TUOMINEN M, TUOMINEN R, RANTA K, RANTA H. Association between acid fumes in the work environment and dental erosion. Scand J Work Environ Health 1989;15:335-338. The effect of inorganic acid fumesfrom the work environmenton the erosionof teeth was studiedblindly. A sampleof 186workers was drawn from four factories. Among the 157dentulous participants, 76 were working in departments containing acid fumes, and 81 had never worked under such conditions and were used as referents. Of the acid workers 18.4 % had one or more teeth with erosion, and the corresponding figure for the referents was 8.6 %. With a longer duration of exposure the proportion of subjects with erosion increased. The acid workers had more teeth with erosion than the referents, especially upper anterior teeth. The findings suggest that even today exposure to inorganic acid fumes from the work environment may increase the erosion of teeth, especially the upper anterior teeth, which are not continuously protected by saliva and the lips.

The effect of inorganic and organic acid fumes on teeth was explored in a cross-sectional study using blind dental examinations. A sample of 180 workers from two factories was randomly drawn. Among the 169 workers who participated in the survey, 88 were exposed to acid fumes and 81 were controls. The percentage of inorganic acid workers with tooth surface loss was 63.2%, while that for the controls was 37.7% (P less than 0.005). The corresponding figures in the organic acid company were 50.0% and 14.3% (P less than 0.02). In both companies the acid workers had significantly more often teeth with surface loss in the maxilla than their controls (P less than 0.02). Both anteriors and posteriors were affected. On the basis of the findings. it can be concluded that acid fumes at work are strongly associated with tooth surface loss.

Subjective orthodontic treatment need and associated factors were studied in a sample of 226 young Finnish adults. The subjects, applicants to enter the University of Helsinki, were interviewed immediately after their entrance examination. A need for treatment was felt by 14% of the subjects. For 47% of those expressing such a need their reason was appearance only, and for 25% it was both appearance and their ability to chew. Among subjects who reported a visible dental irregularity, 38% were dissatisfied with their dental appearance, and 25% felt the need for orthodontic treatment. Women were more often dissatisfied with their dentition than men. Subjective need for treatment was significantly associated with perceived visible dental irregularity and infrequent socializing but not with orthodontic treatment in childhood, pattern of dental attendance, or district of residence. Of various perceptions of anterior teeth, irregularly and wrongly positioned teeth were most often connected with treatment need.

The effect of inorganic acid fumes from the working environment on the occurrence of periodontal pockets and soft oral tissues was investigated in a cross-sectional, blind study. A sample of 186 workers was drawn from 4 factories. Of the 170 participants, 82 were working in departments containing acid fumes, and 88 controls had never worked under such conditions. Of the workers exposed to acid fumes 36.9% and of the controls 30.9% had periodontal pockets. The presence of periodontal pockets increased with age significantly more among the acid-exposed workers than among the controls (p less than 0.0001). Oral mucous membrane lesions were observed among 23.2% of the acid-exposed workers and 21.6% of the controls. The findings suggest that acid fumes in the workplace air do not increase the occurrence of oral mucous lesions but may lead to an increase in the prevalence of periodontal pockets.

To study satisfaction with dental care among elderly Finnish men and to estimate the role of different factors affecting it, a questionnaire was sent to a systematic sample of 2043 elderly Finnish men (mean age 73 years). Acceptably filled-out questionnaires were returned by 1561, a participation rate of 76.4%. The questionnaire included 44 questions concerning dental and denture services and a modified 14-item Dental Satisfaction Questionnaire. The subjects were asked to express how strongly they agreed or disagreed with each of the 14 statements. These were later transformed and recoded to indicate level of satisfaction from +2 (very satisfied) to -2 (very dissatisfied). Overall satisfaction was estimated by summing up all the 14 scores. Dentate subjects were significantly (P<0.01) more satisfied than the edentulous. Subjects were least satisfied with dental care fees and most satisfied with accessibility and availability of services. Dentate subjects viewed almost all 14 items significantly more favorably than did the edentulous. Economics was seen to have a strong influence on dissatisfaction with dental care fees, which was related to income level. Maintaining the remaining dentition and supporting the dentition with fixed or removable dentures seem to be the means to increase satisfaction among the dentate. The benefits of belonging to a clinic's recall system should be explained thoroughly to the elderly.