A nationwide survey of oral conditions, treatment needs, and attitudes toward dental health care in Dutch adults was carried out in 1986. One of the aims of the study was to assess the prevalence of signs and symptoms of temporomandibular disorder (TMD). A sample of 6577 persons (from 15 to 74 yr of age), stratified for gender, age, region, and socio-economic status, was contacted. Of this sample, 4496 persons participated in the behavioral part of the study, of whom 3526 were examined clinically. The TMD prevalence was based on (1) perceived signs and symptoms of TMD and (2) clinical examination of joint sounds, deviation, and pain on mandibular movements. A total of 21.5% of the Dutch adult population perceived some dysfunction, and 44.4% showed clinically assessed signs and symptoms of TMD. In nearly all age groups, the signs and symptoms of TMD appeared more in women than in men. Agreement between the results of the clinical examination and the anamnestic dysfunction index was significant (p < 0.0001); however, the Pearson's correlation coefficient was low (r = 0.29). The odds-value (risk-ratio) that subjects who perceived signs and symptoms of TMD would present with clinically assessed signs and symptoms of TMD was 2.3. The results of the survey were compared with results of a meta-analysis performed on 51 TMD prevalence studies. The analysis revealed (1) a perceived dysfunction rate of 30% and (2) a clinically assessed dysfunction of 44%, both based on compound samples of, respectively, over 15,000 (23 studies) and over 16,000 (22 studies) randomly selected subjects.
The aim of this study was to assess differences in dental health between socioeconomic and ethnic groups in a cohort of 5-yr-old children born in 1982 and in a cohort of 11-yr-old children born in 1976. A further aim was to evaluate the putative role of dental behaviors as intervening factors between ethnicity and maternal education on the one hand and caries experience on the other. A secondary analysis was performed on data collected in a study monitoring the oral health of youths covered by public health insurance (Ziekenfonds) in the Netherlands. The results showed both ethnicity and maternal education to be indicators of caries risk in the primary dentition. For caries in the permanent dentition, only maternal education could be identified as a risk indicator. Dental behaviors were related to caries experience as well as to ethnicity and maternal education, though the evidence for the role of these dental behaviors as intervening factors was weak. It is concluded that the validity and reliability of the behavioral measurements might be questionable and that the mechanism underlying the differences in caries experience between the various groups is still little understood.
In 1986 a nationwide dental survey was performed in the Netherlands. This article describes the prevalence of dentofacial anomalies in the age group 15-74 yr, as well as the subjective and objective need for orthodontic treatment. The main findings were: severe crowding in the mandible was found in approximately 15%; an Angle Class II situation was seen in 28%; a maxillary overjet of greater than 5 mm was found in 23%; orthodontic treatment had or was being performed in approximately 25%; 45% of orthodontic treatment was carried out by a general practitioner; using professionally defined need, 39% of the population required treatment whereas only 14% of the people felt that this treatment was necessary.
With the aim of evaluating the relationship between consumption of sweet snacks (sugars) and caries prevalence, a secondary analysis was performed on data obtained in an epidemiological study of 5-, 8- and 11-year-old children, all participants of Regional Institutions for Youth Dentistry. The children’s primary and permanent teeth were examined mainly by visual examination. Parents completed a questionnaire on the child’s toothbrushing habits, use of fluoride tablets and fluoride toothpaste, consumption of sweet snacks, level of eduction of the mother as an indicator of the socio-economic status of the family and country of birth of the mother as an indicator of ethnicity. The various oral hygiene habits were combined into one variable. Firstly the crude relationship between consumption of sweet snacks and caries experience was evaluated, subsequently oral hygiene habits, socio-economic status and ethnicity were taken into account. Mean dmfs scores of 5- and 8-year-old children who consumed sweet snacks between meals more than 5 times a day (according to parents’ reports) were significantly higher than mean dmfs scores of children with a lower reported sweet snack consumption. Multivariate analysis confirmed this result. Only 4.2% of the children were in the group with such a high sweet snack consumption. A number of parents probably underestimated the sweet snack consumption of their children. As the validity of the data on sweet snack consumption was questionable, the actual influence of this factor might be larger than the results of this study show.
The dental health of 45 children who had been placed on long term evaluation after chemotherapy treatment for malignancies was examined in this study. All children had received cytotoxic drugs during the period of tooth formation. It was found that they had more filled or diseased permanent teeth than control children. Their current caries activity as indicated by initial white spot lesions was also higher. Forty-three of the children showed evidence of disturbed amelogenesis. This had resulted in aesthetically displeasing grooves, pits and discoloration. Twenty-three of the children were counseled on the possibility of cosmetic dentistry. Delayed eruption and shortened, malformed roots were also found on several patients. It was concluded that these patients constitute a high risk dental care group.
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