ABSTRACT
The aim of the present study was to record and describe the oral condition of homeless adults in Stockholm, Sweden. There have been no clinical studies of the oral health of the homeless in Sweden since the 1970s. The study population comprised 147 homeless individuals (110 M, 37 F) in the age range 22-77 years. All underwent oral examination, including registration of periodontal status and caries data. The results show that homeless adults in Stockholm have fewer remaining teeth than the general population. Because conservative periodontal treatment is expensive and time-consuming, teeth with doubtful prognoses are usually extracted and only those with optimal periodontal health are retained. Another consequence of inadequate periodontal treatment, including insufficient oral hygiene instruction, is the high percentage of tooth surfaces with plaque accumulation. Heavy plaque accumulation will also have an effect on caries progression, expressed in this study as high DMFT values. Loss of teeth is likely to create dental and chewing problems, possibly resulting in increased dental and medical treatment needs.
Subject(s)
Ill-Housed Persons/statistics & numerical data , Mouth Diseases/epidemiology , Tooth Diseases/epidemiology , Adult , Aged , DMF Index , Dental Plaque/epidemiology , Dental Prosthesis/statistics & numerical data , Female , Humans , Male , Middle Aged , Needs Assessment/statistics & numerical data , Oral Health , Oral Hygiene/statistics & numerical data , Periodontal Diseases/epidemiology , Periodontal Index , Sweden/epidemiology , Tooth Loss/epidemiologyABSTRACT
The aim of this study was to investigate the expression of the costimulatory molecules CD40 and CD40L in periodontal and bone cells in orthodontically treated and untreated teeth using immunohistochemistry. The upper first molars were moved mesially by a fixed appliance. In the experimental group, CD40+ cells were detected at both the tension and the resorption sides in fibroblast-, macrophage-, and dendritic-like cells. The staining was more pronounced on the resorption side. The strongest expression was observed on day 3, decreased on day 7, and reached a low level on day 10 after application of orthodontic force. In contrast, in the treated animals CD40 ligand was expressed on day 3, the expression was enhanced on day 7, and was more pronounced on day 10. CD40L-expressing cells were found predominantly around hyalinized tissue in the resorption zone and the tension areas of the distal root. CD40L was expressed in the bone marrow cells in the pressure zone. In the tension side, some cells of the cellular cementum expressed CD40L. The expression of CD40 and CD40L was low in untreated teeth. These results suggest that CD40-CD40L interaction appears to be an active process during orthodontic tooth movement and that orthodontic force induces T-cell activation. Such activation may be involved in the induction of inflammatory mediators and subsequent bone remodeling. In addition, this may lead to the generation of anti-inflammatory mediators that support defense mechanisms against root resorption, which depend on the type of immune response that is induced regarding CD40-CD40L expression.
Subject(s)
CD40 Antigens/analysis , CD40 Ligand/analysis , Tooth Movement Techniques , Animals , Bone Marrow Cells/pathology , Bone Resorption/pathology , Dendritic Cells/pathology , Dental Cementum/pathology , Fibroblasts/pathology , Hyalin , Lymphocyte Activation , Macrophages/pathology , Male , Maxilla/pathology , Molar , Periodontium/pathology , Rats , Rats, Wistar , T-Lymphocytes/pathology , Time Factors , Tooth Root/pathologyABSTRACT
BACKGROUND/AIMS: Some symptoms of diseases or causes of death are often related to oral health, especially cardiovascular diseases. The purpose of this study was to investigate the relationship between poor oral health and mortality risk, especially when cases of fatal cardiovascular diseases were excluded. MATERIAL AND METHODS: An odontological investigation was made on a sample of 1393 individuals, aged 18-65 years, in 1970 in the County of Stockholm with a follow-up in 1997, when the mortality rate and causes of death in the sample during the time period 1971-1996 were registered. Oral health was defined as a sum of scores for number of missing teeth, apical lesions, caries lesions and marginal bone loss. RESULTS: A significant correlation was found between poor oral health and an increased mortality risk even when persons dying from cardiovascular diseases were excluded from the analyses. CONCLUSION: Poor oral health was found to be a risk indicator of all-cause mortality. The lack of specificity of the associations between oral health and mortality strengthens the hypothesis that the significant correlations could be explained by not identified confounding factors.
Subject(s)
Mortality , Oral Health , Adolescent , Adult , Age Factors , Aged , Alveolar Bone Loss/mortality , Cardiovascular Diseases/mortality , Cause of Death , Confounding Factors, Epidemiologic , Dental Caries/mortality , Dental Plaque Index , Epidemiologic Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasms/mortality , Periapical Diseases/mortality , Proportional Hazards Models , Risk Assessment , Risk Factors , Sensitivity and Specificity , Sex Factors , Smoking/mortality , Sweden/epidemiology , Tooth Loss/mortalityABSTRACT
The most valuable of all resources in a dental teaching hospital are human intelligence and wisdom. Increasingly, universities recognize that their mission to become a centre of academic (and clinical) excellence is dependent on the most constructive and empowering use of their staff and faculty. The appropriate management and empowerment of individuals will help to maximize intellectual potential, research abilities, educational, clinical and management skills to the mutual benefit of all.
