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Sociology; psychology Dental beliefs, knowledge and behaviour of Chinese people in the United Kingdom
Kwan SYL, Williams SA Community Dent Health 1999; 16: 33–39
Many considered tooth loss to be a natural consequence of ageing.
In 9 towns in the North East of England, a sample of 156 Chinese subjects was recruited for interview by 5 experienced Chinese interviewers who received prior training aimed at uniform procedures. Teenagers accounted for 50 subjects; 56 were aged 20–54; and 50 were aged 55–80. Only 50% of the sample felt able to speak English well, including only 2 of those over 55 years old.
Two-thirds of subjects believed tooth loss to be natural in old age; three-quarters expected to lose one or more teeth in the future; the majority expected to experience toothache, caries and periodontal diseases. Most considered tooth loss, decay and gum diseases had significant consequences. Around half the subjects believed that dental diseases and discomfort were preventable. Nearly half had correct beliefs on the aetiology of caries and periodontal diseases. Only 13% made use of traditional Chinese medicine.
In general, education appeared to influence understanding, and the older people had less knowledge of dental matters and a more fatalistic attitude towards dental health.
Epidemiology; dental public health Prevalence of HIV-associated periodontitis and chronic periodontitis in a southeastern US study group
McKaig RG, Thomas JC et al. J Public Health Dent 1998; 58: 294–300
In a large group of HIV-infected individuals, most had periodontitis, and antiretroviral therapy appeared to reduce the prevalence of necrotising ulcerative periodontitis.
This study used baseline data from 326 HIV-infected adults participating in a 3-year study, and reflected about one-third of the population at a university clinic providing HIV care. Some 10% of North Carolina's AIDS population (total 1828) were included in the sample of whom 316 were dentate. When risk factors were considered, male homosexual behaviour accounted for 40%, heterosexual promiscuity for 25%, injection drugs for 15% and contaminated blood products for 10%.
Mean attachment loss was 2.1 mm in the group; 93% had at least one site at 4 mm, and two-thirds at 5 mm. Increased periodontal attachment destruction was associated with lower immune competence, but because recession was also associated with it, probing depths were paradoxically greater in those with better immune status.
In 15 subjects diagnosed with necrotising periodontitis, all had a CD4+ count below 500, and subjects not managed with antiretroviral therapy were 3 times as likely to have it as those on such drugs(P<0.05).
Paediatric dentistry Dentists' behaviour in response to child dental fear
ten Berge M Veerkamp J et al. J Dent Child 1999; 66: 36–40
Dentist behaviour depended on child fear level, and a direct approach had a positive effect.
Twenty boys and 20 girls aged 6–11 years, who were untreatable in general practice because of their fear, were referred to a Dutch special dental care centre where they were treated by 2 dentists with considerable experience in behaviour management of such children.
Treatment was videotaped and the behaviour of both dentists and children was scored on a scale devised by Venham, ranging from 'relaxed' (0) through 'uneasy' (1), 'tense' (2), 'reluctant to cooperate' (3) and 'interference' (4) to 'out of contact' (5). Eighteen children were assessed as high in fear (4 and 5), and the other 22 as low fear subjects who could be given treatment albeit with difficulty.
The behaviour of the dentists was similar; both varied in respect of the two fear groups. The children in the high fear group received significantly more directive attention: the dentists used commands more frequently, perhaps to avoid reinforcing fear-related behaviour. The dentists also tended to use a greater degree of physical restraint with these children, and a lesser degree of empathy, in line with principles of operant conditioning. The authors concluded that the approach had a positive long-term effect on the high-fear children, whose fear level reduced after several sessions.
Implant dentistry Effects of smoking on implant success in grafted maxillary sinuses
Kan JYK Rungcharassaeng K et al. J Prosthet Dent 1999; 82: 307–311
Smokers had a significantly lower success rate in this as in other implant situations.
A group of 60 patients, of whom 16 smoked tobacco, returned for follow-up out of an initial 118 who received sinus grafts for implant support. The follow-up was for a mean of 3.5 years (range 2 months to 5 years). The results were compared for 158 implants in 58 grafted sinuses in non-smokers and 70 implants in 26 sinuses in smokers.
The failure rates were 17% in smokers and 7% in non-smokers; the cumulative failure rate over the 5 years was significantly greater in the former group (P = 0.027). Within the smoker group, no correlation was found between failure rate and the number of cigarettes smoked.
The authors discuss the problem of implants in the posterior maxilla where sparsely-trabeculated type IV bone is often present; they quote other studies showing a higher failure rate for smokers in this situation without grafting, and a better prognosis when smoking ceases for several days around the time of surgery.
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Abstracts. Br Dent J 187, 602 (1999). https://doi.org/10.1038/sj.bdj.4800341