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Health VIEW

Some Mixed News About Dental Care

March 17, 1987|ALLAN PARACHINI | Times Staff Writer

American adults are keeping their teeth longer, but large percentages of working men and women and the elderly have bleeding gums and nearly everyone has tartar deposits on the teeth, according to a new national federal government dental health survey.

In brief, the survey found: Toothlessness among middle-aged adults has declined to just 4% from about 8% 12 years ago, but 42% of senior citizens are toothless, with just 2% still having all their teeth after age 65.

Working adults had an average of 23 cavities each on the crowns of their teeth, with such cavities more common in women than in men. However, cavities in tooth roots--which become possible when gums deteriorate and roots are exposed--were more common in men, with 21% of employed adults and 63% of the elderly having them.

Gum bleeding was found in 43% of working adults and 47% of old people; 84% of working adults and 89% of the elderly had tartar deposits. Similar numbers showed some evidence of gums receding from teeth. The survey, by the National Institute on Dental Research, was released at a Chicago press conference last week. The conclusions were drawn from examinations of 21,000 adults from 18 to 103 years old. The exams occurred over a one-year period ending in March, 1986. Compared with similar--though not identical--surveys from 1960 to 1962 and 1971 to 1974, "it's clear people are keeping their teeth longer today. The news is encouraging," said Dr. Harald Loe, the institute's director.

BEHIND THE HALF-SMILE

A controversy over whether the model for Leonardo da Vinci's Mona Lisa produced her haunting half-smile because of a facial nerve disorder has reached a new extreme, with the theory's chief advocate arguing that da Vinci was an unwittingly accurate diagnostician.

To Dr. Kedar Adour of the Kaiser Permanente Medical Center in Oakland, the Mona Lisa represents an obvious case of Bell's palsy, a progressive disorder in which facial nerves lose their function, resulting in paralysis that is usually transient but sometimes permanent. Lisa, as Adour calls her, clearly had the disease, which resulted in her sustaining nerve degeneration on the left side of her face, with affected muscles distorting her smile.

Adour first presented his theory in a brief talk at a medical meeting in Santa Fe, N.M., earlier this year and, in a telephone interview, he said he was astonished at the attention it received. Now publication of an account in a newspaper for physicians may renew the interest. Adour believes that, based on what is known about Bell's palsy, it is quite likely that Lisa had been pregnant and that Bell's was a pregnancy complication for her, as it can often be.

Lisa didn't recover completely, Adour said, and apparently developed the same coping behavior sufferers have today: She learned not to smile so her problem would not be betrayed. "They do that," he said of Bell's sufferers, "because when they smile, they become asymmetrical." Da Vinci deliberately chose Lisa and forced a half smile out of her, Adour said, because though Bell's was not scientifically known at the time, 400 years ago or so, the artist recognized a physiological problem--not an emotional enigma. "Being a scientist, da Vinci wanted to accentuate the asymmetry," Adour said. "He was teaching facial muscle anatomy to painters at the time and he could not explain the nature of her smile on the basis of anatomy."

ELDERLY BLOOD DONORS

The elderly--already a national resource in a wide variety of ways--also are an enormous potential pool of blood for transfusion and senior citizens can donate safely even though many people drop out or are pushed out of blood programs after age 66, new research emphasizes.

The conclusion springs from a survey of donors 66 and older whose ability to give blood safely was compared with that of people 55 to 65. Volumes of blood donated and complication rates were identical in the two groups, said researchers for the Greater New York Blood program who published their findings in the Journal of the American Medical Assn. Blood programs hard-pressed by the AIDS scare and fears about such diseases as hepatitis may find recruiting senior citizen donors can restore an element of balance and confidence, the researchers observed.

In an editorial published with the study, Dr. Tibor Greenwalt of the University of Cincinnati Medical Center, urged blood bankers to tap the resource the elderly apparently represent. He noted that many medical blood donation protocols prohibit donations after a person turns 65. People in that age bracket, though, account for an enormous proportion of blood used in hospitals.

"The graying of the population and the swelling ranks of the largest users (of blood) make it necessary to reconsider the basis for this arbitrary upper age limit," Greenwalt said. "I trust that the graying of our donors will be allowed to keep pace with the graying of the population."

A REAL TRAVELERS' AID

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