determined by using descriptive statistics (SPSS v.20).

CONCLUSION

Caries lesions were quite frequent in this school aged child population and the most common code of ICDAS-II observed was that of incipient enamel caries, mainly on the occlusal surfaces, indicative of the need for fissure sealant application. For those surfaces with ICDAS-II=3-6, dental care and intensive prevention programmes, both at home and office based, are needed.

Tooth Wear in a Sample of Community-Dwelling Elderly Greeks

PURPOSE

Increased wear of teeth may constitute a major problem in the future for the elderly. The aim of the present study was to investigate tooth wear in a sample of elderly Greeks and explore the presence and extent of severe occlusal/incisal wear in relation to the parameters of age, gender and remaining teeth.

MATERIALS AND METHODS

A convenience sample of 70 dentate elderly (60-92 years old) was examined. Tooth wear was assessed using a modification of the tooth wear index. The presence of severe occlusal/incisal wear was explored using the multiple correspondence analysis (MCA) and x2 tests and the extent (% of surfaces) with analysis of variance (ANOVA).

RESULTS

Increased prevalence of severe wear was observed in the occlusal/incisal and, to a lesser extent, in the cervical surfaces of the examined teeth. Seventy per cent (70%) of the participants had at least one severely worn tooth surface. Advanced age seemed to be associated with severe occlusal/incisal wear (>70 years: 79.4%; 60-70 years: 52.8%; x2 test, p = 0.024). The mean (± SD) percentage of severely worn teeth and surfaces was 34.2 ± 32.6% and 9.6 ± 9.6%, respectively. ANOVA showed that males and those with less than 20 remaining teeth exhibited more severely worn occlusal/incisal surfaces (p = 0.031 and p = 0.000, respectively).

CONCLUSIONS

The presence and the extent of severe wear in the sample of the examined elderly is high compared to elderly populations in other countries. Severe wear was more prevalent with advanced age and more extensive in the occlusal/incisal surfaces in males and those having less than 20 remaining teeth.

Risk indicators of coronal and root caries in Greek middle aged adults and senior citizens

Background

Dental caries is the result of a complex interplay of multiple determinants which may change overtime. Therefore, periodic surveys of caries experience and redetermination of the risk indicators of the disease are needed. The aim of this study was to assess the prevalence and severity of coronal and root caries in Greeks aged 35-44 and 65-74-year-old in relation to socio-demographic parameters. Furthermore, trends in coronal caries experience of the 35-44-year-olds were investigated.

Methods

A sample of 1188 35-44-year-old and 1093 65-74-year-old individuals was selected in 2005 according to WHO guidelines for national pathfinder surveys. Caries was assessed in dentate subjects using the DMFT, DMFS, RDFS and RCI indices. Socio-demographic data were also collected. Univariate and multivariate regression analyses were performed to identify the effect of socio-demographic parameters.

Results

The mean DMFT and DMFS scores of the adults were 14.06 and 45.78 respectively, while those of the senior citizens were 20.63 and 89.82. Among the 35-44-year-ods, men and those having a higher educational attainment had significantly lower DMFS values (women OR = 1.679, CI: 1.243-2.267 and >12 years of education OR = 0.321, CI: 0.193-0.535 respectively), while educational level was the only predictor of DMFS in senior citizens (OR = 0.279, CI: 0.079-0.992). The mean DMFT score of the 35-44-year-olds has not improved since 1985, but there was a remarkable reduction in the number of DT related to a simultaneous increase in the number of FT. The mean RDFS rose from 0.39 in adults to 2.66 in senior citizens. The mean RDFS score of the middle aged adults was significantly correlated with education (OR = 0.346, CI: 0.180-0.664). The RCI was almost four times greater in seniors (9.73) than in adults (2.53). There were significant differences in caries experience between the surveyed regions. MS and RDS were the major components of the DMFS and RDFS indices respectively, in both age groups.

Conclusions

Caries experience in Greek adults is similar to what is observed in most industrialized countries. The mean DMFT score of the 35-44-year-olds has not improved since 1985, but a great improvement in restorative care has been observed. Senior citizens had a high percentage of untreated coronal and root surfaces. Region and education were the strongest predictors of caries experience. An increase in oral care utilization and effective prevention over the whole lifespan are needed to improve the dental health of the Greek adult population.

Tooth loss and oral rehabilitation in Greek middle-aged adults and senior citizens

PURPOSE

The aims of this study were to investigate the prevalence of tooth loss in Greek individuals aged 35 to 44 and 65 to 74 years in relation to sociodemographic parameters and to describe their prosthetic status and needs.

MATERIALS AND METHODS

A stratified cluster sample of 1,188 middle-aged adults and 1,093 senior citizens was selected according to World Health Organization (WHO) guidelines for national pathfinder surveys. Tooth loss and prosthetic status and needs were recorded according to WHO criteria. Sociodemographic data were collected through face-to-face interviews.

RESULTS

Complete edentulism affected 0.3% of individuals aged 35 to 44 years and 31.5% of those aged 65 to 74 years. Most middle-aged adults (92.1%) had ≥ 21 natural teeth, while the corresponding percentage for the senior citizens was 23.1%. The mean number of missing teeth was 5.2 in middle-aged adults and 21.6 in senior citizens. The multivariate analysis showed that education level was the only predictor of tooth loss in both age groups. Approximately 38% of those aged 35 to 44 years and 80% of those aged 65 to 74 years had dental prostheses, while 47.6% of middle-aged adults and 66.3% of senior citizens did not need any prosthetic treatment. The need for complete dentures was relatively low in both age groups. Comparisons of the present results with those of 1985 indicate that the dentate status of Greek adults aged 35 to 44 years has not improved. Furthermore, the prevalence of tooth loss in the elderly population was high compared with internationally reported findings.

CONCLUSION

The replacement of missing teeth with fixed or removable prostheses will continue to be common in Greece for the foreseeable future.

The early fluoride release pattern of an aged glass ionomer treated with fluoride

The aim of this study was to examine the pattern of early fluoride release from aged glass-ionomer cement after treatment with a 1,000 mg/L NaF solution using hourly and daily time point and to investigate whether surface profile affected release. Composite resin was used as a control. The aged glass-ionomer discs showed a 1.5 fold greater rate of fluoride release during 1st hour post-treatment, equivalent to the original fluoride release value of the newly mixed material. This rate of release dropped sharply to 3 fold greater than baseline during the 2nd hour Composite resin showed negligible levels of release. No significant differences were found between smooth and rough surfaced groups.

Caries prevalence of 11.5 year-olds between 1989 and 2001 in a province of North-Eastern Greece

OBJECTIVE & DESIGN

To compare cross-sectional caries prevalence data of 11.5 year old children over a 13 year period (1989-2001) and to evaluate the maximum effect of the applied preventive programme (sealants to 1st molars and 6-year health education) on DMFT values during the last five years.

PARTICIPANTS

Using the records of a Public Health Centre (PHC) in NE Greece, a number (153-250) of children aged 11.5-years were selected from each calendar year, constituting 11 study groups (totalling 2,217 children), stratified by area of residency.

METHOD

Annual oral health education sessions provided in 1990, a year after the PHC was established. Light-cured fissure sealants were systematically mass introduced in 1996. The same dentist completed all DMFT records in the dental clinic during the children's routine visits. DMFT was analysed using two Poisson and two Binomial models for both data from all years, and for the last five years. The models had as factors: "Time" (year of examination of the study group), "Residency" (semi urban, rural lowland, rural highland), number of "Sealed 1st molars" and "Sealed posterior teeth".

RESULTS

All the factors were highly statistically significant (p<0.001). Dental health was found to be good (DMFT=0), improving progressively year by year (range 12-50%). The mean DMFT decreased steadily from 4.5 (in 1989) to 1.81 (in 2001). The Significant Caries index was almost halved (from 8.08 to 4.23).

CONCLUSION

An important improvement in the caries status of 11.5 year-olds since 1989 has been demonstrated, irrespective of the residency. The systematic application of fissure sealants to all 1st molars, parallel to the cumulative effect of the 6-year health education programme per child, played a significant role in reducing disparities in disease prevalence, despite the difficulty of improving rates of decline when the caries levels are relatively low.

Transient oral microflora in Greeks attending day centres for the elderly and residents in homes for the elderly

OBJECTIVE

To examine the isolation frequency and the carriage of yeasts, Enterobacteriaceae, Staphylococcus and Enterococcus species in oral samples from elderly Greeks living alone or in institutions.

BACKGROUND

Ageing may promote changes in the oral ecosystem, which lead to colonisation of the mouth by microbes found less commonly or only transiently in younger subjects. Previous studies indicate a geographical variation in the isolation frequency of such bacteria in elderly populations.

MATERIALS AND METHODS

Medical and dental records were obtained from 66 attenders at elderly people's day centres (EPDC), and 82 residents of elderly people's homes (EPH), 66-95 years old. Mucosa smear samples were cultured on appropriate media for enumeration of the above species. Microbial identification was performed by conventional microbiological tests. The results were analysed using the Multiple Correspondence Analysis (MCA), ANOVA and other traditional statistical tests.

RESULTS

No statistically significant association was found between the place of residence and the wearing of dentures. The isolation frequencies of Staphylococcus aureus, Enterococcus and Enterobacteriaceae species were 21.6, 20.3 and 7.4% respectively. MCA, and further statistical analysis, revealed that the place of residence affected the isolation frequency of years (54.9% in EPH vs. 37.9% in EPDC). Moreover, ANOVA showed that living in EPH increased the carriage of yeasts.

CONCLUSIONS

Elderly Greeks exhibit a moderate to high oral carriage of transient bacteria compared with other elderly populations. Living in EPH seems to increase both the isolation frequency and carriage of yeasts.

Caries prevalence in 6-, 11- and 14-year-old children in the Cyclades Islands, Greece

Following the World Health Organization criteria, a total of 1,604 out of 3,225 children aged 6, 11 and 14 years living on the 20 islands of the Cyclades complex were examined. Recordings showed that in the 6-year-old children, the mean dmft index was 2.21 (SD=3.00) with 46% caries free. In the 11-year-old children, the DMFT averaged 1.39 (SD=1.78) with 46% caries free. In the 14-year-old children, the mean DMFT was 2.62 (SD=2.83) with 32% caries free. Statistically significant differences were found in the DMFT of the 11- and 14-year-old subjects living in naturally water fluoridated and non-fluoridated areas. According to these data, it appears that the first two WHO targets for the year 2000 are almost fulfilled.