Heidi Kerosuo

Self-reported health complaints among general dental practitioners, orthodontists, and office employees

Studies in the Scandinavian countries have shown that orthodontists run an equal or even greater risk of contracting dermatitis compared to other dental personnel. The aim of the study was to find out whether the self-reported occupation-related health problems of general dental practitioners and orthodontists differ from those of office employees in Finland. The subjects were 147 general dentists, 81 orthodontists and 99 office employees (77% women and 23% men). The data were collected using a mailed questionnaire. Within the past year, 42% of the subjects had had occupational health problems, while 51% had experienced symptoms in the previous year or earlier. The complaints of hand dermatoses, musculoskeletal, as well as respiratory symptoms were significantly more common among women than among men. Musculoskeletal complaints were the most common symptoms in all occupational groups, but the odds ratio of having them were significantly higher for dental professionals compared to office employees. The frequency of self-reported hand dermatoses was 42% for dental professionals and 26% for office employees, but the difference did not reach statistical significance. The odds of having hand dermatoses were higher for atopic subjects and for women. Orthodontists did not differ from general practitioners in respect of any of the complaints reported. Materials used in dentistry were mentioned as the cause of symptoms by 49 (21.5%) of the dental professionals. The present results show an increased risk of self-reported musculoskeletal symptoms for the dental professionals. Also, a tendency towards increased occurrence of skin symptoms was noted for the dental professionals compared to office employees of this study.Studies in the Scandinavian countries have shown that orthodontists run an equal or even greater risk of contracting dermatitis compared to other dental personnel. The aim of the study was to find out whether the self-reported occupation-related health problems of general dental practitioners and orthodontists differ from those of office employees in Finland. The subjects were 147 general dentists, 81 orthodontists and 99 office employees (77% women and 23% men). The data were collected using a mailed questionnaire. Within the past year, 42% of the subjects had had occupational health problems, while 51% had experienced symptoms in the previous year or earlier. The complaints of hand dermatoses, musculoskeletal, as well as respiratory symptoms were significantly more common among women than among men. Musculoskeletal complaints were the most common symptoms in all occupational groups, but the odds ratio of having them were significantly higher for dental professionals compared to office employees. The frequency of self-reported hand dermatoses was 42% for dental professionals and 26% for office employees, but the difference did not reach statistical significance. The odds of having hand dermatoses were higher for atopic subjects and for women. Orthodontists did not differ from general practitioners in respect of any of the complaints reported. Materials used in dentistry were mentioned as the cause of symptoms by 49 (21.5%) of the dental professionals. The present results show an increased risk of self-reported musculoskeletal symptoms for the dental professionals. Also, a tendency towards increased occurrence of skin symptoms was noted for the dental professionals compared to office employees of this study.

Occlusal characteristics in groups of Tanzanian and Finnish urban schoolchildren

The occurrence of different occlusal and space anomalies was studied in groups of 642 Tanzanian and 458 Finnish school-children. Similar diagnostic criteria and methods were used in both countries. The Finnish children had significantly higher prevalences of distal occlusion and crowding and a lower prevalence of anterior openbite than the Tanzanian children. The proportion of subjects with no occlusal or space anomalies was considerably higher among the Tanzanians than among the Finns, 55% and 12% to 22%, respectively. The distinct differences found in occlusion of Tanzanian and Finnish children in this study seem to reflect differences in hereditary or environmental factors, which are expressed as craniofacial or dentoalveolar differences between these ethnic groups.

Orthodontic Treatment Need from Eight to 12 Years of Age in an Early Treatment Oriented Public Health Care System: A Prospective Study

The aim of this study was to investigate the effects of an early treatment oriented orthodontic program on treatment need at age 12 years in a public health care system. The subjects consisted of one whole age cohort in a municipality in Finland, 87 children in total. All children were examined at ages eight, 10, and 12 years. Treatment need was assessed on casts using a modified Dental Health Component of the Index of Orthodontic Treatment Need and a 10-Grade Scale based on the Treatment Priority Index. Early treatment was started on children having definite treatment need according to both indices. The agreement between indices was good at ages eight and 12 years and moderate at age 10 years. Treatment need changed significantly from eight to 12 years. Of the 29 children with definite treatment need at age eight years, only two had treatment need at age 12 years. Of the 38 children with no treatment need at age eight years, 28 remained in this category and only two children had definite need for treatment at age 12 years. The duration of treatment ranged from one to 61 months, although 59% of the treatments lasted two years or less. We conclude that systematically planned early orthodontic treatment may have contributed to the significant reduction in treatment need from eight to 12 years of age.

Subjective need and orthodontic treatment experience in a Middle East country providing free orthodontic services: a questionnaire survey.

The aims of this study were to explore orthodontic treatment experience, subjective need for treatment, and perceptions of teeth and dental appearance in relation to background factors such as funding system, area of living, age, gender, ethnicity, and socioeconomic status. The subjects were 1076 randomly selected second-year high school students from a rural (Jahra) and an urban (Capital) area of Kuwait, with a mean age of 15.1 years. Kuwaiti citizens constituted 79% of the sample, and the rest were of other Arab origins. The data were collected using a questionnaire. Orthodontic treatment rate was significantly higher for Kuwaitis (10%) than for non-Kuwaitis (2%). Among Kuwaiti subjects, urban area of living and female gender increased the odds of receiving orthodontic treatment. Subjective treatment need was 36%, with no difference between Kuwaiti and non-Kuwaiti subjects, but Kuwaitis in the rural area expressed subjective treatment need less often than those in the urban area. The results suggest that access to free-of-cost orthodontic treatment was likely to affect treatment rate, whereas it did not seem to influence the self-perceived need for treatment. Gender and area of living may be significant for the distribution of free-of-cost orthodontic treatment.

Allergic patch test reactions to palladium chloride in schoolchildren

A study of the prevalence of allergic patch test reactions to palladium chloride compared to nickel sulfate was performed in a group of Finnish schoolchildren. All adolescents 14–18 years of age in a Finnish town with 40 000 inhabitants, who had received orthodontic treatment with metallic appliances at a municipal dental clinic, were included in the study. The selection of patients was based on patient records. A non‐treatment control group was randomly selected from the same age groups of the town population. A total of 700 subjects (77% of those invited), 417 (60%) girls and 283 (40%) boys, participated. The majority (91%) of the girls had pieced ears. Orthodontic treatment was equally common (67–70%) in the boys and the girls. The girls had a much higher frequency of allergic patch test reactions to both nickel sulfate and palladium chloride. Of the 700 adolescents tested 48 (7%) had an allergic patch test reaction to palladium chloride. Of the 417 girls, 44 (11%) were palladium‐chloride‐positive, whereas only 4 of the 283 boys tested (1%) had an allergic patch test reaction to palladium chloride 3 patients reacted to palladium chloride only, whereas all other patients with allergic patch test reactions to palladium chloride also had an allergic patch test reaction to nickel sulfate. The results support the concept of cross‐reactivity between nickel sulfate and palladium chloride. The clinical significance of the allergic patch test reactions caused by palladium chloride remains unclear.

The Seven-year Outcome of an Early Orthodontic Treatment Strategy:

The benefits of early orthodontic treatment are continuously discussed, but studies are few. We examined whether definite need for orthodontic treatment could be eliminated in public health care by systematically focusing on early intervention. One age cohort living in a rural Finnish municipality (N = 85) was regularly followed from ages 8 to 15 years, and persons with malocclusions were treated according to a pre-planned protocol. Treatment need was assessed according to the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need, and treatment outcome by the Peer Assessment Rating Index (PAR). Fifty-two percent of the cohort received treatment, and definite treatment need decreased from 33% to 9%. In the treated group, the mean PAR score reduction was 63%, and 51% showed more than 70% improvement. The results suggest that an early treatment strategy may considerably reduce the need for orthodontic treatment in public health care with limited specialist resources.

Face and neck dermatitis from a stainless steel orthodontic appliance.

Although nickel is the most common cause of contact allergy, nickel-containing orthodontic appliances seldom cause adverse reactions that result in discontinuation of treatment. We report on an eruption of dermatitis in the face and neck of an adult female patient after placement of a rapid maxillary expansion appliance (RME). Because the patient suspected nickel allergy, her tolerance to the appliance material was tested intraorally before treatment by cementing bands on four teeth for a week. No visible adverse reactions were seen during the test. One week after cementation of the RME appliance, the patient reported strong itching of the face and a red rash. Clinical examination showed itchy papular erythema on the face and neck. No intraoral reactions or symptoms were present. The RME appliance was removed, and symptoms disappeared in 4 to 5 days. The patient was referred for a nickel patch test, which gave a strong positive result. Adverse patient reactions of potential allergic origin should be diagnosed carefully, and their possible impact on further treatment should be evaluated accordingly.

Outcome and long-term stability of an early orthodontic treatment strategy in public health care

Our aim was to evaluate the long-term treatment outcome of a systematically applied orthodontic screening and early treatment strategy in a public dental health care system, with special reference to occlusal stability at least 5 years post-retention. The subjects (N = 68) belonged to one age cohort born in a Finnish rural municipality (N = 85), and they were regularly followed from 8 to 20 years. Persons with malocclusions were screened and treated according to pre-planned protocol. Treatment need was assessed according to the Dental Health Component of the Index of Orthodontic Treatment Need, and treatment outcome using the peer assessment rating (PAR) Index and Littles Index of Irregularity. Eighty-two per cent of the treated participants were out of retention (mean 6.9 years post-retention) at age 20. Definite treatment need in the study population decreased from 37% to 3 %. In the treated group, the mean PAR improvement decreased from 65 % to 63% from age 15 to 20 years. The mean irregularity score for the mandibular incisors was 4.0 [standard deviation (SD) 2.4] and for maxillary incisors 3.7 (SD 2.1) with no significant difference between treated and not treated subjects. The results suggest that definite need for orthodontic treatment may be predominantly eliminated from the target population with a systematically implemented treatment strategy focusing on early treatment with simple appliances. Emphasis on early timing of treatments may have contributed to the good long-term stability of treatment results.

Nickel sensitization in orthodontically treated and non-treated female adolescents.

Background. The importance of the nickel exposure from fixed orthodontic appliances is under continuous discussion.

Root resorptions related to ectopic and normal eruption of maxillary canine teeth – A 3D study

Abstract Objective. To assess the incidence and severity of root resorption of maxillary incisors caused by ectopically and normally erupting maxillary canines and to analyse factors influencing root resorption of incisors using cone beam computed tomography. Subjects and methods. The study sample comprised 59 patients with a total of 80 canines. Forty-six of the canines, in 37 patients, were defined as ectopic and 34 canines, in 22 patients, were defined as normal. The severity of root resorptions were analysed according to studies by Ericson and Kurol. Multiple logistics regression was used to evaluate the association between various factors and root resorptions. Results. The prevalence of root resorptions was significantly higher in the ectopic canine group, 11.0% of the central incisors and 67.6% of the lateral incisors in comparison to 0% and 36.2% in the normal erupting group. Most resorptions were defined as ‘slight’ and were located in the middle third of the root. There was a statistically significant relationship between canines located mesial to the midline of the lateral incisor and root resorption on the maxillary incisors. Conclusion. The present results show that root resorption of maxillary lateral incisors was common in patients referred to CBCT imaging due to maxillary canine eruption disturbances. Although significantly more frequent in patients with ectopically erupting canines, lateral incisor resorption was also found in association with approximately every third of the normally erupting canines. The best predictor for root resorption seemed to be location of the canine mesial in relation to the midline of the lateral incisor root.