Root caries over the generations

Since the early 1980s root caries has become a subject of interest in dental research and practice. Improved life expectancy and reduction of tooth loss have led to more natural teeth are being retained for longer. While these are significant public health and dental health successes, it may put the older population at a higher risk of root caries. The current international scientific literature reports that root caries is observed in a significant proportion of older adults. Thus, it was hypothesised that retaining more natural teeth in older adults would elevate root caries to being a more prominent problem in the current generation than in the previous generation. This presumption was congruent with the ‘failure of success’ and ‘more teeth, more disease’ theories accepted in both the medical and dental fields. While this has been demonstrated in a cross-sectional study of coronal and root caries, these theories have not yet been verified in studies across the generations. This study aimed to contribute to the understanding of root caries and its risk factors in the contemporary population of older adults. In particular, this study tested the ‘failure of success’ or ‘more teeth, more disease’ theories in relation to root caries among Australian older adults by studying root caries across generations over a 22-year period. This thesis combines a systematic review, meta-analysis and meta-regression study, with three empirical studies using the National Survey of Adult Oral Health 2004-06, the South Australian Dental Longitudinal Study 1 (SADLS1) (started in 1991/1992) and the Intergenerational Change in Oral Health Study in Australia (SADLS2) (started in 2013-2014). This study found that there were a diverse range of root caries studies presented around the world. There is a need to conduct and report root caries research in a globally consistent way to be able to take advantage from a ‘pooled estimate’ of root caries in a future meta-analysis. This study found that root caries has remained a dental public health problem among Australian adults and older adults. The profile of risk indicators of root caries has remained stable across generations. The risk indicators are slightly different between untreated root caries (root DS), and treated related-root caries (root FS and root DFS). Root caries was also found to increase continuously, even among healthier adults. The most important finding of this study was that, despite a higher retention of natural teeth, and a high prevalence of gingival recession in the current generation of Australians, they experienced less root caries than the previous generation. Improvements in the upstream determinants of oral health such as living conditions, expansion of water fluoridation and wider use of dental services might have played a role in protecting the oral health of the older population. In conclusion, the ‘failure of success’ or ‘more teeth, more disease’ theories were not supported in this study of root caries across generations of Australian older adults. The findings support the current population-based program of water fluoridation, and the promotion of healthy lifestyle in order to prevent root caries.Thesis (Ph.D.) (Research by Publication) -- University of Adelaide, Adelaide Dental School, 201

PENGARUH UMUR PANEN TERHADAP RENDEMEN DAN KUALITAS MINYAK ATSIRI TANAMAN NILAM (Pogostemon cablin Benth.)

Tanaman nilam merupakan tanaman penghasil minyak atsiri yang dapat menyumbang devisa lebih dari 50 % dari total ekspor minyak atsiri Indonesia. Minyak nilam bersifat fixatif (pengikat) sehingga mempunyai peluang yang baik karena belum ada produk substitusinya. Peningkat-an jumlah penduduk mempengaruhi permintaan minyak nilam, akan tetapi lahan budidaya nilam semakin menurun. Di Indonesia tanaman nilam memiliki rendemen dan kualitas minyak yang bervariasi, sehingga diperlukan teknik budidaya tanaman nilam yang tepat. Umur panen berhubungan erat dengan fase pertumbuhan tanaman yang mencerminkan tingkat kematangan fisiologis tanaman, dan mempunyai relevansi kuat dengan produksi dan kandungan yang ada dalam tanaman. Penelitian yang bertujuan untuk mengetahui dan mempelajari umur panen yang tepat terhadap rendemen dan mutu minyak tanaman nilam ini dilaksanakan pada bulan Desember 2011 – Maret 2012 di Tempeh – Lumajang. Penelitian ini menggunakan RAK yang terdiri atas 6 perlakuan dan 4 ulangan, yaitu: P1 : 4 bst + 4 bsp; P2 : 5 bst + 3 bsp; P3 : 6 bst + 2 bsp; P4 : 7 bst + 1 bsp; dan P5 : 8 bst (bulan setelah tanam/panen). Hasil penelitian menunjukkan bahwa umur panen berpengaruh nyata terhadap komponen pertumbuhan dan hasil tanaman nilam. Melalui uji Kromatografi Gas Spektrometer Masa minyak nilam memiliki kadar patchouli alkohol 18.40 – 22.40 %. Sedangkan indeks bias memiliki kisaran 1.5042 – 1.5075 dan berat jenis 0.951 – 0.995 g/ml Analisi R/C rasio menunjukkan bahwa P1 adalah perlakuan yang paling optimal, dilihat dari hasil penjualan bahan basah, bahan kering maupun minyak nilam yang masing-masing memiliki nilai R/C rasio 2.34, 2.77 dan 3.58. Kata kunci : Nilam (Pogostemon cablin Benth.), Umur Panen, Rendemen, Patchouli Alkoho

Pengaruh Umur Panen Terhadap Rendemen Dan Kualitas Minyak Atsiri Tanaman Nilam (Pogostemon Cablin Benth.)

Tanaman nilam merupakan tanaman penghasil minyak atsiri yang dapat menyumbang devisa lebih dari 50 % dari total ekspor minyak atsiri Indonesia. Minyak nilam bersifat fixatif (pengikat) sehingga mempunyai peluang yang baik karena belum ada produk substitusinya. Peningkat-an jumlah penduduk mempengaruhi permintaan minyak nilam, akan tetapi lahan budidaya nilam semakin menurun. Di Indonesia tanaman nilam memiliki rendemen dan kualitas minyak yang bervariasi, sehingga diperlukan teknik budidaya tanaman nilam yang tepat. Umur panen berhubungan erat dengan fase pertumbuhan tanaman yang mencerminkan tingkat kematangan fisiologis tanaman, dan mempunyai relevansi kuat dengan produksi dan kandungan yang ada dalam tanaman. Penelitian yang bertujuan untuk mengetahui dan mempelajari umur panen yang tepat terhadap rendemen dan mutu minyak tanaman nilam ini dilaksanakan pada bulan Desember 2011 – Maret 2012 di Tempeh – Lumajang. Penelitian ini menggunakan RAK yang terdiri atas 6 perlakuan dan 4 ulangan, yaitu: P1 : 4 bst + 4 bsp; P2 : 5 bst + 3 bsp; P3 : 6 bst + 2 bsp; P4 : 7 bst + 1 bsp; dan P5 : 8 bst (bulan setelah tanam/panen). Hasil penelitian menunjukkan bahwa umur panen berpengaruh nyata terhadap komponen pertumbuhan dan hasil tanaman nilam. Melalui uji Kromatografi Gas Spektrometer Masa minyak nilam memiliki kadar patchouli alkohol 18.40 – 22.40 %. Sedangkan indeks bias memiliki kisaran 1.5042 – 1.5075 dan berat jenis 0.951 – 0.995 g/ml Analisi R/C rasio menunjukkan bahwa P1 adalah perlakuan yang paling optimal, dilihat dari hasil penjualan bahan basah, bahan kering maupun minyak nilam yang masing-masing memiliki nilai R/C rasio 2.34, 2.77 dan 3.58

Functional Factors on Compliance Drugs Consumption in Diabetes Melitus Patients Related to Periodontal Health

Background: Tambakrejo Health Center is one of the public health services in Surabaya that provides integrated dental and oral health services. As many as 69% of the community in health center working area were exposed to periodontal problems, and around 18% suffered from diabetes mellitus. Objective: This study aimed to identify the factors that play a role in compliance with drug consumption in patients with diabetes mellitus associated with periodontal tissue in the working area of Tambakrejo health center in Surabaya. Methods: This was an observational analytic study with cross sectional method. The study sample was 60 people with diabetes mellitus selected with a random sampling technique. Respondents filled out questionnaires to measure patients’ perceptions, knowledge, attitudes, and actions about drugs, diabetes mellitus, periodontal health, and the level of compliance with drug consumption. The sample oral hygiene status was determined using the Russell Index. Results: The data obtained showed that as many as 67% of the samples had low level of compliance. Whereas, 20% of the sample had moderate level of compliance. Only 13% of the sample had high level of adherence. Conclusion: There was a significant correlation between the level of compliance of patients taking antidiabetic drugs and the periodontal health

An Overview of the Gingival Lead Line in Traffic Officers of Surabaya Capital City Police

Lead exposure in the air comes from the emissions of vehicles, which can damage human health. Exposure to lead will affect the brain, kidneys, and blood. The presence of lead in the body can be seen through a bluish pigmentation in the oral mucosa or gingival lead line. Traffic officers have a high risk of lead exposure which has been demonstrated by the result of previous studies where 96.67% of traffic officers had a gingival lead line. This study aimed to determine the gingival lead line in traffic officers in Surabaya Capital City Police. This study was an descriptive observational study with a cross-sectional approach. The samples in this study were 98 traffic officers, and it used a simple random sampling technique. Data was collected by conducting interviews, intraoral examination, and laboratory tests. All obtained data was analyzed using cross-tabulation and odd ratio measurement with the SPSS program. Gingival lead lines were classified into two categories, i.e. moderate and poor. A moderate gingival lead line was found in 38 respondents, and the remaining 60 were classified as a poor gingival lead line. The results of measurement of the odd ratio (OR) between the gingival lead line and smoking habit, as well as gingival lead line and blood lead level were 3.436 and 1.018, respectively. This showed that a smoking habit and blood lead level were risk factors for a gingival lead line. A gingival lead line was found more in traffic officers who smoked and had excessive blood lead levels

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017 : a systematic analysis for the Global Burden of Disease 2017 Study

Government and nongovernmental organizations need national and global estimates on the descriptive epidemiology of common oral conditions for policy planning and evaluation. The aim of this component of the Global Burden of Disease study was to produce estimates on prevalence, incidence, and years lived with disability for oral conditions from 1990 to 2017 by sex, age, and countries. In addition, this study reports the global socioeconomic pattern in burden of oral conditions by the standard World Bank classification of economies as well as the Global Burden of Disease Socio-demographic Index. The findings show that oral conditions remain a substantial population health challenge. Globally, there were 3.5 billion cases (95% uncertainty interval [95% UI], 3.2 to 3.7 billion) of oral conditions, of which 2.3 billion (95% UI, 2.1 to 2.5 billion) had untreated caries in permanent teeth, 796 million (95% UI, 671 to 930 million) had severe periodontitis, 532 million (95% UI, 443 to 622 million) had untreated caries in deciduous teeth, 267 million (95% UI, 235 to 300 million) had total tooth loss, and 139 million (95% UI, 133 to 146 million) had other oral conditions in 2017. Several patterns emerged when the World Bank’s classification of economies and the Socio-demographic Index were used as indicators of economic development. In general, more economically developed countries have the lowest burden of untreated dental caries and severe periodontitis and the highest burden of total tooth loss. The findings offer an opportunity for policy makers to identify successful oral health strategies and strengthen them; introduce and monitor different approaches where oral diseases are increasing; plan integration of oral health in the agenda for prevention of noncommunicable diseases; and estimate the cost of providing universal coverage for dental care

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation