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Aims: To investigate cerebral cortical changes by using functional magnetic resonance imaging (fMRI) after denture renewal and to test how these relate to prosthodontic treatment adaptability as measured by chewing efficiency and maximum bite force. Methods: Ten complete denture wearers (five women and five men, mean age ± standard deviation: 70.3 ± 9.1 years) participated in the study. Each had their complete dentures renewed and underwent an fMRI examination with three functional tasks (lip pursing; jaw tapping; jaw clenching) as well as a color-mixing test for chewing efficiency and unilateral maximum bite force measurements. Recordings were performed with the old dentures (T0) and with the new dentures on insertion (T1) and at 1 week (T2) and 3 months postinsertion (T3). At T1, denture stability and retention (S/T) were assessed by two independent operators. Wilcoxon signed rank tests and Spearman's rho correlation were carried out for data analysis. Results: The right and the left precentral gyrus (PRCG) and postcentral gyrus (POCG) were identified with significant activation across all three functional tasks. A statistically significant increase in the level of activity between T0 and T2 (POCG: P = .022; PRCG: P = .017) was found during jaw clenching tasks. Both regions of interest (PRCG, POCG) appeared to correlate with S/T of the new dentures while the subject performed a lip-pursing task (PRCG: r = 0.689, P = .027; POCG: r = 0.665, P = .036). The chewing efficiency and maximum bite force increased significantly during the adaptation to replacement dentures (chewing efficiency: T1-T2 P = .032, T2-T3 P = .012; maximum bite force right side: T2-T3 P = .047). Conclusion: Changes in brain activity occurred in the adaptation to replacement dentures and appeared to regain preinsertion activity levels during motor tasks involving the dental occlusion after 3 months postinsertion. [ABSTRACT FROM AUTHOR]

Background: This retrospective cohort study reviewed dental implant treatment completed at the Adelaide Dental Hospital over a 20-year period.Methods: The database of implant treatment completed between 1996 and 2015 was analysed for patient, implant, prosthesis and operator specifics together with known implant status.Results: Three hundred and twenty patients (mean age, 51.50 years) were treated with 527 implants. One hundred and eighty-four female patients received 296 implants and 136 males received 231 implants. Three hundred implants were restored with single crowns, 147 implants were restored with 63 mandibular implant overdentures, five implants were restored with two maxillary implant overdentures and 67 implants were restored with 20 full-arch fixed prostheses. The overall known implant survival rate was 87.67%. Mandibular implant overdentures had a risk of implant failure four times that of single implant-retained crowns that was statistically significant (P = 0.0100).Conclusions: Implant treatment completed in this public sector clinic using finite resources and a defined system of patient and restorative selection criteria demonstrated a high known implant survival rate. Utilizing a structured and maintained patient recall protocol, it would be ideal to investigate further parameters of interest, particularly those that could improve treatment delivery and longevity. [ABSTRACT FROM AUTHOR]

Extracted human teeth have been used to practice operative techniques for a very long time. As a natural surrogate for a live tooth in vivo, their use has traditionally been very important for the development of skills in trainee dentists, as well as their qualified colleagues who wish to practise existing or new skills. As synthetic alternatives develop greater authenticity, alongside a society in which many retain their natural dentition well into old age, the current paradigm relating to how extracted teeth in dental education are used needs to be revisited. An ethical and legal dilemma that must be addressed within dental education relates to where and how teeth may be sourced. This article will seek to question whether there is a legal or ethical requirement to gain consent for the use of extracted teeth from patients, as well as exploring the status of whether extracted dental tissue can be considered to be the property of either patient or surgeon. Whilst synthetic alternatives are being utilized more frequently in education, it is unlikely that they will completely replace extracted natural teeth in the immediate future. It is therefore imperative that their use complies with legal doctrine and contemporary ethical thought. [ABSTRACT FROM AUTHOR]

Objective To determine whether a different number and type of services were provided in Australian regional areas under the Australian Government-funded Chronic Disease Dental Scheme ( CDDS). Design Retrospective analysis of administrative payments data. Setting Australia. Participants Patients receiving dental services under the Medicare CDDS. Interventions The CDDS. Main outcome measures Number and type of services. Method CDDS service categories Australian Statistical Geography Standard ( ASGS) regions were collected by the Australian Department of Human Services between 2008 and 2013 and compared by Australian Bureau of Statistics ASGS estimated resident regional 2011 population, and by employed number of dentists, dental specialists and dental prosthetists from the 2011 National Health Workforce Dataset. Results Number of services provided was greatest in major cities (79.0%), followed by inner regional (15.4%), outer regional (5.2%) and remote/very remote Australia (0.4%). Number of services per head of population decreased from 1.088 in major cities to 0.16 in remote/very remote areas. Number of services provided per dental practitioner showed minimal variation between major city (1672), inner (1777) and outer regional (1627) areas, but was lower in remote/very remote areas (641). Crown and bridge, periodontic, endodontic and removable prostheses per dental practitioner were most frequently supplied in the major cities, but restorative care and oral surgery were more frequently supplied in inner and outer regional areas. Conclusion The number of CDDS services provided declined with regional remoteness. There was a marked difference in the utilisation of the scheme between major cities and remote/very remote areas in both number and type of service levels. [ABSTRACT FROM AUTHOR]

doi: 10.1111/j.1741-2358.2012.00670.x Provision of dental care in aged care facilities, NSW, Australia - Part 1 as perceived by the Directors of Nursing (care providers) Objective: To ascertain the Directors of Nursing (DONs) perception of the provision of dental care and the difficulties in oral health maintenance for residents in New South Wales (NSW) aged care facilities (ACFs). Background: There were no specific figures relating to DONs' perceptions of oral health needs and dental care nor obstructions to dental care of residents. Materials and methods: A total of 414 questionnaires, encoded for confidentiality, were posted to all DONs of ACFs in NSW and the data analysed. Results: Questionnaires were returned from 255 ACFs (response rate 61.6%) representing 16 861 residents with a male-to-female ratio of 1:3.45. Of these residents, 48% had a dental assessment on admission by qualified dental staff. In 74.2% of facilities, no regular visits by dental staff took place, and 58.6% considered the perceived unwillingness of dental professionals to visit residents a barrier to good oral health. DONs reported that 53.6% of residents had dentures only, while 18.3% had natural teeth only. The most frequent difficulties reported by staff were residents' use of abusive language (78.2%) and residents refusing to open mouth (60.9%). Conclusion: Lack of involvement of dental professionals in admission assessment and in ongoing programmes was of concern to DONs in ACFs. [ABSTRACT FROM AUTHOR]

We analyzed data from the 2004-06 Australian National Survey of Adult Oral Health to investigate the paradoxical relationship of better subjective oral health in older adults compared with young or middle-aged adults. In interviews with 14,092 adults, prevalence of problems with eating or appearance was not significantly associated with age among dentate people with no denture(s). In contrast, among dentate denture-wearers, prevalence ranged from 18.7% in ≥ 65-year-olds to 46.7% in 25- to 34-year-olds (p < 0.01). Dentate interviewees (n = 3,724) underwent oral epidemiological examinations and completed the 14-item Oral Health Impact Profile (OHIP-14) questionnaire, evaluating adverse impacts of oral conditions. In multivariable analysis, mean OHIP-14 scores were only weakly associated with age among people who had none of 5 clinical conditions [≥ 5 missing teeth, denture(s), untreated decay, moderate/severe periodontitis, toothache]. However, for people with ≥ 2 clinical conditions, there was a three-fold, inverse association between age and mean OHIP-14 scores (p < 0.01). The findings show that experience of oral disease is more deleterious to subjective oral health when it occurs early in adulthood than when it occurs in old age, a pattern that likely reflects high expectations of young generations and, conversely, great resilience in Australia’s oldest generation. [ABSTRACT FROM PUBLISHER]

Surveys were conducted in Victoria, Australia, to estimate the demand for prosthetic treatment by examining the needs of a randomly selected group of the population. Similar surveys were conducted in relation to the contribution made by the dentists in Victoria and also that of a recently introduced group of workers, the Advanced Dental Technicians. It was found that approximately 19 % of the population required prosthetic treatment in the full denture field and that the existing dentists were not meeting this need. When the Advanced Dental Technicians are more fully engaged in clinical work, the need may well be met. [ABSTRACT FROM AUTHOR]

A survey of approximately 8,300 subjects in the State of South Australia indicated that approximately 228,400 South Australians aged 15 years and over (26 %) were edentulous and, of these, 95 % wore full maxillary and mandibular dentures. The proportion of edentulous subjects increased with age and was lower in males, upper socioeconomic groups, immigrants and in the State capital. [ABSTRACT FROM AUTHOR]

There are few formal publications in Australia relating to Victorian-era dentures and reliable evidence relating to their contemporaneous design, ownership and type is almost non-existent. Archeologists have reported only ten denture units retrieved from eight individuals interred in 19 th century Australian cemeteries. A salvage excavation in 2001 at the North Brisbane Burial Grounds (NBBG, 1843-1875) uncovered, inter alia , an assemblage of two metal- and two vulcanite-based dentures. The names of the owners, the records of the dental practitioners and allied contextual information have been lost. This report is the first detailed analysis in Australia of 19 th century dentures. It presents an investigation into the composition and underpinning laboratory technology within this quartette of NBBG artifacts, which represent half the known, and the only two alloy-based, dentures retrieved from 19 th century cemeteries throughout Australia. The data within is a compilation of and extensive literature review, historical research methods, macroscopic inspection, scanning electron microscopy and energy dispersive x-ray spectroscopy. The results provide insight into dental practice and affiliated technologies in Victorian-era Brisbane., (Copyright 2021 © American Academy of the History of Dentistry.)

Background: We aimed to describe the prevalence of different tooth loss outcomes along with the use of dentures and implants among Australians aged 15+ years across socioeconomic and demographic groups. In addition, we performed time trend analyses of tooth loss., Methods: Data from the National Study of Adult Oral Health 2017-18 included gender, age, residential location, household income, Socio-Economic Indexes for Areas, possession of dental insurance and pattern of dental visiting. Outcomes were complete tooth loss, inadequate dentition, average number of missing teeth, denture wearing and implants. We compared our findings with data from previous surveys carried out in 1987-88 and 2004-06., Results: Tooth loss decreased from 14.4% in 1987-88 to 6.4% in 2004-06, and to 4.0% in 2017-18. The proportion of people with lack of functional dentition halved from 20.6% 1987-88 to 10.2% in 2017-18; the average number of teeth lost due for any reason slightly reduced from 2004-06 (6.1) to 2017-18 (5.7). Tooth loss increased with age and was higher among socioeconomically disadvantaged, uninsured and those with unfavourable pattern of dental visiting groups than in their counterparts., Conclusions: An overall improvement in tooth retention was identified over the last decades. However, socioeconomic inequalities persist., (© 2020 Australian Dental Association.)

The success of the Disaster Victim Identification (DVI) process relies upon sufficient post-mortem data being recovered to allow for a meaningful comparison with ante-mortem records of the missing person. Human bodies subjected to prolonged high temperatures, as experienced during the Black Saturday bushfires in Victoria, are often reduced to fragile skeletal elements. The dental structures, however, are the most durable tissues of the body and often survive these prolonged high temperatures. Without protecting the fragile remains at the scene and during transportation to the mortuary, disruption of the skeletal and dental elements may occur. This disruption will result in difficulties in obtaining post-mortem evidence and lead to problems during the reconciliation (formal identification) phase of the investigation. In the two case reports presented to illustrate these problems, there was significant loss and degradation of dental structures at the scene and during transportation to the mortuary. In the first case described, where no protection was afforded to the remains, total loss of all anatomical dental structures occurred. In the second case, where protection of the structures was undertaken, vital dental evidence was preserved. As a result of the experience in this particular DVI incident, where remains were exposed to prolonged high temperature and physical damage, new protocols have been formulated. Adherence to these protocols will maximise the recovery and preservation of dental evidence at the scene and during transportation to the mortuary., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Background: The Oral Health Assessment Tool (OHAT) was a component of the Best Practice Oral Health Model for Australian Residential Care study. The OHAT provided institutional carers with a simple, eight category screening tool to assess residents' oral health, including those with dementia. This analysis presents OHAT reliability and validity results., Methods: A convenience sample of 21 residential care facilities (RCFs) in urban and rural Victoria, NSW and South Australia used the OHAT at baseline, three-months and six-months to assess intra- and inter-carer reliability and concurrent validity., Results: Four hundred and fifty five residents completed all study phases. Intra-carer reliability for OHAT categories: percent agreement ranged from 74.4 per cent for oral cleanliness, to 93.9 per cent for dental pain; Kappa statistics were in moderate range (0.51-0.60) for lips, saliva, oral cleanliness, and for all other categories in range of 0.61-0.80 (substantial agreement) (p < 0.05). Inter-carer reliability for OHAT categories: percent agreement ranged from 72.6 per cent for oral cleanliness to 92.6 per cent for dental pain; Kappa statistics were in moderate range (0.48-0.60) for lips, tongue, gums, saliva, oral cleanliness, and for all other categories in range of 0.61-0.80 (substantial agreement) (p < 0.05). Intraclass correlation coefficients for OHAT total scores were 0.78 for intra-carer and 0.74 for inter-carer reliability. Validity analyses of the OHAT categories and examination findings showed complete agreement for the lips category, with the natural teeth, dentures, and tongue categories having high significant correlations and percent agreements. The gums category had significant moderate correlation and percent agreement. Non-significant and low correlations and percent agreements were evident for the saliva, oral cleanliness and dental pain categories., Conclusion: The Oral Health Assessment Tool was evaluated as being a reliable and valid screening assessment tool for use in residential care facilities, including those with cognitively impaired residents.

Annual expenditure on dental care in Australia amounts to AUD 1.9 billion. Approximately one-third of this expenditure involves private dental insurance, yet little is known about the impact of insurance on the provision of services. The aim of this analysis was to examine differences in dental service provision between insured and non-insured patients. Data collected from a random sample of dentists from a survey conducted in 1993-94 were used, providing 817 responses (response rate 74%). Logistic regression analysis controlling for patient age and sex and reason for visit indicated that in private general practice insured patients were more likely to receive preventive (OR = 1.37), crown and bridge (OR = 2.25), and endodontic services (OR = 1.27), but less likely to receive extraction services (OR = 0.52). However, no significant differences by insurance status were found for diagnostic, restorative, or prosthodontic services in the multivariate models. These differences in service provision by insurance status indicate a more favorable pattern of services for insured patients, and point to equity issues in the provision of services.

A survey of the dentist-patient relationship, carried out in several Melbourne suburbs, found that the incidence of dentures increases with age; that females visit the dentist more regularly and are more likely to wear partial dentures than males; that the young visit more regularly than the old; and that the wearing of dentures and the expense of treatment are significant factors which deter people from visiting the dentist more regularly. It was found that "fear" and "dislike" of the dentist, "low" confidence in the dentist and a poor dentist attitude to the patient are all associated with poor attendance. "Dislike" is a stronger deterrent than "fear", although "fear" is more common. Confidence in the dentist is high, most have a high opinion of their own dentist, and only a fifth of the respondents consider their dentist to be "rude" or "indifferent". Attitude associations are also discussed.