Should the drinking water of Truro, Nova Scotia, be fluoridated? Water fluoridation in the 1990s.

An epidemiological assessment of differences in caries and fluorosis prevalences between children in Truro (< 0.1 ppm) and Kentville (fluoridated at 1.1 ppm in 1991), Nova Scotia, Canada, was completed in 1991. Out of a total of 429 children, in grades 5 and 6, in the two towns in 1991, 219 (51%) were examined. Parents answered a self-administered questionnaire investigating the sources of drinking water used by the children since birth, residence history, use of fluoride supplements, dentifrices, and other fluoride products during the first 6 yr of the life. The examination criteria differentiated between non-cavitated and cavitated carious lesions. Dental fluorosis was measured using the TSIF index. Examiner agreement was excellent. Of the children examined, 80 (36.5%) drank water (fluoridated or non-fluoridated) from municipal water systems during the first 6 yr of life. The children were assigned into five groups based upon residence history and exposure to fluoridated water during the first 6 yr of life. The percentage difference in mean DMFS scores between children in the fluoridated and non-fluoridated groups is 17% (delta DMFS1 = 0.7) when non-cavitated carious lesions are included and 39% (delta DMFS2 = 1.1) when they are excluded. The differences are not statistically significant. The significant risk factors associated with the DMFS1 and DMFS2 scores identified by a stepwise multiple regression analysis are: education level of the father, gender, and number of years of reported use of toothpaste during the first 6 yr of life. Dental fluorosis (mainly TSIF score of 1) was present in 41.5% and 69.2% of the children in the non-fluoridated and fluoridated groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral health status and treatment needs of an insured elderly population.

The purpose of this study was to describe the oral health status and treatment needs of an elderly group of religious sisters whose dental care expenses had been covered for most of their adult life. While the residents displayed high levels of treated dental disease on examination, evidence of a need for further treatment was considered to be a reflection of their decreasing ability to manage their personal home care and the reduction in professional services available to them. The results of this study reinforce the notion that the continuous provision of preventive and educational strategies coupled with accessible treatment services are essential, especially in an aging population.

Amalcore strength recovery following refilling of access preparations with amalgam.

After endodontic treatment through an amalgam core, the recommended procedure is to replace the entire core. This study examined the strength achieved by restoring the access openings with dental amalgam and reported the type of failure during strength testing. Seventy-two Dispersalloy 8 x 8 mm cylindrical specimens were produced using controlled condensation pressures. The specimens were randomized in three groups: (1) controls, (2) 3 mm access preparations wetted with mercury-rich amalgam before restoration, and (3) 3 mm access preparations restored unwetted. The specimens tested for compressive strength were separated in two subsets. The unwetted group demonstrated significantly less strength than the control and wetted group (p less than 0.05), while the unwetted and wetted groups revealed significantly less strength than the control group (p less than 0.05). The mean diametral tensile strength recovery for the wetted and unwetted groups was 76% and 69%, respectively. The qualitative assessment of the fracture zones indicated that wetted specimens exhibited more fractures through the new amalgam core than the unwetted specimens (p less than 0.05). It would appear that amalgam refilling of access preparations through amalgam cores has clinical potential.

The issues of chemical dependency in dentistry.

The problem of chemical dependency is a topical issue in society today. With the increase in the number and types of prescription drugs, the proliferation of illegal drugs, and easy access to alcohol, chemical dependency has no socioeconomic boundaries. Professionals, blue collar workers and students, both male and female, are susceptible to the problem. The purpose of this paper is to review the literature on chemical dependency as it relates to the profession of dentistry. It will also look at the definition, prevalence, etiology, recognition, treatment and prevention of chemical dependency. Most of the evidence from the literature indicates that chemical dependency is a disease; it is treatable and can be prevented. The treatment of the disease requires the input of support groups at the professional level as well as at student level. The prevention of chemical dependency must begin in the curricula of dental schools with emphasis on the pharmacology and interaction of drugs.

Placement and replacement of restorations in a military population.

The purpose of this study was to investigate the reasons for placement and replacement of restorations provided to military personnel by all 34 dentists stationed in the four Atlantic provinces of Canada. All dentists who participated in this study are salaried. Over a period of 30 working days, each dentist recorded information on all restorations performed. Data were collected on dentists' year of graduation, patient age, treatment requirements, tooth number, restoration class, materials used and reasons for placement and replacement. All dentists used the same data collection form which was pilot tested. Information was collected on 2,280 restorations from 643 adults, 18 to 57 years of age. Of all restorations, 54.3% were placements and 45.7% were replacements. No difference in placement and replacement rates between amalgam and composites was reported. The major reason for placement was primary caries (90%). The major reasons for replacements were recurrent caries (40.0%), primary caries of interproximal surfaces (18.9%), and fractured restorations (12.3%). Of the 297 MOD restorations, 74.3% were replacements and of the 1,140 Class I + III + V restorations, 27.8% were replacements. This study showed that about half of the restorative work carried out were replacements. Caries is the primary reason for placement and replacement of restorations in adults.