Foreword

Little information exists about the loss of all one’s teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO’s) Study on global AGEing and adult health (SAGE) Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367), Ghana (N = 4724), India (N = 7150), Mexico (N = 2315), Russian Federation (N = 3938) and South Africa (N = 3840). Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%–21.7%) than China, Ghana, and South Africa (3.0%–9.0%). In multivariate logistic analysis sociodemographic factors (older age, lower education), chronic conditions (arthritis, asthma), health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption) and other health related variables (functional disability and low social cohesion) were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention

Survival Rates of Teeth with Primary Endodontic Treatment after Core/Post and Crown Placement

Introduction The objective of this study was to determine the effect of delayed placement of the core/post and crown on the outcomes of nonsurgical root canal therapy (NSRCT). Methods According to the Delta Dental of Wisconsin claims database, 160,040 NSRCTs were completed with a core/post and a crown placed before the end of the continuous coverage period or occurrence of an untoward event. Untoward events were defined as a retreatment, apicoectomy, or extraction as defined by the Code on Dental Procedures and Nomenclature. Statistical analysis was performed by using a multivariable Cox proportional hazards model. Results The survival rate from the time of crown placement to an untoward event was 99.1% at 1 year, 96.0% at 3 years, 92.3% at 5 years, and 83.8% at 10 years. Failure rates were greater when a core/post was placed more than 60 days after the NSRCT (adjusted hazard ratio, 1.08) and when the crown was placed more than 60 days after the core/post placement (adjusted hazard ratio, 1.14). Overall, the survival rates of NSRCT were greater when performed by an endodontist versus other providers. Conclusions On the basis of the information available from insurance claims data, this study shows that the long-term survival rates of initial endodontic therapy are adversely affected by the delayed placement of the final restoration and full coverage crown

Prosthetic Rehabilitation Following Lateral Resection of the Mandible with a Long Cantilever Implant-Supported Fixed Prosthesis: A 3-Year Clinical Report

This clinical report describes the prosthetic management of the surgical reconstruction of a patient after mandibular resection. Complete oral rehabilitation was achieved with a maxillary complete denture and a mandibular implant-supported fixed prosthesis with a custom titanium framework and a long unilateral cantilever

Dental amalgam fillings: An under-investigated source of mercury exposure

Dental amalgam fillings, which contain about 50% mercury, have been used since the early 19th century. However, their use has been controversial, particularly because they continually release small amounts of mercury. Inorganic mercury is known to be highly toxic, particularly to the nervous system and kidneys, but exposures from amalgam fillings are generally well below those established as toxic. However, uncertainties about threshold concentrations of effect and the nature of any long-term exposure effects remain. Considering the long-standing and widespread use of these fillings, there has been remarkably little investigation of their safety and most epidemiologic studies have been relatively recent. In general, investigations to date have shown little evidence of effects on general chronic disease incidence or mortality. There have been few studies so far of neurodegenerative diseases and results have been equivocal. Assessments of the safety of dental amalgam have mainly been based on studies of occupationally exposed populations. However, the amalgam-exposed population contains a broader, potentially more susceptible, spectrum of people. In that regard, a number of studies of children that have found no evidence of health effects have provided some reassurance

Social stratification and tooth loss among middle‐aged and older Americans from 1988 to 2004

Objectives Tooth retention has improved over the past few decades, but it is not known whether these trends have been observed across all demographic/socioeconomic subgroups. We examined number of missing teeth among dentate individuals ( n  = 9, 113) as well as edentulism and systematically modeled their trends over time by using clinical examination data. Methods We investigated the association between social stratification and trends in tooth retention among adults ages 50+ from 1988 to 2004, using four waves of the National Health and Nutrition Examination Surveys ( NHANES ) ( n  = 11 812). Results The prevalence of edentulism declined from 24.6% in NHANES III (1988–1994) to 17.4% in 2003–2004, and the mean number of missing teeth declined from 8.19 to 6.50. Older participants, Blacks, the less educated and those with lower income were higher on both edentulism and number missing teeth. Both edentulism and number of missing teeth declined over time, but their patterns varied. For edentulism, age and socioeconomic related disparities decreased over time due to more decline among older and low‐income participants. For missing teeth, there was less decrement among older and low‐income participants, resulting in increased age and socioeconomic related disparities. Conclusions Our study found disparities in trends of tooth loss across demographic/socioeconomic strata. Findings suggest that racial/ethnic disparities are partially explained by socioeconomic status. Interventions designed to improve oral health for older adults, particularly those with low levels of income, need special attention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109563/1/cdoe12116.pd

Oral health and rehabilitation among the institutionalized elderly

The aging and the elderly are highly associated with limitation or dependency, with some loss of capacities and the gain of conditions or age-associated pathologies. Despite advances in preventive dentistry, edentulism and oral diseases are major public health issues in Portugal, mainly among the elderly. This study investigated the oral status and level of oral rehabilitation among Portuguese institutionalized elderly. The purpose of the study was to determine the prevalence of edentulism and assess the oral rehabilitation and oral/prosthetic hygiene habits in a sample of institutionalized elderly using a cross-sectional study in a sample of 118 institutionalized elderly. Data collection was performed by applying a questionnaire about oral health behaviors and through an intraoral observation in order to determine the oral status and verify the condition of the oral rehabilitation of each participant. The findings revealed that 78.6% have a number of decayed, missing and filled teeth more than 20, 58.8% presented total edentulism (with no natural teeth in the oral cavity) and 66.7% had a removable prosthesis. Only 44.1% practiced daily oral/prosthetic hygiene at least twice a day while 29.0% and 67.7% complained of toothache and difficulty in chewing respectively. The educational level of the elderly was associated with dental pain (p=0.012) and oral/prosthetic hygiene (p=0.034). A high prevalence of tooth loss was found in the sample studied and also the need to improve the removable prosthesis is fundamental. Improvement in oral health care and oral hygiene habits is essential to promote better oral health and quality of life among the institutionalized elderly.info:eu-repo/semantics/publishedVersio

Treatment needs and impact of oral health screening of athletes with intellectual disability in Belgium

Background: Special Olympics Special Smiles (SOSS) is an initiative created for oral health data collection and education in oral hygiene for athletes with an intellectual disability. The aims of this study were to evaluate treatment needs of participants of Special Olympics in Belgium 2013 in comparison with those from 2008 and to assess the impact of screening and referral within the SOSS in a group of athletes who participated in two consecutive events, 2012 and 2013. Methods: Data were collected following a standardized protocol developed by the U.S. Centres for Disease Control and Prevention, Division of Oral Health. Oral hygiene habits, treatment urgency and reports of oral pain, gingival signs, sealants, untreated caries, missing and filled teeth were recorded. Data analysis of data from 2013 consisted in descriptive statistics followed by the analysis of the data by univariable and multivariable logistic regression. This data was compared with data from 2008 published by Leroy et al., 2012 using Chi square tests. Data from athletes who participated in both Special Olympics events (2012 and 2013) were compared using Exact McNemar's test and Chi-square test for homogeneity of proportions. The level of significance for all tests was set at a p-value < 0.05. Results: A total of 627 athletes with intellectual disability participated to the SOSS program in 2013, while 132 athletes met the inclusion criteria of being a participant at both SO Belgium 2012 and 2013. The prevalence of gingival signs was 44.3 % in 2013, slightly higher than in 2008 (42.4 %). The burden of untreated decay affected 27.1 % of the population showing a net increase in comparison to 2008 (20.9 %). McNemar's test and Chi-square test revealed that there were no statistically significant differences in the proportions of all compared parameters between 2012 and 2013. Conclusion: Special Olympics results from 2013 indicate a considerable unmet treatment need among Belgian Special Olympics Athletes, persistent from 2008 to 2013. Moreover, SO intervention had no impact in the oral health of athletes who participated in 2012 and 2013 events. Continuous efforts for preventive and restorative oral health care are needed for this population

Decline of the edentulism epidemic in Australia

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included. Prepared by LA Crocombe and GD SladeAustralian Research Centre for Population Oral Health, The University of Adelaide, South Australia; prepared by LA Crocombe and GD Slad

Lower risk for cardiovascular mortality for patients with root filled teeth in a Finnish population

AimTo investigate the relationship of radiographic evidence of root filled teeth to cardiovascular outcomes.MethodologyBaseline data for 506 subjects including 256 angiographically verified heart disease patients and 250 matched cardiologically healthy controls participating in the Kuopio Oral Health and Heart study were collected in 1995â 1996. Cardiovascular disease (CVD) mortalities were accrued until 31 May 2015 and appended to the baseline data. Mortality status data were obtained from the Finnish National Death Register where all mortality cases and the causes of death are compiled for all Finnish citizens. Of the 506 participants, 473 subjects who had no missing values in the predictor, outcome or confounding factors were included in the analyses to assess the relationship of radiographic evidence of root filled teeth with prevalent coronary artery disease (CAD) cross sectionally and also with CVD mortality longitudinally. Multivariable logistic regression was used for the crossâ sectional part and proportional hazard regression analyses for the longitudinal part of the study were used adjusting for age, sex, smoking, edentulism, diabetes, hypertension, total/HDL cholesterol ratio and income. Additionally, whether this association was independent of periodontitis, and a systemic marker of inflammation, serum Câ reactive protein (CRP) was examined.ResultsHaving â ¥1 root filled teeth was associated with 84% lower odds of prevalent CAD with Odds Ratio (OR) = 0.16, 95% confidence interval (CI) 0.09â 0.28, P < 0.0001. The OR for edentulism was 1.32 (CI: 0.73â 2.38), P = 0.36, suggesting a nonsignificant increase in risk. Prospectively, having at least one root filled teeth was associated with a 49% lower risk of CVD mortality (hazard ratio [HR] = 0.51, CI = 0.27â 0.97, P = 0.04) whilst edentulism was associated with nonsignificantly increased risk for CVD mortality: HR = 1.25 (CI: 0.65â 2.42), P = 0.36. Adjustment for periodontitis or serum CRP levels changed the OR or HR slightly but the associations remained significant.ConclusionsHaving â ¥1 root filled teeth was associated with significantly lower odds for prevalent CAD cross sectionally and lower risk of cardiovascular mortality prospectively. These reduced associations with CVD were independent of periodontitis or serum CRP levels.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139934/1/iej12772_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139934/2/iej12772.pd