RESEARCH dental health educationAim To determine the effect of dental health education (DHE) on caries incidence in infants, through regular home visits by trained DH Educators over a period of 3 years. Method A randomly selected cohort of 228 children born between 1st January and 30th September 1995, in a low socioeconomic/high caries suburb of Leeds (UK) were divided into the following groups: A) DHE focused on diet; B) DHE focused on oral hygiene instruction (OHI) using fluoride toothpaste; and C) DHE by a combined diet and OHI message. DHE was given using an interview and counselling for at least 15 minutes at home every 3 months for the first 2 years and twice a year in the third year of the study. A fourth group D was given diet and OHI, at home, once a year only. All children and mothers were examined for caries and oral hygiene . A fifth group E (control) received no DHE and were never visited but examined at 3 years of age only. Results In the groups of children visited regularly only two developed caries and three had gingivitis (all in group A). In group E, however, 33 % of children had caries and nine (16%) had gingivitis. The differences in caries levels and caries risk factors between study and control groups were statistically significant (P < 0.001). Mothers of the study groups also showed an improvement in their own levels of gingivitis, debris and calculus scores by the second and third examinations (P < 0.001). Conclusion Regular home visits to mothers with infants, commencing at or soon after the time of the eruption of the first deciduous teeth, was shown to be effective in preventing the occurrence of nursing caries.

A sociodental investigation was carried out among 254 elderly people living at home in Nottinghamshire. The aim of the inquiry was to ascertain whether this group of people were handicapped by their dental conditions. The dental status of the sample was generally poor. 74% were edentulous and the condition of the full dentures worn by many of the subjects was unsatisfactory. A high proportion (59%) of the subjects had lesions of the oral mucosa. Many members of the sample were orally handicapped, either functionally or socially. 32% complained of oral pain and 30% claimed to have difficulty chewing. Also, subjects were embarrassed by the appearance of their teeth and by their dentures dropping during social contact. The perception of handicap, however, was not strongly related to dental status.

A sociodental investigation was conducted among 254 elderly people living at home in Nottingham. A clinical assessment was made of the subjects' dental treatment needs and this was compared with the subjects' felt and expressed needs. Seventy-eight percent of the sample were clinically judged as needing dental treatment, mainly some form of prosthetic treatment. There was, however, a wide discrepancy between the normative and perceived needs of this elderly population. Only 42% of those who were clinically assessed as needing treatment felt that they required it and only 19% had actually tried to obtain it. Many of the elderly mentioned a number of barriers to obtaining dental care; these included the cost of treatment, fear of the dentist, immobility and the feeling that they should not "bother" the dentist

The aim of this study was to investigate genetic and environmental factors associated with hypoplastic defects of enamel in a detailed family study combined with an overall prevalence study. 68 percent of 1,518 children with a "complete" permanent dentition had enamel defects, 14.6 percent having hypoplasia. The Family Study consisted of 101 Index Cases from the Prevalence Study having 2 or more teeth with hypoplasia and their first degree relatives: they were compared with 101 matched controls and their relatives. The clinical examinations were supplemented with structured interviews to obtain social, medical and dental histories. Three Index Cases had amelogenesis imperfecta and 18 had "chronological hypoplasia". Bilateral hypoplasia of lower central incisors had a multifactorial aetiology (heritability 70 percent +/- 38 percent), while hypoplasia of pre-molars was associated with familial occurrence of defects. There was evidence suggesting a predisposition in some families to developmental defects of enamel.