This article examines the relationship between fluoridation and socioeconomic status on caries experience, as measured by the dmf index, in 5-yr-old New Zealand children in the city of Dunedin (fluoridated in 1967) and in adjacent non-fluoride communities. The children were subdivided into six socioeconomic status groups (SES 1, professional and managerial-SES 6, unskilled workers), but then for simplicity they were combined to form three groups. A two-way analysis of variance demonstrated that interaction between fluoride history and socioeconomic status was not significant. In all three SES groups, dmf was higher in non-fluoride communities, but the difference was significant only in SES group (5&6) (P less than 0.01). Caries experience increased with decreasing socioeconomic status in both fluoride and non-fluoride communities, but this effect was only significant between SES groups (1&2) and (3&4) in the fluoridated community (P less than 0.05), and between SES groups (3&4) and (5&6) in non-fluoride communities (P less than 0.01). These results are compared with those of similar studies, and it is concluded that so far, the relationship between fluoridation and socioeconomic status on caries experience remains equivocal. A note of caution is sounded regarding the interpretation of such results, and the difficulties faced when comparing studies is discussed.
Examination of 2,138 subjects, aged 15-65+ years, was carried out by calibrated examiners using mirrors and fibre optic illumination. Each subject was scored by the Periodontal Status Index, PSI (WHO Oral Health Surveys), Periodontal Index, PI (Russell) and the Oral Hygiene Index, OHI (Greene & Vermillion). For the PSI, PI and OHI all scores were age-dependent with the exception of soft deposits in PSI and OHI, which were age-independent. The advantages of the PSI system were considered to be the ease of scoring and the opportunity to assess treatment requirements, in terms of time, at the public health service level. Disadvantages were lack of quantitation, difficulties of diagnosis of intense gingivitis, and localized and general conditions. The PI and OHI systems provided a more objective, quantitative and sensitive basis of scoring than the PSI. Statistical tests showed the respective indices are associated and measuring the same kind of criteria. Examiner calibration and consistency were similar for both scoring systems.
Since the retention of carbohydrate foods on the teeth is accepted as a determinant of caries activity, it is logical to assume that there will be a direct relationship between the extent to which carbohydrate foods adhere to the teeth and their relative cariogenicity. Therefore, if foods could be rated according to their retentivity to the teeth, there might be reason for excluding some carbohydrates but allowing others in diets designed to control caries. This concept led Bibby, Goldberg, and Chen' to determine "decalcification potentials" for 105 foods from experiments which combined measurements of the amount of food retained around the teeth following mastication and the amount of acid formed on salivary fermentation of that food.Bibby et al.1 measured food retention by means of a carbohydrate analysis of rinsings recovered from the mouth of a test subject who had chewed the food. Their technique for measuring food retention was subject to several inaccuracies, the most important of which was that the value obtained included the food retained on the soft tissues of the mouth as well as that retained on the teeth. Although this was overcome by Ludwig and Bibby's2 modification, the method was still subject to considerable person-to-person and day-to-day variations.In view of these uncontrollable limitations in the in vivo technique, it was considered desirable to develop an in vitro method of measuring the retention of foods to tooth surfaces. Such an in vitro technique could be used to derive cariogenic ratings of foods, and it could also be employed to analyze the factors in the composition or preparation of foods which influenced their retentivity. This information might in turn make it possible to modify the formulation of candies and other highly cariogenic foods to reduce their cariogenicity without affecting their taste appeal. This paper reports the development of such an in vitro technique which gives a fairly wide spread in numerical values for different foods and which rates the foods in much the same order of retentivity as had been obtained with earlier, intra-oral recovery techniques. EXPERIMENTAL METHODS AND RESULTSDevelopment of centrifugal method.-After preliminary experimentation with apparatus designed to imitate masticatory movements, it was decided that centrifugal force was the most easily controlled force that could be used to dislodge test foodstuffs
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