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Notes: Objectives: The Oral Health of Older Adults with Dementia was instigated in the late 1990s to quantify and compare coronal and root caries incidence and increments in community-living older Australians with and without dementia.Methods: A longitudinal design was used to conduct dental inspections at baseline and one-year, for two groups of randomly selected community-living older adults - one group of 116 people with dementia and a comparison group of 116 people without dementia.Results: At one-year there were 103 dementia and 113(112 dentate) non-dementia participants. Coronal and root surface caries incidence was higher for dementia participants (p〈0.05). Dementia participants had higher coronal and root caries adjusted caries increments (ADJCI) (p〈0.01). Both coronal and root ADJCI were evident in half of dementia participants, compared with one-quarter of non-dementia participants. Dementia participants with higher coronal ADJCI were those who had visited the dentist since baseline, who were taking neuroleptics with high anticholinergic adverse effects, and whose carer had high carer burden score (p〈0.01). Dementia participants with higher root ADJCI were those needing assistance with oral hygiene care and whose carers had difficulties with oral hygiene care (p〈0.05). Baseline characteristics predictive in linear regression for: (1) coronal caries increments among all participants were - dementia participants, those with cognitive testing scores indicative of moderate-severe dementia, those with private health insurance; (2) root caries increments among all participants were - dementia participants, and those who had 1 decayed/filled root surface at baseline. Among dementia participants, being male was the baseline characteristic predictive in logistic regression for coronal caries increments, and having 1 decayed coronal surface was the baseline characteristic predictive for root caries increments.Conclusions: Coronal and root caries incidence and increments were significantly higher in the community-living older adults with dementia over the one-year follow-up period. Dementia participants had high levels of coronal and root caries increments; characteristics related to high caries increments included sex (males), dementia severity (moderate-severe), high carer burden, oral hygiene care difficulties, use of neuroleptic medication (with high anticholinergic adverse effects) and previous experience of caries.

Notes: This paper describes a numerical method of solution for wave propagation in a medium whose elastic parameters and density vary with depth in any specified way. Results for a simple two layer problem are given to illustrate the method, and the extension to problems of current geophysical interest is briefly discussed.

Notes: The histomorphological effect of multidose administration of 6 mg/kg pentagastrin b.d. for 5 weeks, and 1000 mg/kg sodium bicarbonate b.d. for 13 weeks, on the rat fundic mucosa has been examined. Sodium bicarbonate induced a significant hypergastrinaemia (plasma gastrin concentrations were 370.5 pg/ml in the control versus 642.6 pg/ml in sodium bicarbonate-treated rats after 13 weeks, P 〈 0.01). Both treatment regimens induced fundic neuroendocrine cell hyperplasia. The cellular proliferation that occurred following hypergastrinaemia of endogenous or exogenous origin suggests that systemic gastrin concentrations play a major role in the control of fundic neuroendocrine cell populations.

Notes: Abstract The aim of the present study was to examine yearly increments in exposure, cumulative exposure, and mean proportion of lifetime exposure to optimally fluoridated water supplies of Australian adolescents over the period 1960 to 1978 and to conditionally predict trends in those exposure measures from 1979 to 1990. The basis of the study was the history of the introduction of water fluoridation. Yearly increments were found to have been most varied, but cumulative exposure has continued to increase from a negligible level in 1960 to approximately two-thirds of adolescents being exposed in 1978. Proportion of lifetime exposure was represented by a smooth sigmoidal curve with time-lagging of successive curves for higher ages between 12 and 17-yr-old. Proportion of lifetime exposure was predicted to increase through to 1990 and 1996 for 12-and 17-yr-olds, respectively. This prediction showed little sensitivity to yearly increment conditions from 1979 to 1990.

Notes: Abstract – Service provision patterns may be influenced not only by clinical oral health status leading to a diagnosis and treatment plan, but also by other variables such as patient characteristics. The main aim of this study was to investigate whether associations between services provided and patient factors would persist after controlling for the main presenting diagnosis or condition. A random sample of dentists surveyed in 1993–94 provided a response rate of 74%. Private general practitioners recorded service provision data from logs of 1–2 typical days of practice. Caries (26.5%) was the most prevalent diagnosis, followed by recall/maintenance care (19.0%), pulpal/periapical infection (10.9%), and failed restorations (10.4%). Diagnoses were associated with variation in the percentage of patients receiving services in main areas of service, and also with insurance status, sex and age distributions of patients, and type of visit (chi-square; P〈0.05). Logistic regressions of receipt of services indicated statistically significant associations with patient characteristics and diagnosis categories. Controlling for diagnosis, uninsured patients and those visiting for emergencies had less favourable service patterns (e.g., higher odds of extractions, but lower odds of preventive and crown and bridge services) compared to patients who had dental insurance or visited for check-ups or other non-emergency dental problems. The influence of these factors on services provided has implications of public health importance in terms of appropriateness of care and social inequality.

Notes: Abstract The dental health status and treatment needs of 302 secondary school students (182 boys, 120 girls: age range 11–16 years) were surveyed. Restorative, exodontic, periodontic, prosthetic, and orthodontic treatment needs were assessed at the time of examination. The dental health status was poor and the amount of treatment needed was high. Treatment needs increased with age and were dominated by restorative work. The average student required 19.8 relative value units of work, taking 23/4 hours and costing A$ 93.00.

Notes: Abstract Increasing numbers of women are entering the once male-dominated dental profession in Australia. Determining what differences exist in the practice of dentistry between male and female dentists has therefore become an important task. The purpose of the present study was to examine differences in practice between male and female dentists. Data were available from a weighted, stratified random sample of 730 dentists (486 male and 294 female dentists) in each State or Territory of Australia. Using discriminant analysis age, practice setting, number of other dentists in the practice, inputs to the practice of dentistry either hired, acquired or contributed, direct demand and community size were all found significant in separating male and female dentists. It was more difficult to separate younger male and female dentists, indicating some convergence between the sexes. However, some differences persisted. Possible reasons for the differences are discussed and some implications noted.

Notes: Abstract – Since their exodus in 1959 about 100 000 Tibetans have settled in disparate communities in northern India and Nepal. This study describes the dental health of 243 Tibetan children in Dharamsala, in the State of Himachal Pradesh, India. Only 20% of 6-yr-olds were caries-free in the primary dentition while 96.9, 53.3, and 22.4% of 6, 12, and 15-yr-olds were caries-free in the permanent dentition respectively. The DMFT of 12-yr-old children was 1.1, while 15-yr-old children had a DMFT of 3.1. While plaque and calculus were present in many sextants, there was little intense gingivitis and signs of advanced periodontal diseases were rarely present. Almost no dental care had been received. Appropriate dental health promotion activities are discussed.

Notes: Abstract Studies using plaster models of teeth and photographs simulating the full range of occlusal conditions have found high agreement between measures of adolescent social acceptability of these conditions and perceived need for orthodontic treatment. This study examined the association between adolescents' acceptability of their own occlusal condition, severity of malocclusion, and likelihood of undergoing orthodontic treatment. The factors predicting the acceptability of occlusal condition of 13-yr-olds, as assessed by the SASOC scale, were measurements of acceptability of general physical appearance, and the severity of occlusal condition. Variability in SASOC scores appeared to be independent of gender, socioeconomic status, and ethnicity. Gender, and severity of occlusal condition were important differences between subjects who had received, planned, or were undergoing orthodontic treatment, and those who had not. Neither SASOC scores nor perceived need for treatment accounted for a significant proportion of the variance between these groups. Although adolescents seeking orthodontic treatment had a greater severity of malocclusion than those not, little difference was observed between these groups in acceptance of occlusal condition.

Notes: Abstract –  Objectives:  Service provision varies by dentist, practice and patient factors. However, limited subsets of these potential influences on service rates have been explored. More comprehensive models could improve our understanding of the factors influencing the pattern of care delivered. The aim of this study was to examine variation in dental services by dentist (treatment choice, practice beliefs, preferences for patients, demographics), practice (type, location, size and volume of practice) and patient (visit, demographic, oral health and socio-economic) characteristics.Methods:  A random sample of Australian dentists was surveyed in 1997–98 (response rate = 60.3%). Private general practitioners (n = 345) provided dentist and practice data, and service provision and patient variables were collected from a log of a typical clinical day (n = 4,115 patients). Multivariate negative binomial regression models were fitted for diagnostic, preventive, restorative, extraction and prosthodontic services.Results:  Significant dentist factors included (P 〈 0.05; RR = rate ratio): lower diagnostic rates (RR = 0.78) for dentists with stronger practice beliefs for giving information about cost and treatment options; preventive rates were lower (RR = 0.74) for male dentists and higher (RR = 1.48) for younger dentists aged 20–29 years; restorative rates were higher (RR = 1.27) for dentists that rated patient preferences more highly in treatment choice and in the dentist age group 30–39 years (RR = 1.25); extraction rates were lower (RR = 0.61) for dentists with stronger preferences for patients that would adhere with treatment but higher (RR = 1.57) for dentists with stronger preferences for sociable patients; and prosthodontic rates were lower (RR = 0.38) for dentists with stronger preferences for adaptable patients who were willing to cooperate when expected to do so. Practice factors included: higher preventive (RR = 1.28) and prosthodontic rates (RR = 2.07) in solo practice; higher preventive (RR = 1.34) but lower prosthodontic rates (RR = 0.42) in capital cities; lower diagnostic (RR = 0.82) and extraction rates (RR = 0.55) in practices with fewer other dentists; higher diagnostic (RR = 1.33) and extraction (RR = 1.62) rates but lower restorative rates (RR = 0.84) in practices with lower patient visits per year. Patient factors included: lower preventive (RR = 0.76) but higher extraction rates (RR = 1.45) for emergency visits; lower extraction rates (RR = 0.60) for the insured; higher diagnostic rates (RR = 1.17) for new patients; higher restorative (RR = 1.31) but lower prosthodontic rates (RR = 0.46) for patients with decayed teeth; higher prosthodontic rates (RR = 2.14) for those with dentures; and lower preventive (RR = 0.66), but higher extraction (RR = 2.22) and prosthodontic rates (RR = 1.82) for patients from lower socio-economic status areas.Conclusions:  Dental service rates were influenced by large number of small effects from a wide range of dentist, practice and patient factors. Socio-economic and geographic barriers may need broad policy innovations to be addressed, but factors such as insurance and visit type have the potential to be altered to achieve better service outcomes and there is scope for research into clinical outcomes to improve the knowledge upon which treatment decisions are based.