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Introduction: This article aims to review the current national and international dental guidance produced during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic to identify the level of consensus on aerosol-generating dental procedures (AGDPs). The outcomes intend to encourage increased collaboration with respect to dental guidelines in relation to the SARS-CoV-2 pandemic, as well as to improve decision making and safety for dental patients and staff. Methods: This rapid review was conducted by 2 authors (MKV and KD), with the support of a third author (SD), to assess current guidelines related to dental AGDPs. This streamlined review approach allowed synthesis of data in an efficient manner in the rapidly evolving environment associated with the SARS-CoV-2 pandemic. Results: The findings identified 1) a lack of consistency in reporting which procedures were deemed an AGDP; 2) that high-speed handpieces, air-water syringes, and mechanical scalers were consistently considered high-risk AGDPs; 3) a lack of consensus on the risk of coronavirus disease 2019 (COVID-19) transmission with the use of slow-speed handpieces; 4) a general agreement, when described, that rubber dam and high-volume evacuation can significantly reduce aerosol production; and 5) a lack of consistency in reporting whether procedures constitute a low, moderate, or high risk of COVID-19 transmission. The findings are discussed in relation to the guidance and future recommendations. Conclusion: It is recommended that future published guidance should indicate the risk stratification (low/moderate/high) of each procedure/exposure in a standardized international approach. Knowledge Transfer Statement: The results of this rapid review can be used by clinicians to increase their awareness of international guidance on aerosol-generating procedures in dentistry. It will also encourage those publishing future guidance to provide an internationally standardized, risk-stratified approach to describing aerosol-generating procedures. Currently, it allows clinicians to consider aerosol-generating procedures as a risk spectrum.

Background COVID-19 is a novel viral respiratory disease caused by a member of the coronavirus family, SARS-CoV-2, and has been declared as a pandemic on March 2020. Dental practitioners are routinely exposed to infectious bodily excretions, for example, saliva, blood, and respiratory excretions. Therefore, they are in the first line of SARS-CoV-2 infection-prone health care providers. The purposes of the current review are to trace documented cases of COVID-19 transmission inside dental settings worldwide and to explore the clinical management of these cases. Methods We searched MEDLINE and Google Scholar for all possible reported cases of COVID-19 transmission in dental practice as of December 1, 2019, until May 13, 2020. Multiple terms and combinations were used, including “coronavirus,” “COVID-19,” “SARS-CoV-2,” “dental,” “dentistry,” “transmission,” and “nosocomial.” Articles that were not written in English were excluded. Results A total of 78 articles were found from December 29, 2019, until May 13, 2020. Of these, 31 articles discussed the risks related to dental practice and recommended infection management protocols for dental health care personnel. Of these articles, only 1 had reported data on transmission of COVID-19 in dental practice. Two possible transmissions of COVID-19 to dental personnel were reported in China before its recognition as an epidemic. Conclusions Although it seems that there are almost no reported cases of infection by SARS-CoV-2 during dental treatments, occupational or nosocomial transmission could not be ruled out. Hence, further prospective assessment of COVID-19 transmission is urgently required, and careful and protective measurements are necessary to avoid infection during dental practice.

Oral health is an important factor of human morbidity worldwide. Yet is often neglected in occupational health despite its direct impact on the quality of life and health of workers.To discuss the role of oral health in sickness absence and presenteeism, as well as in development and work efficiency improvement processes involving governments, companies and the workers themselves.Review of full-text articles on oral health, occupational health, sickness absence and presenteeism published in English or Portuguese in the last 10 years and included in scientific databases.Oral problems accounted for 9 to 27% cases of sickness absence and 28 to 50% of presenteeism, with toothache and temporomandibular joint pain as the most frequent reasons. About 50% of workers prefer company-provided dental care, while 40% visit public and 10% other types of facilities. Despite high, the prevalence of oral diseases and orofacial pain was not associated with high rates of absenteeism, but mainly with presenteeism, this is to say, workers do not tend to miss work days, but their performance is reduced and become susceptible to more serious health problems in the future.Oral health is not dissociated from general and occupational health, and as such it must be enhanced and duly promoted in an integrated manner. Effective and comprehensive oral health promotion and prevention public policies and private sector actions in the workplace can enhance the quality of life of workers.A saúde bucal é um importante fator de morbidade humana mundial, mas frequentemente negligenciada em saúde ocupacional, apesar do impacto direto na qualidade de vida e na saúde do trabalhador. O objetivo deste artigo foi discutir o papel da saúde bucal como fator de absenteísmo e presenteísmo e nos processos de desenvolvimento e eficiência laboral por parte de governos, empresas e pelos próprios trabalhadores. Realizou-se revisão da literatura com artigos na íntegra, em inglês ou português, dos últimos 10 anos, nas bases científicas relacionando-se os temas saúde bucal, saúde ocupacional, absenteísmo e presenteísmo. Doenças bucais variaram como causas de absenteísmo entre 9 e 27%, mas de 28 a 50% como de presenteísmo. Dores dentárias e de ATM são as causas mais comuns. Entre 9 e 56% dos trabalhadores buscaram tratamentos em rede pública, e de 40 a 45%, em rede privada. Nas empresas que oferecem atendimento odontológico, 49% dos funcionários optaram pelo ambulatório da empresa, contra 40% da rede pública e 11% de outros tipos. A elevada prevalência de doenças bucais e de dor orofacial não é causa de elevados índices de absenteísmo, mas principalmente de presenteísmo. O trabalhador não se afasta, trabalha de forma deficitária e com propensão a maiores adoecimentos futuros. A saúde bucal tem importância não dissociada da saúde geral e ocupacional e, como tal, precisa ser incentivada e acompanhada de forma integrada. Políticas públicas e ações do setor privado efetivas e abrangentes na promoção e prevenção em saúde bucal no ambiente laboral podem ofertar melhor qualidade de vida aos trabalhadores.

This study evaluates the association of Non Carious Cervical Lesions (NCCLs), Oral Health-Related Quality of Life (OHRQoL) and Work Ability Index (WAI) in a Brazilian population of Workers. One hundred workers were evaluated in a CEREST (Worker´s Health Reference Center). Participants were examined for oral disease following WHO recommendations, and the Oral Health Impact Profile (OHIP) and Work Ability Index assessment was used to determine OHRQoL and capacity to work, respectively. Assessment of tobacco use and alcohol consumption was made by Fagestron tolerance and Audit test. Statistical analyses were performed using STATA version 13.0. Dimensions with highest OHIP scores were physical pain and psychological discomfort. In bivariate analyses, NCCLs was significant associated with OHIP-14 severity PR 3.8 (CI95%1.26-11.89) and with self-related of oral pain PR 2.16 (CI95% 1.06-4.40). In the multivariate logistic regression analyses, years of smoking habits OR 1.73 (CI95% 1.03-2.9) was significant associated with OHIP-14 severity, independent of other variables. OHIP14 was significant associated to WAI (p=0,02). Strategies for Monitoring oral health Brazilian workers and reduce tobacco use should be done by Brazilian Companies to support Work ability. For future investigations on OHRQoL, analyses of NCCLs should be included.Descriptors: Quality of Life; Oral Health; Occupational Dentistry; Occupational Health; Tooth Erosion.

The purpose of this study was to evaluate effects of oral health education for occupational health nurses. The subjects were 300 occupational health nurses which participated in continuing education of Korean Association of Occupational Health Nurses. Oral health education contents consisted of basic knowledge about oral health, prevention of periodontal disease, oral health care for workers, and oral health program for workers. In order to evaluate the effects of oral health education, we performed questionnaire surveys before and after the education regarding their perceived oral health status and concern for oral health, knowledge about prevention of periodontal disease, attitude about oral health promotion, and needs for implementation of oral health promotion program. The data were analyzed by paired t-test to compare the change of knowledge and attitude according to the education. Linear regression analysis was carried out to assess the factors related to the improvement of their knowledge and attitude. The findings indicated that oral health knowledge and attitude of occupational health nurses were significantly improved by oral health education. A factor of the improvement of knowledge and attitude was concern for oral health. And they would like to be provided primarily oral health education for occupational health nurses. Finally, this study suggested that oral health education for occupational health nurses had significantly effects on improving oral health knowledge and attitude.

This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador – CEREST (Worker’s Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

OBJECTIVE: To describe the profile of dentists in oral health team of the micro-region of Minas Gerais, Brazil. METHODS: Cross-sectional study with 48 dentists in 16 municipalities, in which data collection was conducted by questionnaire. The variables considered for the study were: training time in years, and monthly real salary (centroid), in compliance with weekly working hours, mode of incorporation into the oral health team, postgraduate course, social participation and ongoing involvement in Family Health. All variables were used to group dentists by Two Step Cluster analysis segmentation, with p

The article presents the results of the survey of 150 dentists from 10 closed administrative units of FMBA health care system of Russia in connection with the dynamics of dental staff withdrawal and reduce of volume of preventive work in schools and factories. These problems were found to be associated with the lack of regulations on mandatory preventive dental examinations of workers with occupational hazards, low tariffs for dental services in obligatory medical insurance program, poor wages an lack of apartments for young dentists.Приведены результаты анкетирования 150 врачей-стоматологов из 10 закрытых территориально-административных образований (ЗАТО) системы медицинского обслуживания ФМБА России, проведенного в связи со снижением укомплектованности штатов врачей-стоматологов и уменьшением объема профилактической работы в школах и на промышленных предприятиях. Установлены проблемы стоматологической службы ЗАТО, связанные с отсутствием документов, регламентирующих обязательные профилактические осмотры работников с опасными условиями труда у стоматолога, с низкими тарифами ОМС за стоматологические услуги, с недостаточной заработной платой и отсутствием собственного жилья у молодых врачей-стоматологов.

Resumo Para a estruturação de um sistema de informação em saúde, é importante o fornecimento de um esquema de codificação. A utilização da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) permite a descrição da saúde e dos estados relacionados à saúde, avaliando o que é significativo para o indivíduo e complementando a informação sobre o diagnóstico fornecida pela Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde – CID. Este ensaio explora a estrutura e o modelo conceitual da CIF, indicando as perspectivas de utilização da CIF em saúde bucal do trabalhador. A avaliação do impacto de uma condição de saúde bucal é fundamental para o planejamento de ações que considerem a integralidade da saúde, bem como sua relação com o bem-estar e a qualidade de vida no trabalho. A CIF é a ferramenta imprescindível para a viabilização de uma abordagem abrangente capaz de abarcar as múltiplas dimensões envolvidas em uma situação de comprometimento da saúde bucal, qualificando as informações disponíveis para a definição de estratégias de intervenção em saúde do trabalhador. Abstract A Coding scheme is important for structuring a health information system. The use of the International Classification of Functioning, Disability and Health (ICF) enables the health description and health-related states, evaluating what is meaningful to the individual and complementing the diagnosis information provided by the International Statistical Classification of Diseases and Related Health Problems – ICD. This paper explores the ICF structure and conceptual framework, stating the perspectives of using the ICF in worker’s oral health. The impact of oral health assessment is critical for planning actions, considering the health’s integrality as well as its relation to the well-being and quality of life at work. The ICF is an essential tool for achieving a comprehensive approach to encompass the multiple dimensions involved in a situation of oral health impairment, qualifying the information available for defining intervention strategies in occupational health.

Aim: To analyze the relationships between perceived oral health quality of life and work ability index. Methods: The data regarding administrative workers of a private textile company in Sao Paulo - Brazil, included socio-demographic, occupational characteristics, self-perceived oral health (OHIP 14) and self-perceived work ability index (WAI). Results: The response rate of the questionnaires was 75.20% and the reliability of the instruments (Conbrach’s alpha) was 0.89 for OHIP 14 and 0.64 for WAI. Linear multiple regression analyses showed that OHIP 14 was associated with educational level (p=0.009) and work ability index (p=0.001) of workers, regardless of other variables. Conclusions: These results showed the importance of adopting oral health programs in private companies to improve oral health and work ability.

Dentists are at risk in terms of pain, because of usually hold on particular position, use of highly precision instruments and make repetitive movements in narrow field of study. As well as pain in the musculoskeletal system, dentist could be encountered with restlessness. Avoidance of postural deficiencies, as well as subsequent pathological changes, such as muscle imbalances, muscle necrosis and spinal disk degeneration could be prevented assuring the application of ergonomics in dentistry. Exercises in accordance with advice of a physician should be done daily, the spaces between appointments and small breaks into the treatment session. Dentists could mantain their profession successfully and healthily long time carrying out regular excersize program, accurate posture and postioning strategies

Aim: To evaluate an oral health awareness campaign in an adult population. Design/Setting: Four workplaces in north-east London were selected, matched in two pairs and randomly allocated to test and control groups. Completion occurred in 1995. Subjects: 98 volunteer employees in good general health. Interventions: Two oral examinations were carried out, six weeks apart. The test group received the programme immediately after baseline examination and the controls after the second visit. Main outcome measures: Gingival bleeding on probing (BOP) and probing depths (PD) were measured on each occasion using a controlled pressure probe. Results: The mean percentage of sites with BOP per subject reduced from 56% to 25% in the test group, while remaining static in the control group at 46% to 48%. The mean percentage of sites probing 4 mm and above per subject reduced from 38% to 25% in the test group and from 28% to 25% in the control group. These differences between groups were statistically significant when submitted to analysis of covariance (P < 0.001). Conclusions: The study showed the clinical effectiveness of a workplace-based oral health awareness campaign, which is ideally suited to the skills and resources of the primary care dental team

Absenteeism is determined as an absence from work, resulting in the decrease of the company's production and, consequentially, causing profit reduction. The employer must follow closely the employees' quality of life, assuring that they perform all their tasks effectively. Dental health is directly connected to the employee's general health status and cannot be put aside when trying to assure complete physical and mental well being of an individual. AIM: To analyze pre-employment exams of a military company in order to identify, among all the reasons for exclusion, dental problems that ultimately resulted prevented hiring of job applicants. METHODS: Information was collected in 2008 from the dental files of the Health Department archives, which contained data referring to the candidates applying for a specific position and permitted and analytical study of the reasons for exclusion, based on the International Classification of Diseases (ICD-10). RESULTS: 10.24% (720) of the candidates, from a total of 7,029, were excluded for dental reasons, namely dental cavitation, 2.8% (197), and pulpal and periapical diseases, 3.14% (221). CONCLUSIONS: Aside from being limited, the results of this study suggest that dental problems influence a great deal on the quality of life of employees that are able for work, and, that being said, should be managed closely to reduce absenteeism in the workplace.

The aim of this paper is to describe an efficient clinical protocol used in admittance dental examinations, highlighting the importance of this evaluation in the diagnosis of oral pathologies. Two admission case reports in which gingival abscess and radiopaque apical lesion were found during the examination are presented for illustration purposes. A clinical examination in the admission inspection is the main factor for a good selection of treatment and prevention of future difficulties. The admission dental examination by means of a standardized clinical approach including clinical interview, physical examination and complementary exams, avoids the person to be admitted to the public service while having some pathology that might compromises his/her capacity of handling the selected function, preventing absenteeism for dental reasons and consequently a cost to the state and functional repercussion to the server.

The data from a dental health survey of an Australian employee group in Brisbane were used to test the value of dental health programmes at the workplace as a means of improving general dental health. The amount and complexity of treatment needs were investigated. Although both dental caries and periodontal disease were widespread, few of the employees had major treatment needs, most requiring minimal, simple dental care. Because of the minor treatment needs of a relatively static group of employees, the viability of a dental practice at work with emphasis on restorative dental care was questioned. Given the disease levels, the treatment needs indicated that a system based on prevention and maintenance care would be more appropriate.

Employees from an industrial group in Brisbane were examined at the workplace and found to have generally low levels of dental disease. At the same time, the Australian Bureau of Statistics suggests that less than 45 per cent of Australians attend a dentist annually. This low attendance for regular dental care reduces the effectiveness of any preventive dental service. A pilot scheme of preventive dental care was provided for employees at the workplace in Brisbane. The aim of the programme was to provide regular health counselling and reinforcement of oral health activities, general dental information, regular prophylaxis, scaling and cleaning, and referrals for restorative care. The preventive programme was appropriate given the disease levels. The services were effective in improving the periodontal status and restorative care which resulted from referrals. As well, the preventive dental care programme proved to be readily acceptable to both employees and management.

Major changes affecting oral health in the United States have provided new leadership challenges for public health dentistry. Two new roles for dental public health are proposed: leadership in the incorporation of expanded public health skills into the education of every clinical dentist; and a broadening of the specialty in a manner similar to that of preventive medicine, involving the creation of subspecialties in public health dentistry, occupational environmental dentistry, and management policy dentistry. The current status of community dentistry departments in dental schools and programs of public health education for dental personnel in schools of public health are reviewed. Content is suggested for the incorporation of expanded public health skills into the education of every clinical dentist.

195 Hong Kong Chinese employees from a single company participated in a 10-month longitudinal study on the effects of various modes of delivery of oral hygiene messages on their gingival health. Subjects were allocated to one of the following modes of oral hygiene education: (1) personal instruction; (2) self-education manual; (3) video; (4) a combination of 2 or more of these modes of instruction. Scaling or any other form of periodontal treatment was not given throughout the study period. Full mouth clinical examinations were carried out using a Williams Periodontal probe to examine for the presence or absence of plaque and bleeding on probing from the gingival sulcus. At 2 weeks, 4 months and 10 months, results showed significant reductions in the mean % of plaque and bleeding when compared with baseline. No significant differences were found between the groups given the various modes of oral hygiene education. The study does confirm the effectiveness of oral hygiene alone in improving gingival health, but the lack of difference in the outcome of various oral hygiene education approaches indicates that the mode of instruction is not crucially important to the end result. However, it has to be acknowledged that improvement in oral hygiene may be related to factors other than the oral hygiene programme itself. The findings have significant implications in oral health promotion programmes to improve the periodontal status of the local community.

The principal aim of this study was to assess the feasibility of conducting a systematic examination of the oral mucosa, as an integral part of the routine dental check-up and in conditions comparable with those in NHS dental practice. A total of 1949 individuals, who were already registered as patients with an industrial dental clinic, were invited to attend for an oral screen as part of their dental examination. Of these, 1947 patients agreed to participate and were also asked to complete a 'habits' questionnaire relating to their tobacco and alcohol use. A systematic examination of the oral mucosa was undertaken as part of the routine dental inspection and mucosal lesions were recorded as either a positive or negative screening result. Lesions included as a positive result were those which may be associated with early cancer or precancer. Four patients (0.2%) were considered to have a positive screening result and these were referred for specialist evaluation. Of these, two had tobacco-related leukoplakia, one had oral lichen planus and the other had an early squamous cell carcinoma. This study has confirmed that a systematic and thorough examination of the oral mucosa can realistically be carried out as part of the routine dental inspection in NHS dental practice.

Oral cancer and precancer appear to fulfil many of the criteria for a disease suitable for mass screening. Several commercial organisations in the UK have introduced screening for their employees. One program has been formally evaluated over the course of 1 yr. Of 553 company headquarters staff aged ≥40 yr, 292 (53%) responded to the well‐publicised screening invitation and received a simple clinical examination of the oral mucosa from one of two company dentists. In addition, 17 staff were screened from a separate company work‐site. After screening, subjects were examined independently by an oral medicine specialist with access to the relevant diagnostic aids. The dentists' screening decisions were validated against the specialist's definitive diagnoses (the‘gold standard'). The true prevalence of subjects with lesions diagnosed as positive (white patch, red patch or ulcer of greater than 2 weeks' duration) was 17 (5.5%). Overall, sensitivity was 0.71 and specificity, 0.99. The compliance rate to screening among headquarters subjects in seven occupational categories did not differ significantly from the occupational profile for all headquarters personnel. Estimates of relative risk of a positive diagnosis were calculated by logistic regression for five independent variables: gender, age, moderate smoking, heavy smoking, and smoking combined with greater than low risk alcohol consumption. Only heavy smoking (≥20 cigarettes per day) produced a significant odds ratio (3.43, P < 0.05). Copyright © 1995, Wiley Blackwell. All rights reserved

The periodontal status of 680 industrial employees in Adelaide, South Australia, was assessed in a descriptive epidemiologic survey. Full mouth recording using the recently proposed WHO ‘TRS 621’ survey method (14) was used by two calibrated examiners. Periodontal disease in this population was highly prevalent and typically of moderate severity. Only 4.2% of the subjects were free from any signs of periodontal disease. In 11.1% the disease manifestation was confined to reversible gingivitis. Mild periodontal disease was evident in approximately 60% and severe disease in 25% of the population. The major treatment requirement in all age groups could be categorized as “simple periodontal treatment” manageable by non specialist dental resources. More than 90% of pockets detected occurred interproximally. Some features of the proposed WHO ‘TRS 621’ survey methodology are discussed.

All workers (n = 59) at a Danish chocolate factory were given a questionnaire in order to study dental health behavior and self-assessment of dental health. Regular dental visits at least once a year was reported by 71% of the respondents. Toothbrushing at least twice a day was claimed by most of the workers, but only a few reported to brush their teeth daily at work. One fourth declared that they often consumed chocolate at their working place. Good dental and gingival conditions were only reported by 25% and in correspondence with this, nearly one third claimed to have had much or a great deal of trouble with their teeth. Mean DMFS increased from 22.7 in the age group 16-19 yr to 106.7 among persons 40 yr of age or more. In the age group 20-39 yr half of the teeth present had gingivitis and calculus and among the older individuals half of the teeth had gingivitis and pockets deeper than 5 mm. Chocolate workers were considered a high risk group.

A periodontal study was conducted in a paper mill in Finland. To adapt the Periodontal Treatment Need System (PTNS) to a Finnish adult population the estimates of Finnish periodontologists were used. The mean estimate of periodontal treatment need was 97 +/- 58 (s.d.) min per person and 32 +/- 18 min per jaw segment. Periodontal treatment need increased with age. No significant differences in periodontal treatment need by sex, education, type of employment, regularity of working hours or frequency of dental visits were observed. Adjusted family income and toothbrushing frequency did not produce significant differences in periodontal treatment need, except in the group having four dentulous jaw segments. The groups using sugar, other sweetening agents or neither of these, mainly in coffee or tea, differed significantly: the non-users of sugar had lowest treatment time and those who used other sweetening agents than sugar had highest treatment time.

Presence of clinically diagnosed TMJ dysfunction and the length of sick leaves were significantly associated in a sample of 599 male Finnish shipyard workers. Neglect of dental health care did not seem to be an explanatory factor, because the amount of untreated caries and the regularity of dental care did not differ significantly between the orthofunction and dysfunction groups. Although the association is no proof for a causal relationship, TMJ dysfunction may explain at least a part of the increase in days on sick leave, because dysfunction was found to be common and at best symptomatically treated in the population studied.

“The inevitability of this process [the loss of teeth] was recognized [before the establishment of the National Health Service J and in many industrial towns in the North, people often made the pragmatic decision not to put off the evil day, and so the extracting of all teeth and the fitting of dentures became a recognized twenty-first birthday or wedding present.” 1

A pilot dental program providing diagnostic and preventive services within a corporation has been in operation for two years at the JohnsonJohnson Dental Products Co. The charting system is computerized, allowing automatic problem lists and preventive progress sheets to be generated. Patients are encouraged to see their dentists for treatment of all problems diagnosed. Initial data have demonstrated a significant improvement in periodontal health and a significant reduction in carious lesions. The dental awareness of the participants has been greatly improved and a majority are receiving comprehensive dental care. This demonstrates the effectiveness of this program in which the focus is on oral health through dental diagnosis and prevention.

Occurrence of periodontal disease was investigated in an industrial population by a modified Periodontal Treatment Need System (PTNS). The study comprised an initial clinical examination and a follow-up examination of 165 persons 1 year later. The reproducibility of the modified PTNS was satisfactory; in a subsample studied twice the weighted kappa with its 99 % confidence limits was 0.80 ± 0.18. Only 3 % of the dentulous subjects had no treatment need because of gingival or periodontal disease in the first clinical examination, in spite of the low mean age (33.2 years) of the population. The periodontium of the maxillary teeth was significantly healthier (P < 0.001) than that in the mandibular teeth, but there were no significant differences between right and left side of jaws. During the 1-year follow-up period the periodontal condition of 23% of subjects improved, whereas in 9% it deteriorated.

The aim of the first text is to bridge the gap between medicine and dentistry by familiarizing the dentist with generalized disease states and illustrating their signs and symptoms within the oral cavity. The author holds both medical and dental degrees and is Professor of Oral Medicine and Dean of the School of Dental Medicine at the University of Pennsylvania. Indicative of the value of the text is the fact that it is now in the fifth edition. Topics covered in the text include gingivitis and gingival enlargement, oral manifestations of dermatologic disease, diseases of the tongue, allergy and halitosis, nutritional deficiencies, infectious granuloma, focal infection, and occupational dentistry. The section on diseases of the organ systems will offer no new medical information, and generally the chapter deals with focus of infection; however, some systemic disease states are reflected in the mouth, and this chapter tells how to recognize them.