Poor oral hygiene and dental caries predict high mortality rate in hemodialysis: a 3-year cohort study.

The aim of this study was to investigate the impact of oral hygiene, periodontal diseases, and dental caries on all-cause mortality in hemodialysis. This prospective cohort study included 266 patients with end-stage renal disease who were undergoing hemodialysis. Medical interviews, blood biochemical tests, and comprehensive dental examinations including periodontal pocket examination on all teeth and dental plaque accumulation by debris index-simplified (DI-S), were performed. Survival rates were assessed at a 3-year follow-up. Overall, 207 patients were included in the longitudinal analysis, and 38 subjects died during the follow-up period. Cox proportional hazards analysis of the multivariate model demonstrated that the highest tertile of DI-S had a significantly higher risk of all-cause mortality than the lowest two tertiles after adjustment for age, sex, smoking habit, body mass index, diabetes, prior cardiovascular disease, hemodialysis vintage, high sensitivity C-reactive protein, albumin, and number of remaining teeth (hazard ratio, 3.04; 95% confidence interval, 1.50-6.17; p = 0.002). Moreover, the number of decayed teeth significantly increased the hazard ratio to 1.21 (95% confidence interval, 1.06.1.37; p = 0.003). This study suggests that accumulated dental plaque and untreated decay, but not periodontal disease, may be independently associated with all-cause mortality in patients undergoing hemodialysis.

Survival rates of two atraumatic restorative treatment (ART) types in occlusal carious permanent teeth after two years.

OBJECTIVE: To compare survival rates of Atraumatic Restorative Treatment (ART) restorations placed with and without conditioners in occlusal cariouspermanent teeth after two years. MATERIAL AND METHODS: The study was an experimental study among children, mean age 13.1 +/- 3.0 years. Two types of ART restorations were randomly placed on 186 occlusal carious permanent teeth on contralateral sides using split mouth design. Ethical clearance to conduct the study was obtained from the UI/UCH Review Committee. ART was performed using GC Fuji IX GP and teeth that were conditioned with GC Dentine Conditioner. Time taken to place restorations and average material cost were recorded. Follow-up of subjects to evaluate integrity of restorations was conducted at 6 monthly intervals by one independent examiner. Proportions and percentages were generated; student t-test was used to compare means. Cumulative survival rates were determined by the coded scores and standard criteria for evaluating ART restorations. RESULTS: There was no significant difference in the mean time for placing ART restorations with or without conditioners and in the cumulative survival rates of both treatment types after 2 years (p > 0.05). CONCLUSION: ART restorations placed without tooth conditioners can achieve similar result as those placed with conditioners.

Salud bucodental. Evaluación de los objetivos del Plan de Salud de Cataluña para el año 2000 / Oral health. Evaluation of the objectives of the Health Plan for Catalonia for the year 2000

Fundamento y objetivo: En la década de los años ochenta la caries dental era uno de los problemas de salud más prevalentes entre la población escolar de Cataluña. Por ello, en el ámbito de la salud bucodental, la caries se identificó como un problema de salud prioritario para su abordaje en el Documento marco para la elaboración del Plan de Salud, debido a su elevada prevalencia, a los altos costes de su tratamiento y rehabilitación, así como por la existencia de intervenciones preventivas de probada efectividad. En consecuencia, se propusieron tres objetivos de salud para el año 2000, cuya evaluación constituye el propósito de este trabajo. Población y método: Se han utilizado los datos de distribución y evolución de la prevalencia de caries dental recogidos mediante las encuestas del Departament de Sanitat i Seguretat Social en los años 1983, 1991 y 1997, desarrolladas de acuerdo con la metodología propuesta por la OMS. Resultados: Se observa una tendencia continuada de aumento del porcentaje de escolares libres de caries. Así, en 1997 se llegó hasta el 53,4% de escolares de 12 años sin caries y el 70,2% de escolares de 6 años también libres de caries. Respecto al índice CAOD en los escolares de 12 años, ha pasado de un valor de 2,98 en 1983 a 0,9 en 1997. Conclusiones: Se pudo evaluar la evolución de los indicadores correspondientes a los tres objetivos de salud formulados. De éstos, dos se han alcanzado plenamente y el tercero, relativo a la prevalencia de caries entre los escolares de 6 años, aunque no se ha conseguido plenamente, indica una tendencia claramente positiva (AU)

Background an objective: In the eighties, dental caries was one of the most prevalent health problems among school population in Catalonia. Dental caries was considered a health priority due to its high prevalence, costs of treatment and rehabilitation and the existence of widely proved preventive interventions. Therefore, three health aims were purposed in the framework of Health Plan for Catalonia for the year 2000. The objective of this paper will be discuss if these aims were achieved. Subjects and method: We have analized data related to distribution and evolution of tooth decay prevalence. This information was obtained from surveys carried out in 1983, 1991 and 1997 by the Department of Health and Social Security. This opinion polls were developed according to the methodology purposed by the WHO. Results: We have noticed an upward trend in the percentage of schoolchild free of caries. In 1997 there were 53% of schoolchild under 12 and 70% younger than 6 years old free of tooth decay. Furthermore, the DFT index sunk from 2.98 in 1983 to 0.9 in 1997. Conclusions: We could assess the evolution of the indicators related to the three health objectives drawn up. Two of three aims were fulfilled. We have noticed that the one concerning to dental caries prevalence under 6 years has not been achieved completely, although it showed a positive tendency (AU)

Relationship between oral health and mortality rate.

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.