Writing scientific papers for publication: "Without publication research is sterile".
BACKGROUND: The publication of basic science and clinical research
findings, as well as new clinical diagnosis and treatment techniques, is
widely disseminated. These days there is considerable competition to
publish so the selection process is even more competitive. Aim: To
present advice as to how to enhance the chances of being published and
more importantly how to prepare a paper for submission. METHOD:
Instructions are presented as to the steps to be taken in writing a
scientific manuscript. This covers Introduction, Materials and Methods,
Results and Discussion. Guidance is given as to what should be included
and also what should be left out. The precision of writing is paramount
and scientific text needs to be simple, easily read and translated by
those whose day-to-day language is not English. Advice is given on
journal selection and how to ensure the best chance of manuscript
Key words: scientific papers, publishing
Pedodontics (Study and teaching)
|Publication:||Name: European Archives of Paediatric Dentistry Publisher: European Academy of Paediatric Dentistry Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 European Academy of Paediatric Dentistry ISSN: 1818-6300|
|Issue:||Date: Feb, 2012 Source Volume: 13 Source Issue: 1|
|Topic:||Computer Subject: Company growth|
|Product:||Product Code: 2721320 Scientific & Technical Journals NAICS Code: 51112 Periodical Publishers|
There has been a significant growth in recent years in the numbers of manuscripts submitted to journals concerned with paediatric dentistry, as well as in all other branches of medicine and basic sciences. There is therefore great competition amongst scientists to have their clinical or basic science research, as well as clinical techniques, diagnoses and case reports, published. Editors of scientific and clinically based journals have to decide which papers to publish when there are constraints on printing space.
There is a need for aspiring authors to make sure their work has the best chance of being accepted. In order to do this it is imperative that a manuscript for possible publication should be prepared to the highest standards. Too often manuscripts are submitted to journals inadequately or sloppily prepared, with layouts that do not conform to journals' requirements of style, spelling and grammar. In the authors' experience, as past editors of journals and having served on many editorial boards, is that far too many authors do not pay sufficient attention to detail and submit poorly presented work.
Because of our past experience, this paper has been prepared to give advice on how to approach the task of writing scientific manuscripts to ensure the best chances of acceptance. Because there are many journals, even within dentistry, it is imperative for any aspiring author(s) to do their homework and prepare diligently.
In the first instance an author must decide the essence of what they wish to say and to which audience their work is to be directed. The choice of a journal is important. Is it to be a clinically based one or a basic science orientated one? As an author you should appreciate that:
* A targeted journal must be picked with care,
* Each publication is a showpiece of your work,
* You should have a sense of achievement when an article is published,
* You must understand that rejections happen to everyone.
What and when to publish? There are two questions that are frequently asked:
Question: "What is a good article?" [Lock, 1979]
Answer: "It's one that has a definite structure, makes its point, then shuts up." [Lock, 1979]
Question: "When should one publish?"
Answer: "As soon as there is something worthwhile to report." [Calnan, 1984]
Which journal? Pick a target journal with care because you will want the best and appropriate exposure of your work and to those colleagues you feel will be most interested. Remember each of your publications will be an indication of your work standard. Within the scientific community your publication(s) may well have implications for grant funding for further research, academic advancement, appointments to positions within your specialty, prestige and standing and of course personal satisfaction. Choosing a suitable journal is important, and the following should be considered:
* Who is the target audience--generalist, specialist; international, national, or local?
* What is the information type--clinical, laboratory, or other?
* What sort of contribution is intended--editorial, review, original work, case report, or letter?
* Is it to be a popular article? What is the journal's quality, reputation and is there an objective measure of this? Useful measures are the Web of Knowledge annual Journal Citation Reports Impact Factor (IF) and the IF rank in the discipline categories. A third measure is the journal CJM score [Cleaton-Jones and Myers, 2002].
As an example, Archives of Disease of Childhood has an IF = 2.657 (IF is calculated by dividing the number of articles in a journal published over 2 years into the number of citations of those articles). This journal is in the paediatrics category where it is ranked 12/94 in descending order of IF.
[FIGURE 1 OMITTED]
The journal's CJM score is 7/10. A CJM score is calculated using Log IF+1 arranged in 10 Class intervals (Fig. 1) and allows cross comparison of journal quality between discipline categories with various IF levels [Cleaton-Jones and Myers, 2002]. The higher the IF and CJM scores, the more widely cited a journal is and these scores are deemed to be an indication of its quality. However the indication is relative and some excellent journals have chosen not to be evaluated for an IF. The subjective opinion of respected researchers is another indication of quality.
Once a journal is chosen. The most often neglected aspect of preparing a scientific paper is that authors fail to:
Read the instructions to authors and stick to these!
An author should always obtain a copy of the guidelines or instructions to authors, which are readily available online. These instructions should be kept on the desk while writing, should be read carefully at least three times and should be followed to the letter. As well as this, a current copy of the journal should always be obtained and studied carefully. Attention must be paid to the minutiae of details, for example, are authors' initials or first names to be used? Are degrees and titles used? Is the ranking of an individual within a department recorded? Some journals require these details whereas others do not. In the body of the manuscript check how headings are managed, typeface, font size etc. Are there limits on the number of words in an abstract? Are there restrictions on the number of figures or tables? Are there restrictions on the number of references? Look in detail at how references are managed even down to where full stops (periods) and commas are placed.
Reference styles within the text vary between journals. The main ones are:
* Harvard--last names of reference author(s), with year of publication, given with brackets 'as reported by Smith and Brown,  or '...as previously reported [Smith and Brown, 1998].
* Vancouver--references within a text designated by a number in brackets'... as reported (3)' or as a superscript number '... as reported (3)'.
The reference list should be at the end of the main text; in alphabetical order for Harvard and numbered in order for Vancouver. Occasionally there are other systems used so each journal's requirements must be followed exactly. Because these days reference managers (e.g. Endnote) are used sometimes it is essential to make sure that the style in the manager used conforms to a journal's requirements. Cross checking is imperative.
Risks to not following instructions. It is annoying for an editor to receive a manuscript and on first reading it is obvious that the author(s) have not paid attention to instructions. It is all too easy for an editor, at such an early stage, to say inwardly:
'They have not paid attention to fundamental details of presentation so it is unlikely that due care to detail was applied to the original research.'
With tens, if not hundreds, of papers being submitted to a journal an editor may discard the submitted manuscript immediately and move on to one where all the instructions have been carefully followed.
Rejection. Most journals publish their rejection rates--the number of submitted papers that are not accepted. Such rates vary and in the most prestigious journals can be very high. But also always bear in mind that rejections happen to everyone throughout a scientific career although probably more often in the early years as you learn the techniques of successful publishing.
Sometimes a rejection is simply because you have selected the wrong journal for your work. It is important to choose carefully where to send your manuscript. Read several issues of a possible target journal to grasp what types of papers and which subjects the journal favours. Websites of journals frequently indicate their preferred scope of papers.
If a paper is rejected do not make the mistake of sending it to another journal without re-writing it. Editors are very quick to see, through abstract layout, reference style, and section headings, that a paper has been submitted elsewhere and obviously rejected. The immediate editorial response is that if another journal has thought fit to reject a paper there are probably good reasons for that. Incorporate recommended changes from the reviewers before re-styling to submit to a second journal.
The process of writing the paper.
Crucial advice here is that an author should always:
* Write simply and directly,
* Make sentences short and without too many sub-clauses,
* Use simple words and avoid too much jargon,
* When the English language is used make sure that it is easily translated,
* Check on spelling requirements--English or American and make sure it is consistent.
Clarity is essential, Avoid jargon! It should always be remembered that English can be a simple language but also a complex one. Basic English comprises only about 93 words yet the lexicon of English is over one million. Most of the world does not daily converse in English and therefore published texts often need to be translated into another language. The simpler the English text the quicker and easier it can be translated. Too often it is assumed that everybody in the scientific world speaks English but while they may have a working knowledge of the language they may not be able to readily understand text that is too complicated.
A simple approach long recommended by the eminent dental scientist Basil Bibby was to keep sentences short, a method favoured by the famous writer Ernest Hemmingway. Complicated phrasing, sub-clauses or phrases and jargon must always be avoided. Dr Bibby published over 200 papers during his long career and an aspiring scientific author would be well advised to read some of his writings even though many were in print only during the period 1930 to 1980. The clarity and simplicity of his language is a model to be followed. Dr Bibby's constant mantra on writing scientific papers was to 'Boil it down!'
When authors are writing in English and it is not their daily language they sometimes write the paper in their own language first and then translate it into English. Usually this works quite well but when doing this a direct translation word for word should be avoided. Writing style varies between languages and some favour extensive, long-winded and/ or flowery phrases. Scientific English these days does not favour this approach. Always try to have a colleague who is fluent in English look at a draft of the paper and make changes as needed. There are also websites that provide English translation services that may be useful. A recently published book on writing good English is worth consulting [Heffer, 2011].
Confusing text must also be avoided. For example the phrase The index finger of the surgeon is then inserted into the atrium' can be interpreted in several ways (Fig 2), [Goodman and Edwards, 1997]. Another example is the use of terms that are specific only to the country of the author. An example here is the use of 'Registrar' as a rank in medicine or dentistry in British hospitals (as well as in some Commonwealth countries). But when looked up in a standard dictionary Registrar is defined as 'an official recorder, person charged with keeping a register' [Oxford English Dictionary, 1990]. Thus an author must think 'Will people worldwide understand the terms I am using? Should I rather use, for example in the case of registrar, a specialist in training?'
[FIGURE 2 OMITTED]
Writing tools. The basic tools will be simply: pencil/pen, paper, dictionary, thesaurus and ideally a personal computer and word processor. A dictionary and a thesaurus are essential. A thesaurus is a book of words that provides alternative words (synonyms) that mean the same thing as well as alternative phrases. Such a book is most useful as it enables an author to avoid using the same words repeatedly within a sentence or paragraph. These are readily available in word processor packages along with spell checking and grammar programs. A word of caution here though, if a journal requires English or American spelling and grammar make sure the appropriate package is used.
Verbs. As a general rule all verbs must be in the past tense '... measurements were made.' Because the research was completed obviously in the past, so it is described in the past tense. The present tense is normally confined to referring to tables and figures '... the data is presented in Table 3.' What must certainly be avoided is changing verb tense within a sentence or paragraph. Care must be taken to avoid mixing up plurals, for example '... ten teeth was examined.' when it should be '..ten teeth were examined.'
Preliminary outline. It is highly recommended to prepare an outline of the main headings of the proposed manuscript on a single piece of paper and under each heading to list the main topics to be covered. The usual headings in a paper are simply [Bradford Hill, 1965]:
* Introduction: why did you do it?
* Materials and methods: what did you do?
* Results: what did you find?
* Discussion: what did your results mean?
* Conclusion: what is the important finding?
Procedure for writing the paper
There is a difference between the order of the sections of a paper, as it will be published versus the best order in which to write the paper. This is:
The title and author(s) is straightforward and easily done. The other sections need an order. The reason for this approach is that in almost all cases what is known in greatest detail is the methods and how the research was carried out. The results will also be known in great detail and follow logically from the methods. Once those two sections have been written and are easily completed then the author(s) should write the introduction and finally the discussion. The conclusion and completion of the reference list are simple matters easily completed once the manuscript has been edited, checked for grammar and spelling, typographical errors etc.
Title page and authorship. The title should be simple, not too long and give a clear indication as to what is the main subject and emphasis of the paper. Some journals have limitations on the number of words or characters (which may include spaces between words).
Ambiguities in titles should be avoided. For example if a paper is titled 'The Saucer Preparation' is this about cavity preparation or ceramic manufacture of saucers? This would be better given as 'The saucer cavity preparation for Class V restorations'. Pretentious phrases in titles, attempting to be erudite are also to be avoided such as 'Nature versus nurture in tooth agenesis' when it would better be as 'Case report: Differences in tooth agenesis in monozygotic twins'.
Authorship. When considering who should be listed as authors it is important to consider contribution responsibility [International Committee of Medical Journal Editors, 2011]. Who did the work? Who made major contributions to the successful completion of the research? Too often long lists of authors appear on manuscripts and after reading the work an editor is certain to ask 'What did they all do?' In many cases the present authors have seen lists of names when it is clear that all they have contributed was routine technical work, providing services or materials for a fee, providing funding, editing a manuscript or just status alone. In the latter case one sees authors whose only input was being head of the department. While that was common practice in the 1930s and 40s, it is not the case or acceptable today. A worthwhile article to read on publication ethics is that by Graf et al. .
Only those people who made a significant contribution to the work should be listed as authors [International Committee of Medical Journal Editors, 2011]. Each author should have participated sufficiently to take public responsibility for the content. To be included as main author participation must include three steps:
* Conception or design or analysis or interpretation,
* Drafting or revising critically important content,
* Final approval of the version to be published.
All other people who helped should be recorded as such in a section after the Conclusion, given as an Acknowledgement.
Order of authorship. Does the order of the authors given in the title page matter? Yes it does because:
* In the English-speaking world the first author is assumed to be the 'senior' author and in multi-authored articles would be listed as [Smith et al., 2003],
* In the Germanic world the last author is regarded as the 'senior' author.
It is therefore important to check on which order to use by looking at journal guidelines and also looking at published issues of the journal under consideration.
There can also be conflicts over who should be listed as senior author when a graduate student completed the research. Usually, of course, the student's name goes first. In some institutions however if a postgraduate student has not 'written up' the publication(s) within two years of acceptance of a thesis, then the supervisor may do so and be first author, with the student second instead of first as would be usual. In such cases it is prudent to ensure that the postgraduate student agrees to this policy in advance. Problems over authorship can be avoided within a department by having a policy on such matters. Most journals require a covering letter signed by all authors indicating they have read and are happy with the manuscript.
Abstract. The abstract attached to a manuscript is of great importance. This is the part of a published paper that is quoted in on-line search sites, such as PubMed. In most cases the abstract may well be on line pre-publication of the journal. The abstract text must be succinct, informative, accurate and unambiguous. Usually there is an aim, followed by methods. The latter must very briefly outline the main methods used. There should be data in the results preferably with some statistical indication of significance. A brief conclusion completes the abstract.
The abstract should be written and structured in the style required by the journal. A typical layout in modern style abstracts would appear as follows:
Aim: To determine the reduction in caries rates in Europe produced by fluoride toothpaste use. Methods: A systematic review of 200 articles that reported dental caries rates from surveys using WHO criteria in 20 European countries. Results: Doubling fluoride toothpaste use halved caries prevalence. Conclusions: Fluoride toothpaste use should be promoted.
Ambiguous text phrases and statements must be avoided. For example the following:
Would be much better written as:
This is because the latter statement clearly tells the reader what was done and what was found.
Introduction. This section should be just long enough to introduce the subject of the research/work leading to the aim and posing of a null hypothesis (where appropriate). Too often authors write introductions that are mini-theses. Indeed sometimes it is obvious that an author has just copied a review of the literature from his or her thesis. The relevant and most important aspects of previous publications should be cited. But not every citation going back to the beginnings of dentistry is needed or necessary. Thus it is not unusual to see, within an introduction, long lists of references, for example:
'... as previously reported [Smith and Brown, 1967; Ackroyde et al., 1971; Jones and Martens, 1973; Sing and Wang, 1979; Kochen et al., 1982; Dipstick and Ohm, 1986; Furshon et al; 1988; Angstruther et al., 1993; Basset and Rumpole, 1997; Mahoney and Leakey, 2001] and as recently reviewed by Overdone '.
In this example there are not only far too many references but also the problem is compounded by the final reference to a recent review. This indicates a lack of critical thought by the author(s) in including so many citations and referring to a review anyway. If the review was inadequate then a critical comment would be valid and should be made. Over citation is a common fault and clogs up the text making it difficult to follow and reducing readability.
Materials and methods. This section requires great detail because it has to be entirely clear what was done, how it was done, what equipment and materials were used and how methods were assessed for validity, reliability and reproducibility. In epidemiological studies a power calculation is required in order to determine sample size. This often also applies in laboratory studies.
Reproducibility must be assessed, when appropriate, and details of how this was done provided. Was a sub-sample re-tested and what was the size of the sub-sample? A Kappa score will then need to be calculated and the finding reported. This may be in the methods section or in results.
Unfortunately many researchers, having perhaps spent years on a project, know the methods inside out. When it comes to writing down what they did they do not always include sufficient detail as they subconsciously assume too much. The fullest detail is needed and it is good advice when this section has been written to give it to someone not at all involved in the research and ask him or her if they can fully understand what was done to the extent that they could do it.
Equipment used and any laboratory supplies must be given, with manufacturer's names and brief address. This is usually written in brackets for example instead of
It is better to write:
Oftentimes other researchers will read such a description and they are then able to trace the supplier of the equipment used for their own research. Similarly the manufacturer should be referenced for all reagents, materials, specialist instruments etc.
Statistics. When statistical tests have been used the particular test should be described. The level of significance used must also be reported e.g. p<0.05.
Results. Authors often make the mistake in the section of "not seeing the wood for the trees" and relentlessly report on every finding they have made whether significant or not. This indicates a lack of critical thinking. Editors are presented with massive tables, often 7 or 8 or more (we have seen 14), listing every parameter evaluated and every statistical computation.
In studies involving clinical trials another error is to report highly significant statistical differences but which are clinically meaningless. For example in a clinical trial of a preventive agent for dental caries where perhaps after 4-5 years of a clinical trial, at enormous cost, a reduction in DMFS of half a surface is reported as very highly statistically significant. Such a reduction of only half a surface may well be significant but would be clinically meaningless and of a very low cost-benefit.
An important piece of advice in writing the results is ask,
"What is my most important finding?"
and then focus the results on that. Other statistically significant findings, that are secondary, are reported but with less emphasis. When many of any other parameters have been found to be of no statistical merit they can be just listed in the text as examined but not found to be of significance. The crucial thing here is critical evaluation of your findings.
Tables and/or figures. Graphic depiction of results is more easily assimilated than trying to read complex data within a table. However graphs or charts do simply show trends and do not provide actual data and, more importantly perhaps, the statistical significance. The latter is best presented in a table with data, ranges, confidence intervals, means and standard deviations. Yet it is a mistake to present very large tables of data. Put simply graphs or charts show trends whereas Tables give data for others to use. While tables can be far too big others can be too small. Sometimes authors include tables containing very little data. In those instances it is better to place the data within the text.
Discussion. The discussion is exactly that, a discussion of the findings of the study in relation to previous work and findings. It is not a complete restatement of the literature. Most importantly it should be a statement of principal findings. It should not be a re-writing of the introduction going over the same ground. Docherty and Smith  have suggested that a useful way to write a discussion is under structured headings in a similar way to an abstract, such as:
* Strengths and weaknesses of the study,
* Strengths and weaknesses in relation to other previous studies,
* Meaning of the study,
* Unanswered questions and future research.
Many times manuscripts are submitted with a discussion in which there are no critical comments as to the merits of the methods and results. There has never been a research study carried out that could not have been done better. Good researchers are always self-critical and will honestly say in their discussion how they could have improved the methods.
The same applies to the inference of the results. Have they been critically evaluated and are the results sufficient to draw reliable conclusions? As so much of our work is clinically based or applied, a critique of the findings is essential.
A discussion of the findings in relation to previous publications is required. In this the author(s) should also be critical of previous work as long as their criticisms are objective and well founded. Denigrating others work in order to make one's own seem more important is completely unacceptable.
Conclusion. This is the final section and should be brief. The conclusion is in many ways the 'take-home message'. It should not start "In conclusion we have found that..." There is a heading that says conclusion and repetition is superfluous. Simple statements are indicated here as:
Aknowledgements. This is a useful section whereby others who have aided the research, but who are not main participants, can be thanked for their help. Also this section should record financial support, grants and granting bodies. In some journals it is in this section that Ethical Research Approval is recorded.
References. The use of references is crucial to modern scientific papers. Unfortunately this is an area where there are frequent errors. Many times as editors, we have found far too many mistakes in the use of references. The wrong style may be used (see above); references are cited in the text but not given in the reference list. Correspondingly references are found in the list at the end of a paper may not cited within the text. The key issues are:
* Use Journal house style e.g. Vancouver or Harvard system or what is in the Journal's instructions to authors,
* Place a reference in the reference list as soon as used in the text,
* If using Vancouver system put names in text first then replace them with numbers after the manuscript is in its final form,
* Check that all references in text are in the list and vice-versa and then check again,
* Check on how the journal prints the references: are all authors listed or only the first three? Where is the year placed? How are colons : and semi-colons ; used? Does pagination cover all pages as 112-117 or 112-7?
Attention to detail is essential.
Length of a paper. How long (or short) should a paper be? Clearly as short as is necessary to report the aim, what was done, how it was done and what was the major finding. A common problem is for authors to think that the longer the paper the better it is.
Once a draft manuscript has been written at 12 point, one and a half spacing extends over 18-20 pages an author should look very critically at the work, as it is probably getting too big. One of the most important papers in the last 100 years was the description of how DNA works [Watson and Crick, 1953], which is very short indeed at only 2 pages. The advice is keep it short and keep it simple.
Rejection of a paper
Inevitably at some time or another an author's paper will be rejected. The first time that this happens it comes as a shock and an affront. But reasons for rejection are many and varied. Greenhalgh  lists the most common ones as:
* Unimportant scientific issue,
* Not original,
* No hypothesis tested,
* Wrong type of study,
* Too small a sample,
* Conflict of interest,
* Unjustified conclusions,
* Paper not prepared to a journal's guidelines,
* Incomprehensible writing,
* Incorrect or inadequately controlled,
* Incorrect or inappropriate statistics,
* Practical difficulties, compromised protocol.
It is usually pointless and a waste of time to argue with an editor over a rejection unless there is evidence of bias and lack of objectivity. It may be that the reviewers, and there should always be at least two, give conflicting recommendations. Both of the authors have experienced this. In those circumstances most editors may well have sought a third review or asked an associate editor or member of their editorial board to review all of the material. If that has not been the case it may be possible to request further review(s). However the best approach is to accept the review and decide whether to re-write the paper and send it to another journal or file it as 'experience'.
When receiving a rejection an author should consider it a learning experience and we have often found it courteous to write back to the editor in a letter that might say "... naturally I am disappointed at the manuscript not being accepted but thank you and the reviewers for the time you spent evaluating it and the useful comments made." We have practised this for many years and we believe it adds to an author's reputation.
In the process of publishing your scientific work imagine that you are the reader and try and write so that you could understand exactly what has been done, why, how and what are the most important findings. Our advice is to:
* Always read the instructions and follow them accurately,
* Allow everyone their style,
* Leave each draft to mature before revising, and
* Know when to accept defeat if rejections of a manuscript mount up.
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Greenhalgh T. How to read a paper: getting your bearings (deciding what the paper is about). BMJ 1997; 315: 243-246.
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International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals: ethical considerations in the conduct and reporting of research: authorship and contributorship. Find at http://www.icmje.org/ethical_1author.html (accessed 10 June 2011).
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Watson JD, Crick FH. Molecular structure of nucleic acids: a structure for deoxyribose nucleic acid. Nature 1953;171:737-738.
M.E.J. Curzon *, P.E. Cleaton-Jones **
Emeritus Professors of: * Leeds Dental Institute, Leeds, England, ** University of the Witwatersrand, Johannesburg, South Africa
Postal address: Prof. M.E.J. Curzon. Foxgloves, Galphay, Nr Ripon, North Riding, England, HG4 3NJ
Publication order Writing order 1. Title 1. Title 2. Authors 2. Authors 3. Introduction 3. Methods 4. Methods 4. Results 5. Results 5. Introduction 6. Discussion 6. Discussion 7. References 7. References 8. Abstract 8. Abstract
An extensive survey of dental caries rates in various countries has been made and conclusions drawn about their influencing factors.
Two hundred articles that reported dental caries rates from surveys using WHO criteria in 20 European countries showed that doubling fluoride toothpaste use halved caries prevalence.
Measuring their outline profile assessed the size of squares.
The squares of material, after preparation, were measured using a Profilometer (Model 3827W; Nikon Manufacturing Co, Philadelphia, USA).
Doubling fluoride toothpaste use halved caries prevalence and fluoride toothpaste use should be promoted.
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