The dental awareness and needs of a Parkinson's disease population

The dental awareness and needs of a population with Parkinson's disease were assessed by means of postal questionnaires sent to members of Parkinson's disease societies of Belfast and London. A total of 228 valid replies were received representing a response rate of 31%. Results showed that dental problems were reported often, xerostomia and burning sensation being at least twice that of the general population. Satisfaction with dental care was high although it was significantly reduced in those with loose dentures and burning sensation. The results of this study support a greater participation by dentists in the planning and provision of healthcare for sufferer of Parkinson's disease.     

Dental anxiety among middle-aged and elderly women in Sweden. A study of oral state,utilisation of dental services and concomitant factors

The aim of this project was to investigate dental anxiety and its expression in utilisation of dental services, oral health and oral symptoms. In a cross-sectional study of women's health in Göteborg (population 432,000), Sweden, 1016 women aged 38 to 84 years participated. This randomly selected population took part in a series of investigative procedures including medical and dental clinical examinations, interviews and questionnaires. Levels of dental anxiety were measured on the Corah Dental Anxiety Scale (DAS). The average DAS score obtained was 7.2. The study showed that older women were significantly less anxious than younger ones. Severe dental anxiety (DAS 15) was experienced by 3.9% of the participants. This frequency corresponds well with findings by Hällström and Halling in their analysis of data from the first Göteborg study of women's health 24 years ago. High levels of dental anxiety were correlated with longer intervals between dental visits, poorer oral function and aesthetics and a higher frequency of oral symptoms. Headaches were more prevalent in the younger age groups and a correlation with dental anxiety was revealed. Our previous studies have shown that symptoms such as tension headaches are prevalent among dental phobic patients and that they are reported to be reduced by therapy for dental fear. The clinical and radiographical examinations revealed a generally poorer oral status, with a statistically significant higher number of decayed teeth among women with high dental anxiety.     

Access to National Programs and Needs for Continuing Education1

This paper describes the American Dental Association's ongoing efforts aimed at improving access to comprehensive dental care for special population groups. Primary attention is directed to the elderly population, a major priority of the Association's Access Program. In addition to highlighting the basic components of the Access Program, a review of some of the barriers affecting utilization of dental care by the elderly and programs designed to eliminate those barriers is provided. Finally, the author offers some thoughts regarding the need for appropriate continuing education activities directed to the general dentist on the topic of geriatric dentistry.     

The phenetic distances of the living Druze from other human populations suggest a major genetic drift from the Western Eurasian ancestral category

The objectives were to determine the expression frequency and sexual dimorphism of 16 non-metric crown traits on the sample of permanent dentitions of the living Druze population (a Near Eastern genetic isolate) in Jordan, and to assess the biological affinity of this sample to 21 regional groups, and to the living general Jordanian population, based on these traits. Druze schoolchildren (46 males, 40 females; mean age = 16.0, sd = 0.5 years) were studied in 2011. The traits were classified using the Arizona State University dental anthropology system, counted with the individual count method, and dichotomized according to the criteria of Scott and Turner for the purpose of group comparisons. Fisher's exact test for dichotomized scores was used to assess sexual dimorphism in these traits. Smith's mean measure of divergence was used to measure all pairwise distance values among the groups. Sexual dimorphism was found in five traits (i.e., UI2 interruption grooves, 3-cusped UM2, UM1 Carabelli's tubercle/cusp, 4-cusp LM1, and LM2 Y-groove pattern). This study revealed that the dental pattern of living Druze, which is similar to that of the general Jordanian population, is sufficiently distinct from the Western Eurasian pattern and all other known dental patterns to form a distinct dental pattern for the regional group or subcategory to which these two populations belong. Moreover, the relatively large distance values of the living Druze and Jordanians from the other world groups considered, including the Western Eurasian groups, suggest a similar major genetic difference of these two populations from the Western Eurasian ancestry.     

An Alternative Method for Financing Care for the Non-Institutionalized Geriatric Dental Patient

Developing dental benefit programs for the expanding ambulatory geriatric population represents an important challenge for dentistry. This paper describes Blue Cross of California's experience in developing and providing a dental benefit as part of a HMO. supplement to the Medicare program. A study of a randomly selected sample of 133 Ultra Care enrollees was conducted in a small California city. A dental record review was performed on those individuals who accessed dental care. Patterns of utilization, distribution of planned and rendered treatment, and level of care achieved are presented. The experience of those patients compared to another sample of Ultra Care patients in a California city of comparable size, had similar care patterns. The major difference between the two patient populations was the tendency of one practice to repair existing prosthetic appliances, while the other practice tended to replace the existing appliances. The method of determining a capitation rate for these geriatric enrollees, using this data, is presented.     

The dental informatics online community

Dental Informatics (DI) is the application of computer and information science to improve dental practice, research, education, and program administration. To support the growth of this emerging discipline, we created the Dental Informatics Online Community (DIOC). The DIOC provides a dedicated professional home for DI researchers and serves as an open, common, and worldwide forum for all individuals interested in the field. It was created and is maintained by the Center for Dental Informatics at the University of Pittsburgh School of Dental Medicine, independent from any professional association, corporate interest or funding source. The DIOC''s Website provides many useful features, such as a learning center, publication archive, member and project directories, and the Current Awareness Service (CAS). The CAS automatically notifies members about new information added to the Community. Notifications are individualized according to a member''s profile and activities on the site. The DIOC is a research-oriented online community which provides resources in the dental informatics and dental technology field, as well as a way to establish social connections to share ideas, problems and research opportunities. Member and activity growth since the community''s inception in 2005 have been steady, but future sustainability of the community depends on many factors.     

Demography and dental needs,an international perspective

The population of the world is changing and the science dealing with the study of these changes in human populations, in terms of disease, health and mortality has been called demography. It can be understood to include the evaluation of the size, density, and distribution of populations including the influence of a variety of factors such as age and economics. This paper will review the distribution of the world's population with regard to age and utilization of dental care with particular emphasis on the older cohorts.     

Neandertal dental asymmetry and the probable mutation effect

The purpose of this paper is to show that if Brace's hypothesis concerning the role of random mutations in structural reduction (PME) is accepted for the sake of argument, then it cannot be used to explain hominid tooth size reduction since the Mousterian. Specifically it is shown that Brace's Hypothesis implies a smaller variance in dental asymmetry for Neandertal than modern man. Variance analysis reveals that, to the contrary, Neandertal dentitions are more variable than a large sample of modern man's. Finally it is shown that the sequence of dental asymmetry per tooth class is approximately the same in Neandertal as in modern man.     

Twins and the paradox of dental-age estimations: A caution for researchers and clinicians

The biological age difference among twins is frequently an issue in studies of genetic influence on various dental features, particularly dental development. The timing of dental development is a crucial issue also for many clinicians and researchers. The aim of this study was therefore to verify within groups of twins how dental development differs, by applying Demirjian's method, Mincer's charts of development of third molars and two of Cameriere's methods for dental age estimation, which are among the most popular methods both in the clinical and the forensic scenario. The sample consisted of 64 twin pairs: 21 monozygotic, 30 dizygotic same-sex and 13 dizygotic opposite-sex with an age range between 5.8 and 22.6 years. Dental age was determined from radiographs using the mentioned methods. Results showed that dental age of monozygotic twins is not identical even if they share all their genes. The mean intra-pair difference of monozygotic pairs was low and similar to the difference in dizygotic same-sex twins; the maximum difference between monozygotic twins, however, was surprisingly large (nearly two years). This should lead to some circumspection in the interpretation of systematic estimations of dental age both in the clinical and forensic scenario.     

Factors associated with oral health perception in older Brazilians

Objectives: To investigate the self‐perception of oral health in older people, aged 65–74, from the central region of southern Brazil. Methods: Cross‐sectional population‐based study using data from the Oral Health Conditions Survey of Southern Brazil, developed between the years 2002 and 2003, by the State Health Secretary (SHS) of Rio Grande do Sul (RS), Brazil. Socioeconomic and demographic variables, self‐perception of oral health and clinical data, as well as dental pain were evaluated in 618 elderly people. Multinomial logistic regression was used to evaluate the effect of explanatory variables on the self‐perception of oral health. Results: Almost half of the elderly were edentate and rated their oral health as good or very good. With regard to dental pain, 28.8% of the people declared that they had experienced dental pain in the 6 months before the interview. There was a significant relationship between dental pain and classification of oral health, and chewing ability. Following adjustment, the need for dental prostheses remained associated with the influence of oral health on establishing relationships. Similarly, personal income remained associated with the elderly's perception of their ability to talk. Finally, the level of education remained related to the influence of oral health status in people's relationships. Conclusion: Dental pain and the need for dental prostheses were the main factors that affected the self‐perception of oral health of elderly people from southern Brazil.     

Alzheimer's disease,oral function and nutritional status

Objectives: To study differences in nutritional, dental status and oral function between institutionalised patients with Alzheimer's disease and cognitively healthy elderly people living in the community. Design: Comparison was made between two groups, Alzheimer's disease sufferers and healthy controls, using established criteria for anthropometric, mental and dental state. Setting: An institution and residential area in Stockholm, Sweden. Subjects: Forty patients with Alzheimer's disease living in a nursing home and 40 age-and gender-matched control subjects living independently. Intervention: Dental status and anthropometric variables. Results: Overnutrition was less frequent among the demented than the controls and more demented were undernourished. Dental status was similar in the two groups with few edentulous subjects but only 2 of 7 edentulous subjects with Alzheimer's disease wore dentures. Having natural teeth and many functional oral zones is important for food consistency choice, but not for nutritional status. In the Alzheimer group, the stage of dementia has a strong association to the ability to eat unaided and an association with dental status. Conclusion: There are differences in nutritional status between Alzheimer's patients in institutions and cognitively healthy elderly living at home. The choice of food consistency is correlated to dental status but nutritional status is not shown to be influenced by dental status. However, the ability to eat unaided is strongly correlated to cognitive status.     

Geriatric dentistry in Brazilian universities

The World Health Organization has predicted an increase in the population of elderly people. Objective: The purpose of this study was to investigate the teaching of geriatric dentistry in Brazilian universities. Materials and methods: This study consisted of questionaires regarding the training in geriatric dentistry in 104 dental schools included in the National Institute of Education Research (INEP) in 2001. In order to calculate the sample (a random stratified one), the confidence interval was set at 99% and a maximum permitted error of 3% was adopted. Pearson's chi‐square test was used in the inferential analysis. Results: From the 64 dental courses which were studied, only 25 included geriatric dentistry in the curriculum. From 1857 students who were involved in the study, 41% sought knowledge outside the dental school and 98% considered that it was important that this subject should be included in the curriculum. There was statistical significance between geriatric dentistry teaching and the students’ preference as well as the prospect of working with this group of the population. Geriatric dentistry as an individual subject was absent from the curriculum in two‐thirds of the dental courses investigated. Knowledge was often transmitted as part of dental prosthetics and most of the students stated that they would want to be able to treat elderly people. It was relevant to note that senior students expected to work in this field. Conclusion: Dental students in Brazil do not have adequate training in geriatric dentistry.     

Alzheimer's disease,oral function and nutritional status

Objectives: To study differences in nutritional, dental status and oral function between institutionalised patients with Alzheimer's disease and cognitively healthy elderly people living in the community. Design: Comparison was made between two groups, Alzheimer's disease sufferers and healthy controls, using established criteria for anthropometric, mental and dental state. Setting: An institution and residential area in Stockholm, Sweden. Subjects: Forty patients with Alzheimer's disease living in a nursing home and 40 age-and gender-matched control subjects living independently. Intervention: Dental status and anthropometric variables. Results: Overnutrition was less frequent among the demented than the controls and more demented were undernourished. Dental status was similar in the two groups with few edentulous subjects but only 2 of 7 edentulous subjects with Alzheimer's disease wore dentures. Having natural teeth and many functional oral zones is important for food consistency choice, but not for nutritional status. In the Alzheimer group, the stage of dementia has a strong association to the ability to eat unaided and an association with dental status. Conclusion: There are differences in nutritional status between Alzheimer patients in institutions and cognitively healthy elderly living at home. The choice of food consistency is correlated to dental status but nutritional status is not shown to be influenced by dental status. However, the ability to eat unaided is strongly correlated to cognitive status.     

AGE CRITERIA AND VITAL STATISTICS OF A BLACK RHINOCEROS POPULATION

Tsavo National Park, in Kenya, probably contains the largest population of black rhinoceros (Diceros bicornis (L.)) left in existence. Large-scale damage of the vegetation initiated by elephants and aggravated by fire has changed considerable areas of the park. The ecology of the black rhinoceros in this changing environment has been studied; the present status and population structure is considered here, including the development of detailed ageing criteria for the species, an analysis of natural mortality and survivorship, and a record of the structure of the living populations within the major habitat types. Crania and mandibles were collected from 506 rhinoceros found dead in all areas of the park. This material was divided into 20 relative age classes based on dental characteristics. Crude chronological ages, based on an estimate of the maximum expectation of life and the examination of seven known-age dental records of captive animals, were assigned to each age class. These crude ages were then refined by examination of 16 dental records of known-age wild rhinoceros, and a chronological age scale established. A survivorship curve of the population was thus constructed. Annual mortality during the first and second year of life is about 16%, and the indicated mean annual mortality from 5–25 y is 9.8%. A theoretical model of the population structure is shown, and analysis of the annual mortality and recruitment at birth suggests that the population was stable during the 1960's. Assuming the data represent a stable population the mean expectation of life at birth is 8.4 y. Thirteen major habitat types are described. The characteristics of the rhinoceros population within each habitat type were established both from ground studies and aerial observations. Nearly 700 rhinoceros were identified and catalogued on the ground, in sample areas selected for intensive study. Population structures, cow: calf ratios, and recruitment appear to be average in most habitat types. The analysis of recruitment at birth and mortality during the first year of life, both from computations from the survivorship curve and from the structure of the living populations, support the validity of the ageing criteria, and further suggest that the population was stable during the 1960's. Finally, the relationship between the elephant and the rhinoceros in the changing environment is discussed with reference to recent findings in elephant ecology. In conclusion it is recommended that population reduction of the Tsavo elephants should be initiated.     

Factors influencing older people's self reported use of dental services in the UK

Objectives: This study was designed to determine the use of dental services and factors associated with their use among the United Kingdoms' older population. Design: A national study involving 1,116 older people (aged 60 or older). Setting: Home Interview s were undertaken exploring the time and reason for last dental visit. In addition, socio-demographic characteristics and proxy oral health measures (self-reported number of teeth and edentulous status) of the respondents were collected. Results: Forty seven percent (528) claimed they visited the dentist within the past year, 10% (116) claimed that the reason for their last visit was because of a dental emergency, 43% (484) were classified as “regular attenders” - having attended the dentist within the past year for a non dental emergency. Bivariate analysis identified that regular dental attendance was associated with age (P<0.01), social class (P<0.01), income level (P<0.01), educational attainment (P<0.01), self-reported number of teeth possessed (P<0.01) and edentulous status (P<0.01). In regression analysis, self reported edentulous status and number of teeth possessed emerged as the most important factors in determining service utilisation. Possessing a full denture was associated with a 6-fold decrease, having accounted for other factors, in the likelihood of attending the dentist within the past year for a non dental-emergency (OR=0.15, CI 0.10,0.21). Conclusion: Less than half of the sample population were “regular dental attenders”, their attendance was associated with a number of socio-demographic and oral health factors. In particular, edentulous state was a major factor associated with their use of services.     

Surviving in the High Arctic: dental variation in a casually introduced population of Microtus rossiaemeridionalis (Arvicolinae,Rodentia) on Svalbard

A human‐mediated invasion of a temperate rodent Microtus rossiaemeridionalis on the High Arctic Archipelago of Svalbard in the first half of the 20th century provides an opportunity to explore extent and rate of morphological divergence over decades of isolation. We studied dental size and morphology in 124 voles captured on Svalbard (Spitsbergen) in 1997–2005 and compared the data to mainland conspecific populations across northern Eurasia. Both dental and cranial sizes in the Svalbard population fall within the limits of natural variation of the species. Dental morphology suggests that the population experiences strong effects of isolation as indicated by the significant increase in the frequency of rare dental morphs, possibly caused by inbreeding. No evidence for directional shift towards increased or decreased complexity of the morphotype dental patterns is revealed. Although the population on Svalbard is phenotypically different from the mainland populations (due to increased frequency of rare morphs), those differences are not enough to support the idea of initial rapid evolution related to colonization. The limited spatial extent and environmental homogeneity of suitable habitats on the island allowed the species to initially multiply but not to diversify so that the species exhibits phenotypic conservatism but suffers the consequences of small population size.     

Dental Calculus Reveals Unique Insights into Food Items,Cooking and Plant Processing in Prehistoric Central Sudan

Accessing information on plant consumption before the adoption of agriculture is challenging. However, there is growing evidence for use of locally available wild plants from an increasing number of pre-agrarian sites, suggesting broad ecological knowledge. The extraction of chemical compounds and microfossils from dental calculus removed from ancient teeth offers an entirely new perspective on dietary reconstruction, as it provides empirical results on material that is already in the mouth. Here we present a suite of results from the multi-period Central Sudanese site of Al Khiday. We demonstrate the ingestion in both pre-agricultural and agricultural periods of Cyperus rotundus tubers. This plant is a good source of carbohydrates and has many useful medicinal and aromatic qualities, though today it is considered to be the world''s most costly weed. Its ability to inhibit Streptococcus mutans may have contributed to the unexpectedly low level of caries found in the agricultural population. Other evidence extracted from the dental calculus includes smoke inhalation, dry (roasting) and wet (heating in water) cooking, a second plant possibly from the Triticaceae tribe and plant fibres suggestive of raw material preparation through chewing.     

麋鹿沧桑命运与未来保护展望

麋鹿作为中国特有的鹿科动物,经历129年的保护努力,种群数量恢复到10000多头。因近亲繁殖严重,表面上看已无灭绝危险,但仍存在巨大隐忧。通过对麋鹿种群变迁、灭绝、重引入、恢复现状及四大种群(乌邦寺、南海子、大丰、石首野化种群)的发展趋势进行追踪分析,探究近千年来困扰麋鹿种群发展壮大的多重因素,提出种群保护与栖息地保护并重、强化疫病监测等保护对策,为麋鹿及其它大型陆生濒危哺乳动物突破种群发展瓶颈提供借鉴。     

Effect of dental status on changes in mastication in patients with obesity following bariatric surgery

Background

Patients scheduled for bariatric surgery (BS) are encouraged to chew slowly in order to optimise the digestion process. The influence of dental status on patients'' ability to comply with advice on chewing behaviour is poorly documented. This study aims to compare modifications of chewing function before and after BS in three groups of obese patients differing in dental status.

Method and Findings

A cohort of 46 obese women provided three groups: FD group: fully dentate (7–10 functional dental units [FU]); PD group: partially dentate (4–6 FU) without partial dentures; DW group: partial and complete denture wearers. Chewing time (CT), number of chewing cycles (CC), and chewing frequency (CF) were measured before and after surgery during mastication of standardised samples of raw carrot, peanuts, banana, apple and jelly. The median particle-size distribution (D50) of the pre-swallowed bolus was also evaluated for peanut and carrot. Before surgery, the PD and DW groups exhibited greater mean CCs and CTs than the FD group (SNK p<0.05) and produced a bolus with higher granulometry (SNK, p<0.05) than the FD group. After surgery, CT and CC increased for all groups and for all foods, but not statistically significant for jelly. The resulting changes in bolus granulometry observed depended on both food and dental status. The granulometry of carrot bolus remained as fine or as coarse in FD and DW groups respectively as it was before surgery while it was significantly decreased in the PD group (Student''s test, p<0.001).

Conclusions

After bariatric surgery, all the obese patients, regardless of dental status modified their chewing kinematics. The effects of this chewing behaviour on bolus granulometry depended on dental status and type of food. Further studies are needed to understand better the impact of dental status on feeding behaviour and nutrition in patients with obesity.