Search

A sample of 372 35-44-yr-olds and 537 noninstitutionalized 65-74-yr-olds were clinically examined in an oral health survey of Hong Kong Chinese conducted in 1991. The examination procedures and diagnostic criteria for assessing restorative and extraction treatment need followed those recommended by the World Health Organization. The Community Periodontal Index-based periodontal treatment needs involving index teeth or their replacements were computed from separate clinic scores for maximum probing depth, presence of calculus, and bleeding after probing. A set of criteria for assessing prosthodontic treatment need was specially laid down for this survey. Examiners were calibrated before the survey, and the interexaminer reliability was found to be generally good. Besides reporting the various individual normative treatment need items in the traditional way, the present analysis used some holistic treatment-need categories which may have manpower-requirement implications for the classification of subjects. All dentate subjects surveyed required some treatment. Only 6% of the elderly, all edentulous, required denture work only. Of the 35-44-yr-olds, 42% needed scaling and oral hygiene instruction only, which could be provided by dental hygienists. The treatment needs of the vast majority of the middle-aged and the elderly (mainly scaling: simple fillings; and extractions, dentures, or both) could be easily handled by general dentists. Only about one-fifth of the subjects in both age groups required some complex care such as endodontics, crowns, and advanced periodontal treatment, which could be delivered by senior dentists or dentists with specialist training. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the periodontal conditions in 372 35-44-yr-old and 537 noninstitutionalized 65-74-yr-old Hong Kong Chinese who were examined clinically for loss of attachment, recession, probing depth, calculus, and bleeding after probing. Community Periodontal Index (CPI) data and treatment need indications were compiled from index teeth or their substitutes. The prevalence of loss of attachment varied considerably in both cohorts according to the definition of the threshold (≥6, ≥9, and ≥12 mm, respectively). The mean numbers of teeth with loss of attachment at the ≥6-mm threshold and at higher thresholds were small. In both age cohorts, about one-fifth of subjects had probing depths ≥6-mm, while at the ≥9-mm threshold only 2-3% were so affected. Although recession was an important component of loss of attachment in the younger cohort, in the older cohort the prevalence and extent of recession were greater than for probing depths at thresholds ≥4 mm. All subjects had one or more teeth with calculus, bleeding, or both, most teeth being so affected. Eighty-four of the 537 65-74-yr-old subjects were excluded either because of edentulousness or because extractions indicated for the remaining teeth would have rendered the subjects edentulous. The distribution of subjects according to their highest CPI score was remarkably similar for the two cohorts. No subjects in either age group were assessed as "healthy" (CPI code 0) or had "bleeding only" (code 1) as their highest score. While most subjects scored CPI code 2 or 3 as their highest score, only 17% of the younger and 15% of the older cohort scored Community Periodontal Index of Treatment Needs (CPITN) code 4. Differences in the mean number of sextants affected by CPI codes between the two cohorts were mainly due to a greater number of excluded sextants in the older cohort. CPI findings for 35-44-yr-olds differed little from those reported in 1984. [ABSTRACT FROM AUTHOR]

There have been no reported surveys of oral mucosal lesions among the elderly in Asian countries. Therefore, the purpose of this study was to determine the prevalence of oral mucosal lesions among 65-74-yr-old, community-dwelling elderly Chinese in Hong Kong and to determine the prevalence of lesions in denture wearers, tobacco smokers, and alcohol drinkers. A total of 537 noninstitutionalized 65-74-yr-olds were interviewed and clinically examined in an oral health survey conducted in 1991. In the survey, the elderly underwent a systematic examination of their oral mucosa by one of the three examiners with the aid of an overhead light. The examiners were trained and calibrated before and during the survey, and a specially prepared colour atlas of oral mucosal lesions was used for lesion recognition. No mucosal lesions were detected in 64% of the elderly. In the 193 elderly subjects with lesions, 80% exhibited only one lesion. There was no difference in prevalence between men and women. The more common lesions, each being found in 5-7% of the elderly, were lingual varicosities, frictional keratosis on the buccal mucosa, denture stomatitis on the palatal mucosa, and denture-induced hyperplasia in the maxillary and mandibular buccal sulcus. Denture wearers had a higher prevalence of lesions (40%) than nonwearers (32%). There was no difference in the prevalence or number of oral mucosal lesions between those defined as users of tobacco and alcohol and those defined as nonusers in this study. No confirmed oral malignancies were found. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the state of the dentition of middle-aged and elderly Chinese in Hong Kong in terms of teeth present, tooth spaces, and prosthetic treatment received. In an oral health survey conducted in 1991 in Hong Kong, a sample of 372 35-44-yr-olds and 537 noninstitutionalized 65 74-yr-olds was interviewed and clinically examined. In all dentate subjects, each tooth was scored for the presence/absence of that tooth, a tooth space of 5.5 mm which had not been treated, or the presence of a denture or pontic replacing that tooth. Each denture was assessed according to a set of criteria. None of the 35 44-yr-olds were edentulous and the mean number of teeth present was 27.5. About 40% of the third molars and about 35% of the mandibular first molars were missing. For only 1% of the missing teeth had space closure resulted in missing teeth not being recorded as tooth spaces or treated tooth spaces. Overall, 72% of the 35-44-yr-olds had no prosthesis, 17% had a bridge or bridges, 12% had a denture or dentures, and 1% had both. Of the 65-74-yr-olds, 12% were edentulous, and the dentate subjects had a mean number of 17 teeth present. About 70% of the molars were missing. Overall, only 29% of the elderly had no prosthesis, 52% had a denture or dentures, 33% had a bridge or bridges, and 13% had both. Only 35% and 28%, respectively, of the middle-aged and elderly denture wearers had no complaint about their dentures. There were more assessed problems in the dentures of the elderly than in those of the younger adults, over one-third of the partial dentures and half of the mandibular complete dentures being unstable and unretentive. [ABSTRACT FROM AUTHOR]

The objectives of this analysis were to describe the dental service use pattern of the 35-44- and 65-74-yr-old age groups and to determine to what extent this pattern could be explained by selected sociodemographic and attitudinal variables. The study populations comprised 398 35-44-yr-old and 559 65-74-yr-old Hong Kong Chinese. Use of dental services was determined on the basis of the respondents' own perception of the regularity of their dental visits and by the time since the last dental visit. The younger groups was categorized into regular users, irregular users, and nonusers, and the older group was categorized into three groups according to last dental visit (within 2 yr, 2-5-yr, 5 yr or more). A modification of the Andersen and Newman model for individual determinants of health care use was used as the framework for a logistic regression analysis. Predisposing variables were sex, education, occupation, attitudes, knowledge, preventive orientation, and dental anxiety; enabling variables were Family Possession Index, income, family support and access to a dental programme; need variables were perceived conditions of teeth, dental problems, dental pain, need for treatment, normative need for treatment, and denture wearing. In general, use of dental services was low. For the 35-44-yr-olds, the best regression model (sensitivity: 62%, specificity: 95%, overall correct classification: 88%) indicated that there was an increased probability of having a regular dental care pattern if respondents were prevention oriented, had access to a dental benefit programme, had not experienced pain, had a higher income, perceived their teeth as fair or poor, and perceived a need of treatment. For the 65-74-yr-olds, three variables remained in the final model (sensitivity: 51%, specificity: 68%, overall correct classification: 61%). [ABSTRACT FROM AUTHOR]

In an oral health survey of Hong Kong Chinese conducted in 1991, a sample of 372 35-44-yr-olds and 537 noninstitutionalized 65-74-yr-olds were interviewed and clinically examined. The examination procedures, instruments, and diagnostic criteria used to detect coronal caries followed those recommended by the World Health Organization (1987). The diagnostic criteria used to assess root-surface caries were based on those used in a national oral health survey of US employed adults (National Institute of Dental Research, 1987). Calibration of examiners was conducted before the survey and the interexaminer reliability was found to be very high; the kappa statistics were 0.93 and 0.91 for the younger and older age groups, respectively. None of the 35-44-yr-olds were edentulous and 96% had 21 teeth or more. The prevalence of edentulousness among the elderly was 12%. The DMFT indices of the younger and older age groups were 8.7 and 18.9, respectively. In both age groups, MT was the major component of the DMFT index, and female subjects had a slightly higher score. The prevalences of decayed/filled roots were 7% and 26% for the 35-44- and 65-74-yr-olds, respectively. As compared with previous surveys conducted in Hong Kong, there has been a 40% reduction in the DMFT index of the 35-44-yr-olds since 1968, but little change in the tooth and root conditions was noted between 1984 and 1991. [ABSTRACT FROM AUTHOR]

A sample of 398 35-44-yr-old and 559 65-74-yr-old Hong Kong Chinese were interviewed by trained interviewers using a structured questionnaire in an oral health survey conducted in 1991. The present analysis aimed to describe the dental-care-seeking behaviour and attitudes of these subjects. It was found that 43% of the younger and 23% of the older age group had visited a dentist within the past year. More than half of the elderly and a quarter of the adults had not been to a dentist for 3 yr or more, and the main reason given by these subjects was that they felt that nothing was wrong. The vast majority of the subjects consulted a dentist only when they had toothache or other dental problems. Less than 20% of the 35-44-yr-olds visited a dentist for a check-up or teeth cleaning, and these subjects were described as having a prevention-oriented attitude toward oral care. The result of a logistic regression analysis showed that there was a higher chance for subjects to have this attitude if they had dental programme coverage, perceived their teeth to be good, had better dental health knowledge, had a more positive dental attitude, and were less anxious about dental care. However, the influence of these factors was quite weak, because the overall percentage of correct classification of the model was 83.7% and the sensitivity was only 23.3%. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to study possible relationships between traditional Chinese health beliefs and health practices in adult Chinese in a modernized society. The study populations comprised 398 35-44-yr-old and 559 65-74-yr-old Hong Kong Chinese. The respondents were categorized into three groups with weak, moderate, or strong Chinese beliefs on the basis of interview questions on the causes of gum disease. Chinese preventive practices and Chinese pain practices were defined according to respondents' reported use of recommended traditional cures. Questions on generally accepted oral practices were phrased in terms of frequency of daily brushing of teeth, use of toothpicks the previous day, and whether or not teeth were flossed the previous day. Around one-third of the respondents had weak, almost one-half had moderate, and around one-quarter expressed strong Chinese health beliefs. No significant differences in Chinese health beliefs were found between men and women in either age group, or between the age groups. In the 35-44 age group, more of those with a higher education were in the "weak" Chinese health belief category, whereas, conversely, more of those with a lower education expressed stronger Chinese health beliefs (P<0.05). Women in both age groups reported significantly more frequent brushing. Toothpicks were used by around three-quarters of both age groups, but flossing was extremely rare. Chinese preventive practices were reported significantly more frequently by those in the older group who held strong Chinese health beliefs than those with moderate or weak beliefs, whereas the trend in the younger group was not significant. Chinese pain practices were reported very infrequently. Chinese health beliefs did not correlate with use variables. In the older group, Chinese health beliefs correlated strongly with preventive practices and with knowledge. [ABSTRACT FROM AUTHOR]

Previous studies on adult Hong Kong Chinese have indicated that their level of knowledge of and attitudes toward dental health might be a potential barrier to effective oral preventive efforts. The knowledge and attitudes of elderly Chinese have not previously been studied. The objectives of this study were to describe Hong Kong adults' knowledge of the causes of the two main oral diseases, caries and periodontal disease, and possible preventive measures, and to analyse possible relationships between knowledge and attitudes and selected sociodemographic and utilization variables. Two populations aged 35-44 yr (n=398) and 65-74 yr (n=559) were selected for the study, which was conducted as structured interviews. A knowledge score was constructed from questions on caries and periodontal disease development and prevention. Attitudes were measured in the younger group by beliefs and evaluations of those beliefs according to the theory of reasoned action (the higher the score, the more positive the attitude). Knowledge scores were almost normally distributed in the younger respondents, but were heavily skewed toward 0 in the older group. In both age groups, increased level of education and regularity or recency of dental visits were strongly associated with dental knowledge. Women, regular dental care users, and prevention-oriented respondents had higher attitude scores. There was no correlation between knowledge and attitudes. Some improvement in knowledge seems to have taken place, especially on the cause of caries, with fewer 35-44-yr-old respondents claiming lack of knowledge of the causes of caries and gum disease than in a previous study. In the older group, around half of the respondents were unaware of the causes of dental caries and gum disease. [ABSTRACT FROM AUTHOR]

This second adult oral health survey was conducted with the following main aims: 1) to describe the oral health conditions and to analyse the oral health care needs and demands of 65-74-yr-olds in Hong Kong, and to propose appropriate strategies for meeting their needs in the light of societal obligations; 2) to describe the oral health conditions and to analyse the oral health care needs and demands of 35-44-yr-olds in Hong Kong with special emphasis on assessment of changes in this age group since 1984 (when the first adult oral health survey was conducted); 3) to assess the impact of sociodemographic and dental care system factors on the oral health status of selected adult age groups: and 4) to utilize survey data to refine curriculum development and research strategies in the Faculty of Dentistry, as well as in the proposal of appropriate action to governmental committees on dental health policy. For enhanced comparability with the previous study, the 35-41-yr-olds were selected from the same geographic areas of Hong Kong Island. Multistage cluster sampling was used to recruit the study population, defined geographic units and addresses being used as the starting-point. A sample of 398 subjects was selected, of whom 93% were both interviewed and clinically examined. The 65-74-yr-olds were recruited from housing estates in all principal areas of Hong Kong, yielding a sample of 559 subjects, of whom 96% were both interviewed and clinically examined. The analysis of the data was based on the model used by the International Collaborative Study II, from which other methodologic guidance had been sought. The definitions of selected sociodemographic variables such as occupation, income, Family Material Possession Index, family support, and dental anxiety, which are relevant to the whole study, are given here. [ABSTRACT FROM AUTHOR]