Ilkka Paunio

Oral Health Indicators Poorly Predict Coronary Heart Disease Deaths

Several earlier studies have suggested that development of coronary heart disease (CHD) is causally related to oral infections. The aim of this study was to investigate the association between oral health indicators and CHD deaths. Out of a nationally representative sample, 6527 men and women aged 30–69 years participated in the health examination with a dental check. Detailed oral health data included caries, periodontal and dental plaque status, presence of remaining teeth, and various types of dentures. Over a mean 12-year follow-up, persons dying of CHD were older and more often smoked, had hypertension, hypercholesterolemia, diabetes, and only a basic education compared with other persons. In univariate analyses, several oral health indicators were associated with CHD deaths. Adjustment for the established CHD risk factors reduced all these associations to statistical non-significance. The associations between oral health indicators and CHD are mostly explained by confounding factors, particularly those relating to health behavior.

Occurrence of Root Caries in Relation to Dental Health Behavior

We studied the relationship between the occurrence of untreated root caries and a subjects dental health habits, such as the frequency of tooth-brushing, the avoidance of sugar, and regularity of dental visits. A representative sample of 5028 adults was examined. Information on dental health habits was collected by professional interviewers one to six weeks before the clinical examination. A high frequency of tooth-brushing was strongly related to a low occurrence of root caries. The use of sugar in coffee or tea was strongly associated with root caries occurrence among men. The use of sweets was related to root caries occurrence moderately in men but not at all in women. Regular dental check-up behavior was strongly related to an infrequent occurrence of root caries. It was concluded that dental health behavior influences root caries occurrence and that caries on root surfaces is associated with poor dental health habits. Age and gender differences in root caries occurrence, reported earlier, may relate to different dental health behavior of women and men.

Smoking and Periodontal Disease in the Finnish Population Aged 30 Years and Over

The aim of this study, which was part of the Mini-Finland Oral Health Survey, was to evaluate the effect of smoking on periodontal condition in the Finnish adult population. A representative sample was drawn from the population aged 30 years and over. The total number of subjects was 8000, 90% of whom participated in the clinical examination. Periodontal diagnoses were made according to the modified Periodontal Treatment Need System (PTNS). Information about age, toothbrushing, and smoking habits was collected by personal interviews. When the sample was divided into two groups (with and without periodontal pockets), the overall risk ratio (RR) was 1.39 and was slightly higher for men than for women. A log-linear model was used to study simultaneous associations and interactions between smoking, periodontal disease, and some background factors. In this model, smoking had not significantly affected the periodontal condition.

Remaining teeth in Finnish adults related to the frequency of tooth-brushing

The number of teeth remaining in adults was evaluated with specific reference to the frequency of tooth-brushing. The sample consisted of 5028 dentate subjects, representing the Finnish population aged 30 years and older. Their mean age was 47.5 years. The presence or absence of each individual tooth was recorded. A total of 91,332 teeth was registered. Forty-eight per cent of the women had retained no fewer than 21 teeth, 20% had 20-11 teeth, and 32% had 10-1 teeth. For men the percentages were 52%, 23%, and 25%, respectively. The number of a subjects remaining teeth was strongly related to the frequency to tooth-brushing (p less than 0.001). The more frequent it had been, the more teeth the subjects, both women and men, had retained. This trend was also seen for the teeth in each jaw, and even for type of tooth. The trend was also present when the number of teeth was analyzed in accordance with a subjects income.

Oral health in Finland and the Soviet Union. A joint study.

To develop the functions of a health care system it is essential to compare and evaluate the systems of different countries. The World Health Organization (WHO) has emphasized the importance of collaborative studies in the field of epidemiology. In countries with similar social systems the basis for health care is usually the same. Comparison of health care in such countries is relatively easy because in most cases the criteria for functions, diagnosis, etc. are similar. Comparison of countries having different bases for health care and different philosophies of research is much more complicated and time-consuming. Soviet health care, including oral health care, is based on community responsibility and has complex prophylaxis as its main emphasis. In the USSR there are no private dentists. All dental services are available at polyclinics located either near the place of residence or at the work place. In Finland there are two separate systems for oral health care. Children up to the age of 18 and some special groups of the adult population (pregnant women, military recruits, and students) are treated in municipal polyclinics (called health centres in Finland). Otherwise, the adult population is treated mainly by private dentists. The study will be carried out in three towns in Finland and six towns in the USSR. The aim of this study is to describe the causal epidemiology of dental caries among children 6 to 7, 9 and 12 years old in Finland and the Soviet Union. In addition, certain measures and compounds for caries prevention will be tested during 3 years of follow-up. Our results will help the authorities of both countries to develop and replan the functions of communal dental care for the populations included in this study.