Advances in the Epidemiological Study of Oral-Facial Diseases

Abstract

Both demographic patterns and disease distribution are changing rapidly in the United States. These developments have led to the recognition that the epidemiology of many conditions is poorly understood, and that other research has thus been hindered. Four areas of epidemiological study were chosen for detailed analysis of how new technology will affect the conduct of future research. These areas, selected because information about them will be increasingly needed in an aging society, were periodontitis, temporomandibular disorders (TMD) and other orofacial pain, salivary gland disturbances, and health services research. The potential effect of new technology was examined in the short, intermediate, and long term. While the nature of epidemiological study is unlikely to change with the advent of new technology, the scope of potential studies will become broader. Advances in diagnostic techniques from elsewhere will permit far more precise diagnosis than is possible at present. Computer technology will permit an efficient system of epidemiological surveillance to provide current data on trends in tooth loss, caries, and periodontitis--data which will complement the results of national surveys. Analytical studies to produce hypotheses on the etiology of oral conditions, especially in such poorly-understood areas as chronic pain and TMD, will help direct clinical research in those areas.

Utilization of Dental Services as a Risk Factor for Periodontitis

“…A visual method of checking for a pattern among residuals is to plot the residuals against predicted values. This plot is displayed in Figure 3 and does not show a pattern in the residuals indicative of incorrect functional form or important omitted confounders.61 Table 7 shows the results from a model specified identically to the previous model (Table 6) with the exception that only high utilizers (> 15 routine exams and preventive services) and non-utilizers (no routine exams or preventive services) were used for the analysis. This reduced the number of observations to 184 from the 539.…”

“…Development of summaries must deal with the thorny issues of case definition as well as the number and types of sites to assess.3"8 This requires consideration of severity of the clinical conditions (e.g., clinical attachment or alveolar bone loss) as well as the extent (i.e., percent or number of affected sites). [3][4][5][6][7][8][9] The effect of J Periodontol May 1994 (Supplement) fallible measurements is also an important issue because it can lead to misclassification of periodontal status.10-'1 While all epidemiologie studies use some combination of the concepts of extent and severity to describe the periodontal status of a population, various studies have assessed and combined these concepts differently. Some studies have dichotomized Periodontitis into a case or not a case, based on different combinations of extent and severity of sites.…”

Prevalence, extent, severity and progression of periodontal disease

“…Epidemiological assessment of a group of individuals requires a summary of the periodontal status over individual sites in the mouth. Development of summaries must deal with the thorny issues of case definition as well as the number and types of sites to assess (14,30,41). The effect of fallible measurement techniques is also an important issue and is discussed elsewhere in this volume.…”

“…Prevalence of periodontitis in children[14][15][16][17] years of age by race, United States (NIDR 1987).…”

A Research Agenda for Dental Public Health—Rational and Development

“…To ensure safety, effectiveness, and the cost effectiveness of emerging technologes, further research is clearly needed. New technology may enable further research in areas that have been impeded by diagnostic imprecision, such as periodontitis, temporomandibular disorders and other chronic orofacial pain, salivary gland dysfunction, and the provision of health services (48).…”