Philippus J. Van Wyk

Longitudinal association of smoking-related attitude to oral health with adolescents' smoking onset.

OBJECTIVE The negative oral health effects of smoking, such as stained teeth, gum infection, and bad breath may be more salient to adolescents, and therefore, more important expectancies for adolescent smokers and nonsmokers alike. Informed by the social cognitive theory, this prospective study sought to determine the role of smoking-related attitude to oral health on smoking onset among adolescents over a 12-month interval. METHOD This prospective study involved a community sample of 422 nonsmoking eighth graders selected from three public schools in the capital city of South Africa. Data were collected through a questionnaire, which included a 5-point Likert-scale-type question on dental disease belief related to smoking (smoking causes plaque and bad breath) and an affective evaluation of this effect (bad breath causes peer rejection). The product of these two later variables was used to compute an attitude score. Higher scores represent a more favorable oral health attitude. Health-risk behaviors recorded included past month smoking and alcohol use. RESULTS The mean age of the participants was 13.9 years at baseline. At 1-year follow-up, 11.4 percent (n = 48) of nonsmokers at baseline had initiated smoking. Compared to nonsmokers, current smokers were more likely to report frequent bleeding gums (51.2 versus 33.1 percent; P = 0.02), but there was no significant difference in proportions brushing twice daily (64.4 versus 56.5 percent; P = 0.30). In addition to the independent influence of peers and binge drinking, smoking-related attitude to oral health significantly influenced smoking onset. CONCLUSION The study findings support the development of smoking prevention programs that include restructuring of cognitions about the oral health outcomes of smoking.

A model to determine the economic viability of water fluoridation

OBJECTIVES In view of concerns expressed by South African local authorities the aim of this study was to develop a model to determine whether water fluoridation is economically viable to reduce dental caries in South Africa. METHODS Microsoft Excel software was used to develop a model to determine economic viability of water fluoridation for 17 water providers from all nine South African provinces. Input variables for this model relate to chemical cost, labor cost, maintenance cost of infrastructure, opportunity cost, and capital depreciation. The following output variables were calculated to evaluate the cost of water fluoridation: per capita cost per year, cost-effectiveness and cost-benefit. In this model it is assumed that the introduction of community water fluoridation can reduce caries prevalence by an additional 15 percent and that the savings in cost of treatment will be equal to the average fee for a two surface restoration. RESULTS Water providers included in the study serve 53.5 percent of the total population of South Africa. For all providers combined chemical cost contributes 64.5 percent to the total cost, per capita cost per year was

A retrospective view on the viability of water fluoridation in South Africa to prevent dental caries

0.36, cost-effectiveness was calculated as

Oral health in South Africa.

11.41 and cost-benefit of the implementation of water fluoridation was 0.34. CONCLUSIONS This model confirmed that water fluoridation is an economically viable option to prevent dental caries in South African communities, as well as conclusions over the last 10 years that water fluoridation leads to significant cost savings and remains a cost-effective measure for reducing dental caries, even when the caries-preventive effectiveness is modest.Objectives: In view of concerns expressed by South African local authorities the aim of this study was to develop a model to determine whether water fluoridation is economically viable to reduce dental caries in South Africa. Methods: Microsoft Excel software was used to develop a model to determine economic viability of water fluoridation for 17 water providers from all nine South African provinces. Input variables for this model relate to chemical cost, labor cost, maintenance cost of infrastructure, opportunity cost, and capital depreciation. The following output variables were calculated to evaluate the cost of water fluoridation: per capita cost per year, cost-effectiveness and cost-benefit. In this model it is assumed that the introduction of community water fluoridation can reduce caries prevalence by an additional 15 percent and that the savings in cost of treatment will be equal to the average fee for a two surface restoration. Results: Water providers included in the study serve 53.5 percent of the total population of South Africa. For all providers combined chemical cost contributes 64.5 percent to the total cost, per capita cost per year was

Household Smoking as a Risk Indicator for Caries in Adolescents’ Permanent Teeth

0.36, cost-effectiveness was calculated as

Socio-demographic correlates of early childhood caries prevalence and severity in a developing country - South Africa

11.41 and cost-benefit of the implementation of water fluoridation was 0.34. Conclusions: This model confirmed that water fluoridation is an economically viable option to prevent dental caries in South African communities, as well as conclusions over the last 10 years that water fluoridation leads to significant cost savings and remains a cost-effective measure for reducing dental caries, even when the caries-preventive effectiveness is modest.

Trends in dental caries prevalence, severity and unmet treatment need levels in South Africa between 1983 and 2002

OBJECTIVES Despite a Commission of Inquiry into water fluoridation recommending the fluoridation of public water supplies to the optimal fluoride concentration of 0.7 ppm, as well as regulations for the introduction of water fluoridation which compel water providers to fluoridate public water supplies, no artificially fluoridated water scheme exists in South Africa. In view of concerns expressed by South African local authorities about cost and reports urging further investigation into the effectiveness of water fluoridation, the aim of this study was to determine whether water fluoridation is still a viable option to reduce dental caries in South Africa. METHODS A model based on a cost evaluation of 44 communities in Florida, United States, and applied to South Africa was used as the basis for this study. Twenty-three input variables were used to create a computerized model which was populated with 2006 and 2011 data. Per capita cost, cost-effectiveness ratio and cost-benefit ratio were calculated as economic outputs to facilitate decision making for projected caries reductions of 15%, 30% and 50%. RESULTS The average per capita cost of water fluoridation for all category water providers combined is US

Socio-economic inequities in dental caries experience of 12-year-old South Africans: policy implications for prevention.

0.28 in 2006 and US

Evaluation of a Fissure Sealant Program as Part of Community-Based Teaching and Training

0.35 in 2011, an increase of 23.2% over this period. The average cost-effectiveness for all water providers combined varies from US

Musculoskeletal disorders amongst practising South African oral hygienists

3.32 for a 50% to US