F. A. C. Wright

Tokyo Medical and Dental University, Edo, Tōkyō, Japan

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Publications (26)31.07 Total impact

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    ABSTRACT: This study was to analyze the association of hyposalivation with oral function, nutritional status and oral health in community-dwelling elderly Thai. The subjects were 612 elderly people (mean age = 68.8, SD 5.9 years). Oral function (tasting, speaking, swallowing and chewing) and Mini Nutritional Assessment (MNA) were evaluated. Oral examination investigated teeth and periodontal status. Both unstimulated and stimulated whole saliva were collected for 5 minutes. Among all subjects, 14.4 % were classified within the hyposalivation. Hyposalivation was associated with gender, systemic disease, medication, and smoking. Subjects within the hyposalivation group had a higher number of decayed teeth and a higher prevalence of periodontitis than the normal salivation group (p < 0.05). The hyposalivation group also had a lower number of teeth present and a lower mean MNA score than the normal salivation group (p < 0.05). Logistic regression analysis showed that hyposalivation in both dentate and edentulous subjects was significantly associated with tasting, speaking, swallowing and chewing. This study suggested that hyposalivation is a risk factor not only for dental caries and periodontal disease but also for taste disturbances, speaking problems, swallowing problems, poor chewing ability and malnutrition. Monitoring salivary flow is an important measure in the care of older people.
    Community dental health 03/2012; 29(1):117-23. · 0.87 Impact Factor
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    ABSTRACT: The objective of this study was to investigate clinical oral health status relationships that affect quality of life (using the 12-item General Oral Health Assessment Index (GOHAI)) and self-rated oral health in a community of Japanese residents. 459 residents of Yokote City, Japan aged 40-55 years had oral health examinations and completed self-administered questionnaires collecting data on age, gender, GOHAI items and self-rated oral health. Linear regression analysis was performed with GOHAI or self-rated oral health as a dependent variable and gender, age and indicators of oral health status as independent variables. The GOHAI indicated 42.7% of subjects were concerned about the appearance of their teeth, 30.1% were worried about teeth problems and 27.5% concerned about sensitive teeth. Analyses showed that gender, decayed teeth, oral dryness and missing teeth were significantly associated with variation in GOHAI scores, and that gender, decayed teeth, oral dryness and oral hygiene were significantly associated with variation in self-rated oral health. This study revealed that in this sample of Japanese adults aged 40-55 years, decayed teeth and oral dryness affected both GOHAI and self-rated oral health, whereas missing teeth affected GOHAI and oral hygiene affected self-rated oral health. Subjects did not recognise periodontal disease as a quality of life impacting condition or as a health problem.
    Community dental health 12/2011; 28(4):297-300. · 0.87 Impact Factor
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    ABSTRACT: The Australian population is ageing, and a growing proportion of elderly Australians are now living in residential aged care facilities (RACFs). These residents are commonly dependent on others for their daily oral hygiene care and often display high levels of plaque and calculus. With declining edentulism rates, periodontal disease is becoming more prevalent in this population. The aim of this study was to investigate the ability of a dental hygienist to undertake a dental examination for residents of aged care facilities, devise a periodontal and preventive treatment plan and refer patients appropriately to a dentist. A total of 510 residents from 31 Victorian RACFs were examined, with 275 dentate residents included in this study. Between May 2005 and June 2006, residents were examined by a single experienced dental epidemiologist and one of four dental hygienists using a plane mouth mirror and periodontal probe. A total of 510 residents from 31 RACFs had a dental examination from a dentist and one of four dental hygienists. The treatment needs of residents examined were high, with nearly all of the 275 dentate residents requiring preventive and periodontal treatment, and three-quarters requiring referral to a dentist for treatment. There was excellent agreement between the dentist and hygienists regarding the decision to refer residents to a dentist for treatment, with high sensitivity (99.6%) and specificity (82.9%). Only 8.0% of residents were referred by a hygienist to a dentist when the dentist considered that no referral was required. Dental hygienists have the skills and knowledge necessary for undertaking a dental examination for residents, correctly identifying the majority of residents who require a referral to a dentist. They are capable of formulating appropriate dental hygiene treatment plans for residents of aged care facilities. It is recommended that there should be greater utilization of hygienists in the provision of dental care to residents of aged care facilities, as a safe, efficient and effective use of health resources.
    Community Dentistry And Oral Epidemiology 08/2011; 39(4):378-84. · 1.80 Impact Factor
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    ABSTRACT: The aim of this project was to investigate edentulism and dental caries in nursing home residents in Victoria, Australia. The Australian population is ageing with a growing number of people living in nursing homes. These residents are at increased risk for dental caries, have more teeth present now than at any time in the past 50 years and often have difficulty maintaining adequate oral hygiene. Clinical dental examinations were conducted at 31 nursing homes in Melbourne and regional Victoria between May 2005 and June 2006. A total of 510 residents were examined out of 1345 eligible participants. Socio-demographic and medical history was collected via questionnaire. Just over half of the residents were dentate (53.9%), and dentate residents had a mean of 14.4 teeth present and 2.66 untreated decayed teeth. Residents who required total assistance with oral hygiene had more decayed teeth and fewer filled teeth than residents who did not require assistance. Nursing home residents in Victoria are retaining an increasing number of natural teeth and have more tooth surfaces at risk for dental caries. Untreated dental caries was a significant problem for residents, particularly for those who are dependent on others for their daily oral hygiene care.
    Gerodontology 06/2011; 29(2):e512-9. · 0.81 Impact Factor
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    ABSTRACT: The effects of two types of modelling videotapes, mastery and coping, on anxiety and disruptive behaviour in 5-7-year-old children undergoing a restorative dental procedure were investigated. Results indicated that both treatment videotapes were more effective in reducing self-report anxiety than was a placebo tape. There was no difference between the mastery and coping tapes in reducing anxiety. No differences were found between groups on the measure of disruptive behaviour.
    Australian Journal of Psychology 02/2011; 37(1):65 - 70. · 1.08 Impact Factor
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    ABSTRACT: doi: 10.1111/j.1741-2358.2010.00448.x Oral hygiene and periodontal disease in Victorian nursing homesObjective:  To investigate oral hygiene and periodontal disease in residents of Victoria nursing homes.Background:  The Australian population is ageing with a growing proportion of elderly Australians living in nursing homes. With declining edentulism rates, periodontal disease is becoming more prevalent in this population.Materials and methods:  A total of 275 dentate residents from 31 Victorian nursing homes had a questionnaire and clinical examination using the Visual Plaque Index and a modified Community Periodontal Index.Results:  Self-reported oral hygiene habits of residents were poor, with less than one-third of residents cleaning their teeth twice daily or more. Periodontal health was found to be extremely poor, and the prevalence of 4 mm+ periodontal pockets was 35.6%, with 10.2% having 6 mm+ pockets. Logistic regression found that age, gender, number of teeth present and oral hygiene were all strongly associated with the prevalence of 4 mm+ periodontal pockets.Conclusion:  Poor oral hygiene and the presence of significant plaque and calculus were common findings in this study. Periodontal diseases are a significant problem for residents in nursing homes. Addressing this health issue will require improved training for carers and better access to appropriate dental services.
    Gerodontology 11/2010; 29(2):e220 - e228. · 0.81 Impact Factor
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    ABSTRACT: Objectives: The population is ageing, and by 2051 more than one quarter of Australians will be aged 65+ years. With declining edentulism rates and more elderly living in nursing homes, there needs to be a greater focus on the provision of dental services to this high-risk section of the community. The aim of this study was to determine whether dental hygienists were capable of undertaking examination and referral for nursing home residents. Methods: One dentist and one of four dental hygienists examined 510 residents from 31 nursing homes in Victoria, Australia. The examiners were blinded, and examinations performed using mouth mirror, probe and portable lighting. Hygienists developed a treatment and referral plan for residents, and this was compared to the clinical findings of the dentist. Results: More than half of the residents were dentate, and treatment needs were high. There was excellent agreement between the dentist and hygienists regarding the decision to refer residents to a dentist for treatment (Kappa=0.83), with high sensitivity (99.6%) and specificity (82.9%). Only 8.0% of the sample was referred to the dentist by a hygienist when no treatment was required. This was mostly to check potential soft tissue pathology where the dentist subsequently determined that there was no soft tissue pathology evident, and inadequately fitting dentures where the dentist determined that no treatment was recommended. Overall, there was good agreement between dental hygienists and dentist in the ability to estimate treatment needs and oral health status in nursing home residents, with no prior calibration of the examiners. Conclusions: Dental hygienists are capable of undertaking a dental examination for residents, identifying the majority of residents who require a referral to a dentist and formulating appropriate dental hygiene treatment plans for residents. There should be greater utilisation of dental hygienists to provide dental care in nursing homes.
    IADR General Session 2010; 07/2010
  • F. A. C. Wright, D. J. Beck
    Community health studies 06/2010; 5(2):106-116.
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    ABSTRACT: Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. Net costs were estimated as Costs((programme)) minus Costs((averted caries).) Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal. Community water fluoridation remains a cost-effective preventive measure in Australia.
    Australian Dental Journal 03/2010; 55(1):37-44. · 1.37 Impact Factor
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    ABSTRACT: Smoking has been associated with the number of natural teeth a person has and with the likelihood of periodontitis. The purpose of this study was to determine the relationships between the number of teeth present and periodontal diseases with smoking habits in a cohort of Japanese men. The study group comprised 1088 men, 40-75 years of age. Oral examinations were conducted in dental clinics. Information on smoking status and on oral health behavior was collected from self-administered questionnaires. The relationship between oral health status and smoking status was estimated using adjusted odds ratios. Compared with those whom had never smoked, the odds ratios of having more than eight missing teeth and having periodontitis, among current smokers, were 1.67 and 1.74, respectively. In those who had stopped smoking for 11 years or longer, there was no increase in the odds ratio of having more than eight missing teeth and periodontitis, compared with those whom had never smoked. Smoking has a positive association with missing teeth and periodontitis. However, smoking cessation is beneficial for oral health. The odds of having more than eight missing teeth, or of having periodontitis, in those who had never smoked was similar to that of individuals who reported that they had stopped smoking for 11 years or more.
    Journal of Periodontal Research 09/2009; 45(2):277-83. · 2.22 Impact Factor
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    ABSTRACT: Forty females and 40 males (equal number of Internals and Externals) aged 9-12 years who exhibited moderate to high dental anxiety were randomly assigned to a group rehearsing coping strategies for stress and anxiety or to a placebo condition. Subjects were observed during a dental examination one to two weeks following treatment. Results indicate the coping condition was more effective than placebo in reducing self-report anxiety and in effecting a change of locus of control toward greater internality. Internal subjects exhibited a greater reduction in physiological arousal than did Externals, while External subjects changed their locus of control to a greater extent than did Internal subjects. Sex by treatment interactions were found for reduction in physiologica arousal and behavioral manifestations of anxiety. Results are discussed in regard to Watson and Baumal's (1967) incongruity hypothesis and Phares' (1973; 1976) interactionist position.
    Child & Family Behavior Therapy 10/2008; 8(3):1-18. · 0.67 Impact Factor
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    ABSTRACT: The Australian population is ageing, and a growing proportion of elderly Australians are now living in residential aged care facilities (RACFs). These residents are at high risk of developing dental diseases, have more teeth present now than at any time in the past 50 years and often have difficulty maintaining adequate oral hygiene. Traditionally, dental service provision has been problematic and sporadic for these residents. A postal survey of a random sample of Victorian general dentists and Directors of Nursing (DONs) of Victorian RACFs was undertaken in 2006 to ascertain the participation of dentists in the provision of dental care and to identify factors impacting on the organization and provision of dental care for residents. The response rate for dentists was 57.3 per cent, and for DONs 64.4 per cent. Half of the dentists reported that they had provided care to residents of aged care facilities in the past 12 months, and they spent an average of one hour per month providing care. Overall, dentists were concerned with their level of undergraduate education and training in various aspects of dentistry for residents of aged care facilities. DONs reported significant difficulty obtaining adequate dental care for their residents. Common problems identified by both dentists and DONs included a preference for dentists to treat residents in their own practice, dentists not willing to go to RACFs and a lack of portable dental equipment for dentists to use. There were low levels of interest and participation from Victorian dentists in providing dental care for residents of aged care facilities. Dentists had a strong preference for treating patients at their own practice, and there were a number of significant barriers that appeared to impact on the provision of dental care in RACFs.
    Australian Dental Journal 10/2008; 53(3):239-45. · 1.48 Impact Factor
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    ABSTRACT: Abstract – This paper reports on two studies exploring similarities and contrasts in knowledge, attitudes and opinions onuorides anduoridation of two culturally different population groups. Therst study compares the attitudes and opinions of parents of primary (elementary) schoolchildren in Melbourne, Australia, and Yokohama, Japan, and the second study compares the attitudes and opinions of dentists drawn from the same geographic areas. A self-administered questionnaire collected data on 517 parents and 629 dentists. The questionnaires were of similar design and content for both parents and dentists. They included a series of knowledge and attitudinal statements on preventive dentistry and use ofuorides. Attitudinal responses were measured on a 5-point agree-disagree Likert scale. Data were analyzed using both bivariate and multivariate techniques. Australian parents appeared better informed on the benets of wateruoridation and held more favorable opinions onuorides anduoridation than their Japanese counterparts. Similarly, Australian dentists held more positive attitudes toward the use of fluorides and fluoridation than their Japanese peers. Cultural norms and experiences appear to shape parental attitudes, whereas the focus of dental education and dental practice on restorative treatments in Japan appears to be a substantial inuence on the attitudes and opinions held by Japanese dentists.
    Community Dentistry And Oral Epidemiology 02/2007; 26(3):182 - 193. · 1.80 Impact Factor
  • M V Morgan, G G Adams, A C Campain, F A C Wright
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    ABSTRACT: This paper utilises a Poisson frailty regression model with clustering to report on the failure rates of sealants placed and repaired during a three-year follow-up school-based comprehensive preventive programme. The programme included annual application/reapplication of light-cured fissure sealants in 210 12-year-old subjects over three years. Sealants placed at the commencement of each year of the programme were assessed for retention 12 months later and repair/reapplication was undertaken at that time for those surfaces judged to require it. An application of a Poisson regression model with random effects ("frailties") and clustering was used in this paper to allow for heterogeneity between subjects. Whilst it appears that the direct utilization of frailty models in determining fissure sealant failure rates has not been reported, it is clearly an appropriate use of this statistical method. A total of 1,544 sealants were placed during the study period. Of these, 1,038 (67.2%) were first placements at baseline and 506 (32.8%) were repairs/reapplications. Of these repairs/reapplications, 206 (40.7%) were performed at first year follow-up and 300 (59.3%) at second year follow-up. The Failure Rate Ratios were statistically significantly greater for second molars cf. first molars (FRR=1.33, p=0.008) and for lower molars cf upper molars (FRR=1.32, p<0.001). Failure rate ratios for sealants placed in the distal occlusal pit and fissures cf. mesial occlusal pit and fissures were significantly higher (FRR=1.33, p<0.001). A significant interaction was found for molar type versus pit and fissure site (p=0.009). There was no significant interaction between molar type and arch. Sealants placed on second molars, those placed on lower molars and those placed on the distal fissure sites have a higher failure rate. As individual tooth sites in the mouth are not independent, any statistical analysis should allow for these associations when assessing sealant retention.
    Community dental health 01/2006; 22(4):237-45. · 0.87 Impact Factor
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    ABSTRACT: Many studies on toothbrushing have concentrated on clinically diagnosing plaque and measuring periodontal status as indicators of oral health behaviour. From a behavioural point of view, however, the more important objective is the health behaviour itself. To investigate the relationship of oral health behaviour to periodontal status, 517 urban employees in Japan (249 men and 268 women aged 20-59 years) responded to a 20-item dental health behaviour questionnaire, entitled the HU-DBI, and had their periodontal conditions examined using the CPITN. Only 1 per cent were found with a healthy periodontium (Code 0), and 9 per cent had bleeding on probing (Code 1). Calculus (Code 2) was the most prevalent condition with 51 per cent of subjects having this code as the worst condition, followed by shallow pockets (Code 3) in 30 per cent, and deep pockets (Code 4) in 9 per cent of the sample. The mean HU-DBI score was 4.2 (out of 12). Females had somewhat higher scores than males (4.4 vs. 4.0, p < 0.05). CPITN had a negative relationship with the HU-DBI (r = -0.26, p < 0.001), and a positive relationship with age (r = 0.40, p < 0.001). Similar relationships were observed in each gender. These data demonstrate the relationship of age with periodontal status, and periodontal status with oral health behaviour. A two-dimensional matrix of HU-DBI score by CPITN may provide a simple and effective means of identifying low and high risk individuals.
    Australian Dental Journal 10/1993; 38(5):381-8. · 1.48 Impact Factor
  • F. A. C. Wright
    Australian Dental Journal 05/1992; 37(2):139-42. · 1.48 Impact Factor
  • M A Stacey, F. A. C. Wright
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    ABSTRACT: A survey of 60 pre-school children both from Anglo-Saxon and Lebanese backgrounds collected detailed information on subjects' oral health status and dietary and feeding habits. Lebanese subjects had significantly higher caries experience (mean dmfs = 4.88) than Anglo-Saxon subjects (mean dmfs = 0.56). Subjects from the different backgrounds varied significantly also in the frequency of exposure to cariogenic agents and health practices. In each situation Lebanese children were exposed to higher risk factors than Anglo-Saxon children. Notwithstanding the association between variables, the best single predictor of variance in caries experience of subjects, explaining 23 per cent of the variance of dmfs, was the mother's level of education. Culturally relevant health education programmes need to address the specific requirements of high risk groups.
    Australian Dental Journal 01/1992; 36(6):421-7. · 1.48 Impact Factor
  • F. A. C. Wright, J E Giebartowski, N E McMurray
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    ABSTRACT: Seven-hundred and sixty dentists, selected randomly from all States and Territories except Victoria, responded to a questionnaire survey on beliefs, attitudes and the techniques used in the management of children with anxiety or behaviour problems. The most common techniques used were permitting the child some degree of control over terminating treatment if difficulties were experienced, coaxing and reinforcing positive behaviours, and furnishing waiting areas with child-oriented play materials. Most respondents never used TV or video-tape distraction strategies, film or video-modelling tape or hypnosis. More than half of the respondents believed there was insufficient information available to them on current anxiety/behaviour management techniques. The use of particular management techniques varied by gender, age, university of graduation, State or Territory of residence, and membership of the Australian and New Zealand Society of Paediatric Dentistry. Patterns of use of particular techniques showed similarities and contrasts with other studies. Patterns of use in the national sample were almost identical to the frequency and pattern of use by Victorian dentists. In contrast, however, North American studies have reported a higher frequency of use of hand-over-mouth, and lower use of general anaesthesia within the armamentarium of techniques and strategies used by dentists to manage anxious or difficult children.
    Australian Dental Journal 11/1991; 36(5):378-83. · 1.48 Impact Factor
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    ABSTRACT: A survey of 303 subjects over the age of 60 years collected demographic and oral health status data for analysis. The majority of the sample (64.2 per cent) were edentulous. Over 90 per cent of the dentate subjects required scaling and the removal of plaque (CPITN score of TN2); however, just less than half of the sextants examined were excluded because they contained fewer than two functional teeth. About one-third of the dentate subjects required no treatment for dental caries. Of those who required treatment, most needed only one restoration of any particular type. Total tooth loss was associated with gender, level of education, previous occupation, and birthplace. The need for complex periodontal treatment (TN3) was not high, nor was there a high prevalence of root or cervical dental caries.
    Australian Dental Journal 07/1991; 36(4):280 - 285. · 1.37 Impact Factor
  • F.A.C. Wright
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    ABSTRACT: This article discusses the historical shifts between the treatment-oriented, instructional and primary preventive approaches to oral health promotion, especially in school-based programs in New Zealand and Australia. While in the past much effort has been put into treatment-oriented and instructional programs, their impact has been limited. Among those primary preventive activities that have demonstrated clear benefits are various types of fluoridation and adhesive sealants for the occlusal surfaces of teeth. Further emphasis on primary prevention over treatment is needed to better insure the success of school-based oral health promotion programs. In addition, more effort needs to be put into policy direction, linkages within the educational system, planning, and evaluation.
    Health education quarterly 02/1991; 18(1):87-96.