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Health Evaluation of the Dentist and His Wife: I. Historical Information
Published in The New York Journal of Dentistry, Vol. 37, No. 8, pp. 284-287, October 1967.
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Our reemphasis on the importance of the oral examination in the nation’s program of multiphasic screening for the detection and prevention of chronic disease is being applied to the Annual ADA multiple screening program. A group of dentists and their wives have inaugurated a multiphasic screening program with Professors Cheraskin and Ringsdorf as consultants, who report here the “findings of a health questionnaire.”
Introduction
The health evaluation program came into being in 1964 as a result of the belief that the dentist should be as acutely and definitely aware of his general and oral health as is the physician of his general health…The dentist, who is entirely dependent upon himself for his income, cannot afford to be in poor health which might necessitate not only absence from the office but make it impossible for him to continue his optimum work load.
This statement1 not only served as a justification for and prelude to the multiphasic screening program now being conducted annually at the national meeting of the American Dental Association but also for the development of a periodic multiple testing project of a group of dentists and their wives under the auspices of the Southern Academy of Clinical Nutrition.
This first in a series of reports has a twofold purpose. First, to analyze the results of a questionnaire completed by the members of the Southern Academy of Clinical Nutrition. Second, to compare these findings with the questionnaire results obtained at the multiphasic screening program conducted during the annual meeting of the American Dental Association.
Method of Investigation
One hundred and fifty-two dentists and their wives participated in the survey. The age and sex distribution is summarized (Table 1). It is clear that the majority (54.6 per cent) are male and the age predominance (39.4 per cent) is in the fifth decade.
Table 1–Age and Sex Distribution
Each subject completed the Cornell Medical Index Health Questionnaire.2 This is a self-administered questionary consisting of 195 questions to be answered negatively or affirmatively. The results may be viewed in three ways. First, specific questions relate to specific disease entities. For example, question #21 asks, “Do you suffer from asthma?”. Second, the 195 questions are arranged by systems. Thus, section A includes 9 questions relating to the eyes and ears; section C lists 13 cardiovascular questions. Third, the total number of positive replies may be regarded as a measure of what might be termed the “syndrome of sickness.”
Results
Table 2 summarizes the percentage frequency distribution of positive finding regarding specific problems. It will be noted that, for the entire group of 152 men and women, 39 per cent reported hemorrhoids. Further, Table 2 reveals that this is the most common problem in both sexes. However, the frequency is 10 per cent higher in the female group. Table 2 also discloses that the second most frequent finding for the entire group is overweight [21 per cent]. However, viewing the sexes independently, overweight is the second most common item [29 per cent] in the male. The second most frequently reported finding in the female is kidney and bladder disease [25 per cent]. It is fair to conclude that, within the limits of this relatively young and health-motivated group, a number of problems prevail as judged by the data obtained from a self-administered questionnaire.
Table 2–Percentage Frequency of Positive Findings
It should be recalled that the questions are arranged by systems. Analysis of the data by this technique will be considered in a subsequent report.
Finally, some measure of the so-called syndrome of sickness may be derived by simply analyzing the frequency of positive replies. Table 3 permits such an analysis. Three points deserve consideration. First, the reported findings range from a low of one to a high of 53. Second, the percentage frequency decreases with an increase in the number of affirmative responses. Finally, females report more positive findings than males.
Table 3–Percentage Frequency Distribution of Positive CMI Responses
Discussion
It would appear that, in this relatively young and health-motivated group of dental practitioners and wives, there is evidence of considerable recognized and, to a degree, remedial disease ranging from a high of 39 per cent with admitted hemorrhoids to a low of zero for venereal disease. It is generally agreed2 that more than 25 overall positive replies suggests “significant” disease. On this basis, almost one in five [19 per cent] fall into this category.
As part of the 1964 and 1965 Health Evaluation Programs conducted during the annual conventions of the American Dental Association, a brief questionnaire was included. Table 4 allows a comparison of the age patterns for the participants in the two American Dental Association studies and the project of the Southerns Academy of Clinical Nutrition. It is clear that the A. D. A. projects include more practitioners in the older age categories.
Table 4–Age Distribution
Table 5 allows a comparison, within the limits possible, of the questionary results. The frequency of anemia, hypertension, and tuberculosis are strikingly similar. The other disorders do not vary more than about 2 per cent.
Table 5–Basic Screening Record Results
Summary
- The questionnaire results of 152 individuals [83 dentists and 69 wives] are analyzed and the results compared with the questionary findings obtained during the 1964 and 1965 Health Evaluation Programs conducted during the annual meetings of the American Dental Association.
- Where comparisons allow, the A. D. A. findings and those of the Southern Academy of Clinical Nutrition agree.
- The yield from the Cornell Medical Index Health Questionnaire [utilized by the Southern Academy of Clinical Nutrition] is greater than that obtained in the study at the American Dental Association. This is likely due to the fact that the former form is more exhaustive.
- A report to follow3 will analyze the blood glucose scores in the Southern Academy of Clinical Nutrition and compare the results with those obtained during the 1964 and 1965 Health Evaluation Programs.
References Cited:
- American Dental Association. 1965 Health Evaluation Program. Chicago, A.D.A.
- Brodman, K., Erdmann, A. J., Jr, and Wolff, H. G. Cornell Medical Index Health Questionnaire: Manual. 1949. New York, Cornell Univ. Med. Coll.
- Cheraskin, E. and Ringsdorf, W. M., Jr. “Health evaluation of the dentist and his wife: II. Blood glucose findings.” [in preparation]