B A Burt

University of Michigan, Ann Arbor, Michigan, United States

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Publications (103)203.08 Total impact

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    S M Szpunar, S A Eklund, B A Burt
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    ABSTRACT: This paper assesses the risk from sugar consumption in a population of school children with low caries experience. It relates eight different measures of sugar consumption to the occurrence of any DMFS increment, and, separately, to approximal and pit-and-fissure DMFS. The data are from a 3-yr longitudinal study of 429 children, initially aged 11-15, residing in non-fluoridated rural communities in Michigan, USA. All children completed at least three dietary interviews, were present for baseline and final dental examinations, and had a parent or guardian provide questionnaire information on residence history, use of fluoride and dental services, and family history. Results indicated that a higher proportion of total energy intake from sugars increased the probability of caries on all surfaces, and a higher total intake of sugars was also associated with total caries increment. No relationship, however, was found between DMFS increment and the frequency of eating high sugar foods. Each additional 5 g of daily sugars intake was associated with a 1% increase in the probability of developing caries, and those whose energy intake from sugars was 1 SD above the mean had 2.0 times the risk of developing approximal caries than did children whose energy intake from sugars was 1 SD below the mean.
    Community Dentistry And Oral Epidemiology 07/1995; 23(3):142-6. · 1.80 Impact Factor
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    ABSTRACT: Abstract This paper assesses the risk from sugar consumption in a population of schoolchildren with low caries experience. It relates eight different measures of sugar consumption to the occurrence of any DMFS increment, and, separately, to approximal and pit-and-fissure DMFS. The data are from a 3-yr longitudinal study of 429 children, initially aged 11–15, residing in non-fluoridated rural communities in Michigan, USA. All children completed at least three dietary interviews, were present for baseline and final dental examinations, and had a parent or guardian provide questionnaire information on residence history, use of fluoride and dental services, and family history. Results indicated that a higher proportion of total energy intake from sugars increased the probability of caries on all surfaces, and a higher total intake of sugars was also associated with total caries increment. No relationship, however, was found between DMFS increment and the frequency of eating high sugar foods. Each additional 5 g of daily sugars intake was associated with a 1% increase in the probability of developing caries, and those whose energy intake from sugars was 1 SD above the mean had 2.0 times the risk of developing approximal caries than did children whose energy intake from sugars was 1 SD below the mean.
    Community Dentistry And Oral Epidemiology 05/1995; 23(3):142 - 146. · 1.80 Impact Factor
  • B A Burt
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    ABSTRACT: On January 25, 1945, the city of Grand Rapids, Michigan, began adding sodium fluoride to its drinking water. This action culminated a 14-year period of research which continues to have far-reaching effects on both public health and the practice of dentistry. The fact that the oral health of children and young adults today has never been higher is a direct consequence of this research. These events, and the group of rather extraordinary people who were the principal actors in them, are so important a part of dentistry's development that they are worth a brief retelling.
    British dental journal 02/1995; 178(2):49-50. · 0.81 Impact Factor
  • B A Burt
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    ABSTRACT: January 25, 1995, is the 50th anniversary of the first controlled addition of fluoride to a public water supply. Those 50 years have seen extraordinary advances in oral health and consequent quality of life, for which fluoride use is generally considered the primary reason. More extensive exposure to fluoride in the modern era, however, has led to both a continuing decline in caries experience and an increased prevalence of dental fluorosis in children. At the other end of life, fluoride's role in bone strength among older people is not well defined. This symposium examines several aspects of fluoride use in the United States today, and has the purpose of helping to define the balance between maximizing the benefits of fluoride while minimizing its undesirable side effects.
    Journal of Public Health Dentistry 02/1995; 55(1):37-8. · 1.21 Impact Factor
  • Brian A. Burt
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    ABSTRACT: January 25, 1995, is the 50th anniversary of the first controlled addition of fluoride to a public water supply. Those 50 years have seen extraordinary advances in oral health and consequent quality of life, for which fluoride use is generally considered the primary reason. More extensive exposure to fluoride in the modern era, however, has led to both a continuing decline in caries experience and an increased prevalence of dental fluorosis in children. At the other end of life, fluoride's role in bone strength among older people is not well defined. This symposium examines several aspects of fluoride use in the United States today, and has the purpose of helping to define the balance between maximizing the benefits of fluoride while minimizing its undesirable side effects.
    Journal of Public Health Dentistry 01/1995; 55(1). · 1.21 Impact Factor
  • B A Burt
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    ABSTRACT: Data for caries in the permanent and primary dentitions of children in Mexico, the United States, and Canada are reviewed from the years around 1982 to the present time. Sources are national, state, and provincial surveys, together with a number of smaller, local surveys. Data from minority populations are also reviewed. Conclusions are that caries prevalence and severity in the permanent dentition are continuing to decline in the general populations of Canada and the United States, but that caries experience in the primary dentition may have stabilised since around 1986-87. There is nothing in the limited data available from Mexico to suggest a decline in that country, caries levels remaining high. There are considerable geographic variations in caries experience in the general populations of the United States and Canada; the highest prevalence and severity is found in Quebec. Caries is more prevalent and severe in the indigenous populations of Canada and the United States than in the general population, but there are indications of a decline in the permanent dentitions of those indigenous groups. Caries will probably decline further in the general populations of Canada and the United States before it reaches an irreducible minimum, but that point may not be far away because caries experience is already very low in many localities. It is anticipated that the recent introduction of salt fluoridation in Mexico will help to bring down the high caries levels in that country.
    International Dental Journal 09/1994; 44(4 Suppl 1):403-13. · 1.04 Impact Factor
  • B A Burt, S M Szpunar
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    ABSTRACT: National policies to reduce consumption of sugars to about half of their current levels have been suggested to reduce caries, an approach which assumes that caries experience is directly related to amounts of sugars consumed. This paper uses data from the Michigan diet study to question whether such policies would be effective. The Michigan study (1982-1985) collected detailed dietary information and caries incidence over a three-year period on 499 children aged 10-15 years at baseline. Results showed that caries incidence was poorly related to sugars intake, whether measured as total daily amount, between-meal intake, sugars as a proportion of total energy, or frequency of consumption. Boys had an average daily consumption of 156 g of sugars from all sources, girls 127 g. Mean caries incidence was 2.9 DMFS over the three years. When children were divided into quartiles by amounts of sugars consumed, those in the highest quartile, compared to the lowest, had a relative risk of 1.22 of developing caries. This relative risk rose to 1.80 for proximal lesions. The risks were similar when consumption was restricted to between-meal sugars. If consumption of sugars were to be cut to half that of present levels in this population, fat consumption would be likely to rise from its present level fo 38 per cent of total energy to around 47 per cent. National policies to restrict consumption of sugars might therefore be not only expensive and ineffective, but could damage the public health by inadvertently leading to higher consumption of fats.
    International Dental Journal 07/1994; 44(3):230-40. · 1.04 Impact Factor
  • B A Burt
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    ABSTRACT: This review critically examines recent research on the relation between age and periodontitis. It concludes that some loss of periodontal attachment and alveolar bone is to be expected in older persons, but age alone in a healthy adult does not lead to a critical loss of periodontal support. Although moderate loss of alveolar bone and periodontal attachment is common in the elderly, severe periodontitis is not a natural consequence of aging.
    Journal of the American Dental Association (1939) 04/1994; 125(3):273-9. · 1.82 Impact Factor
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    ABSTRACT: The NHANES I Epidemiologic Follow-up Study (NHEFS) of 1982-84 collected longitudinal data from 10,523 individuals initially seen during the first National Health and Nutrition Examination Survey (NHANES I) of 1971-75. Among this additional data was information on the incidence of total tooth loss during the 10 years between the surveys, which could then be added to NHANES I data to identify risk factors. In this analysis, a series of bivariate analyses were carried out, followed by logistic regression analysis to assess the simultaneous effect of major variables. Results showed that 7.4 percent of dentate Americans aged 25-74 at NHANES I became edentulous over the next 10 years. In bivariate analyses, the incidence of edentulism was correlated with baseline measures of lower income and education status, poorer oral health, self-perceptions of poor general health and oral health, absence of a regular dentist, and a lower number of remaining teeth at baseline. No correlation was found with gender and geographic region, nor with self-reported diabetes and arthritis, and age was not a factor when the number of remaining teeth at baseline were taken into account. In a logistic regression model assessing the effect of these variables simultaneously, none of the demographic variables retained significance; the only variable statistically significant in both age groups was the number of teeth remaining at baseline. Other significant variables in younger persons were higher periodontal disease scores, perceived poor dental health, perceived need for extractions, history of smoking, and low ascorbic acid intake. Some of these variables were reflections of negative health behavior and attitudes rather than direct correlates. Principal findings from this study were the importance of early tooth loss in eventual edentulism and the virtual disappearance of gender and age as determinants of total tooth loss.
    Journal of Public Health Dentistry 12/1993; 54(1):5 - 14. · 1.21 Impact Factor
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    ABSTRACT: A retrospective patient record analysis was conducted to study the cost-effectiveness of dental sealants placed under routine, unrestricted practice condition in a fluoridated community. The 26 dentists who provided care at the clinic over the period of the study used their own clinical judgement to determine sealant placement or alternative treatment. Dental services for 275 patients at a children's dental clinic for low-income families were evaluated. All children had at least 3 years between their first and last dental visit (mean = 5.8 years). A lifetable analysis was conducted to compare the probability of survival (restoration-free tooth years) and costs incurred to first molars of children who did not receive sealants, received any sealants, or received sealants on all first molars. Among the children with sealants, comparisons were also made between sealed and unsealed teeth in children who did and did not have a first molar restoration prior to sealant placement. Costs included the costs of sealants and restorative treatments for these teeth over time. Depending on the conditions under which sealants were placed, cost-savings or improving cost-effectiveness with time were found. A strategy of identifying children with prior restorations and sealing the remaining molars showed cost-savings within 4-6 years. For other comparisons, incremental cost-effectiveness ratios became more favorable over time.
    Social Science [?] Medicine 07/1993; 36(11):1483-93. · 2.73 Impact Factor
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    B A Burt
    Periodontology 2000 07/1993; 2:26-33. · 4.01 Impact Factor
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    R J Weyant, B A Burt
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    ABSTRACT: This study examined endosseous cylinder implant survival, defined as the unqualified presence of the implant in the mouth at the end of the observation period, in 598 consecutive VA patients, with a total of 2098 implants. Data were taken from the Department of Veterans Affairs (VA) Dental Implant Registry, which has maintained longitudinal data on the survival of individual dental implants in VA patients since 1987. The maximum time of observation in any one patient was 2040 days (5.6 yr). Survival analysis by use of life-table methods was carried out on both an implant- and a patient-specific basis. Implant cases were accrued randomly, and therefore a random censoring model was used. A correlated binomial model was used for assessment of the degree of within-patient clustering of implant removals. Results showed that the implant-specific survival rate during the longest time interval (5.6 yr) was 89.9%; the patient-specific implant survival rate during the same time was 78.2%. Among implants which were removed, the mean time to removal was 292 days. The hazard function, which describes the probability of implant loss as a function of time, decreased steadily throughout the observation period. The correlated binomial model suggested a clustering of removals within patients with multiple implants (rho = 0.11, p = 0.0001). The odds of having a second implant removed were 1.3 times greater if the patient had already had one implant removed. This study suggests that when implants fail, they do so soon after placement, and the likelihood of failure decreases steadily from implantation through the first five years post-surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
    Journal of Dental Research 02/1993; 72(1):2-8. · 3.83 Impact Factor
  • B A Burt
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    ABSTRACT: This paper examines the impact on the development of caries, especially on the proximal and the free smooth surfaces, that follows the reduction in sucrose consumption and the increase in consumption of the monosaccharides in the United States and Great Britain. Laboratory evidence shows that sucrose has a special role in proximal- and smooth-surface caries because of its ability to produce extracellular polysaccharides with the mutans streptococci, thus increasing plaque's ability to adhere to the enamel surface. Evidence from human studies, however, is less clear about the relative cariogenicity of the various sugars, possibly because experimental conditions are difficult to maintain in such studies. In the USA sucrose consumption has been diminishing for some year and is now only 47% of the total sugar consumption of 61 kg per person annually. The change in Britain has been less pronounced, sucrose there in 1984 constituted 83% of total consumption of 47.9 kg per person. Sucrose consumption in Britain is, therefore, higher than in the United States, even though the average total consumption of all sugars is higher in the USA. Limited data suggest that proximal- and smooth-surface lesions also constitute a higher proportion of caries incidence in Britain than in USA, and a cause-and-effect hypothesis between these factors is explored. Dietary education for oral health should harmonize with that for general health by emphasizing sensible food choices, which generally means selection of low-fat, low-sugar foods.
    Caries Research 02/1993; 27 Suppl 1:56-63. · 2.51 Impact Factor
  • B A Burt
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    ABSTRACT: The aging of the American population will have enormous social ramifications, among which will be a greater focus on the elderly patient. Traditionally, the dental status of this group has been extracted teeth and full dentures, but that is now steadily changing. There were 41.1% of Americans aged 65 or older who were edentulous in 1985 to 1986, but a good proportion of them have been edentulous for many years. The prevalence of total tooth loss will continue to decline with time. The growth of a dentate elderly population, however, leaves more of that group at risk of caries. Caries, once seen as a disease of childhood, is now clearly a lifelong disease. Elderly persons are particularly at risk of root caries, which follows as a consequence of periodontitis. Total tooth loss and severe caries are both associated with lower socioeconomic status. Although cross-sectional survey data invariably show, on average, a greater extent of periodontitis among older than among younger persons, periodontitis is not considered a disease of aging. The age difference in surveys is not because of greater susceptibility among the elderly but represents disease accumulated over time. Limited longitudinal data suggest that rapid loss of periodontal attachment, serious enough to threaten the dentition, is found in 7% to 15% of any population. But this group exhibits the disease when young. Those who have retained a more-or-less intact dentition into old age rarely exhibit a sudden onset of periodontitis. If such a change is seen it could be indicative of broader changes in the immune system.
    Clinics in Geriatric Medicine 09/1992; 8(3):447-59. · 3.14 Impact Factor
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    S M Szpunar, B A Burt
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    ABSTRACT: Recent epidemiologic and related evidence suggests the following trends: 1. the prevalence of caries continues to decline in children of the US and several other developed countries; 2. the prevalence of mild dental fluorosis is increasing; 3. the majority of the cariostatic effects of fluoride are topical; and 4. dietary fluoride supplements are a risk factor for dental fluorosis. These trends, and the scientific evidence on fluoride and fluorosis, suggest that it is time to re-evaluate the use of dietary fluoride supplements. This paper examines the evidence for each of the four trends and the use of fluoride supplements in caries prevention today.
    Community Dentistry And Oral Epidemiology 07/1992; 20(3):148-54. · 1.80 Impact Factor
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    B A Burt
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    ABSTRACT: Fluorosis prevalence has increased in North America since the 1930's-1940's. It may also have increased since 1970, though the evidence for that is less clear. Continued monitoring will help determine whether increased fluorosis prevalence in children in the United States is a cohort effect from the 1970's. This review considers the evidence for an increase in fluoride ingestion from all sources since the 1970's. If an increase has occurred, the most likely sources are fluoride dietary supplements, inadvertent swallowing of fluoride toothpastes, and increased fluoride in food and beverages. For adults, there is no evidence from dietary surveys to show that fluoride intake has increased over the last generation. Dietary surveys for children aged six months to two years are similarly inconclusive, though the great variation in fluoride content of various infant foods might be obscuring real effects. The data on fluoride intake by children from food and beverages, infant foods included, are not strong enough to conclude that an increase in fluoride ingestion has occurred since the 1970's. However, the suggested upper limit of fluoride intake is substantially being reached in many children by ingestion of fluoride from food and drink (0.2-0.3 mg per day) and from fluoride toothpaste (0.2-0.3 mg per day). Two public health issues that arise from this review are: (a) the need for a downward revision in the schedule for fluoride supplementation, and (b) education on the potential for high fluoride concentration of soft drinks and processed fruit juices.
    Journal of Dental Research 06/1992; 71(5):1228-37. · 3.83 Impact Factor
  • Susan M. Szpunar, Brian A. Burt
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    ABSTRACT: Recent epidemiologic and related evidence suggests the following trends: 1. the prevalence of caries continues to decline in children of the US and several other developed countries; 2. the prevalence of mild dental fluorosis is increasing: 3. the majority of the cariostatic effects of fluoride are topical; and 4. dietary fluoride supplements are a risk factor for dental fluorosis. These trends, and the scientific evidence on fluoride and fluorosis, suggest that it is time ro re-evaluate the use of dietary fluoride supplements. This paper examines the evidence for each of the four trends and the use of fluoride supplements in caries prevention today.
    Community Dentistry And Oral Epidemiology 05/1992; 20(3):148 - 154. · 1.80 Impact Factor
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    K R Phipps, B A Burt
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    ABSTRACT: This study investigated the relationship between cortical bone mass in an older female population and their ingestion of fluoride from community water supplies. The study was conducted among lifelong female residents in Lordsburg (3.5 ppm fluoride) and Deming (0.7 ppm fluoride), NM. A total of 151 postmenopausal women ranging in age from 39 to 87 years took part; 69 were residents of the optimal-fluoride community, while the remaining 82 were residents of the high-fluoride community. Although bivariate analyses showed no difference in cortical bone mass between women in the two communities, with multiple regression analyses, significant predictors of bone mass (p less than 0.05) were weight, years since menopause, current estrogen supplementation, diabetes, and fluoride exposure status. Based on a model containing all of these variables, women living in the high-fluoride community had a bone mass ranging from 0.004 to 0.039 g/cm2 less than that of similar women living in the optimum-fluoride community. These results suggest that lifelong ingestion of water containing 3.5 ppm fluoride, compared with water containing 0.7 ppm fluoride, does not increase cortical bone mass in women of similar age, weight, and menopausal status. Under the conditions of this study, cortical bone mass might be reduced in a high-fluoride area.
    Journal of Dental Research 07/1990; 69(6):1256-60. · 3.83 Impact Factor
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    ABSTRACT: Over 500 residents of Tecumseh, Michigan, were dentially examined in 1959 as part of a community-wide health study. In 1987, the dental examinations were repeated, with use of the same criteria as in 1959, for 167 dentate persons from the original group. Another 28 reported by telephone that they had become edentulous since 1959. This report uses a historical cohort analysis for exploration of the risk factors for tooth loss, both total and partial, over the 28-year period. Over that time, the edentulous lost an average of 18.0 teeth (95% confidence interval 15.5, 20.7), whereas the age-matched 90 dentate persons lost only 3.2 (2.2, 4.2) teeth each. Descriptive data showed the edentulous to have higher baseline scores for plaque, calculus, and gingivitis, and a higher proportion of them smoked, though only loss of periodontal attachment (LPA) of 4 mm or more, early loss of first molars, and educational attainment were significant risk factors in regression analysis. Odds ratios for these three variables were 4.0 (1.2, 12.8), 2.0 (1.3, 3.1), and 0.6 (0.4, 0.9), respectively. The strongest risk factors for partial tooth loss among 116 dentate persons were baseline gingivitis (which was correlated with LPA of 4 mm or more) and the baseline number of teeth present, with odds ratios of 2.4 (1.2, 5.2) and 0.8 (0.7, 1.0), respectively. While the analysis had to be carried out without caries data, it was concluded that total tooth loss is a social-behavioral issue as much as it is disease-related. Social-behavioral factors were less clearly related to partial tooth loss in dentate persons; oral disease characteristics were the most prominent risk factors for partial tooth loss.
    Journal of Dental Research 06/1990; 69(5):1126-30. · 3.83 Impact Factor
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    ABSTRACT: The purpose of this epidemiological study was to estimate the degree of change in periodontal attachment level in a sample of adults examined in 1959 and 1987 in Tecumseh, Michigan. Out of 526 individuals between the ages of five and 60 years in 1959, a sample of 325 resided within an 80-km-radius area in 1987. Of those, 167 were re-examined. Loss of periodontal attachment (LPA) was determined with a Michigan #0 probe on four tooth sites (disto-buccal, mid-buccal, mesio-buccal, mid-lingual) for all teeth present. Of the individuals contacted, 28 had lost all their teeth during the 28 years. Of the 167 adults examined, two refused periodontal probing. Out of the 165 adults with LPA measurements in 1987, only 22 (13.3%) had an average increased loss of 2 mm or more per person between 1959 and 1987; five adults (3.0%) had an average LPA increase of 3 mm or more, and only two adults (1.2%) had an average LPA increase of 4 mm or more. The attachment level in 59.3% of all the tooth sites examined in 1959 in the 165 individuals either did not change or changed within +/- 1.0 mm. On the basis of bivariate analyses, the individuals with high LPA increase (greater than or equal to 2 mm) had the following characteristics significantly different from those with low LPA increase: They were older, smoked, had tooth mobility at baseline, higher gingivitis, plaque, calculus, and tooth mobility scores at follow-up, lower education level, and irregular dental attendance.(ABSTRACT TRUNCATED AT 250 WORDS)
    Journal of Dental Research 03/1990; 69(2):430-5. · 3.83 Impact Factor

Publication Stats

3k Citations
203.08 Total Impact Points

Institutions

  • 1978–2012
    • University of Michigan
      • • Department of Cariology, Restorative Sciences and Endodontics
      • • School of Public Health
      • • Department of Epidemiology
      Ann Arbor, Michigan, United States
  • 2007
    • University of São Paulo
      • Faculdade de Odontologia de Ribeirão Preto (FORP)
      São Paulo, Estado de Sao Paulo, Brazil
    • University of Iowa
      • Department of Operative Dentistry
      Iowa City, IA, United States
  • 1998
    • The Ohio State University
      • College of Dentistry
      Columbus, OH, United States
  • 1993
    • University of North Carolina at Chapel Hill
      North Carolina, United States
    • Centers for Disease Control and Prevention
      Atlanta, Michigan, United States
    • University of Pittsburgh
      • School of Dental Medicine
      Pittsburgh, PA, United States
  • 1985–1989
    • Concordia University–Ann Arbor
      Ann Arbor, Michigan, United States