Mashoto, Kijakazi O; Åstrøm, Anne N; David, Jamil; Masalu, Joyce R
Background Dental caries, dental pain and reported oral problems influence people's oral quality of life and thus their perceived need for dental care. So far there is scant information as to the psychosocial impacts of dental diseases and the perceived treatment need in child populations of sub-Saharan Africa. Objectives Focusing on primary school students in Kilwa, Tanzania, a district deprived of dental services and with low fluoride concentration in drinking water, this study aimed to assess the prevalence of dental pain and oral impacts on daily performances (OIDP), and to describe the distribution of OIDP by socio-demographics, dental caries, dental pain and reported oral problems. The relationship of perceived need estimates with OIDP was also investigated. Methods A cross-sectional study was conducted in 2008. A total of 1745 students (mean age 13.8 yr, sd = 1.67) completed an extensive personal interview and under-went clinical examination. The impacts on daily performances were assessed using a Kiswahili version of the Child-OIDP instrument and caries experience was recorded using WHO (1997) criteria. Results A total of 36.2% (41.3% urban and 31.4% rural, p < 0.001) reported at least one OIDP. The prevalence of dental caries was 17.4%, dental pain 36.4%, oral problems 54.1% and perceived need for dental treatment 46.8% in urban students. Corresponding estimates in rural students were 20.8%, 24.4%, 43.3% and 43.8%. Adjusted OR for reporting oral impacts if having dental pain ranged from 2.5 (95% CI 1.8–3.6) (problem smiling) to 4.7 (95% CI 3.4–6.5) (problem sleeping),- if having oral problems, from 1.9 (95% CI 1.3–2.6) (problem sleeping) to 3.8 (95% CI 2.7–5.2) (problem eating) and if having dental caries from 1.5 (95% CI 1.1–2.0) (problem eating) to 2.2 (95% CI 1.5–2.9) (problem sleeping). Students who perceived need for dental care were less likely to be females (OR = 0.8, 95% CI 0.6–0.9) and more likely to have impacts on eating (OR = 1
Åstrøm, Anne N; Kida, Irene A
Background Need perceptions for dental care play a key role as to whether people in general will seek dental care. The aim was to assess the prevalence of perceived need of problem based dental care, dental check-ups and any type of dental care. Guided by the conceptual model of Wilson and Cleary, the relationship of perceived need for dental care with socio-demographic characteristics, clinically defined dental problems and self-reported oral health outcomes was investigated. Partial prosthetic treatment need was estimated using a socio-dental approach. Method A cross-sectional survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. Information from interviews and clinical examination became available for 511 urban and 520 rural adults (mean age 62.9 yr). Results 51.7% (95% CI 46.2, 57.0) urban and 62.5 % (95% CI 53.1, 70.9) rural inhabitants confirmed need for dental check-up, 42.9% (95% CI 36.9, 48.9) urban and 52.7% (95% CI 44.5, 60.6) rural subjects confirmed need for problem oriented care and 38.4% (95% CI 32.4, 44.6) urban versus 49.6% (95% CI 41.8, 57.4) rural residents reported need for any type of dental care. Binary and ordinal multiple logistic regression analyses revealed that adults who reported bad oral health and broken teeth were more likely to perceive need for dental care across the three outcome measures than their counterparts. Socio-demographic factors and clinically defined problems had less impact. Based on a normative and an integrated socio-dental approach respectively 39.5% and 4.7% were in need for partial dentures. Conclusion About half of the participants confirmed need for problem oriented care, dental check-ups and any type of dental care. Need perceptions were influenced by perceived oral health, clinically assessed oral problems and socio-demographic characteristics. Need estimates for partial denture was higher when based on clinical examination alone compared to an integrative socio-dental approach. PMID:17625014
Rungsiyanont, Sorasun; Vacharotayangul, Piamkamon; Lam-Ubol, Aroonwan; Ananworanich, Jintanat; Phanuphak, Praphan; Phanuphak, Nittaya
Despite the advancement in highly active antiretroviral therapy and improved health status of HIV-infected individuals, dental problems are still affecting their life and well-beings. We aimed to establish the prevalence of oral and dental complaints among HIV-infected patients, the prevalence of delayed access to dental service, and factors related with delayed access to dental service. A cross-sectional study using self-report questionnaire completed by the HIV-positive subjects was conducted at the largest HIV research clinic in Thailand during 2009-2010. Of all 299 subjects (28.6% males, 71% females, and 0.4% sex change from male to female: ages ranged from 22 to 59 years [mean 36.7±5.53)]), 84.3% reported of having past or present illnesses or problems related to the dental or oral conditions. The most reported problems were dental hypersensitivity (93.3%), bleeding from the gum (92.1%), and having dental caries (65.9%). Two-hundred and forty-two subjects (80.9%) would not disclose their HIV status when seeing a dentist. The most cited reasons of such behavior were their personal right whether to reveal or not, and being afraid of not receiving dental treatment from the dentists or staffs (51.7 and 40.9%, respectively). It is important to note that HIV-subjects admitted to having fear of being discriminated by the dental staffs even if they trusted their dentists as having high morality. In conclusion, our HIV-subjects had good basic knowledge of oral health with regard to HIV infection, experienced common dental problems, and wished to have accesses to HIV-dental specialist services, if possible.
Dhanasekaran, Ramyaa; Nayar, Sanjna
Aims: The aim of this study is to evaluate the self-perceived need for dental care among medical professionals and general public. Setting and Design: (1) To determine the perceived oral health status. (2) To evaluate the results in understanding the perception of oral health. (3) To determine the patients attitude toward dentist. Subjects and Methods: The study was carried out on 537 patients who came for their regular checkup and treatment. Statistical Analysis Used: The statistical analysis of this study was based on Chi-square test evaluation. The study was performed among in 537 participants. The participants included from age group of both <30 and >30. The study was made in the form of questionnaires enquiring how they would perceive their personal dental care and their attitude towards dentist. Results: Self-perceived questionnaires in evaluating general public in age group of <30 and >30 shows, that people in age group more than 30 has good oral hygiene maintenance, whereas attitude toward dentist and attending dental problems were more among group less than 30 of age. Conclusions: I conclude that there must be more awareness created by public health dentist among people about various dental problems, their complications and the treatment needs. Hence, that people be aware of their dental problem at the small stage and get cured. By conducting varies Public Health Programs and camp they became very free to contact their dentist for their varies dental problems and people attitude about dentist and toward dentist completely changes. PMID:26015766
Sanders, Anne E.; Lushington, Kurt
Examined the relationship between perceived stress and academic performance in 202 dental students at an Australian dental school. Found little support for an association between increased factor stress scores on the Dental Environmental Stress (DES) questionnaire and reduced academic performance. (EV)
... and modifying dental treatment to accommodate altered muscle strength. Appointment Scheduling It is important to realize that ... and take advantage of the typically greater muscle strength during the morning hours. Appointments are best scheduled ...
Wolf, Thomas M.; And Others
A survey of 38 graduating dental students assessed the types and sources of perceived mistreatment. Students perceived an average of 35 separate incidents. Psychological mistreatment was most common; physical mistreatment was relatively infrequent. Classmates and clinical faculty were the most common sources. Sexual harassment was perceived by…
Ihm, Jung-Joon; Seo, Deog-Gyu
The value of dental students' self-assessment is often debated. The aim of this study was to explore whether reflective learning with feedback enabled dental students to more accurately assess their self-perceived levels of preparedness on dental competencies. Over 16 weeks, all third- and fourth-year students at a dental school in the Republic of Korea took part in clinical rotations that incorporated reflective learning and feedback. Following this educational intervention, they were asked to assess their perceptions of their clinical competence. The results showed that the students reported feeling most confident about performing periodontal treatment (mean 7.1 on a ten-point scale) and least confident about providing orthodontic care (mean 5.6). The fourth-year students reported feeling more confident on all the competencies than the third-year students. Their self-perceived competence in periodontal treatment and oral medicine significantly predicted the instructors' clinical evaluations. This study offered insights into determining if structured reflective learning with effective feedback helps to increase dental students' self-perceived level of clinical preparedness.
From an outline of a general model of inequalities in oral health, three main issues are addressed: (1) Self-perceived oral health; (2) Utilization of dental care; and (3) Satisfaction with dental care. The aim was to study these aspects in relation to each other as well as aspects such as socio-economic factors, health factors, and attitudes to teeth and care organization. Another aim was to study changes between the two study years. The study is a questionnaire study of a longitudinal sample: people born in 1942 and at the time of the studies living in Orebro or Ostergötland county in Sweden. A cohort (5363 persons) was established with those who completed the questionnaire in both 1992 and 1997. The main results were that there were social differences in self-perceived oral health, with those born outside Sweden, those living single, those with lower level of education and those being blue-collar worker perceiving worse oral health. Changes between the two study years were moderate despite major cutbacks in dental care insurance during this period. Socio-economic factors affected dental care utilization as well. Having a private care provider gave higher utilization and higher cost for care. Health perception, both oral and general health, and dental anxiety also affected utilization. Increasing patient cost for care did not appreciably affect utilization. The overall satisfaction with dental care was high, both in general terms and with the most recent dental visit. Differences between the two studied years were small. Persons not visiting dental care within the last year were more dissatisfied, both generally and with the most recent visit. A large number of regular attenders had no feelings of anxiety, pain or unpleasantness at all. Oral health related factors and dental care factors such as cost for care and care organization were related to satisfaction with dental care. So were experiences from the most recent dental visit and, to some extent, past care
Hasan, Syed S.; Ooi, Yong J.; Ahmed, Syed I.; Wong, Pei S.; Ahmad, Siti F.; MNM-Rosdy, Nik M.; Malik, Normaliza A.
Objectives The study objectives were to identify the stress levels and to explore the impact of students' year of study and gender on the perceived sources of stress among Malaysian dental students. Methods This was a cross-sectional study involving dental students from year one to year five from private and public universities in Malaysia. The study was formally approved by the Research and Ethics Committee, International Medical University Malaysia. Dental Environment Stress (DES) questionnaire was used for data collection and the gathered data were analyzed using SPSS® version 18. The Kruskal-Wallis and the Mann-Whitney U tests were used to compare stress items across various academic years and universities. Results A total of five hundred and twenty nine (529) students participated in this study. Fear of failing the course at the end of year exams (mean stress level=5.57); concerns regarding completion of clinical work (mean=5.30); and examination results and grades (mean=5.27) were found as top stressors among dental students. Female students had higher stress scores than males with respect to personal issues, academic performance, educational environment and learning of clinical skills. Students from public universities had higher stress scores than their counterparts from private universities. Conclusion The Malaysian dental students reported higher levels of stress. Present study identified stressors affecting dental students' academic life, and highlights the importance of stress management programs and other measures to minimize the impact of stress on both academic and personal lives of the students. PMID:25935506
Sheridan, Rachel A; Hammaker, Daniel J; de Peralta, Tracy L; Fitzgerald, Mark
This pilot study compared second- and fourth-year dental students' perceived values of newly implemented clinical leadership experiences (CLEs) at one U.S. dental school during the 2012-13 academic year. In the CLEs, fourth-year (D4) students mentored second-year (D2) dental students during faculty-supervised patient treatment. The two cohorts' perceived value of the experiences was measured with questionnaires consisting of five-point Likert scale questions and open text responses. Out of a total of 114 D2 and 109 D4 students, 46 D2 students and 35 D4 students participated (response rates of 40.4% and 32.1%, respectively). While responses from both cohorts showed they highly valued the CLEs, the D2s perceived greater value: 4.07 (0.53) v. 3.51 (0.95), p<0.003. Both cohorts reported feeling that D4s were prepared to mentor D2s, that the CLEs had educational benefits, and that the CLEs increased their comfort with peer communication. Theme analysis of open text questions revealed that the respondents perceived the D4s were more accessible than faculty and provided guidance and individual attention; the CLEs increased student comfort; the CLEs reinforced D4 skills, knowledge, and confidence; and the CLEs provided management, leadership, and collaborative work experience. Theme analysis also highlighted student concerns about a lack of program structure. Overall, the majority of both groups valued CLEs in their dental education. Particular advantages they perceived were increased comfort, guidance, and attention. Further program development should address student concerns. These results suggest that similar programs should be considered and/or expanded in other dental schools' curricula.
Ersan, Nilüfer; Fişekçioğlu, Erdoğan; Dölekoğlu, Semanur; Oktay, İnci; İlgüy, Dilhan
The aims of this study were to identify sources of stress among clinical students and to evaluate the students' perceived levels of stress, general self-efficacy and effective coping strategies in a private dental school environment. The study group consisted of 130 undergraduate clinical dental students in a Turkish private dental school, during the academic year 2014-2015. The students were surveyed using modified version of the dental environment stress (DES) survey, the perceived stress scale, the general self-efficacy scale (G-SES) and the brief coping scale. Age, sex, year of study, history of psychiatric treatment and factors that affected the choice of dentistry were also recorded. Final year and female clinical dental students, who were found to be the most stressful students, had moderate to high perceived stress scores. Total and 'Faculty and administration' related DES scores increased with the year of study. Stressors related to 'Workload' and 'Clinical training' affected females more than males. G-SES scores were higher in male students and students, who had no history of psychiatric treatment. The most and the least common coping strategies were 'Planning' and 'Substance abuse', respectively. 'Religion' was found to be one of the main coping strategies. Stress factors affecting Turkish clinical dental students studying at private dental school differed from the previously reported stress factors affecting students studying at a governmental dental school. Advanced year and female students experienced more stress than the other students.
Arheiam, Arheiam; Masoud, Ibtisam; Bernabé, Eduardo
Aim To explore the barriers to providing preventive dental care to patients, as perceived by Libyan dentists working in Benghazi. Settings and design A cross-sectional, questionnaire-based survey was conducted among dentists working in Benghazi, Libya. Materials and methods All dentists registered with the Dental Association of Benghazi and with 2 or more years of practice were invited to participate. The questionnaire collected information on participants' demographic and professional characteristics as well as the patient-, practice- and dentist-related barriers to providing preventive dental care. Statistical analysis Scores for each type of barrier were compared by demographic and professional characteristics in bivariate and multivariate analyses. Results One hundred and seventy five dentists returned the questionnaires (response rate: 79%) and 166 had complete information on all the variables selected for analysis (75%). The majority were females (70%), aged between 23 and 34 years (85%), was working in the public health sector (43%), and had up to 5 years of service (46%). Patient-related barriers were scored the highest, followed by practice- and dentist-related barriers. Dentists with mixed practice reported lower scores on patient- and practice-related barriers than those in public or private practice. Conclusion Respondents were generally aware of the barriers to preventive dentistry and perceived the barriers as being more related to their patients than to their practices or themselves. However, these perceptions varied by practice sector.
Tuominen, R; Palmujoki, J
A questionnaire study was conducted among 350 private dentists in Finland to investigate their perception of competition and how this associated with practice characteristics. The questionnaire comprised 46 questions dealing with perceptions of competition, marketing, and collegiality, respondents' personal and practice characteristics, including age, sex, area of main practice location, weekly hours in private practice, functioning in solo or in joint practice, cooperation with other dentists, and whether practicing in more than one location. The majority of these private dental practitioners perceived much competition between themselves. Almost all (96%) of those feeling much competition today expected it to be more intense after 5 years, compared to 60% of those not perceiving much competition today (P < 0.001). Private practitioners perceiving much competition also felt it from public health centers significantly (P < 0.001) more often (46%) than others (24%). Logistic regression models revealed that those with a practice in more than one location were over 7 times more likely not to perceive competition. Those practicing outside metropolitan Helsinki area had 3.6 times the odds of not perceiving competition, and for women overall the odds ratio was 2.5. Increasing competition in private practice is a widely felt concern, and it may diminish the willingness of new graduates to attempt penetration of the market and establish their clinics.
orthodontic needs increases, the proportion of spouses with perceived need for orthodontic treatment increases. A significant proportion of spouses...severe or handicapping malocclusions feel they need orthodontic treatment . In Table 6-3, assessed need for restorative care is compared with perceived...parents of children with normal occlusion and one-half of those with elective orthodontic needs feel their child needs orthodontic treatment . Two
Wong, Hai Ming; Bridges, Susan Margaret; McGrath, Colman Patrick; Yiu, Cynthia Kar Yung; Zayts, Olga A; Au, Terry Kit Fong
Patients' perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient's perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver's perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients' demographic information and the caregiver's perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer™) indicated five prominent themes 'disease / treatment', 'treatment procedure related instructions', 'preparation for examination', 'positive reinforcement / reassurance', and 'family / social history' from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme 'Positive reinforcement / reassurance': 'number of related words' (p = 0.002), 'number of related utterances' (p = 0.001), 'percentage of the related words in total number of words' (p = 0.005), 'percentage of the related utterances in total number of utterances' (p = 0.035) and 'percentage of time spent in total time duration' (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver's involvement, such as clinicians' mention of the parent, was also seen as critical to perceptions of quality clinical experience. The study
Larson, Thomas D
The members of the Minnesota legislature have debated methods by which access to dental care and treatment of dental disease can be improved at a cost lower than that of present delivery systems. This review sheds light on some significant aspects of what the dental profession has learned over the last century that has proven significantly beneficial to the overall health of the American populace. Recommendations are made in the use of cost-effective dental public health interventions that could be used to provide better access and improved dental health at lower cost.
Clementino, Marayza Alves; Gomes, Monalisa Cesarino; Pinto-Sarmento, Tássia Cristina de Almeida; Martins, Carolina Castro; Granville-Garcia, Ana Flávia; Paiva, Saul Martins
The aim of the present study was to evaluate the perceived impact of dental caries and dental pain on oral health-related quality of life (OHRQoL) among preschool children and their families. A cross-sectional study was conduct with 843 preschool children in Campina Grande, Brazil. Parents/caregivers answered a questionnaire on socio-demographic information, their child’s general/oral health and history of dental pain. The Brazilian version of the Early Childhood Oral Health Impact Scale was administered to determine the perceived impact of caries and dental pain on OHRQoL. The children underwent an oral examination. Logistic regression for complex sample was used to determine associations between the dependent and independent variables (OR: Odds ratio, α = 5%). The independents variables that had a p-value <0.20 in the bivariate analysis were selected for the multivariate model. The prevalence of dental caries and dental pain was 66.3% and 9.4%, respectively. Order of birth of the child, being the middle child (OR: 10.107, 95%CI: 2.008-50.869) and youngest child (OR: 3.276, 95%CI: 1.048-10.284) and dental pain (OR: 84.477, 95%CI: 33.076-215.759) were significant predictors of the perceived impact on OHRQOL for children. Poor perception of oral health was significant predictor of the perceived impact on OHRQOL for family (OR=7.397, 95%CI: 2.190-24.987). Dental caries was not associated with a perceived impact on the ORHQoL of either the children or their families. However, order of child birth and dental pain were indicators of impact of OHRQoL on preschool children and poor perception of oral health was indicators of impact on families. PMID:26090927
Clementino, Marayza Alves; Gomes, Monalisa Cesarino; Pinto-Sarmento, Tássia Cristina de Almeida; Martins, Carolina Castro; Granville-Garcia, Ana Flávia; Paiva, Saul Martins
The aim of the present study was to evaluate the perceived impact of dental caries and dental pain on oral health-related quality of life (OHRQoL) among preschool children and their families. A cross-sectional study was conduct with 843 preschool children in Campina Grande, Brazil. Parents/caregivers answered a questionnaire on socio-demographic information, their child's general/oral health and history of dental pain. The Brazilian version of the Early Childhood Oral Health Impact Scale was administered to determine the perceived impact of caries and dental pain on OHRQoL. The children underwent an oral examination. Logistic regression for complex sample was used to determine associations between the dependent and independent variables (OR: Odds ratio, α = 5%). The independents variables that had a p-value <0.20 in the bivariate analysis were selected for the multivariate model. The prevalence of dental caries and dental pain was 66.3% and 9.4%, respectively. Order of birth of the child, being the middle child (OR: 10.107, 95%CI: 2.008-50.869) and youngest child (OR: 3.276, 95%CI: 1.048-10.284) and dental pain (OR: 84.477, 95%CI: 33.076-215.759) were significant predictors of the perceived impact on OHRQOL for children. Poor perception of oral health was significant predictor of the perceived impact on OHRQOL for family (OR=7.397, 95%CI: 2.190-24.987). Dental caries was not associated with a perceived impact on the ORHQoL of either the children or their families. However, order of child birth and dental pain were indicators of impact of OHRQoL on preschool children and poor perception of oral health was indicators of impact on families.
Astill, Shannon; Ricketts, Nikelle; Singh, Love-Amrit; Kurtz, Dylan; Gim, Yong Hoon; Huang, Boyen
Background. Dental students have reported a high prevalence of psychological stress and the causes are associated with the challenging dental environmental and demographic factors. This study aimed to conduct a preliminary investigation on dental students’ stress status, using a sample of first-to-third-year Bachelor of Dental Surgery students in an Australian university. Special interests included causes of dental environmental stress and access to help services. Methods. A sample of 145 students was surveyed with a modified Dental Environmental Survey and Depression Anxiety Stress Scale in 2014. The participants’ demographic information was also collected. Results. The response rate was 95.4%. Second-year (P = 0.042), third-year (P < 0.001) and employed students (P = 0.027) were more likely to report stress resulting from transition to clinical learning. Third-year students were more often stressed about communicating and approaching staff (P = 0.023) as well as different opinions between staff (P < 0.001) and reduced holidays (P < 0.001). Students that were younger than 21 years of age (P = 0.001), that were first years (P < 0.001), and that were not in a relationship (P = 0.010) more often found difficulty of course work stressful. Students who were not in a relationship more often considered learning manual dexterity a source of stress (P = 0.034). Students previously seeking professional help were more likely to be stressed (P = 0.010). Conclusion. Causes of dental environment stress varied among years of study and demographic backgrounds. Professional support to stressed students should be enhanced. Further investigation is indicated. PMID:28096955
Massalha, R; Valdman, S; Farkash, P; Merkin, L; Herishanu, Y
Although chronic arterial hypertension is the leading cause of intracranial hemorrhage, an abrupt rise in systemic arterial pressure in normotensive people may sometimes induce a hemorrhagic stroke. Dental treatment is rarely associated with such an event. We report here on two middle-aged women, apparently healthy, who suffered from a fatal intracerebral hemorrhage following a dental treatment. On admission, high levels of arterial hypertension were found. It seems that trigeminal manipulation during dental treatment as well as increased serum levels of induced epinephrine mainly by stress and pain, and the small amounts absorbed from the site of local anesthesia might produce abrupt elevation of blood pressure, subsequent increase in cerebral blood flow and severe, even fatal intracerebral hemorrhage. The addition of catecholamines to local anesthetics should be considered. We recommend the use of benzodiazepin as a premedication drug to reduce stress during dental treatment.
Ciancio, Mae J; Lee, Michelle M; Krumdick, Nathaniel D; Lencioni, Catherine; Kanjirath, Preetha P
Dental practitioners transitioning to dental educators (PTEs) have an integral role in dental education. While PTEs intrinsically apply some form of evidence-based dentistry (EBD) in patient care, it may not be a standardized, systematic approach. The aims of this study were to determine the self-perceived knowledge, skills, attitudes, and behaviors of PTEs regarding EBD at one U.S. dental school and to identify areas where formal calibration may be warranted to facilitate their competence and confidence as dental educators. Participants voluntarily completed a 32-question survey regarding their EBD training and self-perceived EBD skills in several areas: use of the clinical evidence pyramid; systematic, objective, and critical appraisal of the evidence; application of the evidence to patient care; and integrating clinical expertise, scientific evidence, and patient's preferences to formulate a treatment plan. The PTEs were invited to participate in the anonymous survey during regularly scheduled calibration sessions held between May and July 2014. After study information was distributed, 100% of the attendees (n=43) completed the survey. The percentage of total PTEs at the school could not be calculated. Of the responding PTEs, 69% rated themselves better than satisfactory (70% proficiency) in their knowledge, skills, and attitudes regarding EBD skills application. However, only 33-42% of the respondents indicated that they frequently used the evidence pyramid and systematically, objectively, and critically appraised the evidence, even though 65% indicated they applied the evidence to improve patient care over 70% of the time. In addition, the participating PTEs identified a need for more frequent use of formal EBD skills. Providing case-based EBD projects involving PTEs as mentors may provide more opportunities for the judicious and effective use of these important skills and may improve PTEs' self-perceived confidence.
Polychronopoulou, Argy; Divaris, Kimon
The aims of this prospective study were to examine the variation of dental students' perceived stressors throughout the course of their dental studies and to explore the role of gender on stress. A thirty-item modified version of the Dental Environment Stress Questionnaire (DES) was administered annually between 2003 and 2007 to a cohort of 109 Greek dental students enrolled in a five-year D.D.S. curriculum. Descriptive and multivariate longitudinal methods were utilized to examine variations in perceived stressors by year of study and by gender. Response rates ranged from 61 to 97 percent. Mean scores for the DES factors "workload" and "clinical training" decreased over the study period, while "faculty and administration" increased. Males reported substantially lower perceived stress in the "self-efficacy beliefs" (adjusted DES difference=-0.40; 95 percent CI=-0.63, -0.16), "workload," and "performance pressure" domains. Longitudinal analysis revealed substantial changes for numerous individual stressors. Most concerns for "examinations and grades" were expressed in year three (OR=2.7; 95 percent CI=1.4, 5.0; reference: first year), whereas "lack of self-confidence" items peaked in the second year. Marked gender differences in stress appraisal persisted over time. Longitudinal changes in dental students' stress perceptions corresponded with transitions in the didactic, preclinical, and clinical phases of the curriculum.
Divaris, Kimon; Polychronopoulou, Argy; Villa-Torres, Laura; Mafla, Ana Cristina; Moya, Gloria Aranzazu; González-Martínez, Farith; Vila-Sierra, Luis Armando; Fortich-Mesa, Natalia; Gómez-Scarpetta, Ruth Ángela; Duque-Restrepo, Liliana María
The aim of this study was to investigate the association of extracurricular factors including socioeconomic status and career choice with perceived stress in dental school in a large cohort of Colombian dental students. Participants in the study were 5,700 students enrolled in seventeen Colombian dental schools. The study employed a Spanish adaptation of the Dental Environment Stressors (DES30-Sp) questionnaire and recorded an array of demographic, socioeconomic, career choice, and dental studies-related information. Data analyses relied on descriptive, bivariate, and multivariate methods based on multi-level mixed-effects linear regression and post hoc estimation of predictive margins. "Fear of failing a course or year" emerged as the highest ranked item. Male students consistently reported less perceived stress than females, and stress scores were higher among seniors. Independent of gender, age, and study year, having dentistry as one's first career choice, relying on financial support, and belonging to higher socioeconomic strata were associated with lower stress levels. Academic environment interventions aimed to improve students' educational well-being will need to account for the individual heterogeneity among them. These data from a robust cohort of predoctoral dental students underscore the importance of considering students' educational experiences in a broader social and economic context.
Background Anticoagulation therapy is used in several conditions to prevent or treat thromboembolism. Recently, new oral anticoagulants have been introduced as alternatives to warfarin and acenocoumarol. In Europe, the European Medicines Agency has approved dabigatran, rivaroxaban and apixaban. Their advantages include: predictable pharmacokinetics, drug interactions and limited food, rapid onset of action and short half-life. However, they lack a specific reversal agent. Material and Methods A literature search was conducted through November 2015 for publications in the ISI Web of Knowledge, PubMed, Scopus and Cochrane Library using the keywords “apixaban”, “rivaroxaban”, “dabigatran”, “new oral anticoagulants”, “dental treatment” and “dental implications”. We included studies published in English and Spanish over the last 10 years. Results Apixaban has been recently introduced in the daily medical practices for the control of thromboembolism. The number of patients taking apixaban is increasing. Management of patients on anticoagulation therapy requires that dentists can accurately assess the patient prior to dental treatments. It is important for dentists to have a sound understanding of the mechanisms of action and management guidelines for patients taking new oral anticoagulants. Conclusions The dentist should consider carefully the management of patients on apixaban. This paper sets out a clinical guidance of dental practitioners treating these patients. There is a need for further clinical studies in order to establish more evidence-based guidelines for dental patients requiring apixaban. Key words:Apixaban, new oral anticoagulants, dental treatment. PMID:27957279
Klock, Kristin S; Haugejorden, Ola
The purpose of the present study was to assess coping skills and predictors of the ability to cope with dental life events employing a 10-item rather than a 48-item rating questionnaire. A representative random sample of 1490 subjects aged 25 years from 3 Norwegian counties received a mail questionnaire in March 1997. The response rate was 62% after 1 reminder. Eight selected items from the Social Readjustment Rating Questionnaire (SRRQ) plus 2 dental items were presented as graphic rating scales with the endpoints 'not difficult at all' and 'more difficult than anything'. Mean values were used to rank the life events and for comparison with findings from a previous study. Information was also collected for 16 predictor variables (Table 2). The informants found it moderately difficult to cope with losing one or more teeth and with getting dentures. A 10- and a 48-item rating scale seemed to give comparable results. In multiple logistic regression analysis, controlling for having experienced extraction during the previous 5 years, gender, and dental anxiety were significant predictors of both dental life events; education, many cavities, and belief in keeping teeth for life influenced coping with getting dentures. The identified predictors of dental life events explained <11% of the variance. In addition to extending the list of predictors of perceived need for skills to adjust to dental life events, the study also provided evidence to suggest that it may be acceptable to rely on a shorter rating questionnaire.
Omer, Yassir Talal; Bouserhal, Joseph; Hawas, Nuha; Abdel Moneim El Sayed, Ahmed
The aims of this study were to investigate the association between normative and perceived orthodontic treatment need in a Lebanese population and the effect of sociodemographic status on orthodontic treatment need. A prospective cross-sectional clinical study was designed using a sample of 150 subjects (81 males and 69 females) aged 11-18years seeking dental treatment at Beirut Arab University. Normative orthodontic treatment need was scored using the two components of the Index of Orthodontic Treatment Need (IOTN), the Dental Health Component (DHC) and the Aesthetic Component (AC). Perceived need for orthodontic treatment was evaluated by scoring the AC of the IOTN. A total of 31.3% of the sample were in great need of orthodontic treatment according to the DHC of the IOTN. On the other hand, only 9% of the sample perceived their need to be definite. A significant positive but weak correlation was found between the normative and perceived need for orthodontic treatment. There was also a significant association between age and normative treatment need.
Meurer, Maria Inês; Grando, Liliane Janete; Gonzaga Del Moral, Joanita Ângela; da Silva Rath, Inês Beatriz; Schaefer Tavares, Silvia
Dental treatment of patients with leukemia should be planned on the basis of antineoplastic therapy which can be chemotherapy with or without radiotherapy and bone marrow transplantation. Many are the oral manifestations presented by these patients, arising from leukemia and/or treatment. In addition, performing dental procedures at different stages of treatment (before, during, or after) must follow certain protocols in relation to the haematological indices of patients, aimed at maintaining health and contributing to the effectiveness of the results of antineoplastic therapy. Through a literature review, the purpose of this study was to report the hematological abnormalities present in patients with leukemia, trying to correlate them with the feasibility of dental treatment at different stages of the disease. It is concluded in this paper that dental treatment in relation to haematological indices presented by patients with leukemia must follow certain protocols, mainly related to neutrophil and platelet counts, and the presence of the dentist in a multidisciplinary team is required for the health care of this patient. PMID:25784937
Traumatic dental injuries are emergencies that must be treated expediently and efficiently to reduce pain and to restore function and appearance. With an increase in the incidence of traumatic dental injuries in our community (I) it is essential that the dental practitioner has "up-to-date" knowledge of dental trauma. The peak incidences of injury are 2-4 years and 8-10 years of age, with statistics revealing 30% of children suffer trauma to the primary dentition, and 22% of children suffer trauma to the permanent dentition by the age of 14 (I). The male to female ratio is 2:1. Aside from the emergency treatment and clinical decisions that must be made at the time of injury there is a need for long-term follow-up because of the high incidences of complications (2, 3). The factors that will influence the extent of injury will be energy impact, the direction of the impacting object, its shape and its resilience (4). Recent articles have raised concerns about inappropriate treatment for traumatic dental injuries (5, 6). This report will look at one such case.
Saddki, Norkhafizah; Sukerman, Noraini; Mohamad, Dasmawati
Background This study investigated the association of emotional intelligence (EI) and other factors with perceived stress (PS) in undergraduate dental students. Methods A total of 234 undergraduate dental students at the School of Dental Sciences, Universiti Sains Malaysia (USM), in the academic year of 2009/2010, participated in this cross-sectional study. Self-administered questionnaires, the Assessing Emotions Scale and the Perceived Stress Scale (PSS-10), were used to evaluate EI and PS, respectively. Results The mean EI score was 121.2 (SD 11.85). The scores were significantly higher in females than males, and in students who chose dentistry based on their own interest rather than in those who were motivated by others to study dentistry. The mean PSS-10 score was 21.2 (SD 5.08). Pearson correlation analysis indicated a significant inverse relationship between EI and PSS-10 scores (r = −0.337). Multi-variable regression analysis also indicated a significant negative linear association between EI and PSS-10 scores (b = −0.156, 95% CI: −0.207, −0.104). PSS-10 scores were significantly higher for students who were in the clinical years rather than the preclinical years. Conclusions This study of USM undergraduate dental students shows that a low EI, female sex, and being in the clinical years were significant predictors of PS. PMID:28381929
Lazea, Andreea; Todea, Carmen
Objectives: To evaluate the dental anxiety level and the degree of acceptance of laser assisted pedodontic treatments from the children part. Also, we want to underline the advantages of laser use in pediatric dentistry, to make this technology widely used in treating dental problems of our children patients. Methods: Thirty pediatric dental patients presented in the Department of Pedodontics, University of Medicine and Pharmacy "Victor Babeş", Timişoara were evaluated using the Wong-Baker pain rating scale, wich was administered postoperatory to all patients, to assess their level of laser therapy acceptance. Results: Wong-Baker faces pain rating scale (WBFPS) has good validity and high specificity; generally it's easy for children to use, easy to compare and has good feasibility. Laser treatment has been accepted and tolerated by pediatric patients for its ability to reduce or eliminate pain. Around 70% of the total sample showed an excellent acceptance of laser dental treatment. Conclusions: Laser technology is useful and effective in many clinical situations encountered in pediatric dentistry and a good level of pacient acceptance is reported during all laser procedures on hard and soft tissues.
Raittio, Eero; Aromaa, Arpo; Kiiskinen, Urpo; Helminen, Sari; Suominen, Anna Liisa
Objectives In Finland, a dental subsidization reform, implemented in 2001-2002, abolished age restrictions on subsidized dental care. The aim of this study was to investigate income-related inequality in the perceived oral health and its determinants among adult Finns before and after the reform. Materials and methods Three identical cross-sectional nationally representative postal surveys, concerning perceived oral health and the use of dental services among people born before 1971, were conducted in 2001 (n = 2157), in 2004 (n = 1814) and in 2007 (n = 1671). Three measures of perceived oral health were used: toothache or oral discomfort during the past 12 months, current need for dental care and self-reported oral health status. Concentration index was used to analyse the income-related inequalities. Its decomposition was used to study factors related to the inequalities. Results The proportion of respondents reporting need for dental care decreased from 2001 to 2007, while no changes were seen in reports of toothache or self-reported oral health status. Income-related inequalities in reports of toothache and perceived need for care widened, while the inequality in self-reported oral health remained stable. Most of the inequalities were related to income itself, perceived general health and the time since the last visit to dental care. Conclusions It seems that the income-related inequalities in perceived oral health remained or even widened after the reform.
Saini, Rajiv; Marawar, PP; Shete, Sujata; Saini, Santosh; Mani, Ameet
World Health Organization defines palliative care as the active total care of patients whose disease is not responding to curative treatment. Palliative care for the terminally ill is based on a multidimensional approach to provide whole-person comfort care while maintaining optimal function; dental care plays an important role in this multidisciplinary approach. The aim of the present study is to review significance of dentist's role to determine whether mouth care was effectively assessed and implemented in the palliative care setting. The oral problems experienced by the hospice head and neck patient clearly affect the quality of his or her remaining life. Dentist plays an essential role in palliative care by the maintenance of oral hygiene; dental examination may identify and cure opportunistic infections and dental disease like caries, periodontal disease, oral mucosal problems or prosthetic requirement. Oral care may reduce not only the microbial load of the mouth but the risk for pain and oral infection as well. This multidisciplinary approach to palliative care, including a dentist, may reduce the oral debilities that influence the patient's ability to speak, eat or swallow. This review highlighted that without effective assessment of the mouth, the appropriate implementation of care will not be delivered. Palliative dental care has been fundamental in management of patients with active, progressive, far-advanced disease in which the oral cavity has been compromised either by the disease directly or by its treatment; the focus of care is quality of life. PMID:20606852
Montero-Marín, Jesús; Piva Demarzo, Marcelo Marcos; Stapinski, Lexine; Gili, Margarita; García-Campayo, Javier
Background Students of health-professions suffer high levels of stress and burnout. The aim of the present study was to evaluate the relationship between perceived stress latent factors (‘tenseness’ and ‘frustration’) and the features (‘overload’, ‘lack of development’ and ‘neglect’) of the three burnout subtypes (‘frenetic’, ‘under-challenged’ and ‘worn-out’, respectively), in a sample of Spanish dental students. Methods The study employed a cross-sectional design. A sample of Spanish dental students (n = 314) completed the ‘Perceived Stress Questionnaire’ and the ‘Burnout Clinical Subtype Questionnaire Student Survey’. The associations among variables were observed by means of structural equation modelling using the unweighted least squares method from polychoric correlations. Results Strong associations among perceived stress factors and the burnout characteristics were observed, although a distinct pattern of relations was observed for each burnout subtype. The ‘overload’ was moderately and positively associated with both ‘tenseness’ (0.45), and ‘frustration’ (0.38) dimensions of perceived stress; the ‘lack of development’ was positively associated with the ‘frustration’ dimension (0.72), but negatively associated with ‘tenseness’ (−0.69); the ‘neglect’ showed a weaker positive associated with ‘frustration’ (0.41), and a small negative association with ‘tenseness’ (−0.20). The model was a very good fit to the data (GFI = 0.96; RSMR = 0.07; AGFI = 0.96; NFI = 0.95; RFI = 0.95). Conclusions The stress factors of ‘frustration’ and ‘tenseness’ seems to be related in a distinct way to the burnout subtypes in Spanish dental students. This finding suggests that intervention programs specifically tailored to these subtypes may be a promising future direction. PMID:24927260
Kawahara, M; Takeshita, T; Akita, S
The Resuscitation Committee of Hiroshima City Dental Association was established in 1983 in order to provide acute medical support in case of emergency during dental treatment at private dental clinics. This Committee is composed of representatives from the Hiroshima City Dental Association, Hiroshima University School of Dentistry, Hiroshima University School of Medicine, Hiroshima City Health Bureau, and Hiroshima City Fire and Ambulance Department. A portable ECG monitor with defibrillator and a resuscitation kit are held in readiness at the Hiroshima University Hospital. In case of emergency during dental treatment at a private dental clinic, we hurry to the clinic with the resuscitation set and give emergency treatment. We have been involved in two cases of emergency since this system started. Both of them recovered without any sequelae. Besides these activities, we give lectures annually to dentists and dental hygienists on the treatment of medical emergencies.
El Batawi, Hisham Yehia; Panigrahi, Priyankar; Awad, Manal A.
Purpose: To investigate the perceived clinical outcome and parents’ satisfaction after dental rehabilitation under general anesthesia over a follow-up period of 2 years. Materials and Methods: A prospective study of questionnaire data obtained from 352 pediatric patients before and after treatment of early childhood caries with full dental rehabilitation under general anesthesia. Questionnaires focused on oral symptoms, functional limitations, and emotional and social well-being before and after dental treatment. Cases were followed up for 2 years postoperatively. Results: A dramatic disappearance of symptoms was reported from parents’ perspective. There was a high satisfaction rate (99.14%) also among parents of the children included in the study. Conclusion: Children with early childhood caries do not necessarily express it verbally as pain. The disease has a lot of other expressions affecting children's behavior and habits, including the ability to sleep, thrive, and socialize. This study contributes to the existing literature that full dental rehabilitation under general anesthesia [dental general anesthesia (DGA)] has an immediate positive impact on the physical and social quality of life of children suffering from early childhood caries as well as on their families. Postoperative preventive care, early diagnosis, and treatment of recurrent caries are key factors to maintain postoperative outcome of DGA. PMID:25625072
Bader, James D.; And Others
Comparison and analysis of the restorative treatment recommendations made by dentists and dental school students for 63 patients found about 85% agreement on treatment plans. It is observed that the results provide some basis on which to assess how well dental school treatments reflect mainstream practice. (MSE)
1 A NAVAL POSTGRADUATE DENTAL SCHOOL ANALYSIS OF INITIAL ENDODONTIC TREATMENT by Rodney V. Scott LCDR, DC, USN...A thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental School Uniformed Services...Clinical Research A Naval Postgraduate Dental School Analysis of Initial Endodontic Treatment Rodney V. Scott, DDS
The intraoral treatment of dental disease in pet rabbits follows a complete clinical examination, intraoral inspection under general anesthesia, and diagnostic imaging. It also implies thorough knowledge of dental disease in this species. The most common intraoral procedures are extraction of incisor teeth, coronal reduction, and extraction of cheek teeth. These dental procedures require specific instruments and equipment. They should be performed in conjunction with supportive and medical treatment followed by appropriate nutrition.
Mitsunaga, S; Iwai, T; Kitajima, H; Yajima, Y; Ohya, T; Hirota, M; Mitsudo, K; Aoki, N; Yamashita, Y; Omura, S; Tohnai, I
Cervicofacial subcutaneous emphysema is a rare complication of dental procedures. Although most cases of emphysema occur incidentally with the use of a high-speed air turbine handpiece, there have been some reports over the past decade of cases caused by dental laser treatment. Emphysema as a complication caused by the air cooling spray of a dental laser is not well known, even though dental lasers utilize compressed air just as air turbines and syringes do. In this study, we comprehensively reviewed cases of emphysema attributed to dental laser treatment that appeared in the literature between January 2001 and September 2012, and we included three such cases referred to us. Among 13 cases identified in total, nine had cervicofacial subcutaneous and mediastinal emphysema. Compared with past reviews, the incidence of mediastinal emphysema caused by dental laser treatment was higher than emphysema caused by dental procedure without dental laser use. Eight patients underwent CO2 laser treatment and two underwent Er:YAG laser treatment. Nine patients had emphysema following laser irradiation for soft tissue incision. Dentists and oral surgeons should be cognizant of the potential risk for iatrogenic emphysema caused by the air cooling spray during dental laser treatment and ensure proper usage of lasers.
Rosenberg, Dara J.; And Others
A study compared the treatments and the amount of time needed for treatment of the dental needs of developmentally disabled, severely compromised, and moderately compromised patients with those of nondisabled patients in a hospital ambulatory dental clinic. (MSE)
related to technical expertise, Crall and Morris (1988) and Abrams, Ayers and Vogt-Petterson (1986) found that patient satisfaction was not well ...mission of the Army Dental Care Dental Patient Satisfaction 93 System. Dental emergencies in deployed military populations have been well documented...that choice. The ratings of the beliefs about the care received were high as well . Mean scores on the seven belief questions Dental Patient Satisfaction
Beck, Frank M.; And Others
Women, self-referred for dental anxiety, were given four weeks of cue-controlled relaxation treatment. Nonorthogonal planned comparisons indicated significant decreases on dental anxiety, anxiety differential, and state anxiety scales, and systolic blood pressure. Participants reported that treatment was helpful in controlling anxiety when…
Background Nationally representative clinical data on the oral health needs of Canadians has not been available since the 1970s. The purpose of this study was to determine the normative treatment needs of a nationally representative sample of Canadians and describe how these needs were distributed. Methods A secondary analysis of data collected through the Canadian Health Measures Survey (CHMS) was undertaken. Sampling and bootstrap weights were applied to make the data nationally representative. Descriptive frequencies were used to examine the sample characteristics and to examine the treatment type(s) needed by the population. Bivariate logistic regressions were used to see if any characteristics were predictive of having an unmet dental treatment need, and of having specific treatment needs. Lastly, multivariate logistic regression was used to identify the strongest predictors of having an unmet dental treatment need. Results Most of the population had no treatment needs and of the 34.2% who did, most needed restorative (20.4%) and preventive (13.7%) care. The strongest predictors of need were having poor oral health, reporting a self-perceived need for treatment and visiting the dentist infrequently. Conclusions It is estimated that roughly 12 million Canadians have at least one unmet dental treatment need. Policymakers now have information by which to assess if programs match the dental treatment needs of Canadians and of particular subgroups experiencing excess risk. PMID:23102263
Rozier, R. Gary
Objectives. We examined the association between mother-perceived neighborhood social capital and oral health status and dental care use in US children. Methods. We analyzed data for 67 388 children whose mothers participated in the 2007 National Survey of Children’s Health. We measured mothers’ perceived social capital with a 4-item social capital index (SCI) that captures reciprocal help, support, and trust in the neighborhood. Dependent variables were mother-perceived ratings of their child’s oral health, unmet dental care needs, and lack of a previous-year preventive dental visit. We performed bivariate and multivariable logistic regression analyses for each outcome. Results. After we controlled for potential confounders, children of mothers with high (SCI = 5–7) and lower levels (SCI ≥ 8) of social capital were 15% (P = .05) and about 40% (P ≤ .02), respectively, more likely to forgo preventive dental visits than were children of mothers with the highest social capital (SCI = 4). Mothers with the lowest SCI were 79% more likely to report unmet dental care needs for their children than were mothers with highest SCI (P = .01). Conclusions. A better understanding of social capital’s effects on children’s oral health risks may help address oral health disparities. PMID:23327253
Abdullah, Walid Ahmed; Khalil, Hesham
Background Warfarin is one of the most common oral anticoagulants used to prevent thromboembolic episodes. The benefits of discontinuation of this drug before simple surgical procedures are not clear and this approach could be associated with complications. The aim of this study was to evaluate the risk of bleeding in a series of 35 patients (in cases where the international normalized ratio [INR] is less than 4) following simple tooth extraction without modification of the warfarin dose given to patients. Methods Thirty-five patients taking warfarin who had been referred to the Oral and Maxillofacial Department, College of Dentistry, King Saud University, for dental extractions were included in the study. Exclusion criteria included patients with an INR of ≥4 or with a history of liver disease or coagulopathies. No alteration was made in warfarin dose, and the CoaguChek System was used to identify the INR on the same day of dental extraction. Bleeding from the extraction site was evaluated and recorded immediately after extraction until the second day. Results A total of 35 patients (16 women and 19 men) aged between 38 and 57 years (mean =48.7) were included in the present study. All patients underwent simple one-tooth extraction while undergoing warfarin treatment. Oozing, considered mild bleeding and which did not need intervention was seen in 88.6% of patients. Moderate bleeding occurred in 11.4% of all cases. The INR of the patients ranged from 2.00 to 3.50, with 77.2% of patients having INR between 2.0 and 2.5 on the day of extraction. No severe bleeding which needed hospital management was encountered after any of the extractions. The patients who suffered moderate bleeding were returned to the clinic where they received local treatment measures to control bleeding. Moderate bleeding occurred only in four patients, where three had INR between 3.1 and 3.5, and one with INR less than 3. Conclusion In the present study, we have shown that simple tooth
Bridges, Susan Margaret; McGrath, Colman Patrick; Yiu, Cynthia Kar Yung; Zayts, Olga A.; Au, Terry Kit Fong
Patients’ perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient’s perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver’s perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients’ demographic information and the caregiver’s perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer™) indicated five prominent themes ‘disease / treatment’, ‘treatment procedure related instructions’, ‘preparation for examination’, ‘positive reinforcement / reassurance’, and ‘family / social history’ from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme ‘Positive reinforcement / reassurance’: ‘number of related words’ (p = 0.002), ‘number of related utterances’ (p = 0.001), ‘percentage of the related words in total number of words’ (p = 0.005), ‘percentage of the related utterances in total number of utterances’ (p = 0.035) and ‘percentage of time spent in total time duration’ (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver’s involvement, such as clinicians’ mention of the parent, was also seen as critical
Winocur, E; Uziel, N; Lisha, T; Goldsmith, C; Eli, I
To examine possible associations between self-reported bruxism, stress, desirability of control, dental anxiety and gagging. Five questionnaires were distributed among a general adult population (402 respondents): the Perceived Stress Scale (PSS), Desirability of Control Scale (DC), Dental Anxiety Scale (DAS), Gagging Assessment Scale (GAS), and Bruxism Assessment Questionnaire. A high positive correlation between DAS and GAS (R = 0·604, P < 0·001) was found. PSS was negatively correlated with DC (R = -0·292, P < 0·001), and was positively correlated with GAS (R = 0·217, P < 0·001) and DAS (R = 0·214, P < 0·001). Respondents who reported bruxing while awake or asleep showed higher levels of GAS, DAS and PSS than those who did not. There were no differences between the bruxers and the non-bruxers (sleep and aware) with regard to the DC scores. The best predictors of awake bruxism were sleep bruxism (OR = 4·98, CI 95% 2·54-9·74) and GAS (OR = 1·10, CI 95% 1·04-1·17). The best predictors of sleep bruxism were awake bruxism (OR = 5·0, CI 95% 2·56-9·78) and GAS (OR = 1·19; CI 95% 1·11-1·27). Self-reported sleep bruxism significantly increases the odds for awake bruxism and vice versa. Tendency for gagging during dental care slightly increases the odds of both types of self-reported bruxism, but desirability of control is not associated with these phenomena.
Pau, Allan; Rowland, Michael L; Naidoo, Sudeshni; AbdulKadir, Rahimah; Makrynika, Elisavet; Moraru, Ruxandra; Huang, Boyen; Croucher, Ray
This multinational survey investigated the relationship between emotional intelligence (EI) and perceived stress (PS) in seven countries. First-year dental undergraduates attending a dental school in England, Greece, Romania, South Africa, Australia, and the United States and three schools in Malaysia were invited to complete a set of questionnaires on age, gender, academic background, satisfaction with career choice, EI, and PS. Of 860 questionnaires distributed, 596 were fully completed--a response rate of 69.3 percent. Mean EI score was 123.8 (95 percent CI 122.7-124.9), and mean PS score was 19.1 (95 percent CI 18.6-19.7). Significant differences in EI and PS scores were detected between different countries. Females (p<0.05), younger students (p<0.001), those without a previous higher education qualification (p<0.001), and those not satisfied with their decision to study dentistry (p<0.001) were more likely to report PS when compared to their counterparts. A significant inverse relationship (coefficient=-0.29, p=0.001) between EI and PS was detected. Independent significant predictors of PS identified were gender (beta=0.22, t=5.71, p=0.001), previous higher education qualification (beta=-0.14, t=-2.42, p=0.010), satisfaction with decision to study dentistry (beta=-0.20, t=-5.11, p=0.001), and EI (beta=-0.24, t=-6.09, p=0.001), with the latter being relatively the most important predictor. In conclusion, the inverse relationship between EI and PS has been confirmed in this heterogeneous sample representing diverse sociocultural and academic contexts of dental undergraduates.
Myint, Kyaimon; See-Ziau, Hoe; Husain, Ruby; Ismail, Rosnah
Background An equitable and positive learning environment fosters deep self-directed learning in students and, consequently, good practice in their profession. Although demotivating weaknesses may lead to repeated day-to-day stress with a cascade of deleterious consequences at both personal and professional levels, a possible relationship between these parameters has not been reported. This study was undertaken to determine the relationship between students’ perceptions of their educational environment and their stress levels. Methods Sixty-one first year students at the Dental Faculty, University of Malaya, Malaysia participated. The Dundee Ready Education Environment Measure (DREEM) was used to determine educational environment while self-rated perceived stress level was measured by the Depression Anxiety Stress Scale (DASS). Results Most students (62.39%) showed positive perceptions for the total and five domains of DREEM. The highest percentage was observed for “Students perception of learning” (64.04%) while the lowest was for “Students’ social self-perception” (60.32%). At the same time, 61% of students showed high perceived stress levels. However, this was not associated with their DREEM scores. Conclusion Although a positive perception of their educational environment was found, minor corrective measures need to be implemented. Furthermore, longitudinal studies on an annual basis would provide useful input for strategic planning purposes. PMID:27418869
Eslamipour, Faezeh; Riahi, Farnaz Tajmir; Etemadi, Milad; Riahi, Alireza
Background: To determine patient orthodontic treatment need, appropriate self-perceived indices are required. The aim of this study was to assess the sensitivity and specificity of esthetic component (AC) of the index of orthodontic treatment need (IOTN), oral esthetic subjective index scale (OASIS), and visual analog scale (VAS) through dental health component (DHC) IOTN as a normative index to determine the more appropriate self-perceived index among young adults. Materials and Methods: In this cross-sectional study, a sample of 993 was randomly selected from freshman students of Isfahan University. Those with a history of orthodontic treatment or current treatment were excluded. DHC was evaluated by two inter- and intra-calibrated examiners. Data for AC, OASIS, and VAS were collected through a questionnaire completed by students. Descriptive statistics, Mann–Whitney U-test, and Spearman correlation test, were used for data analyses. Sensitivity, specificity, positive and negative predictive values of self-perceived indices were calculated through DHC. Results: Sensitivity of AC, OASIS, and VAS for evaluating definite orthodontic treatment need was calculated at 15.4%, 22.3%, and 44.6%, respectively. Specificity of these indices for evaluating definite orthodontic treatment need was calculated at 92.7%, 90.5%, and 76.2% percent, respectively. All self-perceived indices had a significant correlation with together and with DHC (P < 0.01). Among demographic factors, there was weak but significant correlation only between mother's educational level and VAS (P < 0.01). Conclusion: Due to the sensitivity and specificity of the three self-perceived indices, these indices are not recommended for population screening and should be used as adjuncts to a normative index for decision-making in orthodontic treatment planning. PMID:28348616
... dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C... existence at time of discharge or release from active service, which took place after September 30, 1981... service-connected noncompensable condition, but only if: (A) They served on active duty during the...
.... (Authority: 38 U.S.C. 2062; 38 U.S.C. 1712(a)(1)(H)) (e) Class II(c). Those who were prisoners of war, as... dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C... existence at time of discharge or release from active service, which took place after September 30,...
.... (Authority: 38 U.S.C. 2062; 38 U.S.C. 1712(a)(1)(H)) (e) Class II(c). Those who were prisoners of war, as... dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C... existence at time of discharge or release from active service, which took place after September 30,...
.... (Authority: 38 U.S.C. 2062; 38 U.S.C. 1712(a)(1)(H)) (e) Class II(c). Those who were prisoners of war, as... dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C... existence at time of discharge or release from active service, which took place after September 30,...
Yi, Song; Zhang, Chuqin; Ni, Chulei; Qian, Ying; Zhang, Jun
Objective The objective of this study is to evaluate the psychosocial impact of dental aesthetics in undergraduate students in the People’s Republic of China and to investigate the association between normal orthodontic treatment needs, psychosocial impact of dental aesthetics, and desire for orthodontic treatment. Materials and methods A cross-sectional study was carried out in two universities in a city of the People’s Republic of China with 374 young adults aged between 19 years and 24 years. The students answered a Chinese version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and addressed their desire for orthodontic treatment. Objective malocclusion severity was assessed with the Index of Orthodontic Treatment Need (IOTN). Statistical analysis was performed by the SPSS software (Version 15.0). Results There was no statistical sex difference in relation to the dental health component of IOTN (P=0.893) and PIDAQ scores (P=0.06), but it was found that the desire for orthodontic treatment was significantly stronger among females. The total and subscale PIDAQ scores and malocclusion severity differed significantly among the five grades of desire (P<0.01). Significant positive correlation was found among desire for orthodontic treatment, IOTN-dental health component grades, and total or subscale PIDAQ scores (P<0.01). High correlation was found between desire and PIDAQ score (r=0.93). Conclusion The desire for orthodontic treatment is higher among female young adults who have the same orthodontic treatment needs compared to males. The desire for orthodontic treatment has high positive correlation with PIDAQ scores and increases with the increase in self-perceived psychosocial impacts of malocclusion and the needs for orthodontic treatment. PMID:27354773
Piovesan, Chaiana; Antunes, José Leopoldo Ferreira; Guedes, Renata Saraiva; Ardenghi, Thiago Machado
The influence of socioeconomic factors and self-rated oral health on children's dental health assistance was assessed. This study followed a cross-sectional design, with a multistage random sample of 792 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. A dental examination provided information on the prevalence of dental caries (DMFT index). Data about the use of dental service, socioeconomic status, and self-perceived oral health were collected by means of structured interviews. These associations were assessed using Poisson regression models (prevalence ratio; 95% confidence interval). The prevalence of regular use of dental service was 47.8%. Children from low socioeconomic backgrounds and those who rated their oral health as "poor" used the service less frequently. The distribution of the kind of oral healthcare assistance used (public/private) varied across socioeconomic groups. The better-off children were less likely to have used the public service. Clinical, socioeconomic, and psychosocial factors were strong predictors for the utilization of dental care services by schoolchildren.
Frencken, J E F M; Flohil, K A; de Baat, C
Dental treatment anxiety usually develops during childhood due to a bad experience and the dental drill as well as the injection needle are the most common causes. The Atraumatic Restorative Treatment provides the opportunity to provoke little or no dental treatment anxiety because only hand instruments are used and local anaesthesia is seldom required. Several scientific studies have indicated that the Atraumatic Restorative Treatment causes less pain, discomfort and anxiety by comparison with conventional treatments. Therefore, the Atraumatic Restorative Treatment is considered to be promising for the treatment of carious lesions in anxious children and adults, and potentially also for patients suffering from dental treatment phobia. Furthermore, the Atraumatic Restorative Treatment may be indicated as the primary treatment method in children to prevent dental treatment anxiety and treatment under general anaesthesia. These conclusions must still be confirmed with responsible scientific research.
Bernabé, Eduardo; Flores-Mir, Carlos
Background Previous studies on orthodontic treatment need in young adults have shown that up to 50% had malocclusions that needed orthodontic treatment. The aims of this study were to assess the normative and self-perceived need for orthodontic treatment using the Index of Orthodontic Treatment Need (IOTN) and to determine if the treatment need levels were influenced by sex, age and socio-economic status (SES) in a sample of Peruvian young adults. Methods 281 first-year students (157 male and 124 female students) with a mean age of 18.1 +/- 1.6 years were randomly selected and evaluated through the Dental Health Component (DHC) and Aesthetic Component (AC) of the IOTN. Structured interview and clinical examination were used to assess the students. Descriptive statistics and Chi-square tests were used for data analysis with statistical significance set at P < 0.05. Results An intra-examiner reliability of 0.89 was obtained (weighted Kappa). The percentage of students according to SES was 51.2%, 40.6% and 8.2% corresponding to low, medium and high SES respectively. The percentage of students with DHC grades 4–5 was 29.9% whereas the percentage of students with AC grades 8–10 was 1.8%. There were no significant differences in the distribution of normative and self-perceived orthodontic treatment need based on sex, age and SES comparisons. Conclusion Normative orthodontic treatment need was not matched by a similar level of self-perceived treatment need in these young adults. Sex, age and SES were non-significant factors associated with levels of treatment need. PMID:16884542
Nihtilä, Annamari; Widström, Eeva; Elonheimo, Outi
The aim of this study was to compare treatment provided to adult heavy and low users of dental services in the Finnish Public Dental Service (PDS) and to analyse changes in patients' oral health status. We assigned all adults who attended the PDS in Espoo in 2004 to a group of heavy users (n = 3,173) if they had made six or more dental visits and to a comparison group of low users (n = 22,820), if they had made three or fewer dental visits. Data were obtained from the patient register of the PDS. A sample of 320 patients was randomly selected from each group. Baseline information (year 2004) on age, sex, number and types of visits, oral health status and treatment provided was collected from treatment records. Both groups were followed-up for five years. Restorative treatment measures dominated the heavy and low users'treatments; 88.8% of heavy users and 79.6% low users had received restorations during the five-year period. Fixed prosthetic treatments were provided to just 2% of the heavy users and 0.8% of the low users. Emergency visits were more common for heavy users (74.8%) than for low users (21.6%) (p < 0.001). Fewer than half of the heavy (46.1%) or low (46.5%) users were examined twice. Typical for heavy use of oral health services was a cycle of repetitive repair or replacement of restorations, often as emergency treatment, a lack of proper examinations and preventive care; crown therapy was seldom used. Immediately after the major dental care reform in Finland, the PDS in Espoo had problems providing good quality dental care for the new adult patients. Older patients with lower social class background were not accustomed to regular dental care and the PDS did not actively propose proper comprehensive regular care for adults.
University of the Health Sciences in partial fulfillment of the requirements for the degree of Master of Science in Oral Biology July 2015 Naval...Postgraduate Dental School Uniformed Services University of the Health Sciences Bethesda, Maryland CERTIFICATE OF APPROVAL MASTER’S THESIS This is to...Salehrabi and Rotstein evaluated root canal treatments completed by practitioners in a dental insurance network and reported a 97% survival rate of
Widström, E; Pietilä, I; Nilsson, B
According to the present clinical survey of dental emergencies treated by organised emergency services in two of the larger Finnish cities, the main causes (64 per cent) of the problems leading to these visits were caries and its consequences. In about 80 per cent of the 839 cases treated, the acute treatment was based on clinical examination only. Temporary fillings were provided for 19 per cent, permanent fillings for 8 per cent, endodontic treatment for 22 per cent and extractions for 14 per cent of the patients. Extractions were most often provided for patients who normally visited a dentist irregularly and these had a low mean number of teeth. Patients with pain lasting longer than a week were likely to receive endodontic treatment, whereas permanent fillings were provided for regular dental visitors who had their own dentists. About 90 per cent of the patients were considered to need other dental treatment in addition to the treatment of the acute condition.
Yu, Jen-Fang; Lee, Kun-Che; Hong, Hsiang-Hsi; Kuo, Song-Bor; Wu, Chung-De; Wai, Yau-Yau; Chen, Yi-Fen; Peng, Ying-Chin
During dental treatments, patients may experience negative emotions associated with the procedure. This study was conducted with the aim of using functional magnetic resonance imaging (fMRI) to visualize cerebral cortical stimulation among dental patients in response to auditory stimuli produced by ultrasonic scaling and power suction equipment. Subjects (n = 7) aged 23-35 years were recruited for this study. All were right-handed and underwent clinical pure-tone audiometry testing to reveal a normal hearing threshold below 20 dB hearing level (HL). As part of the study, subjects initially underwent a dental calculus removal treatment. During the treatment, subjects were exposed to ultrasonic auditory stimuli originating from the scaling handpiece and salivary suction instruments. After dental treatment, subjects were imaged with fMRI while being exposed to recordings of the noise from the same dental instrument so that cerebral cortical stimulation in response to aversive auditory stimulation could be observed. The independent sample confirmatory t-test was used. Subjects also showed stimulation in the amygdala and prefrontal cortex, indicating that the ultrasonic auditory stimuli elicited an unpleasant response in the subjects. Patients experienced unpleasant sensations caused by contact stimuli in the treatment procedure. In addition, this study has demonstrated that aversive auditory stimuli such as sounds from the ultrasonic scaling handpiece also cause aversive emotions. This study was indicated by observed stimulation of the auditory cortex as well as the amygdala, indicating that noise from the ultrasonic scaling handpiece was perceived as an aversive auditory stimulus by the subjects. Subjects can experience unpleasant sensations caused by the sounds from the ultrasonic scaling handpiece based on their auditory stimuli.
Shaeesta, Khaleelahmed Bhavikatti; Prabhuji, M Lv; Shruthi, J R
During the sacred month of Ramadan, Muslims abstain from the consumption of food from dawn until dusk. Extended fasting hours produce changes in the body's metabolism during this period. A majority of the population who fast also restrict themselves from undergoing dental treatments due to a fear of breaking the fast. Even among health professionals, a certain amount of uncertainty prevails about the implications of treating a patient who is fasting. To help clinicians carry out safe and effective treatment without hampering a patient's religious beliefs, the present article focuses on the effect of Ramadan fasting on the body's metabolism and the ramifications for treatment aspects, including medications and dental procedures.
Lin, C-S; Wu, S-Y; Yi, C-A
Accumulating evidence has revealed that dental anxiety (DA), as a dispositional factor toward the dental situation, is associated with the state anxiety (SA) and pain related to dental procedures. However, conclusions from individual studies may be limited by the treatment procedures that patients received, the tools used to assess DA, or the treatment stages when anxiety or pain was assessed. It is unclear whether DA, at the study level, accounts for the variance in pretreatment SA. The impact of DA and SA on pain at different treatment stages has not been systematically investigated. To address these questions, we present novel meta-analytical evidence from 35 articles (encompassing 47 clinical groups) that investigated DA in a clinical group. Subgroup analyses revealed that the studies of surgical and nonsurgical procedures did not significantly differ in either DA or pretreatment SA. Furthermore, metaregressions revealed DA as a significant predictor that explained the variance in SA assessed before and during treatment but not after treatment. The findings suggest that patient DA has a significant impact on patient SA. Metaregressions revealed DA as a significant predictor that explained the variance in expected pain, pain during treatment and posttreatment pain. In contrast, pretreatment SA was a significant predictor that explained the variance in expected pain. The findings reveal that DA has a consistent impact on pain through the entire period of dental treatment. Altogether, the findings highlight the role of DA as an overall indicator for anxiety and pain, across different types of dental procedures or treatment stages. We conclude that anxiety should be assessed as a critical step not only in anxiety management for high-DA patients, but also in pain control for all dental patients.
Sundararajan, Sabapathy; Teferi, Abraham
Introduction: Granulicatella adiacens is a Gram-positive bacteria and a normal component of oral flora. It is also found in dental plaques, endodontic abscesses and can rarely cause more serious infections. Case presentation: We describe a prosthetic hip joint infection in an 81-year-old fit and healthy man due to Granulicatella adiacens who underwent a prolonged dental intervention two days earlier without antibiotic prophylaxis. The infection was successfully treated with surgical intervention and a combination of antibiotics. The patient eventually succumbed to severe community-acquired pneumonia two months later. Conclusion: Current guidelines recommend avoidance of antibiotic prophylaxis prior to dental treatment in patients who have no co-morbidities and no prior operation on the index prosthetic joint. This case report indicates that infections of prosthetic joints may be associated with dental procedures even in fit and healthy patients without the recognized risk factors. PMID:28348763
Gazal, G; Fareed, WM; Zafar, MS
Pain control during the dental procedure is essentials and challenging. A complete efficacious pulp anesthesia has not been attained yet. The regional anesthesia such as inferior alveolar nerve block (IANB) only does not guarantee the effective anesthesia with patients suffering from irreversible pulpitis. This main aim of this review was to discuss various aspects of intraseptal dental anesthesia and its role significance in pain-free treatment in the dental office. In addition, reasons of failure and limitations of this technique have been highlighted. Literature search was conducted for peer-reviewed articles published in English language in last 30 years. Search words such as dental anesthesia, pain control, intraseptal, and nerve block were entered using a web of knowledge and Google scholar databases. Various dental local anesthesia techniques were reviewed. A combination of block anesthesia, buccal infiltration and intraligamentary injection resulted in deep anesthesia (P = 0.003), and higher success rate compared to IANB. For pain-free management of conditions such as irreversible pulpitis, buccal infiltration (4% articaine), and intraosseous injection (2% lidocaine) are better than intraligamentary and IANB injections. Similarly, nerve block is not always effective for pain-free root canal treatment hence, needing supplemental anesthesia. Intraseptal anesthesia is an efficient and effective technique that can be used in maxillary and mandibular adult dentition. This technique is also beneficial when used in conjunction to the regional block or local dental anesthesia. PMID:26955316
The validity of the Periodontal Treatment Need System and the Community Periodontal Index for Treatment Need as screening tests for allocation of patients to dental students was assessed and compared. Sixty-one patients reporting to the Department of Periodontology at the University of Oslo were studied. (MLW)
Butters, Janice M.; Vaught, Randall L.
A study investigated the effect of an extramural rotation on dental-hygiene students' self-perceptions of competence in specific clinical areas. Results indicate student perceptions of competence improved significantly on six of 19 dimensions of dental-hygiene practice over the course of the rotation, suggesting that rotation is a valuable…
White, Halley; Lee, Jessica Y.; Vann, William F.
The purpose of this study was to examine (a) parental satisfaction with the dental care their child received under general anesthesia, and (b) perception of the impact of this care on physical and social quality of life. The sample included 45 children (median age 50 months, 26 boys and 19 girls). Data were collected using a 1-page survey instrument completed by the parent at the first follow-up appointment. Dichotomous dependent variables were developed to measure parental satisfaction, dental outcome, and social impact of treatment. There was an overwhelmingly positive impression with dental outcomes (pain relief and improved masticatory efficiency). Parental perceptions in the social dimension were also positive. Parents reported more smiling, improved school performance, and increased social interaction. Relative to overall health, the majority of parents reported an improvement. Logit regression analysis revealed that absence of pain (P < .05) and increased social interaction (P < .01) had a significant impact on parents' perception of overall health. Our findings indicate that dental care under general anesthesia for preschool children has a high degree of acceptance by parents and is perceived to have a positive social impact on their child. PMID:14558585
Gómez-Moreno, G; Cutando-Soriano, A; Arana, C; Scully, C
Patients with hereditary hemostatic disorders, characterized by a tendency to bleeding or thrombosis, constitute a serious challenge in the dental practice. Advances in the medical diagnosis of hemostatic disorders have exposed dental professionals to new patients not amenable to the application of the management protocols associated with other, more well-known, disorders. It is the aim of this paper to review the evidence, to highlight the areas of major concern, and to suggest management regimens for patients with hereditary hemostatic disorders. An extensive review has been made (PubMed, Science Direct, Web of Knowledge, etc.) of literature pertaining to hereditary disorders affecting blood coagulation factors and how they affect the practice of dentistry. Several aspects relating to the care of such patients must be recognized and taken into consideration when dental treatment is planned. Replacement of deficient coagulation factors ensures that safe dental treatment will be carried out. However, the half-life of such coagulation factors requires that dental treatment be specifically planned and adapted to the type of pathology involved.
Rada, Robert E.
Individuals with autism can be quite challenging to treat in a routine dental-office setting, especially when extensive dental treatment and disruptive behavioral issues exist. Individuals with autism may also be at higher risk for oral disease. Frequently, general anesthesia is the only method to facilitate completion of the needed dental…
Cohen, Leonard A.; And Others
Dental attitudes of college students were examined: frequency of past visits; subceptibility to dental conditions; seriousness, preventability, and treatability of dental conditions; and satisfaction with dentists, practices, and other dental conditions. (Authors/CJ)
McGuinness, Niall J P
As a result of recent innovations and improvements, orthodontic treatment has become easier and more efficient to carry out, allowing greater numbers of patients to receive treatment. The main result of orthodontic treatment is improved dental alignment and aesthetics. Treatment has no effect on caries or periodontal disease, and the dental health gain is modest, apart from a very small percentage of destructive malocclusions. Psychological improvements using different psychological parameters show differing results and it is not clear that any psychological gains are long lasting. Social gain (greater willingness to smile, feeling good about oneself, satisfaction with dental appearance, etc.), and reported improved quality of life (QoL measures), are now becoming more important as consumer-related outcomes and may, ultimately, contribute to psychosocial and psychological status. Stability of orthodontic treatment results cannot be guaranteed and all patients need to be informed of this, and of the need for long-term retention. Malocclusion has little or no relationship to temporo-mandibular joint dysfunction and orthodontic treatment neither causes nor cures such problems. Extractions as part of orthodontic treatment do not cause TMD, nor do they cause collapse of the vertical dimension. The major improvements in dental health in the last 40 years have been accompanied by a great increase in demand for treatment. In any public health service that is free at the point of use, demand for treatment invariably exceeds the ability of resources to supply this. Indices of treatment need are widely used to determine treatment need and eligibility for treatment in public health systems. Demand for orthodontic treatment among adolescents can be as high as 60% in the general population, while the professionally-assessed need for treatment is approximately half this figure. Age, sex, socio-economic status, perceived unattractiveness of dental appearance, and availability of
Wannemueller, André; Jöhren, Hans-Peter; Borgstädt, Alina; Bosch, Jessica; Meyers, Milena; Völse, Miriam; Scholten, Saskia; Margraf, Jürgen
A large-group one session treatment (LG-OST) combining exposure and diaphragmatic breathing as a bodily coping element was carried out to investigate its feasibility and effectiveness in a sample of 43 highly dental fearful individuals treated simultaneously. We assessed subjective dental fear, dysfunctional dental-related beliefs, and perceived control pre- and post-intervention and at four-month follow-up. Participants additionally performed a behavioural approach test (BAT) pre- and post-intervention. During the applied exposure exercises, four participants (9.3%) discontinued the program all reporting too high levels of distress. Regarding subjective dental fear and dysfunctional dental related beliefs post treatment effects, LG-OST showed medium to large effect sizes, ranging from Cohen’s d = 0.51 to d = 0.84 in the Intention-to-Treat analysis. Subjective dental fear improved clinically significantly in about one fourth (25.6%) of therapy completers. All post-treatment effects remained stable over time. Concerning the behavioral fear dimension, we observed a strong ceiling effect. Already at pre-assessment, participants accomplished more than six out of seven BAT-steps. Thus, behavioral approach did not increase significantly following treatment. Overall, the LG-OST protocol proved feasible and efficient. Compared to other one-session individual and multi-session group treatments the observed LG-OST effects were smaller. However, if LG-OST could match the efficacy of highly intensive short treatments delivered in an individual setting in the future, for example, by applying a wider array of exposure exercises, it could be a very useful treatment option as an intermediate step within a stepped care approach. PMID:28111556
Corcuera-Flores, José R.; Delgado-Muñoz, José M.; Ruiz-Villandiego, José C.; Maura-Solivellas, Isabel
Dental treatment on Handicapped Patients is often difficult because many people with a wide range of ages (from children to the elderly) with different pathologies that can affect the oral cavity and differ widely are included in this group. This situation creates some controversy, because according to pathology, each patient will be treated differently depending on collaboration, general health status, age or medication used to treat this pathologies. According to this situation we can opt for an outpatient treatment without any kind of previous medication, a treatment under conscious or deep sedation or a under general anesthesia treatment. With this systematic review is intended to help clarify in which cases patients should be treated under general anesthesia, sedation (conscious or deep) or outpatient clinic without any medication, as well as clarify what kind of treatments can be carried in private dental clinics and which should be carried out in a hospital. It will also discuss the most common diseases among this group of patients and the special care to be taken for their dental treatment. Key words:Hospital dentistry, handicapped patient. PMID:24121922
Dickey, Keith Winfield
The article describes a survey of 36 dental education programs to identify educators' reactive policies and procedures in their patient treatment centers to minimize dental contamination and cross-contamination. (Author/CT)
Arnrup, K; Lundin, S A; Dahllöf, G
All inpatients at a regional hospital in Sweden referred for a paediatric dental consultation (n = 269) were studied retrospectively during a two-year period. The children were studied concerning their medical and oral condition and subsequent dental treatment. The most frequent medical condition among the referred children was insulin dependent diabetes mellitus (20%), asthma (9%) and epilepsy (7%). Children with asthma exhibited a significantly increased caries prevalence (p < 0.01) compared to other chronically sick children. Of the children examined 53% were diagnosed with diseases or abnormalities in the oral cavity requiring treatment. Gingivitis, disturbances in occlusal development and dental caries were the most commonly found diagnoses Acute dental or oral problems were diagnosed in 9% of the children. The mean time allocated for each patient was 60 minutes. Thirty percent of the children were subsequently treated at the paediatric dentistry specialist clinic. In conclusion the study emphasises the need of paediatric dental consultation services at regional hospitals.
Palencar, Adrian J
An anterior open bite is one of the most difficult occlusal abnormalities to treat. Quite often this aberration entails dental component and/or skeletal component. The skeletal open bite will require intrusion of the posterior sextants with the assistance of bite blocks, temporary anchorage devices, high pull headgear, and as a last resort - orthognathic surgery. The orthodontic treatment should be augmented with the orofacial myofunctional therapy. In this article, the author describes 3 different variations of treatment of the dental anterior open bite, first on acrylic models, and then on the actual patients. Consideration should be given to patients with a 'short upper lip," and in this case, surgical correction should be entertained.
Farsi, J M A
The aim of this study was to report on dental visit patterns and their association with periodontal health among young Saudi Arabian students. A representative sample of 3090 students was randomly selected. The students' dental visit patterns were assessed with a questionnaire. Clinical examinations were carried out using the community periodontal index of treatment needs. Age, sex and education level were significantly associated with the periodontal health. The prevalence of periodontal disease was significantly lower among subjects who were taught the right way to brush their teeth by the dentist. The highest occurrence of healthy periodontium (23.9%) and the lowest need for complex treatment (0%) were found among students who had annual reminders for check-ups (only 2.8% of the students).
Leisnert, Leif; Axtelius, Björn; Johansson, Veronica; Wennerberg, Ann
The aim of this study is to find out how professionals in Swedish dental care perform diagnostic procedures in general. Is there a common ground between dentists and dental hygienists concerning sharing different job assignments in an effective way? Are the methods of treatment used in accordance with degree of severity of the disease and to what extent is proposed treatment in accordance with the National Guidelines? A questionnaire consisting of three different patient cases with periodontal disease was sent to 804 private practitioners, 809 dentists in Dental Public Service, 802 dental hygienists and 40 dental students on their final semester at the Dental School in Malmö. The questionnaire was completed by 1,103 respondents (47%). A majority of all practitioner groups (94%) found that a relatively healthy patient had disease, the risk for developing further disease was deemed none too low by 97%, but 91% wanted to give preventive care. A vast majority suggested more dental care to healthy patients as compared to patients with severe periodontal disease. In Conclusion the two groups, i.e. dentists and dental hygienists, did not to a sufficiently high degree share views on diagnosis and treatment, in order to optimize the resources in dentistry. The delivery of dental care was not in line with the severity of disease and too much attention was paid to the needs of relatively healthy persons. To change this pattern, the incentives in and structure of the national assurance system could be adapted. Furthermore, the knowledge basis for periodontal diagnosis and treatment needs, with special reference to the National Guidelines, should to a higher degree be shared by all caregivers.
Radford, David R.; Gallagher, Jennifer E.
Objective This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Methods Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008–2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients’ individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Results Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (<18 years) and older adults (≥65 years) received preventive care in the form of ‘instruction and advice’, compared with 46% of working age adults (18–64 years); p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001): ‘partial dentures’ (7%); ‘scale and polish’ (3.7%); ‘tooth extraction’ (3%; p = 0.001), and ‘instruction and advice’ (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive ‘instruction and advice’ than non-smokers (OR 4.124; 95% CI: 3.088–5.508; p = 0.01). A further new finding from the multilevel models was a
Momeni Danaei, Shahla; Salehi, Parisa
Self-perception of dental attractiveness is an important factor affecting orthodontic treatment need. The purpose of this study was to investigate the association between normative and self-perceived orthodontic treatment need and to evaluate the influence of gender and socioeconomic background such as family size, parental education and father's employment. The subjects were 900 male and female junior high school students (450 males, 450 females) aged 12-15 years, from four districts in the city of Shiraz, Iran. The participants were asked to complete a questionnaire and then underwent a dental examination. Normative treatment need was assessed clinically using the Dental Aesthetic Index (DAI) according to the World Health Organization guidelines. Statistical analysis was undertaken using t- and chi-squared tests. There was no statistically significant correlation between DAI scores and demographics. The results showed a significant correlation between DAI scores and a subject's awareness of malocclusion and their satisfaction with dental appearance. There were no differences between genders concerning the questionnaire data. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment.
Shemtov-Yona, K; Rittel, D; Dorogoy, A
This paper investigates the influence of surface preparation treatments of dental implants on their potential (mechanical) fatigue failure, with emphasis on grit-blasting. The investigation includes limited fatigue testing of implants, showing the relationship between fatigue life and surface damage condition. Those observations are corroborated by a detailed failure analysis of retrieved fracture dental implants. In both cases, the negative effect of embedded alumina particles related to the grit-blasting process is identified. The study also comprises a numerical simulation part of the grit blasting process that reveals, for a given implant material and particle size, the existence of a velocity threshold, below which the rough surface is obtained without damage, and beyond which the creation of significant surface damage will severely reduce the fatigue life, thus increasing fracture probability. The main outcome of this work is that the overall performance of dental implants comprises, in addition to the biological considerations, mechanical reliability aspects. Fatigue fracture is a central issue, and this study shows that uncontrolled surface roughening grit-blasting treatments can induce significant surface damage which accelerate fatigue fracture under certain conditions, even if those treatments are beneficial to the osseointegration process.
Klorman, Rafael; And Others
This study examines the relationship between children's disruptiveness during dental treatment and their state (comptemporaneous or situational nervousness), trait (general nervousness), and specific dental anxiety. All patients studied were about 8 years old. Sample I (84 pedodontic patients) underwent a variety of dental procedures (extractions,…
Zitzmann, Nicola U; Arnold, Dario; Ball, Judith; Brusco, Daniel; Triaca, Albino; Verna, Carlalberta
Single-tooth implants in the maxillary anterior region have the highest risk of esthetic complications from infrapositioning due to continuing maxillary growth and the eruption of adjacent teeth. Although the placement of anterior single-tooth implants should normally be postponed, particularly girls and young women with a hyperdivergent growth pattern, if an infraposition of an implant is present, then thorough examination and strategic planning are required. According to the severity, the strategic treatment options are as follows: simple retention; adjustment or replacement of the implant restoration, possibly including adjacent teeth; surgical implant repositioning by segmental osteotomy combined with osseodistraction; or submergence or removal of the implant. With the patient presented, an interdisciplinary approach that combined orthodontic alignment, surgical segmental osteotomy, distraction osteogenesis, and restorative features offered the opportunity to realign the adjacent teeth into the arch and to harmonize the gingival contour by means of continuous soft tissue enlargement and adaptation.
Exley, Catherine E; Rousseau, Nikki S; Steele, Jimmy; Finch, Tracy; Field, James; Donaldson, Cam; Thomason, J Mark; May, Carl R; Ellis, Janice S
Background The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them. Methods/Design Mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs) in three Primary Care Trust areas (n = 300) to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs) and 3 (patients) use qualitative focused one to one interviews with a sample of these practitioners (up to 30) and their patients (up to 60) to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made. Discussion Most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an unusual treatment in
Alrqiq, Hosam M; Scott, Thayer E; Mascarenhas, Ana K
In response to current and projected demographic changes in the United States, many dental schools have taken steps to increase the cultural competence of their students through various educational methods. The aim of this study was to evaluate the effectiveness of the cultural competency curriculum at Boston University Henry M. Goldman School of Dental Medicine (GSDM). The curriculum was evaluated using a pre and post design, utilizing an instrument developed for pharmacy students and modified for dental students. The questionnaire was comprised of 11 items designed to assess changes in students' awareness, knowledge, and skills in providing culturally competent care. Data were collected for two classes of second-year DMD students and first-year Advanced Standing students. The total number of returned surveys was 485, for a response rate of 79.5%. The students' post-curriculum mean scores were all higher than their pre-curriculum scores for overall cultural competence (pre 26.5±6.3 to post 29.8±7.2) and for individual subscores on awareness (pre 5.3±1.4 to post 5.5±1.5), knowledge (pre 7.2±1.9 to post 8.1±2.1), and skills (pre 14.1±4.4 to post 16.2±4.4). The improvements on all scores were statistically significant (p<0.0001), with the exception of the awareness component. This evaluation suggests that the cultural competency curriculum at GSDM has been effective in producing improvements in these students' cultural competence in the domains of knowledge and skills.
Hyde, Susan; Gansky, Stuart A.; Gonzalez-Vargas, Maria J.; Husting, Sheila R.; Cheng, Nancy F.; Millstein, Susan G.; Adams, Sally H.
Objectives Early childhood caries (ECC) is very prevalent among young Hispanic children. ECC is amenable to a variety of preventive procedures, yet many Hispanic families underutilize dental services. Acceptability research may assist in health care planning and resource allocation by identifying patient preferences among efficacious treatments with the goal of improving their utilization. The purposes of this study were (a) to develop a culturally competent acceptability assessment instrument, directed toward the caregivers of young Hispanic children, for five preventive dental treatments for ECC and (b) to test the instrument's reliability and validity. Methods An instrument of five standard treatments known to prevent ECC was developed, translated, reviewed by focus groups, and pilot tested, then tested for reliability. The instrument included illustrated cards, brief video clips, and samples of the treatments and was culturally appropriate for low-income Hispanic caregivers. In addition to determining the acceptability of the five treatments individually, the treatments were also presented as paired comparisons. Results Focus groups and debriefing interviews following the pilot tests established that the instrument has good face validity. The illustrated cards, product samples, and video demonstrations of the five treatments resulted in an instrument possessing good content validity. The instrument has good to excellent test–retest reliability, with identical time 1–time 2 responses for each of the five treatments 92 percent of the time (range 87 to 97 percent), and the same treatment of the paired comparisons preferred 75 percent of the time (range 61 to 90 percent). Conclusions The acceptability instrument described is reliable and valid and may be useful in program planning efforts to identify and increase the utilization of preferred ECC preventive treatments for target populations. PMID:18662256
The purpose of this study is to clarify the effect of advance notice of contents of treatment on the patients' physiological stress during dental treatment The subjects of our study comprised 34 non-dental professionals (22 female and 12 male). In simulated dental treatment, the subjects were exposed to predetermined stimulations comprised of blowing air on the molars, percussion on the premolar and usage of an air turbine next to the molar in randomized order, with/without advance notice. The skin potential level (SPL) of the subjects was measured as a physiological stress index during such simulated dental treatment As a psychological profile, the stress-coping style of each subject was examined using Lazarus Type Stress Coping Inventory (SCI). The number of decayed, missing, filled teeth (DMF). and the experience of teeth extraction in the past of each subject was also recorded. The correlation among advance notice, order and kind of stimulation, factors of SCI, DMF, gender of the subject, the experience of teeth extraction, and the subjects' stress (SPL change) was statistically analyzed using the generalized estimating equation. As a result, the effect of advance notice on the subjects' stress was opposite when the stress-coping style differed; therefore, dentists must pay attention to the patients' psychological characteristics when using advance notice for the purpose of relieving the patients' stress during dental treatment.
de-Freitas, Nayara-Ribeiro; de-Moura, Marcos-Boaventura; Veloso-Guedes, Cizelene-do-Carmo-Faleiros; Simamoto-Júnior, Paulo-César; de-Magalhães, Denildo
Background To analyze articles that studied patients submitted to diphosphonates therapy and who received dental implants before, during or after bisphosphonate (BP) treatment, compared to healthy patients, analyzing the increase of failure and loss of implants or bisphosphonate related osteonecrosis of the jaw (BRONJ) incidence. Material and Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in “PICO” format was: In patients under bisphosphonate therapy, do dental implants placement, compared to healthy patients, increase the failure and loss of implants or bisphosphonate related osteonecrosis of the jaw incidence? PubMed/MEDLINE was searched for articles published up until April 15, 2015 using a combination of MeSH terms and their Entry terms. Results The search resulted in 375 articles. After selection according to the eligibility criteria, 15 studies fulfilled were included (eight retrospective, one prospective and six case series), with a total of 1339 patients analyzed, 3748 implants placed, 152 loss of implants and 78 cases of BRONJ. Conclusions Due to the lack of randomized clinical trials looking at this theme, further studies with longer follow-up are needed to elucidate the remaining questions. Thus, it is wise to be careful when planning dental implant surgery in patients undergoing bisphosphonate therapy because of the risk of developing BRONJ as well as occurring failure of implant. Moreover, complete systemic condition of the patient must be also taking into considering when such procedures are performed. Key words:Bisphosphonates, diphosphonates, dental implants, osteonecrosis. PMID:27475681
Tang, J M; Altman, D S; Robertson, D C; O'Sullivan, D M; Douglass, J M; Tinanoff, N
OBJECTIVES: To assess the prevalence of dental caries in a large group of preschool children, to determine the extent to which the children received dental treatment, to examine the association between demographic and socioeconomic factors and the prevalence of caries, and to compare these findings with those from previous studies of preschool populations in the United States. METHODS: Dental caries exams were performed on 5171 children ages 5 months through 4 years, and a parent or other caregiver was asked to complete a questionnaire giving information about the child and her or his household. The children were recruited from Head Start programs; Women, Infants, and Children (WIC) nutrition programs; health fairs; and day care centers in a representative sample of Arizona communities with populations of more than 1000 people. RESULTS: Of the 994 one-year-old children examined, 6.4% had caries, with a mean dmft (decayed, missing [extracted due to caries], and filled teeth) score of 0.18. Nearly 20% of the 2-year-olds had caries, with a mean dmft of 0.70. Thirty-five percent of the 3-year-olds had caries, with a mean dmft of 1.35, and 49% of the 4-year-olds had caries, with a mean dmft of 2.36. Children whose caregivers fell into the lowest education category had a mean dmft score three times higher than those with caregivers in the highest education category. Children with caregivers in the lowest income category had a mean dmft score four times higher than those with caregivers in the highest category. Children younger than age 3 had little evidence of dental treatment, and most of the children with caries in each age group had no filled or extracted teeth. CONCLUSIONS: The data show that dental caries is highly prevalent in this preschool population, with little of the disease being treated. Timing of diagnostic examinations and prevention strategies for preschool children need to be reconsidered, especially for children identified as having a high risk of
Sicca, Claudio; Bobbio, Elena; Quartuccio, Natale; Nicolò, Giovanni
Background The objective of this study is to review medical and non medical treatments for prevention of caries. Material and Methods A comprehensive literature search of the most relevant and updated published studies from 01/01/2002 through December 2015 in PubMed/MEDLINE, Embase and Scopus databases regarding the efficacy of strategies and treatments aiming to prevent the development of caries was performed selecting papers on the basis of the Evidence-based Medicine Criteria. Results We identified thirty systematic reviews on prevention of caries. Analyzing the data the retrieved literature, performance of prevention treatments seems to be high. Conclusions Prevention treatments may have a relevant impact on the avoiding the development of caries planning. Key words:Dental caries, prevention, fluoride. PMID:27957278
The etiology of malocclusions basically involves both congenital and environmental factors. Malocclusion is the result of the abnormal development of the orofacial complex (including tooth, dental alveolar bone, upper and lower jaws). Early orthodontic interceptive treatments involve the elimination of all congenital and environmental factors that contribute to the malformation of the orofacial complex, as well as interrupt the deviated development of the orofacial complex and the occlusion. Early orthodontic interceptive treatments mainly aim to use children's growth potential to correct abnormal developments of occlusions and orthodontically treat malocclusions more efficiently. The early orthodontic interceptive treatments include correcting the child's bad oral habits, training the abnormal functioned para-oral muscles, maintaining the normal eruptions of succeeding permanent teeth, applying interceptive treatments to the mal-developed teeth, and employing functional orthopedic treatments for abnormal growths of the upper and lower jaws. In orthodontics, correcting mal-positioned teeth is called orthodontic treatment, while rectifying the abnormal relationships of the upper and lower jaws is called functional orthopedic treatment. However, no clear definition is available as regards to the early orthodontic interceptive treatment of malocclusions caused by the deviated development of the dental alveolar bone. This new theory of "early dental alveolar bone and dental arch remodeling technique" was proposed by Professor Li Xiaobing of the Department of Pediatric Dentistry, Faculty of Pediatric Dentistry and Orthodontics in West China Hospital of Stomatology through his clinical analyses and investigation of his early orthodontic interceptive treatments. He defined the early orthodontic corrections of abnormal growth of dental alveolar bone as "remodel". The "early dental alveolar bone and dental arch remodeling theory and technique" is proved useful in
ANNIBALI, S.; RIPARI, M.; LA MONACA, G.; TONOLI, F.; CRISTALLI, M.P.
SUMMARY There are many detailed articles regarding accidents and local complications in dental implantation. Comparison of the data they report is not always easy because different criteria have been followed in the various classifications and there is confusion between the terms accident and complication. The aim of this paper is to propose a classification that considers the timing of the events and makes a distinction between the two terms. Accidents are events that occur during surgery and complications are all the pathological conditions that appear postoperatively. The proper diagnostic procedures and surgical techniques for complications prevention and treatment are also described. PMID:23285333
Kristoffersen, Agnete Egilsdatter; Alræk, Terje; Stub, Trine; Hamre, Harald Johan; Björkman, Lars; Musial, Frauke
Background: Many patients have complex health complaints they attribute to dental amalgam. There is some evidence of symptom relief after removal of amalgam. Objective: The aims of this study were to assess the total symptom load in patients with all their amalgam fillings removed, and to investigate the self-reported improvement of health with regard to precautions taken under amalgam removal and time since removal. Methods: The survey was distributed to all members (n=999) of the Norwegian Dental patients association in 2011. The study participants returned the questionnaires anonymously by means of a pre-stamped envelope. The questionnaire asked for sociodemographic data, subjectively perceived health status, complaints persisting after amalgam removal and self-reported changes in symptoms after amalgam removal. Results: A total of 324 participants were included in the study. The majority of the participants reported improved health after amalgam removal, even though the mean degree of severity of complaints was still high. Exhaustion and musculoskeletal complaints were most severe, and reflects the fact that 38% of the participants reported poor to very poor current health. With regard to amalgam removal, associations between improved health, number of precautions applied, and time since removal were found. Conclusion: Most of the participants in this study reported improvement of health after amalgam removal even though they still suffered a high complaint load. Since absolute symptom load is a robust predictor for general health outcome and socioeconomic burden for society, a possible intervention, which enables patients to further improve their health status is desirable. PMID:28217190
Josefsson, Eva; Bjerklin, Krister; Lindsten, Rune
Orthodontic treatment need and demand in 19-year-olds in Sweden has not previously been analysed in relation to geographic origin. The aim of this follow-up study was to examine the prevalence of self-perceived treatment need, malocclusion, earlier orthodontic treatment, self-perceived dental aesthetics and prevalence of symptoms indicative oftemporomandibular disorders in 18-19 year-olds and to analyze any differences between native born and immigrants. Body esteem and psychological wellbeing were also evaluated. The subjects, n=316, were grouped according to family origin: Group A: both parents born in Sweden (98 girls, 80 boys); Group B:the subject or at least one parent born in Eastern /South Eastern Europe (24 girls, 26 boys) and Group C: Asia (44 girls, 44 boys). Two hundered and sixty-eight participants presented for clinical examination and answered the full questionnaire, and 48 who rejected clinical examination,were interviewed by telephone using selected questions from a questionnaire. The results show that adolescents of Asian origin had a higher self-perceived treatment need than adolescents of Swedish origin. There were negligible inter-group differences with respect to frequency of malocclusion. Forty-four per cent of all participants had previously undergone orthodontic treatment, significantly more Swedish than Asian subjects. Dissatisfaction with dental aesthetics was attributed primarily to tooth colour (38 per cent) and irregular anterior teeth (34 per cent). Adolescents of Asian origin had a higher frequency of headache than those of Eastern/South Eastern European origin. Compared to boys, girls had a higher self-perceived treatment need, a higher frequency of headache and TMD and were more concerned about body appearance. Psychological wellbeing was reduced in nearly one quarter of the participants, predominantly girls: girls of Asian origin had the highest frequency. No association was found between self-perceived orthodontic treatment need
Patel, P M; Lynch, Christopher D; Sloan, A J; Gilmour, A S M
The aim of this study was to examine the confidence, barriers and attitudes towards the replacement of missing teeth by general dental practitioners (GDPs). The perceived impact of the recently introduced National Health Service (NHS) contract on the provision of prosthodontic treatments was also considered. Pre-piloted postal questionnaires were mailed to 500 GDPs in Wales. Open- and closed-ended questions were utilised to establish confidence, adequacy of training and attitudes towards treatments for replacing missing teeth. Two hundred and seventeen completed questionnaires were received (response rate = 43.4%). Many respondents described themselves as 'confident' or 'very confident' in the provision of removable partial dentures (RPDs) (acrylic = 100%, metal based = 99.5%), cantilever resin-bonded bridges (94.4%) and conventional bridgework (98.6%). GDPs were 'not confident' providing fixed-fixed resin-bonded bridges (21.1%) or implants (81.4%). Financial barriers were identified to the provision of prosthodontic treatments, including comments such as "the new [National Health Service] contract does limit the treatments available". Privately funded patients were more likely to be offered a fixed bridge or implant replacement of a missing upper first molar, whereas non-privately funded patients were more likely to be offered no treatment (P < 0.01). Most respondents reported confidence at providing more routine forms of prosthodontic care such as RPDs and bridges. It appears that funding arrangements may have an impact on treatments offered to replace missing teeth, particularly under the current NHS contract.
BORDERS, TYRONE F.; BOOTH, BRENDA M.; STEWART, KATHARINE E.; CHENEY, ANN M.; CURRAN, GEOFFREY M.
Objective To examine how rural/urban residence, perceived access, and other factors impede or facilitate perceived need for drug use treatment, a concept closely linked to treatment utilization. Study Design Two hundred rural and 200 urban African American cocaine users who were not receiving treatment were recruited via Respondent-Driven Sampling and completed a structured in-person interview. Bivariate and multivariate analyses were conducted to test the associations between perceived need and rural/urban residence, perceived access, and other predisposing (eg, demographics), enabling (eg, insurance), and health factors (eg, psychiatric distress). Principal Findings In bivariate analyses, rural relative to urban cocaine users reported lower perceived treatment need (37% vs 48%), availability, affordability, overall ease of access, and effectiveness, as well as lower perceived acceptability of residential, outpatient, self-help, and hospital-based services. In multivariate analyses, there was a significant interaction between rural/urban residence and the acceptability of religious counseling. At the highest level of acceptability, rural users had lower odds of perceived need (OR=.23); at the lowest level, rural users had higher odds of perceived need (OR=2.74) than urban users. Among rural users, the acceptability of religious counseling was negatively associated with perceived need (OR=.64). Ease of access was negatively associated (OR=.71) whereas local treatment effectiveness (OR=1.47) and the acceptability of hospital-based treatment (OR=1.29) were positively associated with perceived need among all users. Conclusions Our findings suggest rural/urban disparities in perceived need and access to drug use treatment. Among rural and urban cocaine users, improving perceptions of treatment effectiveness and expanding hospital-based services could promote treatment seeking. PMID:25213603
The aim of this study is to evaluate the satisfaction of patients with posterior implants in relation to the clinical success criteria and surface electromyography (sEMG) findings of the masseter and temporalis muscles. Total 42 subjects were investigated. Twenty one subjects with posterior dental implants were interviewed using a questionnaire and the clinical success criteria were determined based on The International Congress of Oral Implantologists. The myofunction of the masticatory muscles were assessed using sEMG (21 subjects) and compared to the control group of subjects without implants (21 subjects). Out of 21 subjects, all were satisfied with the aesthetics of their implant. Twenty of them (95.2%) were satisfied with its function and stability. As for clinical criteria, 100% (50) of the implants were successful with no pain, mobility or exudates. sEMG findings showed that patients have significantly lower (p<0.01) basal or resting median power frequency but with muscle burst. During chewing, control subjects showed faster chewing action. There was no difference in reaction and recovery time of clenching for both groups. In conclusion, the satisfaction of implant patients was high, and which was in relation to the successful clinical success criteria and sEMG findings. PMID:26465146
Ankkuriniemi, O; Ainamo, J
The first two surveys of the dental health of young Finnish men were conducted in 1919 and 1965. The objective of four subsequent surveys (1976, 1981, 1986, and 1991) was to collect both interview and clinical examination data for the monitoring of changes in the oral health status of the recruits. A significant reduction in self-reported toothache, gingival bleeding, and number of decayed teeth was observed from 1976 to 1991. At examination, the numbers of decayed teeth, teeth indicated for extraction, teeth in need of fillings, and missing teeth decreased substantially, as did the teeth with visible plaque, subgingival calculus, and teeth with 4-mm or deeper periodontal pockets. This comprehensive series of successive cross-sectional oral health surveys clearly shows that since 1976 a significant decrease in oral disease and treatment needs has taken place among the Finnish population of young men.
O'Callaghan, Patrick M.; Allen, Keith D.; Powell, Shawn; Salama, Fouad
We evaluated the effectiveness of a dentist-implemented behavioral intervention in which brief escape from dental treatment was provided on a regular basis, independent of the child's behavior. Within a multiple baseline design across subjects, 5 children, ages 4 to 7 years, were provided with temporary escape from dental treatment on a fixed-time…
Montero-Marin, Jesús; Piva Demarzo, Marcelo Marcos; Pereira, Joao Paulo; Olea, Marina; García-Campayo, Javier
Background The training to become a dentist can create psychological distress. The present study evaluates the structure of the ‘Perceived Stress Questionnaire’ (PSQ), its internal consistency model and interrelatedness with burnout, anxiety, depression and resilience among dental students. Methods The study employed a cross-sectional design. A sample of Spanish dental students (n = 314) completed the PSQ, the ‘Goldberg Anxiety and Depression Scale’ (GADS), ‘Connor-Davidson Resilience Scale’ (10-item CD-RISC) and ‘Maslach Burnout Inventory-Student Survey’ (MBI-SS). The structure was estimated using Parallel Analysis from polychoric correlations. Unweighted Least Squares was the method for factor extraction, using the Item Response Theory to evaluate the discriminative power of items. Internal consistency was assessed by squaring the correlation between the latent true variable and the observed variable. The relationships between the PSQ and the other constructs were analysed using Spearman’s coefficient. Results The results showed a PSQ structure through two sub-factors (‘frustration’ and ‘tenseness’) with regard to one general factor (‘perceived stress’). Items that did not satisfy discriminative capacity were rejected. The model fit were acceptable (GFI = 0.98; RSMR = 0.06; AGFI = 0.98; NFI = 0.98; RFI = 0.98). All the factors showed adequate internal consistency as measured by the congeneric model (≥0.91). High and significant associations were observed between perceived stress and burnout, anxiety, depression and resilience. Conclusions The PSQ showed a hierarchical bi-factor structure among Spanish dental students. Using the questionnaire as a uni-dimensional scale may be useful in perceived stress level discrimination, while the sub-factors could help us to refine perceived stress analysis and improve therapeutic processes. PMID:24466330
Carounanidy, Usha; Sathyanarayanan, R
Comprehensive management of dental caries should involve the management of disease as well as the lesion. Current decision making process in cariology is influenced by numerous factors such as the size/ depth/ activity of the carious lesion and age/ the caries risk status of the patient. Treatment decisions should involve planning the non-operative/ preventive treatment for non-cavitated or early cavitated lesions and also formulating operative treatment for cavitated lesions. Apart from these two responsibilities, a clinician should also be knowledgeable enough to decide when not to interfere in the caries dynamics and how frequently to recall the patient for follow-ups. The non-operative treatment prescriptions vary in dose, intensity and mode of delivery according to the caries risk status. Minimal invasion and maximal conservation of tooth structure has become the essence of current operative treatments. This part of the series elaborates on the paradigm shift in the management of dental caries. PMID:21217948
Lane, Brittany A; Luepke, Paul; Chaves, Eros; Maupome, Gerardo; Eckert, George J; Blanchard, Steven; John, Vanchit
Calibration in diagnosis and treatment planning is difficult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third- and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chi-square tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically significant difference in responses between third- and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning.
Didinen, Serhan; Atabek, Didem; Kip, Gülay; Patır Münevveroğlu, Aslı; Tulunoğlu, Özlem
The Pallister-Killian syndrome (PKS) is an extremely rare genetic disorder with an incidence estimated around 1/25000. PKS is a multiple congenital anomaly deficit syndrome caused by mosaic tissue limited tetrasomy for chromosome 12p. The presented report is the first confirmed case with PKS in Turkey. This report focuses on the orofacial clinical manifestations of an 6-year-old boy with PKS who was referred to the Department of Paediatric Dentistry clinic, Gazi University. It has been learned that the PKS was diagnosed 1 year after birth. Due to intellectual disability, it was decided to make the dental treatments under moderate sedation. Although significant tongue thrust and anterior open bite were determined, any oral appliances could not be applied because of the 2 epilepsy seizures in the last 2 years. The aim was to treat decayed teeth and set good oral hygiene in the patient's mouth. Still, there is a probability for epilepsy seizures. If epileptic seizures stop permanently, we can apply an oral appliance to block tongue thrust. The patient is now under control. In cases of systemic and oral findings such as PKS, conducting medical and dental approaches together will increase the life quality of patients.
Didinen, Serhan; Atabek, Didem; Kip, Gülay; Patır Münevveroğlu, Aslı; Tulunoğlu, Özlem
The Pallister-Killian syndrome (PKS) is an extremely rare genetic disorder with an incidence estimated around 1/25000. PKS is a multiple congenital anomaly deficit syndrome caused by mosaic tissue limited tetrasomy for chromosome 12p. The presented report is the first confirmed case with PKS in Turkey. This report focuses on the orofacial clinical manifestations of an 6-year-old boy with PKS who was referred to the Department of Paediatric Dentistry clinic, Gazi University. It has been learned that the PKS was diagnosed 1 year after birth. Due to intellectual disability, it was decided to make the dental treatments under moderate sedation. Although significant tongue thrust and anterior open bite were determined, any oral appliances could not be applied because of the 2 epilepsy seizures in the last 2 years. The aim was to treat decayed teeth and set good oral hygiene in the patient's mouth. Still, there is a probability for epilepsy seizures. If epileptic seizures stop permanently, we can apply an oral appliance to block tongue thrust. The patient is now under control. In cases of systemic and oral findings such as PKS, conducting medical and dental approaches together will increase the life quality of patients. PMID:26998367
Abraham, Celeste M
This review highlights a brief, chronological sequence of the history of dental implants. This historical perspective begins with ancient civilizations and spotlights predominant dentists and their contributions to implant development through time. The physical, chemical and biologic properties of various dental implant surfaces and coatings are discussed, and specific surface treatments include an overview of machined implants, etched implants, and sand-blasted implants. Dental implant coatings such as hydroxyapatite, fluoride, and statin usage are further reviewed. PMID:24894638
Derelioglu, Sera Sımsek; Yılmaz, Yücel; Keles, Sultan
KID syndrome is a rare genodermatosis characterized by keratitis, ichthyosis, and sensorineural deafness. Although the dermatological, ophthalmologic, and sensorineural defects are emphasized in the literature, oral and dental evaluations are so superficial. In this case report, dental and oral symptoms of a three year and five months old boy with KID syndrome, suffering severe Early Childhood Caries (s-ECC) and dental treatments done under General Anesthesia (GA) were reported. PMID:24151560
Allen, K D; Stokes, T F
A reinforced practice procedure was used to facilitate cooperative behavior in five children, aged 3 to 6 years, during dental treatment. In a multiple baseline design across subjects, the children were rewarded with escape, inexpensive stickers, and praise for cooperative behavior in the presence of the sights, sounds, and some sensations of the dental instruments prior to actual dental treatment. Direct observations of disruptive behavior via a 15-s interval recording system indicated baseline levels as high as 90% were reduced to less than 15% by the final treatment visit. In addition, the procedure was effective in reducing overall heart rate and blood pressure reactivity to dental treatment. All children were rated by the involved dental professionals as more cooperative and relaxed following exposure to reinforced practice. PMID:3429360
Kranz, A.M.; Rozier, R.G.; Preisser, J.S.; Stearns, S.C.; Weinberger, M.; Lee, J.Y.
Objective: Nearly all state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children; yet, little is known about how treatment outcomes compare with children visiting dentists. This study compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. Methods: We conducted a retrospective study of young children enrolled in North Carolina Medicaid during 2000 to 2006. The annual number of CRT and CRT payments per child between the ages of 3 and 5 yr were estimated with a zero-inflated negative binomial regression and a hurdle model, respectively. Models were adjusted for relevant child- and county-level characteristics and used propensity score weighting to address observed confounding. Results: We examined 41,453 children with > 1 preventive oral health visit from a PCP, dentist, or both before their third birthday. Unadjusted annual mean CRT and payments were lowest among children who had only PCP visits (CRT = 0.87, payment = $172) and higher among children with only dentist visits (CRT = 1.48, payment = $234) and both PCP and dentist visits (CRT = 1.52, payment = $273). Adjusted results indicated that children who had dentist visits (with or without PCP visits) had significantly more CRT and higher CRT payments per year during the ages of 3 and 4 yr than children who had only PCP visits. However, these differences attenuated each year after age 3 yr. Conclusions: Because of children’s increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone. This study supports guidelines and reimbursement policies that allow preventive dental visits based on individual needs. PMID:24891593
Kudo, Takumu; Mishima, Riho; Yamamura, Kensuke; Mostafeezur, Rahman; Zakir, Hossain Md; Kurose, Masayuki; Yamada, Yoshiaki
The effects of sound generated by an ultrasonic dental scaler and a dental turbine on heart rate, systolic and diastolic blood pressure, and hemodynamic changes in the frontal cortex were measured and compared with those of pure tone stimulation in 17 young volunteers. Near-infrared spectroscopy and the Finapres technique were used to measure hemodynamic and cardiovascular responses, respectively. The dental sound changed the various physiological parameters. To determine if this change was related to participants' previous experiences with dental treatment, participants were divided into two groups: those who had a previous unpleasant experience with dental treatment and those who had not. Participants with previous unpleasant dental experiences showed a significant decrease in cerebral blood flow. Participants who had not had an unpleasant dental experience did not show significant changes in cerebral blood flow. Thus, although sounds associated with dental treatment may reduce cerebral blood flow, this effect may depend on the dental experiences of the patient. It is recommended that dentists treat patients gently and with empathy to promote a friendly image of dentistry.
Hamasaki, Tomoko; Kato, Hiroaki; Kumagai, Takashi; Hagihara, Akihito
Communication between physician and patient is critical in all fields of medicine, and various types of communication exist in healthcare settings. Cooperation among healthcare professionals is thought to be essential in providing high-quality services. Dental hygienists are key team members in the provision of dental care, and are known to play an important role in the health of their patients. This study aimed to determine the effect of communication between dentists and hygienists on patient satisfaction. Study subjects were dentists, patients, and dental hygienists, and we examined how dentist-dental hygienist communication affected patient outcome indices. A significant difference was observed only for satisfaction in terms of meeting expectations (p = 0.035). Results for patient satisfaction indicated significant differences in explanatory behavior in dentist-dental hygienist evaluations (p = 0.001). The results showed improved health and reduced fear, indicating significant differences for the dentist-dental hygienist evaluations in explanation behavior (p = 0.016). Our evaluation of the effects of dentist-dental hygienist communication on patient outcomes indicated a significant correlation, suggesting that inter-professional communication in the field of dentistry affects patient satisfaction.
Almas, Khalid; Al-Hawish, Abdullah; Al-Khamis, Waheed
The aims of this study were to determine the prevalence of oral hygiene practices and halitosis among undergraduate students from King Saud University, College of Dentistry. A self-administered questionnaire was distributed among all 481 students; 263 male and 218 female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, treatment received for bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tea drinking habits, and tongue coating. The response rate was 77%. Forty four percent of male and 32% of female students reported the self-perception of breath odor. Self-treatment was sought by 12% male and 22% female. Six percent of males and 4% of females experienced bad breath interference at their work. Seventy-eight percent of male and 62% of female students experienced bad breath after waking up. Brushing was prevalent among 81% of male and 99% of female students. Both miswak (chewing sticks) and tooth brushing were used by 53% male and 83% female students. Fifty seven percent of male students and 44% of female students reported caries. Bleeding gingiva was experienced by 26% of males and 14% of females. Dry mouth was common among 14% of males and 17% of females, while smoking was prevalent among 13% of males and 2% of females. Tea drinking was common among 44% of males and 37% of females, while tongue coating was equally common among both males and females (21% and 20%), respectively. The results indicate female students had better oral hygiene practices, significantly less self-reported oral bad breath, and smoked less compared to male students. There was no difference in tongue coating among male and female students. Further research is needed to examine oral malodor clinically and objectively by the standard procedures available. Students should be motivated to be a health symbol and keeping their mouths free from oral malodor.
Scott, S H; Johnston, L E
Orthodontic patients of African descent often seek some measure of reduction in profile protrusion. Lip retraction, however, seems to imply a need for premolar extraction. But in a nonextraction era, what does orthodontics have to offer the bimaxillary protrusion patient? To a considerable extent, it depends on what the patient wants and what treatment can provide. The present study was designed to address these questions by comparing the esthetic impact of extraction and nonextraction therapy on two morphologically similar samples of African American patients with Class I and II malocclusions. In addition to the patients, four panels of judges (black and white orthodontists and black and white laypersons) were asked to compare the pretreatment and posttreatment profile tracings and to quantify their perceptions of the esthetic impact of the change that occurred during treatment. Although there was a strong correlation among the various groups' ratings, there were a number of statistically significant differences. Premolar extraction led to a modest reduction in dental and soft tissue protrusion; nonextraction, by way of contrast, produced an increase. Presumably in response to these changes, all panels, independent of race or education, tended to prefer the posttreatment profiles, especially the posttreatment extraction profiles. There was, however, a significant interaction between race and treatment. The perceived effects of nonextraction treatment were modest and largely unrelated to the pretreatment profile, whereas the impact of premolar extraction was a highly significant function of initial protrusion: convex profiles were improved, but relatively straight profiles were made worse. The various panels, however, differed in their estimate of the point at which a profile might benefit from extraction (ie, profile reduction). For our white panelists, that point was reached when the lower lip was about 2 mm in front of Ricketts' E-plane. For our black panelists
Orthodontic studies over several decades have found generally inconsistent agreement among dentists when evaluating orthodontic treatment need. There... Orthodontic Treatment Need (IOTN) is an occlusal index that has been found to be both reliable and valid in studies both in Europe and in the United...improve dental students’ ability to assess orthodontic treatment need. Fourth-year dental students were divided into three groups of twenty (control
Widmer, A; Fürst, A; Bettschart, R; Makara, M; Geyer, H; Kummer, M
This clinical report describes two horses with bilateral maxillary fractures following dental treatment. The fractures occurred during dental treatment by a veterinarian, and both had rostral, transverse, and complete bilateral maxillary fractures with instability and minimal displacement. The fractures were repaired using bilateral intraoral wiring with the patients under general anesthesia. The postoperative period was without complications and the fractures healed as expected. Maxillary fractures during or after routine dental treatment are rare, but can occur, especially in older horses. Appropriate sedation and, if necessary, regional nerve blocks might reduce the risk of iatrogenic fractures of the maxilla. General anesthesia must be considered for tooth extraction in horses that are difficult to restrain.
Cohenca, Nestor; Silberman, Adrian
Traumatic dental injuries (TDI) have an array of presentations. Diagnostic challenges are common and clinicians' ability to correctly identify specific injuries dictates the optimal course of treatment(s). The aim of this review is to outline and assess all dental imaging techniques and their applications to traumatic dental injuries. A particular interest is given to the advancement of 3-D imaging techniques and their role in diagnosis and treatment planning. The benefits of achieving a more accurate diagnosis are paramount to perfecting clinical judgments and outcomes. This article is protected by copyright. All rights reserved.
Özkan, Ahmet Selim; Erdoğan, Mehmet Ali; Şanlı, Mukadder; Kaçmaz, Osman; Durmuş, Mahmut; Çolak, Cemil
Objective Most dental procedures can be performed with local anaesthesia, however noncompliant paediatric patients, patients with mental retardation or psychiatric disorders, severe anxiety, severe craniofacial anomalies and orofacial trauma may need general anaesthesia. In these patients accompanying central nervous system diseases and airway problems increase the risk of complications. Anaesthesia records of 467 cases of dental surgery performed under general anaesthesia between 2011–2014 is reported with information from the recent literature. Methods In the study, 467 cases of dental procedures performed under general anaesthesia were taken from the İnönü University of Medicine, Dentistry Disabled Treatment Centre, after approval of the İnönü University Faculty of Medicine Ethics Committee. Demographic data, ASA classification, Mallampati (MP) score, duration of surgery, type of intubation and difficulties, comorbid diseases, premedication application, endocarditis prophylaxis, recovery time, analgesia and reasons for general anaesthesia were recorded as mean±standard deviation (SD) or as a number. Results The mean age of the patients was 16.78±12 years and the female/male ratio was 277/190 (59.3%/40.7%). Of the 467 patients, 219 (46.9%) were classified as ASA I, 234 (50.1%) as ASA II and 14 (3%) as ASA III. Furthermore, 182 (38.9%) patients with mental retardation, 33 (7.1%) with cerebral palsy and 28 (6%) with autism were identified. The mean operative time was 114.53±35.4 min, and the average recovery time 40.4±6 was min. Of the endotracheal intubations 277 (59.3%) were oral, 82 (17.6%) were nasal, and 108 (23.1%) were nasal with the help of fibreoptics. Difficult intubation was observed in 20 (4.3%) patients. The MP score was 1 in 397 (85%) patients, 2 in 50 (10.7%) patients, 3 in 18 (3.9%) patients and 4 in 2 (0.4%) patients. General anaesthesia was applied because of cooperation difficulties in 213 (45.6%), mental retardation in 182 (38
Simon, Arun K.; Bhumika, T. V.; Nair, N. Sreekumaran
Dental anxiety is one of the major problems affecting children, which impairs the rendering of dental care, leading to impaired quality of life. It often leads to occupational stress in dental personnel and conflict between parents/caregivers. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials done in children, to synthesize evidence of the effectiveness of atraumatic restorative treatment (ART) in reducing dental anxiety in children compared to conventional restorative treatments. The databases searched included PubMed, Google Scholar and The Cochrane Oral Health Group's Trials Register. Eligible studies reporting dental anxiety by a variety of psychometric scales were tabulated. The review was conducted and reported in accordance with the guidelines provided by the Cochrane Collaboration. Among 416 studies retrieved through literature search, six studies matched the inclusion criteria. Due to lack of data, only three studies were included for meta-analysis using RevMan software (Review Manager, Version 5.3;The Cochrane Collaboration, Copenhagen, 2014). The pooled meta-analysis data, (standardized mean difference − 2.12 [95% confidence interval: −4.52, 0.27]) failed to show any difference between ART group and the conventional treatment group. In conclusion, ART was not more beneficial in reducing dental anxiety among pediatric dental patients. The findings are relevant in the field of clinical practice in dentistry in the management of the anxious pediatric dental patient. PMID:26038668
Gupta, Nishtha; Pal, Manoj; Rawat, Sheh; Grewal, Mandeep S.; Garg, Himani; Chauhan, Deepika; Ahlawat, Parveen; Tandon, Sarthak; Khurana, Ruparna; Pahuja, Anjali K.; Mayank, Mayur; Devnani, Bharti
Treatment of head and neck cancers (HNCs) involves radiotherapy. Patients undergoing radiotherapy for HNCs are prone to dental complications. Radiotherapy to the head and neck region causes xerostomia and salivary gland dysfunction which dramatically increases the risk of dental caries and its sequelae. Radiation therapy (RT) also affects the dental hard tissues increasing their susceptibility to demineralization following RT. Postradiation caries is a rapidly progressing and highly destructive type of dental caries. Radiation-related caries and other dental hard tissue changes can appear within the first 3 months following RT. Hence, every effort should be focused on prevention to manage patients with severe caries. This can be accomplished through good preoperative dental treatment, frequent dental evaluation and treatment after RT (with the exception of extractions), and consistent home care that includes self-applied fluoride. Restorative management of radiation caries can be challenging. The restorative dentist must consider the altered dental substrate and a hostile oral environment when selecting restorative materials. Radiation-induced changes in enamel and dentine may compromise bonding of adhesive materials. Consequently, glass ionomer cements have proved to be a better alternative to composite resins in irradiated patients. Counseling of patients before and after radiotherapy can be done to make them aware of the complications of radiotherapy and thus can help in preventing them. PMID:27390489
Geringer, Jean; Demanget, Nicolas; Pellier, Julie
Surface treatments of dental implants aim at promoting osseointegration, i.e. the anchorage of the metallic part. Titanium-, grade II-V, based material is used as a bulk material for dental implants. For promoting the anchorage of this metallic biomaterial in human jaw, some strategies have been applied for improving the surface state, i.e. roughness, topography and coatings. A case study, experimental study, is described with the method of acid etching on titanium grade 4, CpTi. The main goal is to find the right proportion in a mixture of two acids in order to obtain the best surface state. Finally, a pure theoretical prediction is quite impossible and some experimental investigations are necessary to improve the surface state. The described acid etching is compared with some other acid etching treatments and some coatings available on dental implants. Thus, the discussion is focused on the tribocorrosion behaviour of titanium-based materials. The purpose of the coating is that the lifetime under tribocorrosion is limited. Moreover, the surgery related to the implantation has a huge impact on the stability of dental implants. Thus, the performance of dental implants depends on factors related to surgery (implantation) that are difficult to predict from the biomaterial characteristics. From the tribocorrosion point of view, i.e. during the mastication step, the titanium material is submitted to some deleterious factors that cause the performance of dental implants to decrease.
Zanon, Ezio; Martinelli, Franco; Bacci, Christian; Cordioli, GianPiero; Girolami, Antonio
We found no prospective studies on dental extraction in anticoagulated patients in the literature, even though most authors suggest that there is no need to change anticoagulant treatment and to utilize a local haemostatic measure after extraction. In the present study, we have verified the incidence of bleeding complications after dental extraction in a group of 250 consecutive anticoagulated patients. Two hundred and fifty non-anticoagulated subjects requiring dental extraction represented the control group. In all patients, anticoagulant treatment was not changed (International Normalized Ratio, 1.8-4) and local haemostatic measures (fibrin sponge, silk suture and a gauze saturated with tranexamic acid) were used. All procedures were performed in an outpatient clinic setting. We registered four bleeding complications in the group of anticoagulated patients and three in the control group. The difference of bleeding complications in the two groups was not statistically different (relative risk, 1.14; 95% confidence interval, 0.29-6.04; P = 0.7). None of the post-operative late bleeding required hospitalization and/or blood transfusions, and further local measures were sufficient to stop the bleeding. The protocol proposed in the present study makes dental extractions in anticoagulated patients possible on an outpatient basis with a cost reduction for the community and minor discomfort for the patients.
This study investigated student and faculty perceptions of their experiences with online learning in dental hygiene Bachelor of Science degree completion programs on the dimensions of: quality of learning, connectedness to the learning environment, technology factors and student satisfaction. The experiences of dental hygiene students who took…
Zimmerman, M; Bornstein, R; Martinsson, T
The aim of this study was to estimate dental treatment need in groups of Chilean and Polish refugees in Sweden. Of the Nordic countries, Sweden accepts the greatest number of refugees. An average of 5000 refugees arrived annually in 1981-85, increasing to 15,000 during 1986-87. Refugees and their families now comprise 93% of non-Nordic immigration. In 1981-83 a sample of 193 Chilean and 92 Polish refugees in the county of Stockholm was selected for this study. Dental treatment needs were calculated in accordance with CPITN and the working study of Swedish dentistry, which formed the basis for the Swedish scale of dental fees for the National Dental Insurance Scheme. The estimated mean treatment time (+/- SD) in the Chilean sample was 6.9 +/- 2.3 h and in the Polish group 8.4 +/- 3.0; in comparison with estimated treatment needs in a Swedish material, both would be classified as extreme risk groups. There was no correlation between the number of months in Sweden and the estimated treatment needs. The results indicate a cumulative, unmet need for dental care in these groups. Barriers to ensuring adequate health care for immigrants persist; special outreach programmes, conducted by dental health personnel, may be an effective means of introducing immigrants to the Swedish dental care system.
Choung, Y H; Park, K; Choung, P H; Oh, J H
Most of the previous treatment methods for auricular haematoma are inconvenient for both patients and doctors because they are time-consuming and complex and must be performed under sterile conditions. The purpose of this study was to evaluate the effectiveness of a simple compressive method using a dental (silicone) impression material and comparing it with other methods for treatment of auricular haematomas. The authors aspirated a haematoma and then placed a mixed base and catalyst of silicone putty material on the anterior and posterior surfaces of the auricle in the shape of an inverted U for seven days. From the 24 cases managed with this method, 23 cases (95.8 per cent) were successfully healed. Eight patients were treated with a collodion-cotton wool cast and 16 of 19 patients were successfully treated with dental cotton-wool rolls. The average number of those visiting the hospital was 2.7 for the collodion-cotton wool cast, 6.9 for the dental cotton-wool roll, and 3.1 for dental silicone. The mean treatment durations were 8.1 days for the collodion-cotton wool cast, 13.8 days for the dental cotton-wool roll, and 8.6 days for dental silicone. The authors believe that this compressive method using dental silicone material is simple and appropriate for the treatment of auricular haematoma.
Colletti, Giacomo; Felisati, Giovanni; Biglioli, Federico; Tintinelli, Roberto; Valassina, Davide
A fungus ball is one of the fungal diseases that can affect the paranasal sinuses. It requires surgical treatment. Because there is only one previously reported case of dental implant placement after treatment of a maxillary sinus fungus ball, the authors here report on a case of a maxillary sinus fungus ball with bone erosion that was treated surgically with a combined endoscopic endonasal and endoral (Caldwell-Luc) approach. One year later, a graft from the ilium was obtained and a sinus elevation was performed to allow the placement of dental implants. Three months later, the dental implants were placed, and they were all osseointegrated at the 9-month follow-up.
Passia, Nicole; Kern, Matthias
This survey of German dental schools sought to gain insight into the present prosthetic treatment concepts and their application in student and postgraduate education, as well as to compare the results to those from an identical 2002 survey. A questionnaire, based on this issue, was sent via email to the chairpersons of all prosthetic departments of the German dental schools, and 93.1% of the departments completed the questionnaire. Within the limitations of this survey, almost all treatment concepts for the reduced dentition are taught intensively at dental schools in Germany while some therapy forms are preferred.
Kim, Dai-Hwan; Kim, Kyung-Il; Yoon, Seokyoung; Kim, Hyung-Jo; Ahn, Jin-Soo; Jun, Sang Ho; Kang, Ho Chang; Pang, Changhyun; Kim, Jaeyun; Cha, Hyung Joon; Han, Kwon-Hoon; Kim, Dong-Myong; Lee, Jung Heon
We report the development of hydroxyapatite nanoparticle (HAp NP)-functionalized hetero-graft materials (HGMs) for dental applications. These HGMs were prepared by attaching platelet-, needle-, and sphere-shaped HAp NPs to the surface of xenograft materials through chemical conjugation. Although all three HAp NPs contributed to increase the surface area of bone graft material (BGM), the shape of the HAp NPs was a determining factor. Platelet HAp NPs were most effective, because they caused a 48.9% increase in BGM surface area whereas the influence of the spherical NP was only a 6.7% increase. This suggests that geometric factors regarding both the attached HAp NPs and graft material surface are essential in controlling the surface roughness of graft materials. Among the three HAp NPs, it was the platelet HAp NPs that helped to increase the efficacy of the BGM most significantly. Compared with BGM with no HAp NP attachment, HGM with platelet HAp NP ('platelet-HGM) treatment had ~46.1% higher cell attachment and proliferation rate. The MTT assay also showed that the HAp NP-treated hetero-graft materials had negligible cytotoxicity.
Young, Andrea S.; Horwitz, Sarah M.; Findling, Robert L.; Youngstrom, Eric A.; Arnold, L. Eugene; Fristad, Mary A.
Objective The goal of these analyses was to describe the 12-month prevalence and identify predictors of mental health services retention for youth, ages 6–12 years, using data from the Longitudinal Assessment of Manic Symptoms (LAMS) study. Methods In a longitudinal cohort study, 416 children and their parents completed measures of mental health services use and parents’ perception of the services and semi-structured psychodiagnostic interviews at a baseline and 12-month assessment. Logistic regression analyses examined the effects of demographic and clinical variables and parents’ perception of how well their children’s treatment matched their needs on 12-month treatment retention. Results Sixty-nine percent of youth (n=289) continued to use services at 12 months. White race (p<.001) and greater functional impairment (p=.024) were associated with treatment retention; greater perceived treatment match at baseline significantly predicted retention above and beyond the effects of sociodemographic and clinical variables (p=.001). Conclusions White race and parents’ perceptions about appropriateness of treatment predict 12-month treatment retention. PMID:26522675
Mora-Rincones, Oscar A; Corona-Rodríguez, Julio C; Díaz-Carvajal, Alvaro L; Franco-Carrero, Isabel C
The purpose of this work is to present a surgical alternative in the treatment of the dental fusions through the placement of demineralized human bone matrix (DHBM) (Grafton Putty)*, immediately after the separation and extraction of the fused tooth to the permanent one. The dental fusion is a dental anomaly of union, that consists in the union of two dental germs during development. It could happen at any of the dental germ evolution stages from the dental sheet or from more advanced processes of differentiation. For the clinical treatment, an allograft of DHBM with osteoinductive and osteoconductive properties was used. This had several factors of bone growth, it allowed the gradual growth of a new bone that helped to correct the bone defects post-extraction and to cover the exposed distal wall of the remaining permanent tooth. The clinic evaluation and the periapical and panoramic radiographies images were used for the clinical control. It can be concluded that the surgical separation and the extraction of the tooth with less anatomical likeness to the contralateral and the placement of the DHBM, represent a surgical treatment alternative of the dental fusion.
Carpenter, Janet S.; Wu, Jingwei; Burns, Debra S.; Yu, Menggang
Background Lower perceived control over hot flashes has been linked to fewer coping strategies, more catastrophizing, and greater hot flash severity and distress in midlife women; yet, this important concept has not yet been studied in breast cancer survivors. Objective To explore perceived control over hot flashes and hot flashes in breast cancer survivors compared to midlife women without cancer. Methods 99 survivors and 138 midlife women completed questionnaires and a prospective, electronic hot flash diary. All data were collected at a baseline assessment prior to randomization in a behavioral intervention study. Results Both groups had moderate perceived control over hot flashes. Control was not significantly related to hot flash frequency, but was significantly related to hot flash severity, bother, and interference in both groups. A significantly stronger association between control and hot flash interference was found for survivors than for mid-life women. Survivors using hot flash treatments perceived less control than survivors not using hot flash treatments, whereas the opposite was true in midlife women. Conclusions Findings extend our knowledge of perceived control over hot flashes in both survivors and midlife women. Implications for Practice Findings emphasize the importance of continued menopausal symptom assessment and management, support the importance of continuing nursing care even for survivors who are already using hot flash treatment, and suggest that nursing interventions aimed at improving perceived control over hot flashes may be more helpful for survivors than for midlife women. PMID:21946903
António, Natália; Castro, Graça; Ramos, Domingos; Machado, António; Gonçalves, Lino; Macedo, Tice; Providência, Luís A
The management of patients taking long-term oral anticoagulants who require dental surgery is still highly controversial. The risk of bleeding associated with dental treatment under oral anticoagulants must be weighed against the risk of thromboembolism associated with suspension of antithrombotic therapy. Mortality and morbidity associated with thromboembolic events are higher than those associated with hemorrhagic events after minor oral surgery procedures. Evidence-based information does not support oral anticoagulant suspension before minor oral surgery. The authors propose a management protocol for chronically anticoagulated patients who require a dental procedure, to reduce both thromboembolic risk and the risk of bleeding.
Shapira, Y; Sapir, S; Amir, E
Seizures are not infrequent in childhood and may occur during dental treatment. Generalized seizures and particularly the Tonic-clonic (grand-mal) are the most hazardous and may induce self-injury, aspiration, and medical emergency as status epilepticus. The differential diagnosis of isolated seizure attack should consider hyperventilation, hyperglycemia, local anesthetic toxicity, and anoxia. The pediatric dentist should be aware of predisposing factors that may induce seizure attack in their patients. Proper precautionary measures could prevent the attack from occurring or at least reduce its consequences. The diagnosis as to the cause of the seizure, as well as providing proper management, could prevent further complications. This article presents the medical and dental history relevant for prevention of seizure attack in the dental chair, antiepileptic drugs with possible interactions with the dental treatment and management of such attack, should they occurs.
Gonzalez, Jeffrey S.; Shreck, Erica; Psaros, Christina; Safren, Steven A.
Objective To understand independent pathways linking emotional distress, medication adherence and glycemic control in adults with type 2 diabetes, as well as the potential mediating effects of perceived control over illness and self-efficacy. Methods Adults with type 2 diabetes (N = 142) were recruited for an intervention study evaluating cognitive behavioral therapy for adherence and depression. Depressive symptom severity was assessed via semi-structured interview. Validated self-reports assessed diabetes-related distress, perceived control over diabetes (perceived control), self-efficacy for diabetes self-management and medication adherence. Glycemic control was evaluated by hemoglobin A1c (A1C). Only baseline data were included in correlational and linear regression analyses. Results Perceived control was an important mediator for both medication adherence and A1C outcomes. Specifically, regression analyses demonstrated that diabetes distress, but not depression severity, was significantly related to medication adherence and A1C. Self-efficacy and perceived control were also independently associated with medication adherence and A1C. Mediation analyses demonstrated a significant indirect effect for diabetes distress and medication adherence, through perceived control and self-efficacy. The relationship between distress and A1C was accounted for by an indirect effect through perceived control. Conclusion Results demonstrate that diabetes-related emotional distress is associated with poorer treatment adherence and glycemic control among adults with type 2 diabetes; these relationships were partially mediated through perceived control over diabetes. Perceptions of one’s personal ability to influence diabetes may be important in understanding the pathway between emotional distress and poor diabetes treatment outcomes. PMID:25110840
Elkington, Katherine S.; Hackler, Dusty; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.
This research explores the experiences of mental illness stigma in 24 youth (58.3% male, 13-24 years, 75% Latino) in psychiatric outpatient treatment. Using Link and Phelan's (2001) model of stigmatization, we conducted thematic analysis of the interview texts, examining experiences of stigma at individual and structural levels, in addition to the…
Mougari, F; Jacquier, H; Berçot, B; Hannouche, D; Nizard, R; Cambau, E; Zadegan, F
We report prosthetic knee arthritis in a 55-year-old diabetic man due to Granulicatella adiacens, a micro-organism present in the oral flora, usually described in endocarditis but rarely in prosthesis joint infection. This patient had undergone a dental extraction without antibiotic prophylaxis one month before, and an aseptic loosening of the prosthesis had been diagnosed previously. If antimicrobial prophylaxis against infective endocarditis for dental procedures is well established, such an approach is still controversial for joint prosthesis and should be considered in some conditions.
Consolaro, Alberto; Consolaro, Renata Bianco; Francischone, Leda
With regard to the best moment for carrying out or recommending dental bleaching to orthodontic patients, some explanations and orientations are given in order to answers the following questions: 1) Why orthodontic treatment completion is considered the best opportunity for carrying out the procedure? 2) Why dental bleaching should not be performed immediately before orthodontic treatment? 3) If that would be possible at any special case, what would that be? 4) Why dental bleaching should not be performed during orthodontic treatment? 5) If that would be possible at any special case, what would that be? This article highlights why it is essential to protect both the mucosa and the cervical region, regardless of the moment when dental bleaching is performed, whether associated with orthodontic treatment or not. The "how", "why" and "if" it is or not convenient to perform dental bleaching before orthodontic treatment are still a matter of clinical suggestion, as it is a procedure that is under analysis, empirical knowledge waiting for scientific proof or disproof! Although tooth enamel has adamantine fluid flowing within it, providing a specific metabolism that is peculiar to its own and which could scientifically explain and base the option of carrying out teeth whitening before and during orthodontic treatment, we must still be very careful.
Awooda, Elhadi M.; Siddig, Reem I.; Alturki, Ruaa S.; Sanhouri, Nada M.
Aim: To radiographically evaluate the technical quality of root canal treatment performed by undergraduate dental students and compare the findings with other institution's work. Materials and Methods: A retrospective, cross-sectional study was conducted at the Academy Dental Teaching Hospital involving postoperative periapical radiographs of patients who were endodontically treated by batch #14 undergraduate dental students of final year (2013–2014) from UMST, Sudan. The total number of the students was 21, while periapical radiographs fulfilling the required criteria were 173. The radiographs of each case were evaluated in terms of length, density, and taper of the root canal filling. Procedural errors such as presence of a ledge, perforation, and a separated instrument were also recorded. Chi-square test was used to determine statistically significant differences between variables, with the level of significance set at P ≤ 0.05. Results: The overall quality of performed root canal treatment was adequate in almost half (55.5%) of the evaluated teeth. The length and taper of the root canal filling were found to be significantly associated with maxillary and mandibular posterior teeth with P = 0.018 and 0.006, respectively. No associations were found between the density and presence of separated instrument in the maxillary and mandibular posterior teeth, P = 0.314 and 0.480, respectively. Conclusion: The radiographic quality of root canal treatment performed by undergraduate students of batch #14 UMST was acceptable in 55.5% of the cases. Special emphasis must be placed on the educational methods and training of students for providing root canal treatment on molar teeth. PMID:28032048
Tawares, Mary; And Others
The study developed a profile of dental implant patients from 38 private practices to document characteristics of endosseous implant recipients of the past 10 years. Data were then analyzed using multivariate techniques to examine the relationship between these characteristics and patient-reported outcomes. Patients tended to have high incomes and…
Eshghi, Alireza; Samani, Mahdi Jafarzadeh; Najafi, Naghme Feyzi; Hajiahmadi, Maryam
Background: General anesthesia (GA) allows dental treatment to be rendered under optimal conditions, theoretically ensuring ideal outcomes. The aim of this study was to determine the efficacy of restorative dental procedures performed under GA. Materials and Methods: In this cross-sectional retrospective study, 305 pediatric patients who had been treated under GA 6 to 24 months before our survey at Isfahan's hospitalized dentistry center were examined. The examination was performed on dental chair with oral mirror and dental probe. The results were recorded in a special form for each patient for statistical analysis and evaluation of restorations to be successful or failed. Statistical analysis was performed by chi-square and fisher exact tests for comparison between success rates of restorations and Kendall's tau-b test for evaluating the effect of time on success rates of them (P < 0.05). Results: Stainless steel crown restorations had significantly better results vs class I and class II amalgam and class I and class II tooth color restorations. All types of posterior tooth color restorations had statistically same results with amalgam restorations. Anterior composite resin build-up represented significantly low success rates. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up (P = 0.344 and P = 0.091, respectively). Conclusion: Stainless steel crown restorations had significantly better results vs other posterior restorations. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up in comparison of other restorations. PMID:23162592
Chesnokov, V A; Chesnokova, M G; Leontiev, V K; Mironov, A Yu; Lomiashvili, L M; Kriga, A S
The issues of pre-nosologic diagnostic and effectiveness of treatment of diseases of oral cavity is an actual issue in dentistry. The long- duration orthodontic treatment of patients with dentoalveolar anomalies using non-removable devices is followed by such negative consequences as development demineralization of enamel and caries registered during treatment and after remove ofdevices. The level of quantitative content of oral streptococci was analyzed and dental status in children with dentoalveolar anomalies was evaluated during treatment with non-removable devices was evaluated. The caries and inflammation of periodontium of oral cavity were most often detected in children with high level of content of streptococci. In different periods of study the firm tendency of increasing of concentration of Streptococcus mutans and S. sanguis of dental plaque of oral cavity is established. The established index indicators of dental status of patients testify intensity of caries damage, level of poor hygiene of oral cavity, development of average degree of severity of inflammation process of periodontium. The obtained results substantiate involvement ofstreptococci, associates of microbiota of dental plaque of oral cavity in children, in process of development of caries. The characteristics of micro-ecology of dental plaque to evaluate cariesgenic situation that can be used as a basis for constructing diagnostic algorithm under monitoring of patients with dentoalveolar anomalies with purpose of forthcoming planning and implementation of effective orthodontic treatment.
Szepesi, Márta; Radics, Tünder; Vitályos, Géza; Hegedűs, Csaba
The recognition and treatment of allergy is a great challenge for all fields of medicine. The high prevalence of allergic reactions to dental materials and the related financial burden of their treatment make investigation of this disease very important. Our investigation was carried out on patients assigned to our outpatient department for dental allergy test between 1996 and 1998. We determined the distribution of gender and age among the allergic patients in the examined population. We also studied the prevalence of allergic reactions to different dental allergens and the distribution of dental allergens. In a follow-up study we determined the proportion of those patients, who were retreated in conformity with the results of epicutan tests and we followed up the positive effects of these treatments. We have found that dental allergy occurred five times more frequently in women (84%) than in men (16%) and the most affected age group was between 20 to 39 and 40-49 years (31%). Seventy-five percent of the patients suffered from a combination of metal and polymer allergy. The most frequent metal allergen was TEGDMA (triethylene glycol dimethacrylate) (49.7%). The suggested treatment plan was carried out in 63% of the allergic patients. The applied treatment was successful in 48% of these cases. We experienced that 48% of these patients got rid of their earlier signs and symptoms.
Rolim, Thaís de Souza; Fabri, Gisele Maria Campos; Nitrini, Ricardo; Anghinah, Renato; Teixeira, Manoel Jacobsen; Siqueira, José Tadeu T de; Cesari, José Augusto Ferrari; Siqueira, Silvia Regina Dowgan Tesseroli de
Oral infections may play a role in Alzheimer's disease (AD). Objective To describe the orofacial pain, dental characteristics and associated factors in patients with Alzheimer's Disease that underwent dental treatment. Method 29 patients with mild AD diagnosed by a neurologist were included. They fulfilled the Mini Mental State Exam and Pfeffer's questionnaire. A dentist performed a complete evaluation: clinical questionnaire; research diagnostic criteria for temporomandibular disorders; McGill pain questionnaire; oral health impact profile; decayed, missing and filled teeth index; and complete periodontal investigation. The protocol was applied before and after the dental treatment. Periodontal treatments (scaling), extractions and topic nystatin were the most frequent. Results There was a reduction in pain frequency (p=0.014), mandibular functional limitations (p=0.011) and periodontal indexes (p<0.05), and an improvement in quality of life (p=0.009) and functional impairment due to cognitive compromise (p<0.001) after the dental treatment. Orofacial complaints and intensity of pain also diminished. Conclusion The dental treatment contributed to reduce co-morbidities associated with AD and should be routinely included in the assessment of these patients.
Regis, Rômulo Rocha; Rocha, Cristiane Tomaz; Torres, Carolina Paes; Queiroz, Ivna Fernandes; de Queiroz, Alexandra Mussolino
West syndrome (WS) is a rare, severe form of epilepsy that typically manifests early in infancy. It is considered a malignant condition that combines episodes of spasms that occur in clusters (infantile spasm), hypsarrhythmia on the electroencephalogram, and neuropsychomotor delay. Although WS has been widely investigated from a medical standpoint, few reports have focused on the oral findings in patients with this syndrome. This article reports the case history of a 7-year-old child diagnosed with WS. The major clinical features were generalized tooth wear and gingival enlargement, altered chronology and sequence of dental eruption, primary canine cusp-to-cusp relationship, ectopic dental eruption, and mildly arched palate. Multiple white spot lesions were also observed, possibly associated with poor oral hygiene, due to a fermentable carbohydrate-rich diet, and continuous use of sugar-containing medications. Dental care management of patients with special needs is discussed and the dental treatment for this child with WS is described.
Welsh, Ericka M.; Jeffery, Robert W.; Levy, Rona L.; Langer, Shelby L.; Flood, Andrew P.; Jaeb, Melanie A.; Laqua, Patricia S.
Objective: To characterize perceived barriers to healthful eating in a sample of obese, treatment-seeking adults and to examine whether changes in barriers are associated with energy intake and body weight. Design: Observational study based on findings from a randomized, controlled behavioral weight-loss trial. Participants: Participants were 113…
Fitzigibbons, David J.; And Others
Patients' self perceived treatment needs can be understood with reference to seven clusters of needs: need for help with anxiety depression, superego complaints, gross psychotic symptoms, physical symptoms causing emotional difficulties, economic vocational complaints, feelings of inadequacy and marital difficulties. These factors showed minimal…
Nezafati, Saeed; Ghavimi, Mohammad Ali; Yavari, Amir Saeed
Osteomyelitis of the jaws following dental treatment is a rare condition which usually occurs in immuno-compromised patients both locally and generally. A case is presented with the alveolar bone necrosis resulting from leakage of an arsenical devitalizing paste into the periodontium. The treatment procedures and the outcomes are discussed in this article. PMID:23230486
Yorty, Jack S.; Brown, K. Birgitta
A survey of 42 U.S. dental schools was conducted to identify the number and characteristics of caries risk- assessment/treatment programs. Findings address lectures about caries risk, use of variable recall programs, categorization of risk level, early detection and treatment of lesions, and restoration of radiographically visible lesions. (DB)
Logan, H L; Muller, P J; Edwards, Y; Jakobsen, J R
In this new era of relationship-based care, involvement in treatment planning and goal setting is a high priority for patient satisfaction. This study reports on the use of standardized patients (SPs) in training third-year dental students to gather dental, medical, and psychosocial information from patients and to involve the patient in the decision-making process leading to the dental treatment plan. Among the skill areas measured, students were most successful in gathering dental information, with 94 percent of the students obtaining the complete set. Students were least successful in identifying the patient's goals for treatment (81 percent of the students identified the patients' goals). Students were most challenged by discussing sensitive topics with patients such as grief-related depression (25 percent of the students recognized and discussed such topics). It is important that dental schools familiarize students with patient issues and teach them how to talk effectively to patients about personal issues and to incorporate those issues into a discussion of the treatment plan for the patient. Standardized patients can be used effectively toward this end.
Eli, I; Baht, R; Blacher, S
Behavior modification techniques are effective in the treatment of extreme dental anxiety, but their success is by no means absolute. In the present article, the Corah Dental Anxiety Scale (DAS), the self-report symptom inventory SCL-90R and a questionnaire accessing subjects' daydreaming styles (the Short Imaginal Process Inventory) were used to develop possible predictive measures for success and failure of behavior modification as a treatment for dental fear. The patients' level of distractibility and mind wandering, initial dental anxiety and somatization significantly predicted the success of therapy. The odds ratio indicated that the risk of therapy failure increased about 11 times with an increase of one scale of the Poor Attention Control Scale, about three times with an increase of one level of the mean DAS score, and 0.17 times with an increase of one level of somatization. The predictive value of the chosen scales was 80%. Thus, the use of these scales as part of an initial admittance process for patients who suffer from dental anxiety can enhance our ability to better recognize patients who are prone to fail behavior therapy as treatment for their problem, and enable their referral for other possible modes of treatment.
Dumont, Adriana Fróis Santos; Salla, Juliana Tito; Vilela, Marina Beatriz Lara; Morais, Patrícia Carneiro; Lucas, Simone Dutra
The present study was developed among Xakriabas Indians in Minas Gerais and aimed at identifying their needs for dental treatment so that patients could be scheduled for treatment. Native health agents were trained by dental-surgeons for conducting the survey in household visits. The total Indian population is of 6.498 inhabitants, 3.686 of these living within the territory of the "Base Mata Fome", where 61% of the population was examined. Results showed that the population is mainly young, a great number of individuals presented no need for treatment and dental caries was the most frequent problem. The survey is expected to help in the organization of a schedule that allows giving priority to the more serious cases and promoting equity.
Bassuk, E; Schoonover, S
Dental Caries are an uncommon, but significant side effect of the tricyclic antidepressants and other anticholinergic psychoactive drugs. The authors trace the etiological aspects of this syndrome including the effects of depression and antidepressant medication on salivary properties. A typical clinical presentation of the syndrome is described and the side effect profiles of the various tricyclic antidepressants are compared. With this clinical background guidelines for the management of dry mouth are presented, emphasizing the importance of technical skill, safety and continuity of care.
Vernazza, Christopher R; Rousseau, Nikki; Steele, Jimmy G; Ellis, Janice S; Thomason, John Mark; Eastham, Jane; Exley, Catherine
Objectives The decision-making process within health care has been widely researched, with shared decision-making, where both patients and clinicians share technical and personal information, often being cited as the ideal model. To date, much of this research has focused on systems where patients receive their care and treatment free at the point of contact (either in government-funded schemes or in insurance-based schemes). Oral health care often involves patients making direct payments for their care and treatment, and less is known about how this payment affects the decision-making process. It is clear that patient characteristics influence decision-making, but previous evidence suggests that clinicians may assume characteristics rather than eliciting them directly. The aim was to explore the influences on how dentists' engaged in the decision-making process surrounding a high-cost item of health care, dental implant treatments (DITs). Methods A qualitative study using semi-structured interviews was undertaken using a purposive sample of primary care dentists (n = 25). Thematic analysis was undertaken to reveal emerging key themes. Results There were differences in how dentists discussed and offered implants. Dentists made decisions about whether to offer implants based on business factors, professional and legal obligations and whether they perceived the patient to be motivated to have treatment and their ability to pay. There was evidence that assessment of these characteristics was often based on assumptions derived from elements such as the appearance of the patient, the state of the patient's mouth and demographic details. The data suggest that there is a conflict between three elements of acting as a healthcare professional: minimizing provision of unneeded treatment, trying to fully involve patients in shared decisions and acting as a business person with the potential for financial gain. Conclusions It might be expected that in the context of a high
Chaveli-López, Begonya; Gavaldá-Esteve, Carmen
Introduction: Adequate hemostasis is crucial for the success of invasive dental treatment, since bleeding problems can give rise to complications associated with important morbidity-mortality. The dental treatment of patients who tend to an increased risk of bleeding due to the use of anticoagulant and/or antiplatelet drugs raises a challenge in the daily practice of dental professionals. Adequate knowledge of the mechanisms underlying hemostasis, and the optimized management of such patients, are therefore very important issues. Objectives: A study is made of the anticoagulant / antiplatelet drugs currently available on the market, with evaluation of the risks and benefits of suspending such drugs prior to invasive dental treatment. In addition, a review is made of the current management protocols used in these patients. Material and Methods: A literature search was made in the PubMed, Cochrane Library and Scopus databases, covering all studies published in the last 5 years in English and Spanish. Studies conducted in humans and with scientific evidence levels 1 and 2 (metaanalyses, systematic reviews, randomized phase 1 and 2 trials, cohort studies and case-control studies) were considered. The keywords used for the search were: tooth extraction, oral surgery, hemostasis, platelet aggregation inhibitors, antiplatelet drugs, anticoagulants, warfarin, acenocoumarol. Results and Conclusions: Many management protocols have been developed, though in all cases a full clinical history is required, together with complementary hemostatic tests to minimize any risks derived from dental treatment. Many authors consider that patient medication indicated for the treatment of background disease should not be altered or suspended unless so indicated by the prescribing physician. Local hemostatic measures have been shown to suffice for controlling possible bleeding problems resulting from dental treatment. Key words:Tooth extraction, oral surgery, hemostasis, platelet
Coyne, R; Woods, M; Abrams, R
A professionally managed telephone survey was undertaken to assess community-perceived need and demand for orthodontic treatment, and to determine the proportion of the community with a history of having some form of orthodontic treatment. The sample included 505 respondents, aged eighteen and over, from metropolitan and non-metropolitan households across the state of Victoria in Australia. The sample distribution had a ninety-five per cent confidence limit with a five per cent margin of error, and closely matched the known population distributions for age, sex and geographical location. From the survey it can be concluded that apparently forty-four per cent of Victorian families include someone who has already received some form of orthodontic treatment. Twenty-five per cent of the survey respondents perceived some need for the treatment of a family member; only fifteen per cent of respondents, however, reported that someone in their family actually wanted treatment. This survey has established baseline values for community perceived need and demand for orthodontic treatment. Use of these values should assist in future resource management within both the public and private sectors.
Badran, Serene Adnan
The aims of this study were to evaluate the effect of normative treatment need, perceived social impact of malocclusion and satisfaction with dental appearance on self-perceived treatment need, self-perceived aesthetics, and self-esteem; the influence of self-perceived need and aesthetics on self-esteem; and whether receipt of orthodontic treatment influences self-esteem. A questionnaire was administered to a random sample of 410 students (195 males and 215 females) aged 14-16 years. Self-esteem was measured using the Global Negative Self-Evaluation (GSE) scale. The Aesthetic and Dental Health Components (AC and DHC) of the Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need. Students' AC scores determined their self-perceived dental aesthetics. Spearman correlation coefficient was used to analyse the association between all variables, and multiple stepwise regression analysis to study the effect of independent variables on self-perceived need for treatment, self-perceived aesthetics, and self-esteem. A correlation existed between the students' and examiner's AC scores (P < 0.01); however, students were less critical in evaluating their aesthetic appearance. Students who perceived themselves in need of treatment had a great need for treatment, as assessed by the DHC and the AC of the IOTN (r = 0.421 and 0.489, respectively), were dissatisfied with their dental appearance (r = 0.542) and avoided smiling to hide their teeth (r = 0.457). Students who scored high on the GSE scale perceived a need for orthodontic treatment, evaluated their dental aesthetics poorly, perceived an impact of malocclusion on social acceptance, and had a great normative orthodontic treatment need; the correlation, however, was weak with r values ranging from 0.134 to 0.317. Students who had received orthodontic treatment showed greater self-esteem than those who had not, although the correlation was weak. Dissatisfaction with dental appearance had a
Schuler, Megan S.; Puttaiah, Savitha; Mojtabai, Ramin; Crum, Rosa M.
Objective Low rates of alcohol treatment seeking has been shown to be associated with perceived barriers to treatment, yet heterogeneity in patterns of perceived barriers have not been explored. We used data from a population-based sample of adults with alcohol abuse and dependence to: describe latent classes of perceived barriers to seeking alcohol treatment and identify characteristics associated with class membership. Methods Data are from the National Epidemiologic Survey on Alcohol and Related Conditions (2001-02). Analyses were restricted to treatment-naive adults with alcohol abuse or dependence with a perceived treatment need (N=1,053). Latent class analysis was performed to identify subgroups with respect to barriers to treatment; latent class regression was performed to identify variables associated with each subgroup. Results Two subgroups emerged: the low barriers class (87%), characterized primarily by attitudinal barriers, and the high barriers class (13%), characterized by significant attitudinal, financial, stigma and readiness for change barriers. In both classes, the most frequently endorsed barrier was the attitudinal belief that they should be “strong enough” to handle it on their own. Univariate analyses showed strong associations between membership in the high barriers class and comorbid psychiatric disorders, alcohol dependence (relative to abuse), and family history of alcohol problems; multivariate analyses found significant associations with lifetime anxiety disorder and education level. Conclusions Findings show that attitudinal barriers are most prevalent, and highlight the existence of a notable subgroup with multiple barriers, including financial and stigma-related barriers, who may require additional resources and support in order to enter treatment. PMID:26234326
Benoliel, R; Leviner, E; Katz, J; Tzukert, A
Thirty patients taking anticoagulants received routine dental treatment without altering their prothrombin time values. In a follow-up of 5 years, no serious complications were seen in patients with a prothrombin time value of up to 2.5. A protocol is suggested for dental treatment in these patients.
O'Callaghan, Patrick M; Allen, Keith D; Powell, Shawn; Salama, Fouad
We evaluated the effectiveness of a dentist-implemented behavioral intervention in which brief escape from dental treatment was provided on a regular basis, independent of the child's behavior. Within a multiple baseline design across subjects, 5 children, ages 4 to 7 years, were provided with temporary escape from dental treatment on a fixed-time schedule. The intervals were signaled by an electronic timer worn by the dentist. Clinically significant reductions were observed in physically disruptive behavior across all 5 children with the introduction of noncontingent escape, and verbally disruptive behavior was markedly reduced in 4 of the 5 children. In addition, the dental staff's use of physical restraint was reduced to near zero across all 5 children. The research extends the literature in both clinical dentistry and in applied behavior analysis by demonstrating that a dentist can easily and effectively implement noncontingent reinforcement to produce clinically significant and socially important changes in children's health behavior. PMID:16813038
Mamaladze, M; Nizharadze, N; Vadachkoria, O
Trauma related injuries of permanent teeth occur frequently and are the most pressing issue the dentists are facing today. In different age groups the same type of trauma affects the teeth with different frequencies. For instance, accident related dental trauma in children and adults affected permanent teeth in 30% and deciduous teeth in 20%, respectively. It should also be noted that front teeth are more susceptible to traumatic injuries compared to the incisors. Upper front teeth were injured in 72% of cases, while lower central, upper lateral incisors, canines and premolars only in 6-8%. The severity of dental injury depends on the type and extent of the trauma. Dental injury can be result of either direct or indirect trauma. A strong, «fast as lightning» impact most often affects the dental crown. A weak and dull impact (thump) extends toward the root apical direction resulting in avulsion of the tooth and root fracture. Dental injury caused by trauma has been always considered as an emergency condition. It requires prompt complex treatment methods from maintaining pulp vitality to tooth extraction option. Treatment plan always depends on the type and severity of the injury and on current clinical condition of tooth. In all cases, the combined treatment includes: care of visible wound, fixation of teeth, performance of surgical manipulations, determining of the need of endodontic treatment, restorations and orthodontic consultation. The recorded clinical cases include descriptions of dental injuries of various types, as well as performed diagnostic and treatment procedures. In both cases root was fractured by impact. In Clinical Case 1 the tooth 2.1 vertical partial displacement of the tooth (extrusion) with root fracture in the apical third was observed; Clinical Case 2 - 1.1 dental root fracture in its middle third and vertical extrusion. Treatment strategy is dictated by pulp condition (Assessment of pulp vitality and status). In both cases, the
Andås, Charlotte Andrén; Ostberg, Anna-Lena; Berggren, Pontus; Hakeberg, Magnus
The aim of this study was to investigate whether the revenues cover the costs in a pilot capitation plan, a dental insurance scheme, and to compare this capitation plan (CP) with the original fee-for-service system (FFS), in terms of the amount and type of dental care provided. Data was collected longitudinally over a period of three years from 1,650 CP patients in five risk groups at a test clinic, and from 1,609 (from the test clinic) and 3,434 (from a matched control clinic) FFS patients, in Göteborg, Sweden. The care investigated was the number of total treatments provided and the number of examinations by dentists and dental hygienists, together with preventive, restorative and emergency treatments. The economic outcome was positive from the administrator's perspective, in all risk groups for the three-year period. The amount and type of care provided differed between the payment models, as CP patients received more preventive treatments, less restorative treatments, and more examinations by dental hygienists than the FFS patients. Emergency treatment was performed more often on CP patients, and the difference was due to a higher frequency of such treatments among women in the CP group. The difference between clinics concerning certain treatment measures was sometimes greater than the difference between payment models. The results from this study indicate a net positive economic outcome for the pilot CP system over three years. The payment model and the clinic affiliation had impact on what type and amount of dental care the patients received. This might suggest that the risk of skewed selection and its consequences as well as the influence of clinic-specific practice need further investigation, to ensure economic sustainability in a longer perspective.
Pototski, Mariele; Amenábar, José M
Antiplatelet and anticoagulant agents have been extensively researched and developed as potential therapies in the prevention and management of arterial and venous thrombosis. On the other hand, antiplatelet and anticoagulant drugs have also been associated with an increase in the bleeding time and risk of postoperative hemorrhage. Because of this, some dentists still recommend the patient to stop the therapy for at least 3 days before any oral surgical procedure. However, stopping the use of these drugs exposes the patient to vascular problems, with the potential for significant morbidity. This article reviews the main antiplatelet and anticoagulant drugs in use today and explains the dental management of patients on these drugs, when subjected to minor oral surgery procedures. It can be concluded that the optimal INR value for dental surgical procedures is 2.5 because it minimizes the risk of either hemorrhage or thromboembolism. Nevertheless, minor oral surgical procedures, such as biopsies, tooth extraction and periodontal surgery, can safely be done with an INR lower than 4.0.
Fernández-Luna, Álvaro; Burillo, Pablo; Felipe, José Luis; del Corral, Julio; García-Unanue, Jorge; Gallardo, Leonor
The objective of this study was to determine which chemical treatment used for disinfecting water in indoor swimming pools had the least impact on users' perceptions of health problems, and which generated the greatest satisfaction with the quality of the water. A survey on satisfaction and perceived health problems was given to 1001 users at 20 indoor swimming pools which used different water treatment methods [chlorine, bromine, ozone, ultraviolet lamps (UV) and salt electrolysis]. The findings suggest that there is a greater probability of perceived health problems, such as eye and skin irritation, respiratory problems and skin dryness, in swimming pools treated with chlorine than in swimming pools using other chemical treatment methods. Pools treated with bromine have similar, although slightly better, results. Other factors, such as age, gender, time of day of use (morning and afternoon) and type of user (competitive and recreational), can also affect the probability of suffering health problems. For all of the above, using combined treatment methods as ozone and UV, or salt electrolysis produces a lower probability of perceived health problems and greater satisfaction.
Sgura, Ricardo; Reis, Mariana Cavalcante; Hernandes, Antonio Carlos; de Abreu Fantini, Márcia Carvalho; Andreeta, Marcello Rubens Barsi; Medeiros, Igor Studart
This work tested continuous CO2 laser as a surface treatment to dental porcelain and compared it to oven glaze (auto-glaze) by means of roughness and color parameters. Three commercial veneering porcelains with different crystalline content were tested: VM7, VM9, and VM13. Porcelain discs (3.5 × 2.0 mm, diameter × height) were sintered and had one side ground by a diamond bur (45 μm) simulating a chairside adjustment in a clinical office. Specimens (n = 7) were divided into the following groups: C--control (no treatment), G--auto-glaze (oven), and L--surface continuous irradiation with CO2 laser (Gem Laser, Coherent; λ = 10.6 μm). Laser was tested in three exposure times (3, 4, or 5 min) and two irradiances (45 and 50 W/cm(2)). Roughness parameters (Ra, Rz, and Rpm/Rz) were measured using a rugosimeter (Surftest 301, Mitutoyo). Color differences (ΔE) between the G and L groups were calculated (VITA Easyshade); ΔE values up to 3.3 were considered as not perceivable. A surface analysis was conducted by stereomicroscopy (Olympus SZ61) and SEM (Stereoscan 440, LEO). Crystalline content of specimens from groups C and L (50 W/cm(2), 5 min) was assessed by X-ray diffraction and then compared. Surface roughness (Ra and Rz) observed for laser-irradiated groups was similar to G for all studied porcelains. Rpm/Rz ratios were near 1.0 for all groups that indicated a sharp ridge profile for all specimens. Only one laser condition studied (50 W/cm(2), 3 min) from VM7 porcelain resulted in color difference (ΔE = 3.5) to G. Specimens irradiated with 50 W/cm(2) for 5 min presented the smoother surface observed by SEM, comparable to G. X-ray diffraction data revealed an increase in leucite crystallite size for VM9 and VM13 porcelains after laser treatment. Regarding roughness, continuous CO2 laser applied on porcelain surface was as effective as conventional oven auto-glaze.
Pina, Patricia M; Douglass, Joanna
This study aimed to evaluate the opinions and practices of general dentists in Connecticut regarding dental care during pregnancy. A survey was mailed to Connecticut general dentists to acquire data regarding age, gender, training, type of practice, years in practice, payment types accepted, procedures provided for pregnant women according to trimester, provider comfort level with treating pregnant patients, reasons for not treating pregnant patients, and provider opinions about dental care during pregnancy. The response rate was 42%, yielding a sample of 116 dentists. The majority of respondents (97%) reported treating pregnant patients; however, only 45% felt "very comfortable" treating these patients. All dentists in the sample agreed that physicians need to include an oral health evaluation and appropriate referral for patients' prenatal care. However, 70% of respondents had never received a dental referral for a pregnant patient. The majority of dentists favored providing dental treatment during the second trimester of pregnancy. Most dentists (77%) would take a radiograph for a patient 10 weeks into the pregnancy seeking treatment for dental pain, but only 2% would take routine radiographs regardless of the pregnancy trimester. There was a lack of consensus about medications dentists reported acceptable to prescribe for pregnant patients, and female dentists were significantly less likely than males to prescribe ibuprofen (P < 0.05). At least half of the respondents reported not being completely comfortable treating pregnant patients. Further, many dentists appear to not follow medication prescribing guidelines for this population. While additional research is needed, these initial results indicate that additional education regarding the treatment of pregnant patients would be a beneficial addition to dental school and continued education course curricula.
Allen, Keith D.; Stokes, Trevor F.
A contingency management procedure using both positive and negative reinforcement was used to strengthen cooperative behavior in five children (ages 3-6) during a series of restorative dental treatment sessions lasting from 15-60 minutes. Baseline levels of disruptive behavior as high as 90 percent were reduced to less than 15 percent. (JW)
Carter, Ava Elizabeth; Carter, Geoff; Abbey, Robyn
Objective. The differential diagnosis of pain in the mouth can be challenging for general medical practitioners (GMPs) as many different dental problems can present with similar signs and symptoms. This study aimed to create a treatment algorithm for GMPs to effectively and appropriately refer the patients and prescribe antibiotics. Design. The study design is comprised of qualitative focus group discussions. Setting and Subjects. Groups of GMPs within the Gold Coast and Brisbane urban and city regions. Outcome Measures. Content thematically analysed and treatment algorithm developed. Results. There were 5 focus groups with 8-9 participants per group. Addressing whether antibiotics should be given to patients with dental pain was considered very important to GMPs to prevent overtreatment and creating antibiotic resistance. Many practitioners were unsure of what the different forms of dental pains represent. 90% of the practitioners involved agreed that the treatment algorithm was useful to daily practice. Conclusion. Common dental complaints and infections are seldom surgical emergencies but can result in prolonged appointments for those GMPs who do not regularly deal with these issues. The treatment algorithm for referral processes and prescriptions was deemed easily downloadable and simple to interpret and detailed but succinct enough for clinical use by GMPs.
Carter, Geoff; Abbey, Robyn
Objective. The differential diagnosis of pain in the mouth can be challenging for general medical practitioners (GMPs) as many different dental problems can present with similar signs and symptoms. This study aimed to create a treatment algorithm for GMPs to effectively and appropriately refer the patients and prescribe antibiotics. Design. The study design is comprised of qualitative focus group discussions. Setting and Subjects. Groups of GMPs within the Gold Coast and Brisbane urban and city regions. Outcome Measures. Content thematically analysed and treatment algorithm developed. Results. There were 5 focus groups with 8-9 participants per group. Addressing whether antibiotics should be given to patients with dental pain was considered very important to GMPs to prevent overtreatment and creating antibiotic resistance. Many practitioners were unsure of what the different forms of dental pains represent. 90% of the practitioners involved agreed that the treatment algorithm was useful to daily practice. Conclusion. Common dental complaints and infections are seldom surgical emergencies but can result in prolonged appointments for those GMPs who do not regularly deal with these issues. The treatment algorithm for referral processes and prescriptions was deemed easily downloadable and simple to interpret and detailed but succinct enough for clinical use by GMPs. PMID:27462469
Kryst, L; Kowalik, S; Bartkowski, S; Henning, G
After a study in three maxillofacial surgery teaching hospital departments the authors evaluated the usefulness of Solcoseryl dental adhesive paste as compared to Apernyl in the treatment of postextraction alveolitis. Solcoseryl paste was found to shorten the healing period by about 50% in comparison with Apernyl.
The case report of a woman with severe osteoporosis who was treated with dental implants is presented. Polyarthritis was diagnosed in 1955, and a corticosteroid medication treatment was started in 1960. During the years, the patient has undergone multiple joint surgeries. Dental implants were inserted in the maxilla in 1987 and in the mandible in 1988. Due to a compression of the spine, the patient lost 12 cm in body height between 1991 and 1993; a spontaneous femur fracture was diagnosed in December 1992. However, the arch bone has been stable; the 6- and 5-year follow-up results of the maxillary and mandibular implants, respectively, are presented.
Kochlashvili, L Sh; Gogilashvili, K T; Gerzmava, O Kh
Dental health is an integral part of a normal state of a human body and, first of all, depends on knowledge of the population of bases of individual hygiene of an oral cavity and ability to use them in practical life. Numerous researches indicate low level of knowledge of the population in questions of prevention of dental diseases and individual hygiene of an oral cavity that testifies to existence of problems in the organization of sanitary education. Existing practice of hygienic training and education, in a certain measure, lags behind modern requirements, and some questions demand specification and optimization. For efficiency of sanitary and preventive actions it is necessary to study character and motivation structure to prevention and treatment of dental diseases and to develop an effective method of its increase. Therefore actual search of new forms of psycho hygiene and psycho prevention with use of modern information technologies which should provide high level of dental health of the military personnel is represented. The purpose of the real research was establishment of the factors forming motivation to prevention and treatment of the main dental diseases, and development of a psycho physiological method of its increase. The carried-out research allows to expand and systematize ideas necessary for the practical doctor of the major factors forming motivation to prevention and treatment of the main dental diseases. Development of an objective technique of a complex assessment of level of motivation of patients to prevention and treatment of dental pathology will allow to prove the new perspective direction of the sanitary educational work, allowing to reduce fobiya level, effectively to increase motivation of the patient to receiving the timely dental help. It especially is important if to consider that numerous programs of hygienic training and the education, applied in our country, didn't lead to change of hygienic skills of the population in expected
Hurlen, B; Gerner, N W
Acquired immune deficiency syndrome (AIDS) is a new disease which has recently alerted the medical world. AIDS may also concern dental practitioners and oral surgeons who may be the first to suspect impairment of immunity in patients presenting opportunistic oral infections. Extraordinary resistance to treatment of dental infections, such as encountered in a 27-year-old man developing AIDS, could also be a sign of immunodepression. Epidemiological features of AIDS indicate transmissibility, and interim recommendations for prevention of spread correspond to the measures appropriate for hepatitis B.
Zou, Huiru; Wang, Yanan; Zhang, Hongjie; Shen, Jun; Liu, Hao
Rubber dam technique is the a method used in dentistry to isolate the operation field from the rest of mouth with rubber sheet. Rubber dam can protect both patients and dental workers effectively and provide patients with more professional, safe and comfortable experience. In recent years, this technique has gradually gained more and more recognition by dentists. However, the prevalence of using rubber dam technique in our country is still relatively low compared with those in developed countries. This condition involves many factors and need to be paid enough attention. This review summarized the current situation of rubber dam usage in various countries, the technique's application field, the effect analysis, the influencing factors and the modified products.
Kwon, Su-Jung; Park, Yoon-Jung; Jun, Sang-Ho; Ahn, Jin-Soo; Lee, In-Bog; Cho, Byeong-Hoon; Son, Ho-Hyun
While it is reasonably well known that certain dental procedures increase the temperature of the tooth's surface, of greater interest is their potential damaging effect on the pulp and tooth-supporting tissues. Previous studies have investigated the responses of the pulp, periodontal ligament, and alveolar bone to thermal irritation and the temperature at which thermal damage is initiated. There are also many in vitro studies that have measured the temperature increase of the pulp and tooth-supporting tissues during restorative and endodontic procedures. This review article provides an overview of studies measuring temperature increases in tooth structures during several restorative and endodontic procedures, and proposes clinical guidelines for reducing potential thermal hazards to the pulp and supporting tissues. PMID:24010075
Marlowe, D B; Merikle, E P; Kirby, K C; Festinger, D S; McLellan, A T
Motivational assessment instruments typically measure clients' attributions about their readiness to change problem behaviors. They do not indicate why a client may be motivated to change, or provide guidance on how to retain an unmotivated client in treatment. The authors interviewed 415 substance abuse clients about their reasons for entering treatment and scored their responses along the dimensions of (a) negative versus positive treatment-entry pressures, (b) internal versus external sources of those pressures, and (c) the life domain from which the pressures emanated. Exploratory cluster analysis yielded 5 types of clients characterized by different profiles of perceived treatment-entry pressures. Cluster membership was predictive of treatment outcomes, and the clusters differed by demographic variables. These data support the discriminative and predictive utility of performing a multidimensional assessment of pressures to enter treatment.
Peretz, Benjamin; Bercovich, Roly; Blumer, Sigalit
Most dental practitioners are familiar with pediatric patients expressing dental fear or anxiety. Occasionally, the dentist may encounter a situation where all behavioral techniques fail, while, for some reason, premedication or general anesthesia are contraindicated or rejected by the patient or his/her parents and a different approach is required. Hypnosis may solve the problem in some cases. The purpose of this study was to review the literature about techniques that use elements of hypnosis and hypnotic techniques prior to or during pediatric dental treatment. There is a limited amount of literature regarding the use of hypnosis and hypnotic elements in pediatric dentistry. Induction techniques, reframing, distraction, imagery suggestions, and hypnosis are identified, although mostly anecdotally, while there are very few structured controlled studies. Nevertheless, the advantages of using hypnotic elements and hypnosis in pediatric dentistry are evident.
Fernández-Barrera, Miguel Ángel; Medina-Solís, Carlo Eduardo; Casanova-Rosado, Juan Fernando; Mendoza-Rodríguez, Martha; Escoffié-Ramírez, Mauricio; Casanova-Rosado, Alejandro José; Navarrete-Hernández, José de Jesús; Maupomé, Gerardo
Background. Tooth loss is an easily identifiable outcome that summarizes a complex suite of factors in an individual's history of dental disease and its treatment by dental services over a lifetime. Assessment of overall tooth loss data is essential for epidemiologically evaluating the adequacy of dental care provided at a systems level, as well as for placing in context tooth loss for non-disease causes. For example, when derived from prosthetic treatment planning, the latter may unfortunately lead to some teeth being extracted (pulled) for the sake of better comprehensive clinical results. The objective of the present manuscript was to identify the contribution to overall tooth loss, by extraction of permanent teeth because of prosthetic treatment reasons. Material and Methods. A cross-sectional study included sex, age, total number of extractions performed by subject, sextant (anterior vs. posterior), group of teeth (incisors, canines, premolars and molars), upper or lower arch, and the main reason underlying extraction (extraction for any reason vs. prosthetic treatment), in patients 18 years of age and older seeking care at a dental school clinic in Mexico. A multivariate logistic regression model was generated. Results. A total of 749 teeth were extracted in 331 patients; 161 teeth (21.5% of total) were extracted for explicit prosthetic treatment indications. As age increased, the likelihood of having an extraction for prosthetic reasons increased 3% (OR = 1.03, p < 0.001). Women (OR = 1.57, p < 0.05) were more likely to be in this situation, and molars (OR = 2.70, p < 0.001) were most at risk. As the total number of extractions increased, the risk of having an extraction for prosthetic reasons decreased (OR = 0.94, p < 0.05). Conclusions. A significant amount (21.5%) of the extractions of permanent teeth were performed for prosthetic reasons in this dental school clinical environment; age, sex, type of tooth, and the total number of extractions moderated
Fernández-Barrera, Miguel Ángel; Casanova-Rosado, Juan Fernando; Mendoza-Rodríguez, Martha; Escoffié-Ramírez, Mauricio; Casanova-Rosado, Alejandro José; Navarrete-Hernández, José de Jesús; Maupomé, Gerardo
Background. Tooth loss is an easily identifiable outcome that summarizes a complex suite of factors in an individual’s history of dental disease and its treatment by dental services over a lifetime. Assessment of overall tooth loss data is essential for epidemiologically evaluating the adequacy of dental care provided at a systems level, as well as for placing in context tooth loss for non-disease causes. For example, when derived from prosthetic treatment planning, the latter may unfortunately lead to some teeth being extracted (pulled) for the sake of better comprehensive clinical results. The objective of the present manuscript was to identify the contribution to overall tooth loss, by extraction of permanent teeth because of prosthetic treatment reasons. Material and Methods. A cross-sectional study included sex, age, total number of extractions performed by subject, sextant (anterior vs. posterior), group of teeth (incisors, canines, premolars and molars), upper or lower arch, and the main reason underlying extraction (extraction for any reason vs. prosthetic treatment), in patients 18 years of age and older seeking care at a dental school clinic in Mexico. A multivariate logistic regression model was generated. Results. A total of 749 teeth were extracted in 331 patients; 161 teeth (21.5% of total) were extracted for explicit prosthetic treatment indications. As age increased, the likelihood of having an extraction for prosthetic reasons increased 3% (OR = 1.03, p < 0.001). Women (OR = 1.57, p < 0.05) were more likely to be in this situation, and molars (OR = 2.70, p < 0.001) were most at risk. As the total number of extractions increased, the risk of having an extraction for prosthetic reasons decreased (OR = 0.94, p < 0.05). Conclusions. A significant amount (21.5%) of the extractions of permanent teeth were performed for prosthetic reasons in this dental school clinical environment; age, sex, type of tooth, and the total number of extractions moderated
Chen, Fu; Wang, Dong
Importance of the field: Dental caries is one of the most common preventable childhood diseases; people are susceptible to this ailment throughout their lifetime. In the United States, 90% of late adolescents and young adults have dental caries, while 94% of all dentate adults had evidence of treated or untreated coronal caries. Dental caries is often not self-limiting and without proper care, caries can progress until the tooth is destroyed. Areas covered in this review: In this paper, the etiology of dental caries was briefly introduced. It was followed by a thorough review of patents and literatures on the recent development of various novel technologies for the prevention and treatment of dental caries. What the reader will gain: Recent advances in anti-plaque agents, including chemoprophylactic agents, antimicrobial peptides, vaccines, probiotics/replacement therapy and sugar substitutes, and remineralization agents including fluorides and casein phosphopeptides are analyzed. Take home massage: Both the discovery of new anti-caries agents and the development of dentotropic delivery systems will be the future focus of this research field. PMID:20230309
Wiersema, E J; Kreulen, C M; Latzke, P; Witter, D J; Creugers, N H J
For the manufacture of single- and multi-unit fixed dental prostheses, effective communication between dentist and dental technician is required. Mutual insight concerning the (im)possibilities of available treatments and technical options is prerequisitefor this communication. The manufacture of single- and multi-unit fixed dental prostheses involves 4 phases: recording the required detailed information on the relevant teeth and the occlusal system, the technical adjustments, the technical design and the technical fabrication. These phases can be accomplished through an analogue or (semi)digital procedure. Pioneering developments are computer aided design and computer aided manufacturing (CAD/CAM), and computerised milling machines. Associated with this are 3 manufacturing methods which can be distinguished: the dental practice method, the dental laboratory method and the milling centre method. Materials applied are metal alloys and ceramics, while resins are used for provisional and transitional constructions. Due to the fact that the choice of material in the analogue procedure is limited, CAD/CAM offers more options, the digital procedure is expected to gain ground gradually. It is expected that this development will provide an impulse to higher quality.
Kaakko, Tarja; Milgrom, Peter; Coldwell, Susan E.; Getz, Tracy; Weinstein, Philip; Ramsay, Douglas S.
A survey of 270 University of Washington permanent employees who were potential candidates for teaching clinics, found dental anxiety prevalent, correlating with poorer perceived dental health, longer intervals between dental appointments, higher frequency of past fear behaviors, more physical symptoms during last dental injection, and more…
Lillis, Theodoros; Ziakas, Antonios; Koskinas, Konstantinos; Tsirlis, Anastasios; Giannoglou, George
Optimal dental management in patients on long-term antiplatelet treatment is not clearly defined. Antiplatelet discontinuation increases the risk of thrombotic complications, whereas uninterrupted antiplatelet therapy, which is the currently recommended approach, is assumed to increase the bleeding hazard after dental procedures. We sought to prospectively compare the risk of immediate and late postextraction bleeding in patients receiving uninterrupted single or dual antiplatelet therapy. We recruited 643 consecutive patients referred for dental extractions. In total 111 (17.3%) were on clinically indicated antiplatelet therapy: aspirin (n = 42), clopidogrel (n = 36), and aspirin and clopidogrel (n = 33). Controls (n = 532, 82.7%) were not on antiplatelet treatment. Immediate and late bleeding complications were recorded. Compared to controls the risk of prolonged immediate bleeding was higher in patients on dual antiplatelet therapy (relative risk [RR] 177.3, 95% confidence interval [CI] 43.5 to 722, p <0.001) but not in patients on aspirin alone (RR = 6.3, 95% CI 0.6 to 68.4, p = 0.2) or clopidogrel alone (RR = 7.4, 95% CI 0.7 to 79.5, p = 0.18); however, all immediate bleeding complications in all treatment groups were successfully managed with local hemostatic measures. No patient developed any late hemorrhage. In conclusion, dental extractions may be safely performed in patients receiving single or dual antiplatelet therapy when appropriate local hemostatic measures are taken, thus averting thrombotic risk of temporary antiplatelet discontinuation.
Shimotoyodome, Akira; Koudate, Takashi; Kobayashi, Hisataka; Nakamura, Junji; Tokimitsu, Ichiro; Hase, Tadashi; Inoue, Takashi; Matsukubo, Takashi; Takaesu, Yoshinori
Initial attachment of the cariogenic Streptococcus mutans onto dental enamel is largely promoted by the adsorption of specific salivary proteins on enamel surface. Some phosphorylated salivary proteins were found to reduce S. mutans adhesion by competitively inhibiting the adsorption of S. mutans-binding salivary glycoproteins to hydroxyapatite (HA). The aim of this study was to develop antiadherence compounds for preventing dental biofilm development. We synthesized phosphorylated polyethylene glycol (PEG) derivatives and examined the possibility of surface pretreatment with them for preventing S. mutans adhesion in vitro and dental biofilm formation in vivo. Pretreatment of the HA surface with methacryloyloxydecyl phosphate (MDP)-PEG prior to saliva incubation hydrophilized the surface and thereby reduced salivary protein adsorption and saliva-promoted bacterial attachment to HA. However, when MDP-PEG was added to the saliva-pretreated HA (S-HA) surface, its inhibitory effect on bacterial binding was completely diminished. S. mutans adhesion onto S-HA was successfully reduced by treatment of the surface with pyrophosphate (PP), which desorbs salivary components from S-HA. Treatment of S-HA surfaces with MDP-PEG plus PP completely inhibited saliva-promoted S. mutans adhesion even when followed by additional saliva treatment. Finally, mouthwash with MDP-PEG plus PP prevented de novo biofilm development after thorough teeth cleaning in humans compared to either water or PP alone. We conclude that MDP-PEG plus PP has the potential for use as an antiadherence agent that prevents dental biofilm development.
Feng, Yi-miao; Fang, Bing; Xia, Yun hui; Shu, Rong; Hans, Mark Guenther
In contemporary dental care, an increasing number of adult patients with periodontal disease are seeking orthodontic treatment. Achieving optimal results in such adult patients is difficult because decreased posterior tooth anchorage is risky. This case report demonstrates the use of miniscrew implant anchorage (MIA) in a Chinese male 21 years 5 months of age with maxillary and mandibular anterior dental spacing, bimaxillary protrusion, and severe bone loss caused by periodontal disease. Prior to orthodontic treatment, the patient underwent treatment to control his periodontitis. The patient was treated with 0.022-in straight-wire orthodontic appliances. After 17 months of active orthodontic treatment, the patient had healthier periodontal tissue with increased bone support, as well as improved facial esthetics and a functional occlusion. The results demonstrate that MIA is useful in enhancing anchorage in patients with bone loss associated with severe periodontal disease.
Heaven, Tim J.; Gordan, Valeria V.; Litaker, Mark S.; Fellows, Jeffrey L.; Rindal, D. Brad; Gilbert, Gregg H.
Objective To quantify the agreement between treatment recommended during hypothetical clinical scenarios and actual treatment provided in comparable clinical circumstances. Methods A total of 193 practitioners in the National Dental Practice-Based Research Network participated in both a questionnaire and a clinical study. The questionnaire included three hypothetical scenarios about treatment of existing restorations. Clinicians then participated in a clinical study about repair or replacement of existing restorations. We quantified the overall concordance between their questionnaire responses and what they did in actual clinical treatment. Results Practitioners who recommended repair (instead of replacement) of more scenario restorations also had higher repair percentages in clinical practice. Additionally, for each of the three hypothetical scenario restorations, practitioners who recommended repair had higher repair percentages in clinical practice. Conclusions The questionnaire scenarios were a valid measure of clinicians’ tendency to repair or replace restorations in actual clinical practice. Clinical implications Although there was substantial variation in practitioners’ tendency to repair or replace restorations, responses to questionnaire scenarios by individual practitioners were concordant with what they did in actual clinical practice. PMID:25998565
Fear of dental treatment is undoubtedly widespread. In the present study this fear, the "stress phenomenon", has been investigated. So-called biosignals were used to demonstrate the factual presence of these "anxiety conditions"; it has been found that they are increasing at the beginning of treatment and reach peak levels during certain much feared procedures. Moreover, it has been demonstrated that audio-analgesia may reduce anxiety and stress.
Fairclough, Gillian; Fox, John; Mercer, Gemma; Reuber, Markus; Brown, Richard James
Psychological therapy is generally considered the treatment of choice for psychogenic nonepileptic seizures (PNES), but there is a paucity of research on patients' attitudes towards psychological referral. We conducted semistructured interviews with twelve patients with PNES awaiting psychological treatment in order to understand their perceived treatment needs. Data were analyzed inductively according to the principles of thematic analysis. The results indicated that our patients had clear ideas about their treatment needs and a desire to recover by 'returning to normality'. Many participants felt 'caught in limbo' following their PNES diagnosis, however, because of uncertainties about their condition and a lack of support from professionals. This linked with participants feeling unsure whether psychological treatment would meet their needs; there was also apprehension for some participants about the potential negative consequences of therapy. The clinical implications of these findings are discussed, and recommendations for future research are made.
Sgan-Cohen, H D; Horev, T; Zusman, S P; Katz, J; Eldad, A
A survey was conducted to determine dental caries prevalence and treatment among 1,095 25- to 44-year-old permanent force Israeli military personnel. Caries experience, by decayed, missing, and filled permanent teeth (DMFT), was 11.66, with an average of 1.37 untreated caries, 2.40 extracted teeth, and 7.90 treated teeth. Caries was positively associated with age (p < 0.001). Females demonstrated statistically higher DMFT levels than males (p = 0.009). Negative associations were detected for education levels and untreated and extracted components (p < 0.001), and a positive association was detected for the treated caries component (p < 0.001). Permanent military personnel treated by private dentists exhibited 17.6% untreated caries, compared with 9.4% among personnel treated in the army. Officers had lower levels of untreated caries (8.6%) than others (13.3%). Among the present population, 77% had attended a dental clinic in the preceding 2 years. Permanent force personnel are offered free, comprehensive, and accessible dental treatment. The data emphasize a need for further dental health education.
Prabhu, Neeta T; Nunn, June H; Evans, D J; Girdler, N M
The goal of this study was to elicit the views of patients or parents/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients/parents/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.
Taichman, L. Susan; Gomez, Grace; Inglehart, Marita Rohr
Objective Approximately 200,000 women are diagnosed with breast cancer in the U.S. every year. These patients commonly suffer from oral complications of their cancer therapy. The purpose of this study was to assess dental hygienists’ knowledge and professional practice related to providing care for breast cancer patients. Methods A pre-tested 43-item survey was mailed to a random sample of 10% of all licensed dental hygienists in the State of Michigan (N=962). The survey assessed the respondents’ knowledge of potential oral complications of breast cancer treatments as well as their professional practices when treating patients with breast cancer. After two mailings, the response rate was 37% (N=331). Descriptive and inferential analyses were conducted using SAS. Results Many dental hygienists were unaware of the recommended clinical guidelines for treating breast cancer patients and lacked specific knowledge pertaining to the commonly prescribed anti-estrogen medications for pre-and postmenopausal breast cancer patients. Over 70% of the respondents indicated they were unfamiliar with the AI class of medications. Only 13% of dental hygienists correctly identified the mechanism of action of anti-estrogen therapy. Dental hygienists reported increased gingival inflammation, gingival bleeding, periodontal pocketing, xerostomia and burning tissues in patients receiving anti-estrogen therapies. Less than 10% believed that their knowledge of breast cancer treatments and the oral side effects is up to date. Conclusions Results indicate a need for more education about the potential oral effects of breast cancer therapies and about providing the best possible care for patients undergoing breast cancer treatment. PMID:24771774
Chambers, D W; Geissberger, M; Leknius, C
It is hypothesised that dental educators have perceptions of their roles as effective teachers. It is expected that subject matter expertise would be amongst the components of such personal philosophies of education, but it is unclear whether faculty member self-perceptions carry over into student ratings of instructors' effectiveness. A 20-item survey of 'Teaching Characteristics' was completed by 86% of full-time and 64% of the part-time faculty members at the University of the Pacific. Respondents distributed 100 points amongst the descriptions of what makes an effective instructor. The responses were factor-analysed, resulting in four general faculty 'types' that explained about 50% of the variance in ratings: expert, enthusiast, judicial and good soldier. Student ratings for the 2 years running up to the date of the survey administration were used to gauge student perceptions of instructor effectiveness. Faculty members who placed emphasis on expertise as key to being a good instructor received significantly lower ratings for teacher effectiveness from students than did other faculty members. Faculty members who conceived their roles as motivating students, explaining difficult concepts, displaying interest in the subject, showing compassion and caring, and being proactive tended to receive high ratings for teaching effectiveness from students.
Al-Jobair, Asma M; Baidas, Laila F; Al-Hamid, Anfal A; Al-Qahtani, Sara G; Al-Najjar, Amani T; Al-Kawari, Huda M
Objective To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices. Materials and methods This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13–21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test. Results Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics (P=0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics (P<0.0001). Conclusion Young Saudis receiving free orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics. PMID:27843351
Guiney, H; Felicia, P; Whelton, H; Woods, N
Use of fluoride has led to dramatic improvements in oral health; however, the impact of these improvements on the volume and mix of treatment provided in dental systems is largely unknown. The use of administrative data to analyze trends in treatment provision gives 'real-life' insight into the impact of changing levels of oral health on oral health services. The first aim of this study was to determine the extent to which useful data on temporal treatment patterns could be extracted from a public insurance database. The second aim, contingent on the first, was to investigate whether increased tooth retention and decreases in caries were reflected in the volume and types of treatment provided to adults within a public social insurance scheme between 1997 and 2008. Data were retrieved from the Dental Treatment Benefit Scheme databases, and new datasets were generated to analyze the distribution of treatments and mean treatments provided to 1,271,937 adults over the 12-year period. Provision of restorations, extractions, and dentures decreased, and the ratio of preventive/diagnostic to invasive treatments per dentist increased, which supports reported improvements in oral health. In conclusion, this paper illustrates the decline in invasive treatments, and increase in preventive treatments that accompanied improvements in oral health.
Background The objective of this study was to compare the socioeconomic and family characteristics of underprivileged schoolchildren with and without curative dental needs participating in a dental health program. Methods A random sample of 1411 of 8-to-10 year-old Brazilian schoolchildren was examined and two sample groups were included in the cross-sectional study: 544 presented curative dental needs and the other 867 schoolchildren were without curative dental needs. The schoolchildren were examined for the presence of caries lesions using the DMFT index and their parents were asked to answer questions about socioenvironmental characteristics of their families. Logistic regression models were adjusted estimating the Odds Ratios (OR), their 95% confidence intervals (CI), and significance levels. Results After adjusting for potential confounders, it was found that families earning more than one Brazilian minimum wage, having fewer than four residents in the house, families living in homes owned by them, and children living with both biological parents were protective factors for the presence of dental caries, and consequently, curative dental needs. Conclusions Socioeconomic status and family structure influences the curative dental needs of children from underprivileged communities. In this sense, dental health programs should plan and implement strategic efforts to reduce inequities in oral health status and access to oral health services of vulnerable schoolchildren and their families. PMID:24138683
Coelho, Marcelo Santos; Parker, Jeffrey M; Tawil, Peter Z
The aim of this retrospective clinical study was to evaluate the location and treatment of second canals in mesiobuccal roots (MB2) of first and second maxillary molars in a predoctoral endodontic clinic by the graduating classes of 2008 to 2015. These results were compared to similar clinical studies. Included in the study were 368 root canal treatments performed by 310 third- and fourth-year dental students at one U.S. dental school. All cases were done under faculty supervision, and the students were instructed to use dental loupe magnification. Students' evaluation sheets were used to deteremine the total MB2 canals treated in first and second maxillary molars. The results showed that, overall, 72.55% of the teeth had an MB2 canal treated. The frequency was higher in first molars (75.91%) than in second molars (56.92%) (p<0.05). Third-year students were able to detect 39 MB2 canals in 57 maxillary molars (68.42%), while fourth-year students detected 228 MB2 canals in 311 teeth (73.31%) (p>0.05). Under proper supervision by experienced endodontists, these dental students were capable of treating MB2 canals in maxillary molars. The frequency of MB2 canals located and treated by dental students with the assistance of experienced professionals was higher in first than in second molars. No significant difference was found between third- and fourth-year students. The incidence of MB2 canals located and treated in this study was found to be similar to that in other clinical studies.
Galeotti, Angela; D'Antò, Vincenzo; Gentile, Tina; Giancristoforo, Simona; Romeo, Umberto
Aim. The purpose of this study was to evaluate the efficacy of Er:YAG laser used for treating hard dental tissue in patients with epidermolysis bullosa (EB). Methods. We report two cases of EB in which an Er:YAG laser was used for conservative treatments. In the first case, the Er:YAG laser (2,940 μm, 265 mJ, 25 Hz) was used to treat caries on a deciduous maxillary canine in an 8-year-old male patient affected by dystrophic EB. In the second case, we treated a 26-year-old female patient, affected by junctional EB, with generalized enamel hypoplasia, and an Er:YAG laser (2,940 μm, 265 mJ, 25 Hz) was used to remove the damaged enamel on maxillary incisors. Results. The use of the Er:YAG laser, with the appropriate energy, was effective in the selective removal of carious tissue and enamel hypoplasia. During dental treatment with the Er:YAG laser, patients required only a few interruptions due to the absence of pain, vibration, and noise. Conclusions. Laser treatment of hard dental tissues is a valuable choice for patients affected by EB since it is less invasive compared to conventional treatment, resulting in improved patient compliance. PMID:25431688
Sullivan, C; Schneider, P E; Musselman, R J; Dummett, C O; Gardiner, D
Virtual reality, a three-dimensional computer generated world, has been shown to relax adults during dental treatment. The purpose of this study was to investigate the effect of virtual reality on the behavior and anxiety of children during dental treatment. The behavior, anxiety and heart rate of twenty-six children, ages five to seven years were evaluated for the first five minutes of two restorative treatment visits. Thirteen children viewed virtual reality at their first restorative visit and not the second, and thirteen children viewed virtual reality at the second restorative visit and not the first. Before and immediately following the restorative visits, each child was instructed to draw a human figure. The restorative appointments were video recorded and heart rate monitored. The drawings and videotapes were rated independently by two examiners. The Koppitz method of evaluating drawings was used to measure anxiety. The Frankl behavior rating scale was used to evaluate behavior. Differences (ANOVA) in behavior (p < or = 0.50) and anxiety (p < or = 0.65) were not significant. The overall pulse rate was significantly lower (ANOVA p < or = 0.001) when the child was wearing glasses and viewing virtual reality. In conclusion, virtual reality during dental treatment had no significant effect on the behavior or anxiety but significantly reduced the pulse.
Brennan, David S; Spencer, A John
Service rate variations have focused attention on treatment decisions. The aims of this study were to examine factors considered in choosing treatments, to classify dentists in terms of clinical decision making, and to investigate the association of decision making with services provided. From a random sample of dentists (response rate 60.3%) treatment constraints (15.0%), periodontal status (12.1%), tooth status (11.3%), mouth status (10.1%), and patient factors (9.8%) were considered important factors across six alternative treatment pair choice scenarios. Cluster analysis of the treatment choice scenarios produced one cluster that reflected patient preferences, another that reflected treatment constraints such as cost, and a third that reflected oral health factors. Compared with the oral health cluster, dentists in the constraints cluster had higher rates (p < .05) of extractions (rate ratio [RR] = 1.49), bridge work (RR = 1.77), and dentures (RR = 1.32), whereas dentists in the patient cluster had higher restoration rates for two-surface ionomers (RR = 2.45) and resins on three or more surfaces (RR = 1.50) and other preventive services (RR = 1.78) such as oral hygiene instruction. Although a range of factors influenced treatment choice, a limited set accounted for the majority of responses, with cost a major determinant, ahead of oral health status and patient preference. Decision-making style was associated with service provision.
Al-Jundi, Suhad H
Traumatic dental injuries are emergencies that must be treated promptly and properly in order to reduce the suffering, costs, and time for patients, parents, and health care providers. The aim of this study was to investigate the treatment, long-term prognosis, and number of visits needed to manage cases resulting from complications of late presentation of traumatic dental injuries. The sample consisted of 195 children, all presented with complications of dental trauma at the Pediatric Dentistry Clinics in the Dental Teaching Hospital of Jordan University of Science and Technology in Irbid city, Jordan. Retrospective data relied on trauma forms as well the clinical notes and radiographs in the patients' records. Prospective data was collected by examining patients at recall appointments. The treatment of traumatized teeth in this sample ranged from no active treatment to extraction and prosthetic replacement. It was estimated that the number of visits needed to carry out the planned treatment for these patients ranged between 3 and 17.2 visits according to the type of treatment. Apexification procedure was the most time consuming. Thirty-two per cent of teeth with apexification ended up with root fracture mainly subsequent to another minor trauma episode (in 85%), the rest were reported to be spontaneous fractures. Almost half of the teeth with luxation injuries became necrotic after 3 years. Teeth with avulsion actually kept on deteriorating even at the 36-month follow-up appointment. The long-term prognosis of teeth with middle root fracture was favorable in (80%) of the teeth in the sample, despite the fact that they were splinted late. Luxation injuries led to more necrotic teeth (50%) than uncomplicated crown fractures. Multiple dental trauma episodes (MDTE) were reported in about 30% of the patients in the sample and were responsible for some of the complications noticed in this report. As all cases followed up in this report are late presentation of dental
Al-Khotani, Amal; Bello, Lanre A'aziz; Christidis, Nikolaos
Abstract Aim: Dental anxiety leads to undesirable distresses such as avoidance of dental treatment and increase stress among caregivers that consequently affect the treatment quality. The aim of this study was therefore to evaluate the effectiveness of viewing videotaped cartoons using an eyeglass system (i-theatre™) as an audiovisual (AV) distraction technique on behaviour and anxiety in children receiving dental restorative treatment. Methods: Fifty-six consecutive children patients who presented for treatment and met inclusion criteria were included and randomly divided into two groups; a control group without distraction (CTR-group) and a distraction-group (AV-group). Three dental treatment visits were provided for each patient. Anxiety and cooperative behaviour were assessed with the Facial Image Scale (FIS) and the Modified Venham’s clinical ratings of anxiety and cooperative behaviour scale (MVARS). The vital signs, blood pressure and pulse were also taken. Results: The AV-group showed significantly lower MVARS scores than the CTR-group (p = 0.029), and the scores decreased significantly during treatment in the AV-group (p = 0.04). Further, the pulse rate was significantly increased in the CTR-group during injection with local anaesthesia (p = 0.02), but not in the AV-group. Conclusion: AV distraction seems to be an effective method in reducing fear and anxiety in children during dental treatment. Further, children who used eyeglass goggle display as a distraction tool during dental treatment reported not only less anxiety than control groups but also showed more positive responses after injection with local anaesthesia. Hence, AV-distraction seems to be a useful tool to decrease the distress and dental anxiety during dental treatment. PMID:27409593
Bathomarco, Ti R. V.; Solorzano, G.; Elias, C. N.; Prioli, R.
The surface of commercial unalloyed titanium, used in dental implants, was analyzed by atomic force microscopy. The morphology, roughness, and surface area of the samples, submitted to mechanically-induced erosion, chemical etching and a combination of both, were compared. The results show that surface treatments strongly influence the dental implant physical and chemical properties. An analysis of the length dependence of the implant surface roughness shows that, for scan sizes larger than 50 μm, the average surface roughness is independent of the scanning length and that the surface treatments lead to average surface roughness in the range of 0.37 up to 0.48 μm. It is shown that the implant surface energy is sensitive to the titanium surface area. As the area increases there is a decrease in the surface contact angle.
Bittencourt, Marcos Alan Vieira
Abstract Class III skeletal pattern is characterized by disharmony between maxillary and mandibular basal bones anteroposteriorly, and might or might not be associated with dental changes. In general, facial esthetics is hindered significantly, which most of times is the reason why patients or patient's guardians seek treatment. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) in partial fulfillment of the requirements for Diplomate recertification and revalidation. PMID:26691976
Al-Maweri, Sadeq; Al-Sufyani, Ghadah
Background: Oral health in Down syndrome (DS) children has some peculiar aspects that must be considered in the follow-up of these patients. The objective of the present study was to assess the prevalence of dental caries and treatment needs among children with DS in Yemen and also to investigate the association between these outcomes with various socio-demographic and clinical variables. Materials and Methods: This cross-sectional study involved 96 children with DS aged between 6 and 15 years. Data were gathered through the use of a questionnaire and clinical observation. The dentition status and the treatment needs were recorded according to World Health Organization recommendations. ANOVA, Chi-square test, t-test and multiple regression analyses were applied using the statistical package for the social sciences (SPSS, Chicago, IL, USA) version 20.0 software, with P < 0.05 considered as significant. Results: The results showed that 93.8% of the subjects had dental caries; overall, decayed missing filled surfaces (dmfs), decayed missing filled teeth (dmft), DMFS, DMFT were 10.35, 4.44, 4.32 and 2.45, respectively. Stepwise linear regression analysis has revealed that age was the most important predictor for DMFT and DMFS, while early age and less frequent teeth brushing were the most predictors for dmft and dmfs. Restorative care and extractions were the most needed specific treatments. Conclusion: The findings of this study demonstrate that children with DS in Yemen have a high prevalence of dental caries and extensive unmet needs of dental treatment. They would benefit from frequent oral health assessment. PMID:25540656
Escanilla-Casal, Alejandro; Aznar-Gómez, Mirella; Viaño, José M.; Rivera-Baró, Alejandro
This is a comparative study between two groups, one of healthy children and the other of children with cerebral palsy, which underwent dental treatment under general anesthesia at Hospital Sant Joan de Déu Barcelona. The purpose of the study was to compare and determine oral pathology, frequency, severity and postoperative complications in pediatric patients with and without an underlying disease which undergo a dental treatment under general anesthesia. Key words:General anesthesia, cerebral palsy, pediatric patients. PMID:24608223
ABSTRACT Objectives The purpose of present article was to review the classifications suggested for assessment of the jawbone anatomy, to evaluate the diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone, as well as to suggest new classification system of the jawbone anatomy in endosseous dental implant treatment. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandible; mandibular canal; alveolar nerve, inferior; anatomy, cross-sectional; dental implants; classification. The search was restricted to English language articles, published from 1972 to March 2013. Additionally, a manual search in the major anatomy and oral surgery books were performed. The publications there selected by including clinical and human anatomy studies. Results In total 109 literature sources were obtained and reviewed. The classifications suggested for assessment of the jawbone anatomy, diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone were discussed. New classification system of the jawbone anatomy in endosseous dental implant treatment based on anatomical and radiologic findings and literature review results was suggested. Conclusions The classification system proposed here based on anatomical and radiological jawbone quantity and quality evaluation is a helpful tool for planning of treatment strategy and collaboration among specialists. Further clinical studies should be conducted for new classification validation and reliability evaluation. PMID:24422030
Shoshi, Avdyl; Alushi, Adem; Isufi, Ramazan
Introduction: The importance of the dental implantology has influenced the development of many treatment methods in this field. The aim of our study is to evaluate the advantages and disadvantages of the treatment with TIOLOX-DENTAURUM dental implants in cases of partial and total lack of teeth, compared to classic dentures. To conduct our research we have used the prospective method. Material and methods: The analyzed cases have undergone surgical treatment at the “Policlinic Shoshi” in Prishtina during 2010–2011. This study included 29 patients, 23 in the research group and 6 in the control group. The patients involved in the study were 30-59 years old. 52,2% of our patients were 30-39 years old, while 17,4% were 50-59 years old. Results: In the research group, the average time of placing the dental bridges in the lower jaw was 2 months and 4.2 months in the control group. In the upper jaw, the average time was 3 months for the experimental group and 5,4 months for the control group. Conclusion: The period after the placement of implants until the placement of dentures, can be shortened from 4-6 months to 3 months for the upper jaw and from 3 to 2 months for the lower jaw. PMID:25568555
Tarján, Ildikó; Gábris, Katalin
In the dental practice--for more than a 100 years--it has been a vital topic how to prevent, eliminate, or at least relieve pain and fear associated with dental treatments. 'Fogorvosi Szemle,' the scientific journal of the Hungarian Dental Association is now a 100 years old. Authors present how the approaches and methods of relieving pain and fear have changed in the past century, based on the reports published in this journal. The reports are grouped in three main topics: local anaesthetics and sedatives; ambulatory narcosis and sedative analgesia; hypnosis and hypnotherapy. Based on the publications of the last one hundred years, it can be concluded that the Hungarian dental practice has followed the trends and principles of the well-known international dental schools.
Yoshioka, Masami; Shirayama, Yasuhiko; Imoto, Issei; Hinode, Daisuke; Yanagisawa, Shizuko; Takeuchi, Yuko; Bando, Takashi; Yokota, Narushi
AIM To investigate awareness and attitudes about preventive dental visits among dialysis patients; to clarify the barriers to visiting the dentist. METHODS Subjects included 141 dentate outpatients receiving hemodialysis treatment at two facilities, one with a dental department and the other without a dental department. We used a structured questionnaire to interview participants about their awareness of oral health management issues for dialysis patients, perceived oral symptoms and attitudes about dental visits. Bivariate analysis using the χ2 test was conducted to determine associations between study variables and regular dental check-ups. Binominal logistic regression analysis was used to determine factors associated with regular dental check-ups. RESULTS There were no significant differences in patient demographics between the two participating facilities, including attitudes about dental visits. Therefore, we included all patients in the following analyses. Few patients (4.3%) had been referred to a dentist by a medical doctor or nurse. Although 80.9% of subjects had a primary dentist, only 34.0% of subjects received regular dental check-ups. The most common reasons cited for not seeking dental care were that visits are burdensome and a lack of perceived need. Patients with gum swelling or bleeding were much more likely to be in the group of those not receiving routine dental check-ups (χ2 test, P < 0.01). Logistic regression analysis demonstrated that receiving dental check-ups was associated with awareness that oral health management is more important for dialysis patients than for others and with having a primary dentist (P < 0.05). CONCLUSION Dialysis patients should be educated about the importance of preventive dental care. Medical providers are expected to participate in promoting dental visits among dialysis patients. PMID:27648409
Hu, X L; Ho, B; Lim, C T; Hsu, C S
Numerous studies have demonstrated the effects of laser-induced heat on demineralization of enamel; however, no studies have investigated the link between heat/laser-induced changes in physicochemical properties and bacterial adhesion. In this study, we investigated the effects of thermal treatment on surface properties of enamel such as hydrophobicity and zeta potential. Bacterial adhesion to treated surfaces was characterized by confocal laser scanning microscopy, and adhesion force was quantified by atomic force microscopy. The hydrophobicity of enamel increased after heating (p < 0.05), and the zeta potential of heated enamel became more negative than that of the control (p < 0.01). Streptococcus oralis and S. mitis were more hydrophilic than S. sanguis, with more negative zeta potential (all p < 0.01). S. mitis and S. oralis occupied significantly less area on enamel after being heated (p < 0.05). Heating reduced the adhesion force of both S. mitis and S. oralis to enamel with or without saliva coating. Reduction of adhesion force was statistically significant for S. mitis (p < 0.01), whereas that of S. oralis was not statistically significant (p > 0.05). Heating did not affect the adhesion of S. sanguis with or without saliva coating. In conclusion, thermal treatment and photothermal/laser treatments may modulate the physicochemical properties of enamel, preventing the adhesion of some bacterial species.
Pedersen, Eric R.; Paves, Andrew P.
Perceived public stigma regarding seeking mental health treatment seeking can be a barrier to accessing services for young adults. While factors associating with personal stigma regarding how one would view and treat others have been identified, the discrepancies between perceived and personal stigma has received less research attention. We designed the current study to expand on previous research and examine the discrepancies between perceived public stigma and personal stigma among a sample of 386 primarily White and Asian college students. Participants completed surveys of mental health symptoms, treatment experience and attitudes, perceived public, and personal stigma. Overall, participants generally reported greater perceived public stigma than personal stigma; an effect that was particularly evident for women and those with mental health symptoms. The majority of participants disagreed with items assessing personal stigma. Negative attitudes toward treatment and anxiety symptoms associated with perceived public stigma, while male gender, Asian ethnicity, and negative attitudes toward treatment associated with personal stigma. Findings have implications for interventions and marketing programs to help change perceptions about mental health stigma to encourage utilization of services for those young people who could benefit from care. PMID:24889842
Emerich, Katarzyna; Kaczmarek, Jan
In view of the widespread lack of knowledge of first aid procedures in cases of dental trauma, this article describes the current state of knowledge and highlights the need for education of those likely to witness or be victims of dental trauma while practising sports. Dental and oral injuries, the commonest type of orofacial injuries, are often sustained by athletes playing contact sports; indeed, they represent the most frequent type of sporting injury. Studies of a large group of children and adults have shown that as many as 31% of all orofacial injuries are caused by sporting activities. Furthermore, current literature on the subject emphasizes that awareness of appropriate triage procedures following dental trauma is unsatisfactory. Delay in treatment is the single most influential factor affecting prognosis. What should we know and, more importantly, what should we do? Immediate replantation of an avulsed tooth is the best treatment option at the site of the accident. If replantation is impossible, milk is the preferred transport medium for the avulsed tooth. There is a general low level of awareness about the need for prompt triage of traumatic dental injuries sustained in sports, despite their relative frequency. When a cohort of Swiss basketball players was interviewed, only half were aware that an avulsed tooth could be replanted. Cheap, commercially available tooth storage devices containing an isotonic transport medium (so-called 'Save-a-Tooth boxes'), can maintain the viability of an avulsed tooth for up to 72 hours, prior to replantation. More readily available storage media such as milk, sterile saline or even saliva may be used, but knowledge of this information is rare among sports participants. For example, just 6.6% of the Swiss basketball players interviewed were aware of the 'Tooth Rescue box' products. Sporting organizations seem to offer very little information about sports-related risks or preventive strategies for orodental trauma. Having
Spivack, Jordan G; Swietlik, Maggie; Alessandrini, Evaline; Faith, Myles S
This study evaluated primary care providers' (PCPs, pediatricians, and nurse practitioners) knowledge, current practices, and perceived barriers to childhood obesity prevention and treatment, with an emphasis on first-year well-child care visits. A questionnaire was distributed to 192 PCPs in the primary care network at The Children's Hospital of Philadelphia (CHOP) addressing (i) knowledge of obesity and American Academy of Pediatrics (AAP) guidelines, (ii) anticipatory guidance practices at well visits regarding nutrition and exercise, and (iii) perceived barriers to childhood obesity treatment and prevention. Eighty pediatricians and seven nurse practitioners responded, and a minority correctly identified the definition (26%) and prevalence (9%) of childhood overweight and AAP guidelines for exercise (39%) and juice consumption (44%). Most PCPs (81%) spent 11-20 min per well visit during the first 2 years, and 79% discussed diet, nutrition, and exercise for > or =3 min. Although >95% of PCPs discussed juice, fruits and vegetables, sippy cups, and finger foods during the first year, over 35% never discussed fast food, TV, or candy, and 55% never discussed exercise. Few rated current resources as adequate to treat or prevent childhood obesity. Over 90% rated the following barriers for obesity prevention and treatment as important or very important: parent is not motivated, child is not motivated, parents are overweight, families often have fast food, watch too much TV, and do not get enough exercise. In conclusion, there is much room to improve PCPs' knowledge of obesity and AAP guidelines. Although PCPs rate fast-food consumption, TV viewing, and lack of exercise as important treatment barriers, many never discussed these topics during the first year.
Ali, Mir M; Teich, Judith L; Mutter, Ryan
The expansions in insurance coverage under the Patient Protection & Affordable Care Act (ACA) that took full effect in 2014 have been projected to increase the number of users of behavioral health services. By analyzing data from the 2008-2012 National Survey on Drug Use and Health, this paper examines whether health insurance expansion may result in an increase in substance use disorder (SUD) treatment utilization. The study sample includes 18,600 adults with SUD but no diagnosable mental health condition. The analysis finds that over 80% of that population receives no treatment and 97% do not perceive a need for treatment. When they do receive treatment, they are more likely to receive mental health treatment. Using multinomial logistic regression, the study finds that having Medicaid or private insurance is associated with higher likelihood of receiving SUD treatment, but only when individuals perceive a need for it, compared to being uninsured and not perceiving a need for treatment (the reference category). These results indicate that increased service utilization is associated with perceiving a need for substance abuse treatment, implying that outreach initiatives to raise awareness about SUD and the effective role of substance use treatment are needed to enhance the impact of the structural changes to the substance abuse treatment system resulting from the ACA.
Oomens, M A E-M; Booij, L H D; Baart, J A
General anaesthesia in children younger than 4 years of age can cause brain damage with cognitive and behavioral problems as a result. The chance of these side effects is small, but increases with prolonged duration of the anaesthesia or when the general anaesthesia is provided more frequently. It goes without saying that the indication for anaesthesia should be very strictly set. In order to reduce the chance of damage, the anaesthesia itself should be performed in consultation between the anaesthesiologist and care provider, according to a set protocol. The parents need to be informed of the potential risks of general anaesthesia. Delayed treatment (and thereby provision of the anaesthesia) should be considered.
Wang, Panpan; Chen, Xinmei; Zheng, Liwei; Guo, Lan; Li, Xin; Shen, Simin
Methamphetamine-induced caries (MIC) is the rampant caries often found in methamphetamine (MA) users and is often called "meth mouth". It leads to devastating effects on dentition and is the major reason that brings patients to professional help. Dental management of these patients is challenging and the most important factor is cessation of MA use. Dentists must be aware of the signs and medical risks associated with this serious condition. If duly attended to, the dental team can help patients on many levels. Treatment plans can be simplified, so that each visit does not last too long. Finally, more attention should be paid topostoperative care. This case report presents a 40-year-old man with rampant caries caused by MA abuse with poor oral hygiene and smoking habits. He was advised to stop the drug abuse and the affected teeth underwent endodontic, restorative and prosthetic rehabilitation. One year later, the patient had some secondary caries but had stopped all drug abuse.
Al-Himdani, Sarah; Woodnutt, David
We report a case of a prosthetic joint infection occurring secondary to group C Streptococcus following dental treatment in a 66-year-old woman. This patient presented 11 years following a right hip resurfacing procedure with increasing pain and difficulty mobilising the right hip. An ultrasound and MRI scan identified a collection in the right hip joint, which was subsequently aspirated. Cultures revealed a group C Streptococcus. Extensive washout and surgical debridement of the hip joint was undertaken and the patient was treated with a protracted course of antibiotics. At 1 year follow-up, the patient demonstrated no evidence of recurrent infection. We discuss the evidence underlying prophylactic antibiotic usage regarding dental procedures in the prevention of septic arthritis in patients with prosthetic joints. We also review the spectrum of diseases caused by this organism.
Certosimo, Fred; Walton, Martin; Hartzell, David; Farris, Jennifer
There are environmental health concerns for dental health care providers chronically exposed to trace amounts of waste nitrous oxide (N2O). This study compared the effectiveness of three N2O scavenging systems, the Porter/Brown, the Accutron, and the Matrx, in actual time during use in a standardized mock dental treatment protocol that reflected clinical practice while minimizing the influence of confounding variables. At every occasion during the procedure, the Porter/Brown scavenger system left the operatory with significantly less N2O than any of the other scavengers tested. The Porter/Brown removed between 71% and 91% of the N2O compared to the control (no device).
Hirota, Y; Sugiyama, K; Niwa, H; Matsuura, H
Marfan's syndrome is a dominantly inherited connective tissue disorder characterized by skeletal, ocular, and cardiovascular abnormalities, such as arachnodactyly, dolichostenomelia, kyphosis, scoliosis, pectus excavatum, ectopia lentis, aortic aneurysm and dissection, aortic valve incompetence, and mitral valve prolapse. This report describes the systemic management during dental treatment of a 26-year-old man with Marfan's syndrome. Blood pressure, electrocardiogram, echocardiography, systolic time intervals, and aortic pulse wave velocity were monitored. Nitrous oxide inhalational sedation was employed. In contrast to the vasopressin, felypressin (contained in prilocaine), epinephrine (contained in lidocaine) caused an acceleration of cardiac function--increased heart rate, cardiac output, 1/pre-ejection period (PEP), and aortic pulse wave velocity and decreased PEP and left ventricular ejection time. This experience suggests that the use of anesthetics containing epinephrine in dental patients with Marfan's syndrome needs to be carefully managed.
Pradeep, Y.; Chakravarty, Kalyan K.; Simhadri, Kavya; Ghenam, Alexis; Naidu, Guntipalli M.; Vundavalli, Sudhakar
Aims: To identify the relation between need, demand, and effective demand for dental services in Andhra Pradesh, India. Materials and Methods: This is a cross-sectional study performed among populations residing in the rural and urban areas of Krishna district, Andhra Pradesh, India. Data were collected from 3102 individuals who were selected through multiphase random sampling. Data regarding self-perceived dental need, dental service utilization, and barriers for utilization were collected through s pretested questionnaire followed by type-III clinical examination to assess the normative need of the individuals. Chi-square test was used to compare independent and dependent variables, and further comparison was done with multivariate logistic regression analysis for significant variables. Results: Less than half (40%) of the participants perceived a need for dental care. Among the people who perceived need for care, only 21.4% utilized dental care and 78.6% of them had unmet dental needs. The two main reasons for not seeking dental care was lack of money, i.e., unaffordable dental treatment (48%) and having the perception that they do not have any dental problem (19.4%). Conclusions: There is an enormous difference between normative need, demand, and actual utilization rates in dental care, and hindrances for effective demand need to be addressed to improve dental care delivery system. PMID:27652242
Brunharo, Ione Helena Vieira Portella
Orthodontic preparation for surgical treatment of skeletal Class III malocclusion involves joint planning with an oral and maxillofacial surgeon to address the functional and esthetic needs of the patient. In order to allow surgical manipulation of the jaws in the preoperative phase, the need to achieve a negative overjet through incisor decompensation often leads the orthodontist to extract the upper first premolars. This report illustrates an orthodontic preparation case where due to specific factors inherent in the patient's psychological makeup retroclination of the upper incisors and proclination of the mandibular incisors was achieved without removing any teeth. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) in partial fulfillment of the requirements for obtaining the BBO Diploma.
Misch, Carl E
Bruxism is a potential risk factor for implant failure. Excessive force is the primary cause of late implant complications. An appreciation of the etiology of crestal bone loss, failure of implants, failure to retain implant restorations, and fracture of components will lead the practitioner to develop a treatment plan that reduces force on implants and their restorations. The forces are considered in terms of magnitude, duration, direction, type, and magnification. Once the dentist has identified the source(s) of additional force on the implant system, the treatment plan is altered to contend with and reduce the negative sequelae on the bone, implant, and final restoration. One viable approach is to increase the implant-bone surface area. Additional implants can be placed to decrease stress on any one implant, and implants in molar regions should have an increased width. Use of more and wider implants decreases the strain on the prosthesis and also dissipates stress to the bone, especially at the crest. The additional implants should be positioned with intent to eliminate cantilevers when possible. Greater surface area implant designs made of titanium alloy and with an external hex design can also prove advantageous. Anterior guidance in mandibular excursions further decreases force and eliminates or reduces lateral posterior force. Metal occlusal surfaces decrease the risk of porcelain fracture and do not require as much abutment reduction, which in turn enhances prosthesis retention. The retention of the final prosthesis or super-structure is also improved with additional implant abutments. Night guards designed with specific features also are a benefit to initially diagnose the influence of occlusal factors for the patient, and as importantly, to reduce the influence of extraneous stress on implants and implant-retained restorations.
Suttmoeller, Michael; Keena, Linda D
In the fall of 2005, the state of Missouri launched a three-prong assessment of the relationship between probation and parole and three of their stakeholders: police, courts, and treatment providers. The Division of Probation and Parole was interested in identifying these perceptions as they implement the Missouri Reentry Process (MRP). The MRP promotes the formation of interdependent working relationships between stakeholders and probation and parole. Before these relationships can be fostered or improved, an assessment of the current relationship was necessary. This article focuses on the 2nd year's project that involved a web-based, statewide survey of treatment providers. The purpose of the study was to conduct a utilization-focused evaluation to ascertain treatment providers' perceptions of probation and parole's service delivery. The descriptive statistics examined and described broad perceptions of the relationship. Bivariate analysis was conducted to determine whether a relationship existed between different dimensions such as education level, facility staff size, and other variables such as perceived support for treatment and whether probation and parole officers participate in information-sharing meetings. An overall favorable perception of probation and parole was apparent from the survey results. Statistically significant results for several dimensions of the relationship between probation and parole officers and treatment providers were found. These statistically significant results provided insight into the effectiveness of probation and parole's service delivery. The article concludes with a presentation of policy implications.
Desai, M; Messer, L B; Calache, H
A selected population of children with disabilities in Melbourne, Australia, was studied with reference to their oral disease and treatment needs. A total of 300 children (aged 9-13 years), 150 attending special developmental schools (SDS) and 150 attending special schools (SS), received an oral examination and the parent/guardian completed a questionnaire. Six levels of function were defined, based on the child's independence for five self-care activities (brushing teeth, feeding self, dressing self, walking and performing toilet). The caries experience of children in the SS was lower than in SDS (d + D: 1.3 +/- 1.6 versus 1.5 +/- 2.4; dmft + DMFT: 2.0 +/- 2.3 versus 2.5 +/- 3.1); those attending SDS had higher unmet preventive and restorative needs. Significant associations were seen between the number of decayed teeth, the dmft + DMFT index, and the level of function (p < 0.005). Periodontal disease was prevalent; significant associations were seen between periodontal status, the need for periodontal therapy, and the level of function (p < 0.005). Assessment of the level of function by staff could assist in triaging individuals for urgent dental examination. Despite 41 per cent of children requiring simple treatment, the preventive and treatment needs of many remained unmet. Following examination, diagnosis and treatment planning by a dentist, much of the preventive, simple treatment and oral health promotion could be performed by trained dental auxiliaries. An epidemiological survey followed by the implementation and evaluation of a long-range public dental health care plan for children and adolescents with disabilities is needed urgently.
Bassir, Mahshid Mohammadi; Bagheri, Golnaz
Purpose: To compare the effectiveness of phosphoric acid (H3PO4)-pumice compound with conventional hydrochloric acid (HCl)-pumice compound in treating different severities of dental fluorosis with the microabrasion technique. Materials and Methods: Sixty-seven anterior teeth from seven patients with different severities of dental fluorosis were treated. In each patient, half of the teeth were treated with HCl-pumice compound and the other half with H3PO4-pumice compound (split-mouth design). Both treatment compounds were applied for 30-second periods and treatment continued up to 10 minutes. Before and after treatment, standardized photographs were taken. The photographs were compared by two experienced observers unaware of the modality of treatment. Two indices of aesthetics, improvement in appearance (IA) and degree of stain removal (DSR), were determined according to a visual analog scale. The inter- and intra-correlation coefficients were made; then, statistical analyses were calculated using Mann-Whitney and t-test. Results: There were no significant differences in interobserver evaluation. Improvements in aesthetic indices were observed in all fluorotic teeth by both compounds; however, the mean treatment time with HCl-pumice was significantly lower than H3PO4-pumice. Conclusion: The H3PO4-pumice compound improved aesthetic indices in fluorotic teeth similar to the HCl-pumice compound. PMID:23349575
Viña-Almunia, Jose; Borras, Consuelo; Gambini, Juan; El Alamy, Marya; Viña, Jose
Background Different methods have been used in order to isolate dental pulp stem cells. The aim of this study was to study the effect of different types of pulp treatment during isolation, under 3% O2 conditions, in the time needed and the efficacy for obtaining dental pulp stem cells. Material and Methods One hundred and twenty dental pulps were used to isolate dental pulp stem cells treating the pulp tissue during isolation using 9 different methods, using digestive, disgregation, or mechanical agents, or combining them. The cells were positive for CD133, Oct4, Nestin, Stro-1, CD34 markers, and negative for the hematopoietic cell marker CD-45, thus confirming the presence of mesenchymal stem cells. The efficacy of dental pulp stem cells obtention and the minimum time needed to obtain such cells comparing the 9 different methods was analyzed. Results Dental pulp stem cells were obtained from 97 of the 120 pulps used in the study, i.e. 80.8% of the cases. They were obtained with all the methods used except with mechanical fragmentation of the pulp, where no enzymatic digestion was performed. The minimum time needed to isolate dental pulp stem cells was 8 hours, digesting with 2mg/ml EDTA for 10 minutes, 4mg/ml of type I collagenase, 4mg/ml of type II dispase for 40 minutes, 13ng/ml of thermolysine for 40 minutes and sonicating the culture for one minute. Conclusions Dental pulp stem cells were obtained in 97 cases from a series of 120 pulps. The time for obtaining dental pulp stem cells was reduced maximally, without compromising the obtention of the cells, by combining digestive, disgregation, and mechanical agents. Key words:Dental pulp stem cells, mesenchymal stem cells, isolation method. PMID:26946201
Blank, Molly A. B.; Friedrich, Michal; Hamilton, Jeffrey D.; Lee, Peggy; Berg, Joel; Seibel, Eric J.
Complications that arise during endodontic procedures pose serious threats to the long-term integrity and health of the tooth. Potential complexities of root canals include residual pulpal tissue, cracks, mesial-buccal 2 and accessory canals. In the case of a failed root canal, a successful apicoectomy can be jeopardized by isthmuses, accessory canals, and root microfracture. Confirming diagnosis using a small imaging probe would allow proper treatment and prevent retreatment of endodontic procedures. An ultrathin and flexible laser scanning endoscope of 1.2 to 1.6mm outer diameter was used in vitro to image extracted teeth with varied root configurations. Teeth were opened using a conventional bur and high speed drill. Imaging within the opened access cavity clarified the location of the roots where canal filing would initiate. Although radiographs are commonly used to determine the root canal size, position, and shape, the limited 2D image perspective leaves ambiguity that could be clarified if used in conjunction with a direct visual imaging tool. Direct visualization may avoid difficulties in locating the root canal and reduce the number of radiographs needed. A transillumination imaging device with the separated illumination and light collection functions rendered cracks visible in the prepared teeth that were otherwise indiscernible using reflected visible light. Our work demonstrates that a small diameter endoscope with high spatial resolution may significantly increase the efficiency and success of endodontic procedures.
Background HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Methods Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview. Results A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8). Conclusion Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance
Pich, Olena; Franzen, René; Gutknecht, Norbert; Wolfart, Stefan
In the present paper, we investigate the behaviour of different dental materials under laser irradiation. We have used e.max Ceram, e.max ZirCAD, and e.max Press dental ceramics and glass ionomer cement Ketac Cem in the present study. The dental ceramics were prepared in the form of samples with thickness of 0.5-2 mm. We used two lasers [solid-state laser (Er:YAG, Fidelis III+, Fotona) and an 810- nm diode laser (FOX, A.R.C)] for the transillumination of ceramic samples. It has been shown that the laser energy transmitted through the ceramic material decreases to 30-40% of the original values along with an increase in the thickness of the irradiated sample. Pigmented ceramic samples show more laser energy loss compared to the samples containing no pigment. We investigated the temperature evolution in composite sandwiched ceramic/cement samples under laser treatment. The increase in the irradiation time and laser power led to a temperature increase of up to 80 °C. The surfaces of irradiated ceramic samples were examined with X-ray photoelectron spectroscopy to evaluate changes in chemical composition, such as a decrease in the C signal, accompanied by a strong increase in the Zr peak for the Er:YAG laser, while the 810-nm diode laser showed no change in the ratio of elements on the surface.
Demant, Sune; Markvart, Merete; Bjørndal, Lars
There is a gap between the endodontic outcome that can be achieved and the outcome observed on the basis of worldwide general dental practitioner data. The quality of root canal treatment (RCT) is shaped by the dentist's knowledge, attitude, and skills, but it may also be influenced by the patient's demands and degree of satisfaction. The topic has only been sparsely investigated. Although dental health has increased over the years in Denmark, the number of performed root fillings has also increased, probably because the number of tooth extractions have declined and more molar teeth have been treated. Caries appears to be the main cause for performing RCT and a preventive approach by employing stepwise excavation may reduce RCT, but this strategy does not remove the gap. Factors influencing RCT quality could be the status on adoption of nickel-titanium rotary technology, more focus on infection control (rubber dam use, knowledge of factors important for prognosis), as dentists often think that they are good at doing RCT, but often perform inadequately, an alteration of clinician's awareness of their performance in the context of dental practices, seems warranted. Finally, the development of new preventive modalities for pulp and apical inflammation are crucial. PMID:22536241
Gibson, Pamela Reed; Elms, Amy Nicole-Marie; Ruding, Lisa Ann
Multiple chemical sensitivity (MCS) is a condition in which persons experience negative health effects in multiple organ systems from exposure to low levels of common chemicals. Although symptoms experienced from particular chemicals vary across persons, they are generally stable within persons. The sensitivities often spread over time, first to related chemicals and then to other classes of chemicals. This study examined self-reported perceived treatment efficacy of 101 treatments used by 917 persons with self-reported MCS. Treatments examined included environmental medicine techniques, holistic therapies, individual nutritional supplements, detoxification techniques, body therapies, Eastern-origin techniques, newer therapies, prescription items, and others. The three most highly rated treatments were creating a chemical-free living space, chemical avoidance, and prayer. Both creating a chemical-free living space and chemical avoidance were rated by 95% of respondents as helpful. Results for most therapies were mixed. Participants had consulted a mean of 12 health care providers and spent over one-third of their annual income on health care costs. We discuss this drain on personal resources and describe respondents' attitudes toward the possibility of healing from MCS. PMID:12948890
McComas, Martha J; Inglehart, Marita R
The changing role of dental hygienists deserves dental and dental hygiene educators' attention. The first aim of this survey study was to assess University of Michigan dental, dental hygiene, and graduate students' and faculty members' perceptions of dental hygienists' roles; their attitudes and behaviors related to clinical interactions between dental and dental hygiene students; and perceived benefits of engaging dental hygiene students as peer teachers for dental students. The second aim was to assess whether one group of dental students' experiences with dental hygiene student peer teaching affected their perceptions of the dental hygiene profession. Survey respondents were 57 dental hygiene students in all three years of the program (response rate 60% to 100%); 476 dental students in all four years (response rate 56% to 100%); 28 dental and dental hygiene graduate students (response rate 28%); and 67 dental and dental hygiene faculty members (response rate 56%). Compared to the other groups, dental students reported the lowest average number of services dental hygienists can provide (p≤0.001) and the lowest average number of patient groups for which dental hygienists can provide periodontal care (p<0.001). Dental students also had the least positive attitudes about clinical interactions between dental hygiene and dental students (p<0.001) and perceived the fewest benefits of dental hygiene student peer teaching (p<0.001) before experiencing peer teaching. After experiencing dental hygiene student peer teaching, the dental students' perceptions of dental hygienists' roles, attitudes about clinical interactions with dental hygienists, and perceived benefits of dental hygiene student peer teachers improved and were more positive than the responses of their peers with no peer teaching experiences. These results suggest that dental hygiene student peer teaching may improve dental students' perceptions of dental hygienists' roles and attitudes about
Rakhshan, Hamid; Rakhshan, Vahid
Background and objectives As the most common complication of orthodontic treatment, pain can negatively impact quality of life and cause patients to discontinue treatment. However, few studies have evaluated pain during orthodontic treatment, with controversial findings. This study assessed the intensity and duration of pain and discomfort caused by active orthodontic treatment. Methods This descriptive cross-sectional study examined 67 patients (22 men, 45 females; age range: 18–32 years) undergoing fixed orthodontic treatment. Patients were interviewed after the active treatment stage to assess their perceived pain and discomfort at different sites during different activities by a visual analogue scale. Frequency and duration of pain in different areas were analyzed by the chi-squared and chi-squared goodness-of-fit tests (α = 0.05). Results Among the 67 patients, 65.7% experienced general dentogingival pain or discomfort and 34.3% had localized dentogingival pain or discomfort (p = 0.010, chi-squared goodness-of-fit test). Masticating soft foods reduced discomfort (p = 0.000, chi-squared) in the tongue, cheeks, and in or around the teeth and gingivae. Pain and discomfort were mostly moderate while masticating sticky, fibrous, and firm foods. Mild pains were mostly reported during tooth brushing and while consuming soft foods (p < 0.05, chi-squared). Pain and discomfort tended to last for more than 4 weeks, except in the tongue, where pain and discomfort lasted less than 4 weeks (p < 0.05, chi-squared goodness-of-fit test). Conclusions Pain and discomfort occur for more than 4 weeks after beginning fixed orthodontic treatment. Changing diets to incorporate softer foods is recommended to alleviate pain. PMID:26082574
Fedyai, S. G.; Prochonchukov, Alexander A.; Zhizhina, Nina A.; Metelnikov, Michael A.
We report results of clinical application of the new computer-laser system. The system includes hardware and software means, which are applied for new efficient methods of prevention and treatment of main dental diseases. The hardware includes a laser physiotherapeutic device (LPD) `Optodan' and a fiberoptic laser delivery system with special endodontic rigging. The semiconductor AG-AL-AG laser diode with wavelengths in the spectral range of 850 - 950 nm (produced by Scientific-Industrial Concern `Reflector') is used as a basic unit. The LPD `Optodan' and methods of treatment are covered by Russian patent No 2014107 and certified by the Russian Ministry of Health. The automated computer system allows us to examine patients quickly and to input differential diagnosis, to determine indications (and contraindications), parameters and regimen of laser therapy, to control treatment efficacy (for carious -- through clinical indexes of enamel solubles, velocity of demineralization and other tests; for periodontal diseases trough complex of the periodontal indexes with automated registry and calculation). We present last results of application of the new technique and methods in treatment of dental diseases in Russian clinics.
Lin, Mau-Chin; Tung, Kuo-Lung; Lin, Sheng-Chieh; Huang, Her-Hsiung
This study investigated the bonding of dental porcelain to non-cast Ti surface with different treatments. Mechanically ground non-cast Ti strips, simulating surface conditions produced by CAD/CAM, were Al(2)O(3)-sandblasted, then subjected to different surface treatments, including immersion in HNO(3)-containing acid, NaOH-containing alkaline, and NaOH-containing alkaline then HNO(3)-containing acid. Ti-porcelain specimens preparations and their bend strength measurements were based on ISO 9693. Ti surface treatment changed not only surface roughness but also surface chemistry, leading to influence on bond strength. Bond strengths of all Ti-porcelain groups were higher than ISO 9693 minimum requirement. The sandblasted/acid-treated Ti surface showed the highest bond strength (34.60 MPa) with porcelain; no significant difference in bond strength (27.92-29.63 MPa) was found among other Tiporcelain groups. All Ti-porcelain specimens showed adhesive bond failure. Bonding between non-cast Ti and dental porcelain was strengthened by a simple and practical sandblasting/acid-etching treatment of the Ti surface prior to porcelain sintering.
Mattos Júnior, Francisco Moreira; Mattos, Rafael Villanova; Teixeira, Manoel Jacobsen; Siqueira, Silvia Regina Dowgan Tesseroli de; Siqueira, Jose Tadeu Tesseroli de
The objective was to investigate the effect of nitrous/oxygen in chronic pain. Seventy-seven chronic pain patients referred to dental treatment with conscious sedation with nitrous oxide/oxygen had their records included in this research. Data were collected regarding the location and intensity of pain by the visual analogue scale before and after the treatment. Statistical analysis was performed comparing pre- and post-treatment findings. It was observed a remarkable decrease in the prevalence of pain in this sample (only 18 patients still had chronic pain, p < 0.001) and in its intensity (p < 0.001). Patients that needed fewer sessions received higher proportions of nitrous oxide/oxygen. Nitrous oxide may be a tool to be used in the treatment of chronic pain, and future prospective studies are necessary to understand the underlying mechanisms and the effect of nitrous oxide/oxygen in patients according to the pain diagnosis and other characteristics.
Patients with dental emergencies sometimes present to their physician. This article outlines the role of the physician in the management of dental patients who have suffered traumatic injuries, postoperative hemorrhage, pain, and infection. It deals with those difficulties for which the physician may easily prescribe treatment and outlines the treatment that would be undertaken by a dentist who receives such a patient on referral. PMID:21253249
Bassirnia, Anahita; Briggs, Jessica; Kopeykina, Irina; Mednick, Amy; Yaseen, Zimri; Galynker, Igor
Internalized stigma of mental disorders has significant negative outcomes for patients with bipolar disorder and their families. The aim of this study is to evaluate the association between personality traits and internalized stigma of mental disorders in bipolar patients and their treatment partners. Five different questionnaires were utilized in this study: (1) Demographic data questionnaire, (2) Millon Clinical Multiaxial Inventory-III (MCMI-III) for personality traits, (3) Internalized Stigma of Mental Illness (ISMI) for stigma, (4) Self Report Manic Inventory (SRMI) for mania and (5) Center for Epidemiological Studies-Depression Scale (CES-D) for depression. The scores of personality traits were combined to create externalizing and internalizing personality trait scores. Results showed that patients with bipolar disorder and their treatment partners both experienced internalized stigma of mental health disorders. There was a significant positive correlation between internalized stigma and internalizing personality traits, but not externalizing traits. In a multi-variate regression analysis, internalizing personality trait score was found to be a significant predictor of internalized stigma. In conclusion, patients with bipolar disorder and their treatment partners perceive higher level of internalized stigma of mental disorders if they have internalizing personality traits.
Bernhard, Bo; Abarbanel, Brett L. L.; St. John, Sarah; Kalina, Ashlee
The objective of this study was to evaluate the relationship between treatment service quality, perceived improvement in social, functional, and material well-being and reduction in gambling behaviors among clients of Nevada state-funded pathological gambling treatment programs. Utilizing survey data from 361 clients from 2009 to 2010, analyses revealed that client satisfaction with treatment services is positively associated with perceived improvements in social, functional, and material well-being, abstinence from gambling, reduction in gambling thoughts and reduction in problems associated with gambling, even after controlling for various respondent characteristics. These findings can be useful to treatment program staff in managing program development and allocating resources. PMID:23756725
Lin, Shih-Ming; Svoboda, Kathy K.H.; Giletto, Anthony; Seibert, Jeff; Puttaiah, Raghunath
Objectives: To study effects of various concentrations of hydrogen peroxide on mature waterline biofilms and in controlling planktonic (free-floating) organisms in simulated dental treatment water systems; and to study in vitro the effects of 2%, 3%, and 7% hydrogen peroxide on the removal of mature biofilms and inorganic compounds in dental waterlines. Methods: Four units of an automated dental unit water system simulation device was used for 12 weeks. All units were initially cleaned to control biofilms and inorganic deposits. H2O2 at concentrations of 1%, 2%, 3% was used weekly for periodic cleaning in three treatment group units (units 1, 2 & 3), with 0.05%, 0.15% and 0.25% H2O2 in municipal water used as irrigant respectively. The control unit (unit 4) did not have weekly cleanings and used municipal water as irrigant. Laser Scanning Confocal Microscopy and Scanning Electron Microscopy were used to study deposits on lines, and weekly heterotrophic plate counts done to study effluent water contamination. A 24 hour in vitro challenge test with 7%, 3% and 2% H2O2 on mature biofilms was conducted using harvested waterlines to study biofilm and inorganic deposit removal. Results: Heterotrophic plate counts of effluent water showed that the control unit reached contamination levels in excess of 400,000 CFU/mL while all treatment units showed contamination levels <500 CFU/mL through most of the 12 weeks. All treatment units showed varying levels of biofilm and inorganic deposit control in this short 12 week study. The in vitro challenge test showed although there was biofilm control, there was no eradication even when 7% H2O2 was used for 24 hours. Conclusions: 2% H2O2 used as a periodic cleaner, and diluted to 0.05% in municipal water for irrigation was beneficial in controlling biofilm and planktonic contamination in dental unit water systems. However, to remove well established biofilms, it may take more than 2 months when initial and multiple periodic cleanings
ABSTRACT Non-bullous congenital ichthyosiform erythroderma (NBCIE) is an autosomal recessive form of inherited icthyosis appears as fine white scales that gradually replace collodion membrane. This case report describes management of 5 years and 11-month-old child with NBCIE suffering from early childhood caries (ECC) under general anesthesia. How to cite this article: Choudhary R, Satish V. Dental Treatment of a Child Suffering from Non-bullous Congenital Ichthyosiform Erythroderma under General Anesthesia. Int J Clin Pediatr Dent 2015;8(2):157-162. PMID:26379388
Dmitrenko, M I
The results of investigation showed that it is necessary to use complex methods of orthodontic treatment in patients with malocclusion complicated by dental crowding. Orthodontic appliance therapy should be accompanied by differentiated massage and mioymnastics to improve functional state of masseter and temporal muscles. It was found that after the treatment electromyographic potential amplitude of temporal muscles is on the average in 1.5 times lower as compared with pretreatment records (P < 0.05). It was observed increase on the average in 1.5 times in electromyographic potential oscillation amplitude of masseter muscles during clenching after the treatment of maxillary and mandibular dental crowding (P < 0.05). Treatment of dental crowding resulted in restoration of masseter muscles functional symmetry. During clenching index MASI(MM) significantly decreased in all groups in comparison with pretreatment indices (P < 0.05).
Kateeb, Elham T; Warren, John J; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael; Weber-Gasparoni, Karin; Ansley, Tim
The International Dental Federation and World Health Organization have promoted the use of Atraumatic Restorative Treatment (ART) in modern clinical settings worldwide. In the United States, the practice of ART is not believed to be widely used, which may be a result of little attention given to ART training in predoctoral pediatric dentistry curricula in U.S. dental schools. This study investigated the extent of clinical and didactic instruction on ART provided in U.S. dental schools by surveying the predoctoral pediatric dentistry programs in 2010. Of the fifty-seven directors asked to complete the survey, forty-four responded for a response rate of 77 percent. Of these forty-four programs, 66 percent reported providing clinical training on ART, though only 14 percent provide this training often or very often. The types of ART training provided often or very often included interim treatment (18 percent) and single-surface cavities (14 percent) in primary teeth. However, ART was said to be rarely taught as a definitive treatment in permanent teeth (2 percent). Attitude was a major predictor, for clinical training provided and using professional guidelines in treatment decisions were associated with a positive attitude towards ART. These predoctoral pediatric dentistry programs used ART mainly in primary, anterior, and single-surface cavities and as interim treatment. As ART increases access of children to dental care, the incorporation of the ART approach into the curricula of U.S. dental schools should be facilitated by professional organizations.
Rahal, Vanessa; Gallinari, Marjorie O; Perdigão, Jorge; Cintra, Luciano T A; dos Santos, Paulo H; Briso, André L F
The aim of this study was to quantify tooth sensitivity during bleaching and after a desensitizing treatment. Sensitivity was measured with a new device, TSA-II, which uses thermal stimuli for Quantitative Sensory Testing (QST). Ten patients underwent bleaching treatment using Whiteness HP Maxx (FGM Produtos Odontológicos Ltda) containing 35% hydrogen peroxide. After the bleaching session, the teeth were cleaned with air/water spray and the product Desensibilize KF 2% (FGM Produtos Odontológicos Ltda) was applied to the upper left teeth. Saline solution at room temperature was applied in the upper right teeth. QST was performed before bleaching, immediately after bleaching, and immediately after desensitizing treatment. In order to standardize tooth analysis, a 100% ethylene copolymer and vinyl acetate tray with circular perforations was used during measurements. Analysis of variance and the Student's t-test were used (a=0.05). Mean temperatures (SD) of cold sensation threshold for the upper right quadrant were: BB-13.898 (4.81), AB- 19.241 (3.68), AD-20.646 (3.72) and for the upper left quadrant they were: BB-14.102 (3.22), AB-19.646 (4.82), AD- 13.835 (3.63). Dental bleaching with highly concentrated peroxides changed dental cold sensation thresholds, but the topical desensitizer changed the immediate cold sensation thresholds produced by the cold stimulus.
Yakob, Bereket; Ncama, Busisiwe Purity
Objective To investigate the levels and factors affecting the perceived quality of HIV/AIDS treatment and care services. Design A cross-sectional study. Setting The study was conducted in Wolaita Zone of southern Ethiopia in one hospital and five health centres providing antiretroviral therapy (ART) and pre-ART. Participants 481 persons infected with HIV on outpatient care, 408 (83.8%) on ART and 73 (16.2%) on pre-ART care. Results 324 (71.4%) of the participants perceived the quality of HIV care as ‘good’, while 130 (28.6%) stated that it was ‘not good’; 219 (46.2%) and 255 (53.8%) were satisfied and not satisfied with the services, respectively. In the multivariate analysis, a unit increase in the doctors subscale of multidimensional health locus of control-form c score resulted in a 1.27 (1.04 to 1.55) increase in the odds of perceived good quality of care (p<0.05). Similarly, a unit increase in the responsiveness, perceived financial fairness, and perceived transportation convenience scores was associated with a 1.03 (1.01 to 1.05) (p<0.05), 1.08 (1.05 to 1.15) (p<0.01), and 1.07 (1.05 to 1.18) (p<0.05) increase in the odds of perceived good quality of HIV care, respectively. In terms of client satisfaction with services, a 1 km increase in the distance from health facilities, and unemployment were associated with a 4.64 (2.61 to 8.25) (p<0.001), 1.02 (1.01 to 1.04) (p<0.05) and 2.23 (1.30 to 4.54) (p<0.01) times, respectively, increase in the perceived quality of HIV treatment and care services. Conclusions The majority of the participants reported perceptions of good quality HIV care and satisfaction with the services. Satisfaction with services; responsiveness; health locus of control; perceived financial fairness; perceived transportation convenience; employment status; and distance from the health facility were predictors of the perceived quality of HIV care. Thus, improving quality of HIV treatment services may require addressing the above
Brahm, Carl-Otto; Klingberg, Gunilla; Ekfeldt, Anders
In 1998 the Swedish Parliament decided about increased financing of dental support and service given to persons with disabilities who were dependent on nursing personnel or others in their activities of daily life including oral hygiene procedures. One part of the legislation called "Necessary dental care, group 3" (NDC3) includes persons with intellectual disabilities and disabilities due to brain damage, autism and autism-like disorders, and persons with lasting mental and physical disabilities not related to normal ageing. The objectives where to investigate persons affected by this legislation; how many and what patients covered by NDC3 in Västra Götaland County received prosthodontic therapy from 2001 through 2004, at hospital dental clinics or dental specialist clinics. Patients treated with prosthodontic restorations covered financially by the county council under the terms of NDC3 were identified through the county council's registers. The application forms for NDC3 were retrieved and information about patient characteristics and type of treatments were compiled. It was shown that 57 patients covered by NDC3 in Västra Götaland County received prosthodontic therapy at dental specialist clinics and 50 were treated at the hospital dental clinics for extensive prosthodontic treatment needs. The mean age for the patients rehabilitated with removable dentures was higher (56.2 years) compared with patients treated with single tooth implants (39.7 years). About 30 patients, representing 1 to 2% of the NDC3 population in Västra Götaland County were rehabilitated with more advanced prosthodontic restorations in hospital dental clinics or dental specialist clinics each year. In conclusion and with respect to the probably large need for prosthodontic therapy among persons with disabilities, the use of NDC3 has not been properly utilized.
The Role of Smoking-Specific Experiential Avoidance in the Relation Between Perceived Stress and Tobacco Dependence, Perceived Barriers to Cessation, and Problems during Quit Attempts Among Treatment-Seeking Smokers.
Garey, Lorra; Farris, Samantha G; Schmidt, Norman B; Zvolensky, Michael J
Despite the clinically-significant association between perceived stress and smoking, there is little understanding of the mechanisms underlying this relation. The present study examined smoking-specific experiential avoidance as an explanatory mechanism linking perceived stress and smoking, including nicotine dependence, perceived barriers to cessation, and problems reported during past quit attempts among treatment-seeking daily smokers (n = 365; 48.5% female; Mage = 38.02; SD = 13.10). Results indicated that smoking-specific experiential avoidance had a significant, indirect effect on perceived stress and the studied smoking criterion variables. The present findings provide initial empirical support that smoking-specific experiential avoidance may help explain how perceived stress is associated with smoking. These data suggest that there may be merit to targeting smoking-specific experiential avoidance during smoking cessation among smokers with elevated perceived stress.
The Role of Smoking-Specific Experiential Avoidance in the Relation Between Perceived Stress and Tobacco Dependence, Perceived Barriers to Cessation, and Problems during Quit Attempts Among Treatment-Seeking Smokers
Garey, Lorra; Farris, Samantha G.; Schmidt, Norman B.; Zvolensky, Michael J.
Despite the clinically-significant association between perceived stress and smoking, there is little understanding of the mechanisms underlying this relation. The present study examined smoking-specific experiential avoidance as an explanatory mechanism linking perceived stress and smoking, including nicotine dependence, perceived barriers to cessation, and problems reported during past quit attempts among treatment-seeking daily smokers (n = 365; 48.5% female; Mage = 38.02; SD = 13.10). Results indicated that smoking-specific experiential avoidance had a significant, indirect effect on perceived stress and the studied smoking criterion variables. The present findings provide initial empirical support that smoking-specific experiential avoidance may help explain how perceived stress is associated with smoking. These data suggest that there may be merit to targeting smoking-specific experiential avoidance during smoking cessation among smokers with elevated perceived stress. PMID:27231668
Firmino, Ramon Targino; Siqueira, Maria Betânia Lins Dantas; Vieira-Andrade, Raquel Gonçalves; Gomes, Genara Brum; Martins, Carolina Castro; Paiva, Saul Martins; Granville-Garcia, Ana Flávia
The objective of this study was to evaluate prediction factors for failure to seek treatment following a traumatic dental injury (TDI) to primary teeth among preschool children in the city of Campina Grande, Brazil. A cross-sectional study was carried out involving 277 children 3 to 5 years of age, with TDI, enrolled in public and private preschools. Parents filled out a form addressing demographic data and whether or not they had sought treatment. Clinical examinations were performed by three dentists who had undergone a calibration exercise (Kappa: 0.85 to 0.90) for the evaluation of TDI. Bivariate and multivariate Poisson regression models were constructed (α=5%). Enamel fracture was the most prevalent type of TDI (48.7%) and the upper central incisors were the most affected teeth (88.4%). The frequency of seeking dental treatment was low (9.7%). The following variables were associated with failure to seek treatment following TDI: a household income greater than one minimum wage (PR=1.170; 95%CI 1.018-1.341), parents/caregivers' perception of a child's oral health as poor (PR=1.100; 95%CI 1.026-1.176), and the non-perception of TDI by parents/caregivers (PR=1.250; 95%CI 1.142-1.360). In the present study, the frequency of seeking treatment following TDI was low, and parents/caregivers with a higher income, a poor perception of their child's oral health and a lack of awareness regarding the trauma were more likely to fail to seek treatment following TDI to primary teeth.
Kim, J W; Kim, L U; Kim, C K
Nearly monodispersed silica nanoparticles having a controlled size from 5 to 450 nm were synthesized via a sol-gel process, and then the optimum conditions for the surface treatment of the synthesized silica nanoparticles with a silane coupling agent (i.e., 3-methacryloxypropyltrimethoxysilane (gamma-MPS)) were explored to produce dental composites exhibiting enhanced adhesion and dispersion of silica nanoparticles in the resin matrix. The particle size was increased by increasing amounts of the catalyst (NH4OH) and silica precursor (tetraethylorthosilicate, TEOS) and by decreasing the amount of water in the reaction mixtures regardless of solvents used for the synthesis. The particle size prepared by using ethanol as a solvent was significantly larger than that prepared by using methanol as a solvent when the composition of the reaction mixture was fixed. The nanosized particles in the 5-25 nm range were aggregated. The amount of grafted gamma-MPS on the surface of the synthesized silica nanoparticles was dependent on the composition of the reaction mixture when an excess amount of gamma-MPS was used. When surface treatment was performed at optimum conditions found here, the amount of the grafted gamma-MPS per unit surface area of the silica nanoparticles was nearly the same regardless of the particle size. Dispersion of the silica particles in the resin matrix and interfacial adhesion between silica particles and resin matrix were enhanced when surface treated silica nanoparticles were used for preparing dental nanocomposites.
Elsayed, Randa Osman; Abu-Bakr, Neamat H; Ibrahim, Yahia Eltayeb
The aim of the present study was to evaluate the quality of root canal treatment performed by undergraduate dental students at the University of Khartoum. Assessment was by examination of periapical radiographs of completed endodontically treated teeth, performed by undergraduate dental students. A total of 166 postoperative periapical radiographs compromising 265 roots were included. The quality of endodontic treatment was examined in relation to the length of the root filling in relation to the radiographic apex, the density of the obturation according to presence of voids and the taper of root canal fillings. Adequate length of the root filling was found in 34.7% of the maxillary teeth and in 10.9% of mandibular teeth in this study. Adequate density was found in 38.87% of maxillary and 16.98% of mandibular teeth and appropriate taper was found in 40% of maxillary and 16.6% of mandibular teeth. Overall 24.2% in all evaluated teeth were found to have a root filling of an acceptable quality. This result may be because of insufficient preclinical endodontic training of the students' operators or because of the introduction of students to endodontic clinical practice late in their program.
Lee, Yu-Rim; Enright, Robert D.
This study examined how forgiveness mediates and moderates between fathers' perceived unfair treatment (PUT) from a family of origin member and anger with the child (AWC). Eighty married fathers who have at least one child between the ages of 2 and 7 years individually completed the Opening Questionnaire, the Enright Forgiveness Inventory, the…
Wilson, Coralie Joy; Deane, Frank P.; Marshall, Kellie L.; Dalley, Andrew
The "Building Bridges to General Practice" (BBGP) program is an outreach initiative. It aims to reduce young peoples' perceived knowledge- and belief-based barriers to engaging in treatment and to increase their behavioral intentions to consult a general medical practitioner (GP) for physical and psychological problems. By increasing…
Gunlicks-Stoessel, Meredith; Mufson, Laura; Jekal, Angela; Turner, J. Blake
Objective: Aspects of depressed adolescents' perceived interpersonal functioning were examined as moderators of response to treatment among adolescents treated with interpersonal psychotherapy for depressed adolescents (IPT-A; Mufson, Dorta, Moreau, & Weissman, 2004) or treatment as usual (TAU) in school-based health clinics. Method:…
Teitelbaum, Valérie; Balon-Perin, Alain; De Maertelaer, Viviane; Daelemans, Philippe; Glineur, Régine
The impact of dental and skeletal movements on the soft tissues during orthodontic and surgical treatments is widely known. Most studies are limited to examining the repercussions of a dental or skeletal movement on a given soft tissue point. The uniqueness of the present study, carried out on 95 patients, lies in the examination of the impact of movements of various landmarks--2 dental points (incision superius and incision inferius) and 4 skeletal points (anterior nasal spine, point A, point B, andpogonion)--on 7 soft tissue landmarks (from the tip of the nose to soft tissue pogonion). The study was carried out with the purpose of providing a simple, practical, and accurate tool for clinical use to assist in treatment planning. This article outlines the main aspects of the tool while specifying its limitations and error margins.
Jacob, Helder Baldi; dos Santos-Pinto, Ary; Buschang, Peter H.
Introduction Due to the lack of studies that distinguish between dentoalveolar and basal changes caused by the Thurow appliance, this clinical study, carried out by the School of Dentistry - State University of São Paulo/Araraquara, aimed at assessing the dental and skeletal changes induced by modified Thurow appliance. Methods The sample included an experimental group comprising 13 subjects aged between 7 and 10 years old, with Class II malocclusion and anterior open bite, and a control group comprising 22 subjects similar in age, sex and mandibular plane angle. Maxillary/mandibular, horizontal/vertical, dental/skeletal movements (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6) were assessed, based on 14 landmarks, 8 angles (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) and 3 linear measures (N-Me, ANS-Me, S-Go). Results Treatment caused significantly greater angle decrease between the palatal and the mandibular plane of the experimental group, primarily due to an increase in the palatal plane angle. ANB, SNA and S-N-ANS angles significantly decreased more in patients from the experimental group. PNS was superiorly remodeled. Lower face height (ANS-Me) decreased in the experimental group and increased in the control group. Conclusions The modified Thurow appliance controlled vertical and horizontal displacements of the maxilla, rotated the maxilla and improved open bite malocclusion, decreasing lower facial height. PMID:24713556
Dadresanfar, Bahareh; Mohammadzadeh Akhlaghi, Nahid; Vatanpour, Mehdi; Atef Yekta, Hojat; Baradaran Mohajeri, Ladan
INTRODUCTION: This study was carried out to evaluate the technical quality of root canal treatment (RCT) performed by undergraduate dental students at the Islamic Azad University in Tehran, Iran. MATERIALS AND METHODS: Four-hundred records of patients who had received RCT at faculty of dentistry, between the years 2004-2006 were evaluated. For each treated tooth at least three periapical x-rays were assessed: preoperative, working length measurement, and postoperative. Evaluation of root canal filling was based on two variables: length and density. The filling length was recorded as adequate, under- or overfilled. Density of filling was recorded as poor or adequate. Fillings with adequate length and density were recorded as acceptable. Detected iatrogenic errors were: ledge formations, root perforations, furcation perforations, strip perforations and presence of fractured instruments. Results were evaluated statistically using one-way ANOVA and Chi-square analysis. RESULTS: Out of the 400 teeth, 50.5% had at least one of the mentioned errors. Acceptable filling was observed in 32.5% of all studied teeth. Ledge was found in 17.5% of the teeth. Canal curvature was the most important factor associated with ledge formation (P<0.05). CONCLUSION: The technical quality of RCT performed by undergraduate dental students using step-back preparation and cold lateral condensation was classified as acceptable in 32.5% of the cases. PMID:24146674
Hassan, Khalid S
The use of composite bone grafts in dehiscence defects around immediate dental implants are aimed at improving the outcome of the regenerative process. The present study was designed to evaluate the efficacy of combinations of autogenous bone graft with a synthetic copolymer polylactic and polyglycolic acid (Fisiograft) on bone healing of buccal dehiscence defects around immediate dental implants. Sixteen adult male patients who each received an immediate implant for a single tooth replacement at a maxillary anterior or premolar site were included in this study. Patients were divided into 2 groups. One group received immediate dental implants augmented with autogenous bone graft combined with Fisiograft. The other group received immediate dental implants augmented with autogenous bone graft alone. The results revealed that both treatment modalities led to significant improvements for the primary outcome regarding bone fill as well as a significant reduction of probing pocket depth and gain of attachment level. Moreover, there were slightly statistically significant differences between the groups. In conclusion, the combination of autogenous bone graft and Fisiograft showed a slight superiority to autogenous bone graft alone, suggesting that it could be an optimum bone substitute for treatment of dehiscence around immediate dental implant.
Kasraei, Shahin; Torkzaban, Parviz; Shams, Bahar; Hosseinipanah, Seyed Mohammad; Farhadian, Maryam
The aim of the present study was to evaluate the success rate of failed implants re-implanted after surface treatment with CO2 laser. Despite the widespread use of dental implants, there are many incidents of failures. It is believed that lasers can be applied to decontaminate the implant surface without damaging the implant. Ten dental implants that had failed for various reasons other than fracture or surface abrasion were subjected to CO2 laser surface treatment and randomly placed in the maxillae of dogs. Three failed implants were also placed as the negative controls after irrigation with saline solution without laser surface treatment. The stability of the implants was evaluated by the use of the Periotest values (PTVs) on the first day after surgery and at 1, 3, and 6 months post-operatively. The mean PTVs of treated implants increased at the first month interval, indicating a decrease in implant stability due to inflammation followed by healing of the tissue. At 3 and 6 months, the mean PTVs decreased compared to the 1-month interval (P < 0.05), indicating improved implant stability. The mean PTVs increased in the negative control group compared to baseline (P < 0.05). Independent t-test showed that the mean PTVs of treated implants were significantly lower than control group at 3 and 6 months after implant placement (P < 0.05). Based on the PTVs, re-implantation of failed implants in Jack Russell Terrier dogs after CO2 laser surface debridement is associated with a high success rate in terms of implant stability.
Maeda, S.; Kita, F.; Miyawaki, T.; Takeuchi, K.; Ishida, R.; Egusa, M.; Shimada, M.
Patients with serious intellectual disability (ID) are occasionally unable to tolerate dental treatment when intravenous sedation or general anaesthesia (IVSGA) is involved. In order to make a decision regarding the application of IVSGA, the International Classification of Functioning, Disability and Health (ICF) is useful. Therefore, in this…
de Paula, Janice S; Sarracini, Karin L M; Meneghim, Marcelo C; Pereira, Antônio C; Ortega, Edwin M M; Martins, Natália S; Mialhe, Fábio L
This study aimed to evaluate the impact of dental caries treatment on oral health-related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ8-10 ) instrument. Brazilian schoolchildren, 8-10 yr of age, were randomly selected and assigned to two groups--dental caries treatment (DCT) and caries-free (CF)--according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥ 0]. The CPQ8-10 instrument was administered at baseline and at 4 wk of follow-up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ8-10 scores were observed between the baseline and follow-up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ8-10 scores. Responsiveness of the CPQ8-10 instrument (magnitude of change in CPQ8-10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ8-10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL.
Kryst, L; Kowalik, S; Bartkowski, S; Henning, G
On the basis of a study carried out in three teaching departments of maxillofacial surgery the effect was analysed of Solcoseryl dental adherent paste and Linomag in the treatment of acute radiation-induced stomatitis. Both drugs were effective but Solcoseryl was superior to the other drug since it accelerated healing by about 50% and formed a protecting dressing on the inflamed mucosa.
Gebert, Tarcisio Jacinto; Palma, Vinícius Canavarros; Borges, Alvaro Henrique; Volpato, Luiz Evaristo Ricci
Introduction Dental transposition and impaction are disorders related to ectopic eruption or failure in tooth eruption, which can affect child physical, mental and social development and may be difficult to be clinically solved. Methods We describe a case of transposition between the upper left canine and lateral incisor associated with impaction of the central incisor on the same side, in a 12-year-old patient. Conservative treatment involving surgical-orthodontic correction of transposed teeth and traction of the central incisor was conducted. Conclusion The option of correcting transposition and orthodontic traction by means of the segmented arch technique with devices such as cantilever and TMA rectangular wire loops, although a complex alternative, was proved to be esthetically and functionally effective. PMID:24713567
Background Bruxism is a parafunctional habit characterized by grinding and/or clenching of the teeth. It may happen while awake (awake bruxism) or while sleeping (sleep bruxism). In adults, the prevalence is 20% for the awake bruxism and 8% for the sleep bruxism. Peripheral, central, and psychosocial factors influence the disorder, which may predispose to pain in the masticatory muscles and neck, headache, decreased pain thresholds in the masticatory and cervical muscles, limitation mandibular range of motion, sleep disorders, stress, anxiety, depression, and overall impairment of oral health. The aim of this study is to compare two distinct physical therapy interventions with dental treatment in pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. Methods/Design Participants will be randomized into one of three groups: Group 1 (n = 24) intervention will consist of massage and stretching exercises; Group 2 (n = 24) will consist of relaxation and imagination therapies; and Group 3 (n = 24) will receive dental treatment. The evaluations will be performed at baseline, immediately after treatment, and at 2-month follow-up. Pain intensity will be assessed using the visual analogical scale, while pain thresholds will be determined using dolorimetry. Mandibular range of motion will be assessed using digital pachymeter. Sleep quality will be assessed by the Pittsburgh Sleep Quality Index, anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale-10, depression by the Beck Depression Inventory, and oral health will be assessed using the Oral Health Impact Profile - 14. Significance level will be determined at the 5% level. Discussion This project describes the randomization method that will be used to compare two physical therapy interventions with dental treatment in the management of pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and
Background Many young paediatric patients with severe dental caries receive dental treatment under general anaesthesia. Oral health-related quality of life (OHRQoL) can be evaluated to assess the outcome of dental general anaesthesia (DGA) treatment. The aim of our study was to examine the OHRQoL of young Lithuanian children in need of DGA treatment and analyse the impact of DGA treatment on children’s OHRQoL. Methods We carried out a prospective clinical follow-up study on OHRQoL among all young Lithuanian child patients who received DGA treatment at the Lithuanian University of Health Sciences Hospital during 2010–2012. The study consisted of clinical dental examinations of patients younger than six years, data collected from their patient files, and an OHRQoL survey completed by their parents prior to the child’s dental treatment. We conducted a follow-up OHRQoL survey one month after the DGA treatment. The Early Childhood Oral Health Impact Scale (ECOHIS) and its effect size (ES) served to evaluate children’s OHRQoL, and the Wilcoxon signed-rank test served for statistical analyses. Results We obtained complete baseline and follow-up data for 140 and 122 participants, respectively (84.7% follow-up rate). Pain and eating problems among children and parents feeling upset and guilty were the most frequently reported impacts at baseline. The parents reported greater impacts on boys than on girls. The ECOHIS score decreased significantly (69.5%, p < 0.001) after DGA treatment, revealing a large ES for the child (1.6) and family (2.4) sections of the ECOHIS. Conclusions The OHRQoL of young Lithuanian children requiring DGA treatment is seriously impaired. Dental general anaesthesia treatment results in significant improvement of the children’s OHRQoL. The children’s parents also greatly appreciate this treatment modality for its positive impact on the family’s quality of life. PMID:24984901
Kim, Yoon-Tae; Pang, Kang-Mi; Jung, Hun-Jong; Kim, Soung-Min; Kim, Myung-Jin
Objectives Infererior alveolar nerve (IAN) damage may be one of the distressing complications occurring during implant placement. Because of nature of closed injury, a large proportion is approached non-invasively. The purpose of this study was to analyze the outcomes of conservative management of the injured nerve during dental implant procedure. Materials and Methods Sixty-four patients of implant related IAN injury, who were managed by medication or observation from January 1997 to March 2007 at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, were retrospectively investigated. The objective tests and subjective evaluations were performed to evaluate the degree of damage and duration of sensory disturbance recovery. Tests were performed on the day of the first visit and every two months afterward. Patient's initial symptoms, proximity of the implant to the IAN, time interval between implant surgery and the first visit to our clinic, and treatment after implant surgery were analyzed to determine whether these factors affected the final outcomes. Results Among the 64 patients, 23 had a chief complaint of sensory disturbance and others with dysesthesia. The mean time until first visit to our hospital after the injury was 10.9 months.One year after nerve injury, the sensation was improved in 9 patients, whereas not improved in 38 patients, even 4 patients experienced deterioration. Better prognosis was observed in the group of patients with early visits and with implants placed or managed not too close to the IAN. Conclusion Nearly 70% of patients with IAN injury during implant placement showed no improvement in sensation or dysesthesia with the conservative management. Earlier decision for active treatment needs to be considered because of possibility of deterioration of symptoms and unsatisfactory recovery. PMID:24471030
Forrest, Jane L
The aims of this paper are to present the findings from the scientific literature that discuss strategies that can contribute to a "best practices" treatment plan model for effectively integrating Evidence-Based Decision Making (EBDM) into curricula. MEDLINE, CINAHL, and HealthSTAR databases were searched, as was the Cochrane Database of Systematic Reviews. Studies and articles, ranging from systematic reviews to articles proposing models and recommendations for how to implement EBDM into curricula and faculty development were reviewed. Several common themes emerged and form the basis for a treatment plan model. The first step in developing any treatment plan is a thorough assessment of the current situation or problem. Recognizing that there are multiple phases to the assessment of an educational system, the focus of this paper will be to understand which teaching and learning strategies are most effective. These, in turn, will inform faculty of needed curricular changes and skill development training, requisites in order for them to prepare students to be successful in providing patient care using the best available evidence. Elements of a suggested treatment plan will be presented with the caveat that each dental school will need to develop an implementation plan based on an assessment of its own environment and needs.
De Maeztu, M A; Braceras, I; Álava, J I; Recio, C; Piñera, M; Gay-Escoda, C
This clinical study evaluated a new surface treatment of ion implantation with CO ions which has previously been subjected to extensive study in animal models. The aim of this work was to assess its effect in humans. Experimental mini-implants were used; half of their longitudinal surface was machined and the other half was treated with CO ion implantation. The study was conducted in healthy volunteer patients who required prosthetic treatment with dental implants, and in accordance with the corresponding ethics committees. Coinciding with the insertion of commercial implants for oral restoration, one or two mini-implants were placed in the upper maxillary tuberosity or in the retromolar trigone of the mandible. The mini-implants were removed with a trephine jointly with a small volume of surrounding bone after a 3-month period. Two evaluation methods were used and both showed a greater degree of bone integration in the mini-implant section that underwent CO ion implantation treatment in comparison with the non-treated surface: 62.9% vs. 57.9%, and 54.8% vs. 46.2%. In addition, no adverse reactions were observed in the surface treatment with CO ion implantation. These results confirm the positive benefits in humans, based on the findings obtained from previous animal experiments.
Su, H L; Chen, P S
The purpose of this study is to evaluate the comprehensive dental treatment for children under general anesthesia. From 1989 to 1991, 57 children with mean age of 3 years 2 months were treated, followed up with a minimal of 1 year. This procedure allows the dentition to be restored in one visit. Further care including preventive options and behavior shaping was provided on a 3-6 months recall schedule. The reasons for general anesthesia are that these children were either unable to accept treatment because of handicaps, extreme fear or young age. Their mean number of decayed tooth was 15 (Standard Deviation, SD = 5) and nearly three quarters of the children were under 6 years old. The most frequent treatment procedures were the extraction of teeth, composite resin restoration and Ni-Cr crown restoration. The Ni-Cr crown (1.7% failure rate) was more successful than the amalgam and composite resin restoration (9.7% failure rate). Pedo-strip crown had the highest failure rate (22%) for anterior teeth restoration. Nineteen children needed retreatment with conventional behavior guide. Six children had new caries and required further treatment. Thirty eight children returned for regular recall during the minimal 1 year follow-up period.
Coldwell, S E; Getz, T; Milgrom, P; Prall, C W; Spadafora, A; Ramsay, D S
This paper describes CARL (Computer Assisted Relaxation Learning), a computerized, exposure-based therapy program for the treatment of dental injection fear. The CARL program operates primarily in two different modes; in vitro, which presents a video-taped exposure hierarchy, and in vivo, which presents scripts for a dentist or hygienist to use while working with a subject. Two additional modes are used to train subjects to use the program and to administer behavioral assessment tests. The program contains five different modules, which function to register a subject, train subjects to use physical and cognitive relaxation techniques, deliver an exposure hierarchy, question subjects about the helpfulness of each of the therapy components, and test for memory effects of anxiolytic medication. Nine subjects have completed the CARL therapy program and 1-yr follow-up as participants in a placebo-controlled clinical trial examining the effects of alprazolam on exposure therapy for dental injection phobia. All nine subjects were able to receive two dental injections, and all reduced their general fear of dental injections. Initial results therefore indicate that the CARL program successfully reduces dental injection fear.
Gracis, Margherita; Molinari, Elena; Ferro, Silvia
The main aim of this retrospective study was to describe clinical and histopathological findings in cats with mucogingival lesions developed at the contact point of the premolar and molar teeth of the opposite quadrant. Cases were retrieved following manual review of the medical records, dental records and photographic documentation of all feline dental patients visited in the period between February 2001 and August 2011. Cats showing different lesions at different times were calculated as multiple cases. A total of 27 cats (31 cases) with 44 lesions (26 proliferations [59%], 11 clefts [25%] and seven foveae [16%]) were included. Mean age at the time of the first visit was 6.6 years. The lesion object of the study was the main reason for presentation in only five cases (16%). Proliferations showed two different histopathological patterns and had characteristics in common with human oral pyogenic granuloma. Successful treatment was achieved in all cases by removing the occlusal contact by dental extraction or coronal reduction, possibly associated with lesion excision. This study underlines the need for a thorough oral examination and evaluation of dental occlusion in all patients. Causes for the development of traumatic occlusion may include an acquired overbite (possibly secondary to selective dental extraction), congenital or post-traumatic malocclusion, abnormal latero-lateral mobility of the mandible, occlusal drift of the premolar and molar teeth, and/or alveolar bone expansion.
... Products and Medical Procedures Dental Devices Dental Amalgam Dental Amalgam Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Dental amalgam is a dental filling material which is ...
Zilversmit, Leah; Kane, Debra J.; Rochat, Roger; Rodgers, Tracy; Russell, Bob
Objectives The Iowa Department of Public Health I-Smile program provides dental screening and care coordination to over 23,000 low-income and Medicaid-enrolled children per year. The purposes of this study were to evaluate I-Smile program effectiveness to ensure that Medicaid-enrolled children obtained dental treatment after having been screened and to determine the factors associated with failure to receive dental care after screening through the I-Smile program. Methods Based on I-Smile program priorities, we limited our sample to children younger than 12 years of age who screened positive for decay and who linked to a paid Medicaid claim for dental treatment (n = 1,816). We conducted bivariate analyses to examine associations between children’s characteristics who screened positive for decay and received treatment within 6 months of their initial screening. We also performed multivariate logistic regression to assess the association of sociodemographic characteristics with receipt of treatment among children who screened positive for decay. Results Eleven percent of children screened positive for decay. Nearly 24 percent of children with decay received treatment based on a Medicaid-paid claim. Being 5 years or older [adjusted odds ratio (aOR): 1.48, confidence interval (CI): 1.17, 1.88] and not having a dental home (aOR: 1.90, CI: 1.41, 2.58) were associated with higher odds of not receiving dental treatment. Conclusions Children 5 years and older and without a dental home were less likely to obtain dental treatment. Opportunities exist for the I-Smile program to increase the numbers of at-risk children with dental homes and who obtain dental care after screening. PMID:25131658
Nalcaci, Ruhi; Demirer, Serhat; Ozturk, Firat; Altan, Burcu A; Sokucu, Oral; Bostanci, Vildan
The aim of this study was to determine the relationship of orthodontic malocclusion with periodontal status, dental caries, and sociodemographic status. Our study population consisted of a sample of 836 school children (384 male and 452 female, aged 11-14 years). Four experienced orthodontists and two experienced periodontists performed the clinical examinations. The Treatment Priority Index (TPI), Community Periodontal Index of Treatment Needs (CPITN), decayed, missing, filled teeth (DMFT) scores, and a questionnaire that surveyed socio-demographic status of students were used. Spearman's rank correlation coefficients were used to measure the association between variables. TPI scores showed that 36.4% of the students had normal occlusion, while 41.2% had slight, 15.7% had definite, 4% had severe, and 2.7% had very severe malocclusion. TPI values did not show any significant differences between pupils in different age, gender, socioeconomic status groups, and CPITN scores, whereas there was a significant relationship between TPI and DMFT scores. The orthodontic treatment need was not significantly correlated with CPITN or socio-demographic status; however, the correlation coefficient showed a significant relationship between TPI and DMFT scores.
Peeran, Syed Ali; Al Sanabani, Fuad; AL-Makramani, Bandar M. A.; Elamin, Elfatih Ibrahim
Objectives: The study aimed to evaluate and compare the dental prosthetic status and treatment needs of adult population in Jizan, Saudi Arabia, in relation to the age. Materials and Methods: A total of 1779 people aged 35–74 years from 4 survey areas (Hay al matar, Mahata khams, Dara ut tawhid, and Suq ad dakhili) selected through convenient sampling, around Jizan University, were surveyed, using the WHO survey criteria, 1997. Statistical Analysis: Number and percentages were calculated, and univariate analysis was performed using Chi-square test at 5% level of significance. Results: Different forms of prosthesis were present among patients in the upper (19.9%) and lower (19%) arches, respectively. Prosthetic treatment need was recognized in subjects, 56.4% for the upper and 57.2% for the lower arches, respectively. The prosthetic status and treatment needs differed statistically with respect to age. Conclusion: More than half of the surveyed adult populations were in need of some or the other forms of prosthesis. This study provides data for an oral health-care provider program for Jizan. PMID:28042258
Katzhendler, E; Steigman, S
This study evaluated the response of treated teeth to renewed orthodontic force. Thirty female rats (201 +/- 2.7 g) were divided into groups A and B. Linguointrusive loads (20.58 +/- 1.88 g) generated by springs were applied to the lower left incisor for 2 weeks and then removed to allow recovery during 27 weeks (group A). Identical loading was then repeated in group A and applied as primary treatment in group B. Five animals from each group were killed with the springs in situ (A-1 and B-1), while the remaining 20 animals were killed after a 3-month recovery (A-2, B-2). The decalcified incisors were cross-sectioned serially (2 microm), and the distance of each section from the apex was computed. Dental and periodontal injuries were evaluated by light microscopy and plotted according to their location on the tooth axis. The intrusion of the teeth in group A-1 was significantly greater, whereas recovery of the normal eruption rate in group A-2 was significantly slower compared with groups B-1 and B-2. The histopathologic lesions in groups A-1 and B-1 did not differ. However, group A-2 showed a higher frequency of injured enamel organ, tissue infiltration by inflammatory cells, necrotic areas, and dentin resorption than group B-2. Initial orthodontic loading had a detrimental effect on the ability of the periodontal and dental tissues to cope with, and to recover from, repeated stress, probably because of a decrease in the number of periodontal fibroblasts and damage to the dentin-protecting cementoblastic layer.
Nixdorf, Donald R.; Law, Alan S.; Lindquist, Kimberly; Reams, Gregory J.; Cole, Emery; Kanter, Keith; Nguyen, Ruby H.N.; Harris, D. Robert
Root canal treatment (RCT) is commonly performed surgery and persistent pain is known to occur, but little is known about how these patients are affected by this pain. While biopsychosocial mechanisms are thought to be associated with the development of such pain, similar to persistent pain following surgery in other body sites, little is known about the baseline predictors for persistent pain. We assessed the frequency of persistent pain 6 months following RCT, measured the impact this pain had on patients, and determined predictive factors for persistent tooth pain in a multi-center prospective cohort study conducted within the National Dental Practice-Based Research Network. Of 708 patients enrolled, 651 (91.9%) provided follow-up data, with 65 (10.0%) meeting criteria for pain 6 months following RCT. On average, these patients reported their pain as mild to moderate in intensity, present for about 10 days in the preceding month, and minimally interfered with daily activities. After adjusting for type of dental practitioner and patient age, gender and household income, pain duration over the week prior to RCT significantly increased the risk of developing persistent pain (odds ratio [OR]=1.19 per 1 day increase in pain duration, 95% confidence interval [CI]: 1.07–1.33), whereas optimism about the procedure reduced the risk (OR=0.39, 95% CI: 0.22–0.67). Our data suggest that persistent pain following RCT is fairly common, but generally does not have a large impact on those experiencing it. Furthermore, patient age and gender did not predict persistent pain, while pre-operative pain duration and the patient’s expectation did. PMID:26335907
Nixdorf, Donald R; Law, Alan S; Lindquist, Kimberly; Reams, Gregory J; Cole, Emery; Kanter, Keith; Nguyen, Ruby H N; Harris, D Robert
Root canal treatment (RCT) is commonly performed surgery and persistent pain is known to occur, but little is known about how these patients are affected by this pain. Although biopsychosocial mechanisms are thought to be associated with the development of such pain, similar to persistent pain after surgery in other body sites, little is known about the baseline predictors for persistent pain. We assessed the frequency of persistent pain 6 months after RCT, measured the impact this pain had on patients, and determined predictive factors for persistent tooth pain in a multicenter prospective cohort study conducted within the National Dental Practice-Based Research Network. Of 708 patients enrolled, 651 (91.9%) provided follow-up data, with 65 (10.0%) meeting criteria for pain 6 months after RCT. On average, these patients reported their pain as mild to moderate in intensity, present for approximately 10 days in the preceding month, and minimally interfered with daily activities. After adjusting for the type of dental practitioner and patient age, gender, and household income, pain duration over the week before RCT significantly increased the risk of developing persistent pain (odds ratio = 1.19 per 1 day increase in pain duration, 95% confidence interval: 1.07-1.33), whereas optimism about the procedure reduced the risk (odds ratio = 0.39, 95% confidence interval: 0.22-0.67). Our data suggest that persistent pain 6 months after RCT is fairly common, but generally does not have a large impact on those experiencing it. Furthermore, patient age and gender did not predict persistent pain, whereas preoperative pain duration and the patient's expectation did.
Al-Fouzan, Khalid S.
The purpose of this study was to evaluate the practice and depth of knowledge of root canal treatment by general dental practitioners working in private dental centers in different cities within the Kingdom of Saudi Arabia. A questionnaire was distributed to 400 general dental practitioners. Completed questionnaires were analyzed in term of simple summary statistics. A total of 252 (63%) practitioners responded. The majority of the respondents were Syrians (59%) and Egyptians (32%). Ninety-one per cent of the respondents indicated that they performed root canal treatment. Amongst those who carried out root canal treatment, only seven practitioners (3%) used rubber dam for isolation. More than half of the respondents (55%) used saline to irrigate canals during treatment. Forty-six per cent of practitioners used formocresol as an inter appointment medicament. The standardized and step-back preparation techniques were the method of choice for the majority of the respondents (91%). Ninety-seven per cent of the practitioners used stainless steel hand instruments to prepare root canals and the majority (92%) used gutta-percha for obturation. Seventy-four per cent of the respondent used cold lateral condensation. The average number of radiographs routinely taken for root canal treatment was four. Ninety-three per cent indicated that they usually completed a root canal treatment of molar teeth in three or more visits. Eighty-eight per cent of the practitioners preferred waiting for 1 or 2 weeks to restore the teeth permanently. Results of this study confirm that many general dental practitioners are not following quality guidelines for endodontic treatment. PMID:23960485
Ofori, Marian A.; Adu-Ababio, F.; Nyako, E. A.; Ndanu, Tom A.
Objective: To find out the prevalence of dental anxiety and fear amongst patients in various selected dental clinics in Accra, Ghana. Study design: Dental patients (n = 279) who had either been exposed to dental treatments or had no prior dental exposure, attending four selected dental clinics in Accra were randomly sampled. They were interviewed…
Palotie, Ulla; Vehkalahti, Miira
Our aim was to evaluate restorative treatment and the use of local anesthetics in free and subsidized public dental care in Helsinki, Finland. Public dental clinics are open to all patients under the age of 36, and to some specific groups above that age. Patients up to age 19 receive all treatment free of charge and others at highly subsidized rates. Data were collected in May 2001 during a maximum 2-week period covering all public dental clinics in Helsinki. A one-page questionnaire was sent to all dentists (n = 140) in clinical fields. The data requested included the patient's gender and year of birth, and details on restorations: which tooth and which surfaces were filled, the reason for placement or replacement, the material used, and use of local anesthetic. The response rate was 96%. Of all restorations (n = 3057) placed, 14% were in primary teeth and in permanent teeth: 17% in premolars, 17% in incisors, and 52% in molars; the restorative material most often used was composite resin (69%). Glass-ionomer/compomers dominated in the primary teeth. Local anesthetic was used least (35%) in patients under 13 years of age. Replacements of restorations accounted for 10% of all in the free service (under 20 years of age) and 46% in subsidized dental care (20 and older). The major reasons for replacement were secondary caries (41%) and fractured or lost restoration (40%).
Moradabadi, Ashkan; Roudsari, Sareh Esmaeily Sabet; Yekta, Bijan Eftekhari; Rahbar, Nima
This paper presents the results of an experimental study to understand the dominant mechanism in bond strength between dental resin agent and zirconia ceramic by investigating the effects of different surface treatments. Effects of two major mechanisms of chemical and micromechanical adhesion were evaluated on bond strength of zirconia to luting agent. Specimens of yttrium-oxide-partially-stabilized zirconia blocks were fabricated. Seven groups of specimens with different surface treatment were prepared. 1) zirconia specimens after airborne particle abrasion (SZ), 2) zirconia specimens after etching (ZH), 3) zirconia specimens after airborne particle abrasion and simultaneous etching (HSZ), 4) zirconia specimens coated with a layer of a Fluorapatite-Leucite glaze (GZ), 5) GZ specimens with additional acid etching (HGZ), 6) zirconia specimens coated with a layer of salt glaze (SGZ) and 7) SGZ specimens after etching with 2% HCl (HSGZ). Composite cylinders were bonded to airborne-particle-abraded surfaces of ZirkonZahn specimens with Panavia F2 resin luting agent. Failure modes were examined under 30× magnification and the effect of surface treatments was analyzed by scanning electron microscopy (SEM) and atomic force microscopy (AFM). SZ and HSZ groups had the highest and GZ and SGZ groups had the lowest mean shear bond strengths among all groups. Mean shear bond strengths were significantly decreased by applying a glaze layer on zirconia surfaces in GZ and SGZ groups. However, bond strengths were improved after etching process. Airborne particle abrasion resulted in higher shear bond strengths compared to etching treatment. Modes of failure varied among different groups. Finally, it is concluded that micromechanical adhesion was a more effective mechanism than chemical adhesion and airborne particle abrasion significantly increased mean shear bond strengths compared with another surface treatments.
Ram, D; Mamber, E; Chosack, A; Fuks, A B
The purpose of the present study was to determine whether the administration of 5 mg of the anti-emetic drug metoclopramide (MTP) would improve the effectiveness of 3.7 mg/kg of hydroxyzine (HYZ) in dental treatment of young patients. Thirty uncooperative children, with a mean age of twenty-nine months, and needing at least two restorative visits, participated in this study. The patients were assigned randomly to receive either 3.7 mg/kg HYZ or the same drug in conjunction with MTP; alternate regimens were administered at the two appointments. All the children received 50 percent nitrous oxide, and were restrained in a Papoose Board with a head holder. The following parameters were evaluated at baseline (before initiation of treatment), and at five-minute intervals throughout the procedure: degree of alertness, crying and movement. Evaluation of the overall behavior at each session was performed by one investigator, who was blind to the drug regimen the child had received, utilizing a separate rating scale. The results were submitted to statistical analysis. No differences were observed in the behavior of the children receiving both regimens. Successful sedation, as assessed by lack or minimal crying and/or movement was observed in all the treatment visits, with both regimens (mean score 4.4 for HYZ + MTP and 4.6 for HYZ). In the few occasions, however, where the restorative sessions were longer (45 to 60 minutes), more children fell asleep after receiving protocol A (pramin + hydroxyzine), suggesting a possible trend to improve effectiveness in these situations. No adverse effects were observed, and all the treatments were successfully completed. Although no significant differences could be observed in treatments lasting up to a half hour, the addition of MTP could help in sedations lasting longer than a half hour.
The aim of this study was to assess the usefulness of Lehman's appliance for the management of distocclusion and to establish indications and contraindications to its use. The mean duration of treatment was also determined and compared to such in similar form of malocclusion treated with other types of functional appliances. Linear measurements were performed on dental plaster casts before and after treatment. Cephalometric analysis served to establish the mechanism of Class II correction (skeletal or dentoalveolar) and to reveal any increase in mandibular length caused by Lehman's appliance. The material consisted of thirty-three Class II patients (18 girls and 15 boys), aged 9 to 15 years, treated successfully with Lehman's appliance for distocclusion. Dental plaster casts and lateral cephalograms were obtained at the beginning and end of treatment. Improvement in occlusal relationship in the molar, canine and incisor segments was the result of dental and skeletal changes. Metric analysis of dental casts before and after treatment showed that active treatment was associated with an increase in transversal dimensions of the upper arch ranging from 1.8 to 2.4 mm. Overbite and overjet decreased considerably. Anterior length of upper arch was reduced significantly in boys only and was accompanied by distraction and transition from a V-shaped to U-shaped type of arch. These changes helped to harmonize transversal dental relationship of both arches and improved conditions for functional skeletal base adaptation. Treatment with Lehman's appliance improved the intermaxillary relationship and led to a decrease in the ANB angle attributable to a change in the SNA angle in girls and the SNB angle in boys. The mandibular reaction in girls with Class II/2 was interesting: the SNB angle increased considerably, indicating "unblocking" of the mandible. Changes in the vertical skeletal relationship were limited to a minor reduction in the index. Maxillary incisors moved little
De Oliveira, Katharina Morant Holanda; Silva, Raquel Assed Bezerra; Carvalho, Fabricio Kitazono; Silva, Lea Assed Bezerra; Nelson-Filho, Paulo; Queiroz, Alexandra Mussolino
The purpose of this study was to report the clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome. The patient had alopecia, delayed speech, low weight and height, cholestasis, and iron deficiency anemia. Furthermore, there were carious lesions and darkened spots on all primary molars. Microdontia of a premolar was observed at the radiographic examination. The patient and family had no commitment to her oral health and dental treatment at first appointments. Oral hygiene instructions, composite restorations, endodontic treatments, teeth extractions, and stainless steel crown installations were performed. The patient was followed up for 7 years through the present due to other possible future clinical findings associated with the syndrome. An improvement in social aspects was observed after removal of toothache and improved esthetics. Such patients need continuous periodic services, which contributes to improving the quality of life in both buccal and general aspects. PMID:27307676
van Asselt, Kathryn Watkins; Senstock, Tracy D. Baldo
Spirituality is a potential area of concern for counseling clients. This study presents the empirical results of a survey completed by 572 counselors to determine if counselors' spiritual beliefs, experiences, or training had an impact on their focus of therapy or self-perceived competence. A counselor's personal spirituality, spiritual…
Schiff, Miriam; Gilbert, Louisa; El-Bassel, Nabila
This study examines the positive aspects of intimate relationships perceived by drug-involved women victims of intimate partner violence (IPV). The article examines the association of psychological distress, childhood abuse, and severity of IPV with the different positive aspects the women indicated. Most analyses were conducted on a subsample of…
Touboul, Virginie; Germa, Alice; Lasfargues, Jean-Jacques; Bonte, Eric
Objective. The objective of this retrospective study is double: (1) to assess the 1–4 years of outcome of endodontic treatment performed by postgraduate students in endodontics in the Dental Clinic of Bretonneau Hospital and (2) to examine outcome predictors. Method. 363 teeth in 296 patients were treated between 2007 and 2011. 183 patients (224 teeth) were lost during the followup. 113 patients were included in the study (recall: 38%), corresponding to 139 teeth of which 8 were extracted. 131 remaining teeth (36%) were examined clinically and radiographically. Apical periodontitis (AP) was absent (PAI = 1) or present (PAI ≥ 2). Outcome was classified as “healed,” “healing,” or “diseased”. Results. The success rate was 92%. No failure was observed among the 23 initial endodontic treatments. Among the 108 retreated teeth, 80% were “healed” and 11% were “healing.” An association was found between success rate and preoperative signs or symptoms (absent 95% versus present 83%), preoperative root filling density (inadequate 93% versus adequate 57%), but not between preoperative AP status and success. Conclusion. Outcomes in this retrospective study were similar to those previously reported. However, a larger sample size is needed to assess outcome predictors more precisely. PMID:24778652
Marín-Fernández, Ana-Belén; García Medina, Blas; Aguilar-Salvatierra, Antonio; Jiménez-Burkhardt, Alberto
Bisphosphonates (BP) are a type of drug known to inhibit bone resorption through complex interventions. Their primary mechanism of action is aimed at the cellular level, inhibiting osteoclast activity and so bone resorption. BPs are widely used, with many patients receiving continuous treatment for years. But it is well known that these drugs can produce osteonecrosis of the jaw (ONJ). Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication. ZA is the most potent BP in clinical development. This report describes the case of a 62-year-old woman with breast cancer antecedents which relapsed, who had received a maxillary dental implant two years before the start of therapy with zoledronic acid. She later developed osteonecrosis of the jaw (ONJ), which began in the peri-implant area, and was treated for stage 3 ONJ by sub-total maxillectomy. Key words:Bisphosphonates, zoledronic acid, osteonecrosis of the jaw, peri-implantitis, maxillectomy. PMID:26330946
... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for... teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities, but may... will consider each defective or missing tooth and each disease of the teeth and periodontal...
... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for... teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities, but may... will consider each defective or missing tooth and each disease of the teeth and periodontal...
Newton, J. T.
Background: Dental disease is more common among people with intellectual disabilities than in the general population. Improvements in oral health require individuals to engage in daily oral hygiene and regular visits to a dental practitioner; both may be challenging for the individual with intellectual impairment. Materials and Methods: A review…
Aksoy, G; Polat, H; Polat, M; Coskun, G
Surface treatment procedures such as grinding and polishing are needed to provide the ceramic dental restorative materials with proper fitting and occlusion. The treated surfaces are customarily glazed to improve the strength and smoothness. Though smoothness and wetting of the dental surfaces are important to minimize bacterial plaque retention, influence of the surface treatment and glazing procedures on the final surface roughness and its correlation to wettability are overlooked. In this work, effect of various treatment (diamond fraising, stoning, sanding and aluminum oxide and rubber polishing) and glazing (auto and overglazing) techniques on the final roughness and the resulting wettability of dental ceramic surfaces were investigated using scanning electron microscopy (SEM) observations and atomic force microscopy (AFM) scans, 75 scans per sample. The surfaces were characterized and assigned an average roughness measure, R(a). The wettability of the same surfaces was evaluated using micro-contact angle measurements (25 micro-bubbles placed on a grid on each surface) to correlate the final surface roughness and wettability. The results show that overglazing prevails over surface irregularities from different treatment procedures and provides homegeneously smooth surfaces with mean R(a)<10 nm. It also produces uniformly wetted surfaces with low contact angles around 20 degrees . The autoglazed surfaces are less smooth (mean R(a) around 50 nm) and displays sporadic topographic irregularities. They display larger and less uniform contact angles ranging between 35 degrees and 50 degrees . The results suggest that overglazing should be preferred after surface treatment to obtain a smooth and well-wetted dental ceramic surface.
Faus-Matoses, Vicente; Alegre-Domingo, Teresa; Faus-Llácer, Vicente J.
Objectives: To evaluate radiographically the quality of root canal fillings and compare manual and rotary preparation performed on extracted teeth by undergraduate dental students. Study Design: A total of 561 premolars and molars extracted teeth were prepared using nickel-titanium rotary files or manual instrumentation and filled with gutta-percha using a cold lateral condensation technique, by 4th grade undergraduate students. Periapical radiographs were used to assess the technical quality of the root canal filling, evaluating three variables: length, density and taper. These data were recorded, scored and used to study the “technical success rate” and the “overall score”. The length of each root canal filling was classified as acceptable, short and overfilled, based on their relationship with the radiographic apex. Density and taper of filling were evaluated based on the presence of voids and the uniform tapering of the filling, respectively. Statistical analysis was used to evaluate the quality of root canal treatment, considering p < 0.05 as a statistical significant level. Results: The percentage of technical success was 44% and the overall score was 7.8 out of 10. Technical success and overall score were greater with rotary instruments (52% against 28% with a manual one, p < 0.001; 8.3 against 6.7 respectively, p < 0.001). Conclusions: It appears that inexperienced operators perform better root canal treatment (RCT) with the use of rotary instrumentation. Key words:Dental education, endodontics, rotary instrumentation, radiographs, root canal treatment, undergraduate students. PMID:24121911
John, Vanchit; Lee, Seung-Jun; Prakasam, Sivaraman; Eckert, George J; Maupome, Gerardo
Considerable disagreements and variations exist in diagnosis and treatment planning of periodontal disease. Achieving high interrater periodontal diagnosis can prove challenging. The objectives of this study were to measure variations in periodontal diagnosis and treatment planning among predoctoral periodontics faculty members after consensus training and to compare such variation with those identified in third- and fourth-year dental students. Nine electronically stored case vignettes and survey instruments were made available to eighteen faculty members and twenty dental students under standardized conditions. A chi-square test was used to compare responses between groups, and multirater kappa tests were used to evaluate interrater agreement/reliability. Of the nine cases, only one differed between groups significantly in terms of treatment. Also, third-year students differed from fourth-year students on the diagnosis of aggressive periodontitis versus chronic periodontitis. Most respondents were able to distinguish clearly among diagnoses of chronic periodontitis, aggressive periodontitis, and gingivitis. This study established a baseline assessment of the current status of consensus after training. We will reassess variations after addressing the specific challenges identified. Programs designed and implemented to help decrease the variation in periodontal diagnosis and treatment planning among faculty members may ultimately translate into better agreement and better standardization of dental instruction.
Monserrat, Carlos; Alcaniz-Raya, Mariano L.; Juan, M. Carmen; Grau Colomer, Vincente; Albalat, Salvador E.
This paper describes a new method for 3D orthodontics treatment simulation developed for an orthodontics planning system (MAGALLANES). We develop an original system for 3D capturing and reconstruction of dental anatomy that avoid use of dental casts in orthodontic treatments. Two original techniques are presented, one direct in which data are acquired directly form patient's mouth by mean of low cost 3D digitizers, and one mixed in which data are obtained by 3D digitizing of hydrocollids molds. FOr this purpose we have designed and manufactured an optimized optical measuring system based on laser structured light. We apply these 3D dental models to simulate 3D movement of teeth, including rotations, during orthodontic treatment. The proposed algorithms enable to quantify the effect of orthodontic appliance on tooth movement. The developed techniques has been integrated in a system named MAGALLANES. This original system present several tools for 3D simulation and planning of orthodontic treatments. The prototype system has been tested in several orthodontic clinic with very good results.
Dental Therapists are in a prime position to be involved with the management of anxious and phobic patients. They earn less than dentists and are therefore a more cost-effective way of providing specialised care for anxious patients. Dental Therapists can spend more time educating and acclimatising these patients, do most if not all of the patient's treatment, only referring back to the dentist for RCT, crown/bridgework/dentures and permanent extractions. Ultimately this means that the patient receives high quality continuity of care. Treating anxious and phobic patients is time-consuming but ultimately very rewarding. If handled correctly and sensitively the anxious and phobic patient will not always be anxious or phobic, in the same way that children won't always be children. Dental Therapists can now extend their duties to include Relative Analgesia. This should enhance their employability and role within the dental team especially in the management of anxious and phobic patients. Employing a therapist with a toolbox of techniques at their disposal can be seen as part of a long-term practice plan to ensure that anxious and phobic patients become rehabilitated, happy, compliant and loyal to the practice! In fact .... the sort of patients every dentist really wants to see.
Rood, Janneke A J; van Zuuren, Florence J; Stam, Frank; van der Ploeg, Tjeerd; Eeltink, Corien; Verdonck-de Leeuw, Irma M; Huijgens, Peter C
For patients with haematological malignancies, information on disease, prognosis, treatment and impact on quality of life is of the utmost importance. To gain insight into the perceived need for information in relation to sociodemographic and clinical parameters, comorbidity, quality of life (QoL) and information satisfaction, we compiled a questionnaire based on existing validated questionnaires. A total of 458 patients diagnosed with a haematological malignancy participated. The perceived need for information was moderate to high (40-70%). Multivariate regression analyses showed that a higher need for information was related to younger age, worse QoL, being member of a patient society and moderate comorbidity. The need for disease and treatment-related information was higher than the need for psychosocial information. A higher need for disease and treatment-related information was associated to being diagnosed with multiple myeloma. A higher need for psychosocial information was related to a lower educational level. The information provision could be improved according to 41% of the patients. Higher satisfaction with provided information was associated with better QoL. Most patients (62%) reported that they wanted to be fully informed about their illness and actively involved in treatment decision-making. The results contribute to improving patient-tailored information provision and shared decision-making in clinical practice.
Park, Minjeong; Pang, Nan-Sim
Objectives Sodium hypochlorite (NaOCl) is an excellent bactericidal agent, but it is detrimental to stem cell survival, whereas intracanal medicaments such as calcium hydroxide (Ca[OH]2) promote the survival and proliferation of stem cells. This study evaluated the effect of sequential NaOCl and Ca[OH]2 application on the attachment and differentiation of dental pulp stem cells (DPSCs). Materials and Methods DPSCs were obtained from human third molars. All dentin specimens were treated with 5.25% NaOCl for 30 min. DPSCs were seeded on the dentin specimens and processed with additional 1 mg/mL Ca[OH]2, 17% ethylenediaminetetraacetic acid (EDTA) treatment, file instrumentation, or a combination of these methods. After 7 day of culture, we examined DPSC morphology using scanning electron microscopy and determined the cell survival rate with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. We measured cell adhesion gene expression levels after 4 day of culture and odontogenic differentiation gene expression levels after 4 wk using quantitative real-time polymerase chain reaction. Results DPSCs did not attach to the dentin in the NaOCl-treated group. The gene expression levels of fibronectin-1 and secreted phosphoprotein-1 gene in both the Ca[OH]2- and the EDTA-treated groups were significantly higher than those in the other groups. All Ca[OH]2-treated groups showed higher expression levels of dentin matrix protein-1 than that of the control. The dentin sialophosphoprotein level was significantly higher in the groups treated with both Ca[OH]2 and EDTA. Conclusions The application of Ca[OH]2 and additional treatment such as EDTA or instrumentation promoted the attachment and differentiation of DPSCs after NaOCl treatment. PMID:26587415
Bergholm, Åsa; Östberg, Anna-Lena; Gabre, Pia
The aim of this study was to obtain an understanding of the factors that affected the way new technology and methods were used in dentistry after a training program. A qualitative research method was used to collect data. Nine dentists working in the Public Dental Service (PDS) in Uppsala County in Sweden agreed to be interviewed in the study. They worked in five different clinics, all with laser equipment, and had received training in the use of lasers. The interviews were tape recorded and transcribed, and were analysed using manifest and latent qualitative content analysis. The categories in this study were identified as "Prerequisites and obstacles to imple- mentation", "Attitudes to laser technology and treatments" and "Laser technology in the future'". The dentists described working with lasers as complicated and problematic. They had concerns about the method relating to the working environment, evidence of efficacy of treatment, costs, and benefits for patients and dentists. The main finding was that the decision to adopt the technology seemed to be based on individual perceptions of the value of lasers compared to other ways of achieving the same goal. They provided uniform proposals regarding how an organization should implement new methods, including an emphasis on the importance of preparation and having opportunities to be able to test and evaluate the technology. Another important factor was support from surrounding staff, colleagues and management. Despite all the barriers, the respondents were positive about working with lasers in the future, mainly due to their belief that patients would demand laser treatment. In conclusion both individual and organizational factors affected the extent to which the respondents used the laser. The main finding was the individual perception of the value of lasers compared to other methods which could achieve the same goal.
Chang, Chi-Chang; Li, Ya-Hsin; Chen, Yi-Fen; Liao, Kuo-Hsiung
The purpose of this study was to explore the dental patients' preferred roles in Taiwan. A convenience sample of 66 patients, 26 recruited from one dental clinic, and 40 from one medical center, were interviewed and their preferences for participation in treatment decision making were established using a measurement tool designed to elicit decision-making preferences. Patients' preferences for participation in treatment decision making were established using Control Preference Scale (CPS) tool. In addition, Unfolding theory provided a means of analyzing the data so that the degree of control preferred by each patient could be established. This study found that nearly 70% clinic patients perceived passive role in treatment decision making whereas 50% patients in medical centre. Further, the collaborative role was most commonly preferred, but an active role was more commonly perceived in clinics than in medical centre. Finally, the implications of the results for patient participation are discussed.
Wieger, V.; Yousif, A.; Strassl, M.; Wintner, E.
Within the last years, modern ultra-short pulse lasers have successfully proven their potential for application in medical tissue treatment in many respects. In dentistry, overheating of the pulp and induction of micro cracks are usually among the most problematic issues which can be solved in this way. An additional benefit can be seen in the possibility of plasma emission spectroscopy as a means of feedback. Up till now it was shown by many authors that the application of picosecond or femtosecond pulses allows to perform ablation with very low damaging potential also fitting to the special physiological requirements. Beside the short interaction time with the irradiated biological matter, lateral scanning of ultra-short pulses following optimized algorithms turned out to be crucial for ablating cavities with the required quality and size, a finding which we also believe to be valid for dental restoration materials. Additionally, out of practical reasons, scanning is necessary to treat larger volumes than just the focal spots typically having dimensions on the order of more than 1 mm 3, thereby allowing to realize an "optical drill".
Choo, Seung-Sik; Huh, Yoon-Hyuk; Cho, Lee-Ra
PURPOSE The aim of this study was to evaluate the effect of metal primers on the bonding of dental alloys and veneer resin. Polyvinylpyrrolidone solution's tarnish effect on bonding strength was also investigated. MATERIALS AND METHODS Disk-shape metal specimens (diameter 8 mm, thickness 1.5 mm) were made from 3 kinds of alloy (Co-Cr, Ti and Au-Ag-Pd alloy) and divided into 4 groups per each alloy. Half specimens (n=12 per group) in tarnished group were immersed into polyvinylpyrrolidone solution for 24 hours. In Co-Cr and Ti-alloy, Alloy Primer (MDP + VBATDT) and MAC-Bond II (MAC-10) were applied, while Alloy Primer and V-Primer (VBATDT) were applied to Au-Ag-Pd alloys. After surface treatment, veneering composite resin were applied and shear bond strength test were conducted. RESULTS Alloy Primer showed higher shear bond strength than MAC-Bond II in Co-Cr alloys and Au-Ag-Pd alloy (P<.05). However, in Ti alloy, there was no significant difference between Alloy Primer and MAC-Bond II. Tarnished Co-Cr and Au-Ag-Pd alloy surfaces presented significantly decreased shear bond strength. CONCLUSION Combined use of MDP and VBATDT were effective in bonding of the resin to Co-Cr and Au-Ag-Pd alloy. Tarnish using polyvinylpyrrolidone solution negatively affected on the bonding of veneer resin to Co-Cr and Au-Ag-Pd alloys. PMID:26576256
Mulic, Aida; Vidnes-Kopperud, Simen; Skaare, Anne B.; Tveit, Anne Bjørg; Young, Alix
This study aimed to investigate dentists' general experience, knowledge about diagnosis, and treatment of dental erosive wear in young adults. A questionnaire was sent to 1262 Norwegian public dental health-employed dentists. The response rate was 60%. Results indicated that most dentists recorded erosive wear, half of them used a specific scoring system, and half registered lesions at the tooth surface level. Lesions were reported most often on palatal surfaces of upper anterior teeth (79% of dentists), on occlusal surfaces of lower 1st molars (74%), and on upper 1st molars (32%). Half the dentists used clinical photographs for documentation and 60% made study models. While 40% reported more erosive lesions in males, 36% reported no gender differences. High intake of carbonated beverages and acidic juices were reported as the most common cause by 97% and 72% of the dentists, respectively. Only 21% of dentists recorded the patient's dietary history, and 73% never measured saliva secretion. The majority (78%) of the dentists treated patients with erosive wear themselves. In general, the survey suggests that the dentists are relatively up to date regarding the clinical recording, diagnosis, and treatment of dental erosive wear. However, dietary and salivary analyses were not given priority, and early, preventive treatment was lacking. PMID:22927855
Tanja-Dijkstra, Karin; Pahl, Sabine; White, Mathew P; Andrade, Jackie; Qian, Cheng; Bruce, Malcolm; May, Jon; Moles, David R
Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n = 69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people's previous experiences affect their behaviour for future events.
Rashkova, Maya; Rocca, Jean-Paul
Introduction: Maintaining deciduous teeth as long as possible represents a goal in pediatric dentistry and avoids a plethora of health problems. Er:YAG carious decay treatment may help for prevention as well as during the curative processes. Materials and Methods: An Er:YAG laser was used to ablate 30 carious lesions on primary teeth. Diagnosis being conventionally dressed, treatment was conducted in respect of the following parameters: Er:YAG laser (Lite Touch, Syneron): output power from 300 mJ (enamel) to 200 mJ (dentine), frequency 20 Hz, sapphire tip (diameter 1.3 mm), air water spray ratio 8 (39 ml/min), pulse duration 50 µsec., theoretical fluence ranging from 15.08 J/cm2 for dentin to 22.61 J/cm2 for enamel. Then cavity depth was controlled (observation + probe). Glass-ionomer cement (GC Fuji Triage capsule) or flowable composite resin or compomer were used to fill the cavities. Children's acceptance to Er-YAG laser treatment was evaluated. According to predefined criteria, each case was followed up for one month after treatment and then with further monthly follow-ups for one year. Results: Clinical cases illustrate the validity of this clinical approach. The benefit of laser dental treatment has been shown to be the greatest in children. However, the lack of studies evaluating laser ablation capability in primary teeth restrains the adoption of this technology. The interaction between the Er:YAG laser and primary enamel and dentin depends on the composition of the tissues - a higher presence of water and lower presence of minerals- comparative to the permanent enamel and dentin. Thus, photoablation of primary enamel and dentin requires lower energy. This study shows that the laser parameters used (300 mJ/20 Hz for enamel and 200 mJ/20 Hz for dentin) are efficient enough for the ablation of tissues of deciduous teeth and moreover demonstrates to be well accepted by young patients. PMID:25705080
Zimmerman, B; Datko, L; Cupelli, M; Alapati, S; Dean, D; Kennedy, M
The mechanical properties of dentin and enamel affect the reliability and wear properties of a tooth. This study investigated the influence of clinical dental treatments and procedures, such as whitening treatments or etching prior to restorative procedures. Both autoclaved and non-autoclaved teeth were studied in order to allow for both comparison with published values and improved clinical relevance. Nanoindentation analysis with the Oliver-Pharr model provided elastic modulus and hardness across the dentin-enamel junction (DEJ). Large increases were observed in the elastic modulus of enamel in teeth that had been autoclaved (52.0 GPa versus 113.4 GPa), while smaller increases were observed in the dentin (17.9 GPa versus 27.9 GPa). Likewise, there was an increase in the hardness of enamel (2.0 GPa versus 4.3 GPa) and dentin (0.5 GPa versus 0.7 GPa) with autoclaving. These changes suggested that the range of elastic modulus and hardness values previously reported in the literature may be partially due to the sterilization procedures. Treatment of the exterior of non-autoclaved teeth with Crest Whitestrips, Opalescence or UltraEtch caused changes in the mechanical properties of both the enamel and dentin. Those treated with Crest Whitestrips showed a reduction in the elastic modulus of enamel (55.3 GPa to 32.7 GPa) and increase in the elastic modulus of dentin (17.2 GPa to 24.3 GPa). Opalescence treatments did not significantly affect the enamel properties, but did result in a decrease in the modulus of dentin (18.5 GPa to 15.1 GPa). Additionally, as expected, UltraEtch treatment decreased the modulus and hardness of enamel (48.7 GPa to 38.0 GPa and 1.9 GPa to 1.5 GPa, respectively) and dentin (21.4 GPa to 15.0 GPa and 1.9 GPa to 1.5 GPa, respectively). Changes in the mechanical properties were linked to altered protein concentration within the tooth, as evidenced by fluorescence microscopy and Fourier transform infrared spectroscopy.
Chackartchi, T; Sachar Helft, S; Findler, M
Surgical intra-oral treatment for patients under antithrombotic therapy presents a challenge for the dental team. Within the last few years evidence based systematic reviews established new clinical guidelines for wide groups of patients which need to use antithrombotic treatment. The expected increase in use of antithrombotic treatment forced the pharmaceutical industry to provide new treatments. The former anticoagulant and anti-platelets aggregation groups of drugs were limited to small variety of medication. The search for the new treatments with ideal properties led to newly invented groups of drugs. In this article we will describe the new advancements in anti-thrombotic treatments. The article will summarize the limited knowledge of surgical management of patients under the new anti-thrombotic medications and the recommended approach for oral surgical procedures.
Miller, Craig S.; Avdiushko, Sergei A.; Kryscio, Richard J.; Danaher, Robert J.; Jacob, Robert J.
Human herpesviruses (HHVs) are ubiquitous pathogens that intermittently reactivate from latency. Transmission is believed to be facilitated by their frequent appearance in saliva. This study sought to understand the factors that influence the appearance of these viruses in saliva by examining the prevalence, pattern, and quantity of all eight HHVs in saliva of immunocompetent adults with a history of recurrent oral herpes simplex virus (HSV) infections following dental treatment and antiviral therapy. Valacyclovir or matched placebo was given (2 g twice on the day of treatment and 1 g twice the following day) to 125 patients in a randomized, double-blind controlled trial. Saliva, collected on the day of dental treatment and 3 and 7 days later, was analyzed using real-time quantitative PCR. At all visits, HHVs coinfected saliva. Over the course of the week, the DNAs of HHV-6 and HHV-7 were detected significantly more often (97% to 99% of patients) than Epstein-Barr virus (EBV; 64.8%), HSV-1 (13.0%), HHV-8 (3.2%), cytomegalovirus (2.4%), HSV-2 (0%), and varicella-zoster virus (0%), irrespective of drug treatment (P < 0.002). Mean genome copy numbers were highest for HSV-1 and HHV-6. Dental treatment did not influence asymptomatic viral shedding patterns. However, valacyclovir treatment resulted in significantly fewer patients shedding EBV at both postoperative visits compared with placebo (P < 0.008). These results suggest that HHVs are simultaneously present in the saliva of healthy adults at levels that could facilitate transmission, and valacyclovir therapy decreases the prevalence of EBV in saliva but has little effect on HHV-6 and HHV-7. PMID:15872238
Shaw, A J; Niven, N
Dental fear and anxiety in children and adolescents is a common problem. Hypnosis has been shown to be useful in the treatment of these patients. This paper briefly reviews conventional management skills before considering the application of hypnosis. Following a definition of hypnosis, the concepts of relaxation, restricted awareness, blunting of critical faculties and the enhanced capacity to respond to suggestion are outlined. Consideration is given to the induction of hypnosis and its general application in an informal and formal manner. The application of more specific techniques, such as the use of hypnoanalgesia to reduce physical discomfort and the development of coping strategies to help children overcome their fears, are discussed. It has been widely shown that hypnosis is a useful adjunct in dentistry. However, it is unfortunate that hypnosis is not more widely used as it has the potential for making conventional dental management more acceptable and reducing the number of children requiring general anaesthesia.
Karhunen, Sini; Virtanen, Jorma I
Objective The Patient Insurance Centre in Finland reimburses patients who sustained injuries associated with medical and dental care without having to demonstrate malpractice. The aim was to analyse all dental injuries claimed through the Patient Insurance Centre over a 12-year period in order to identify factors affecting reimbursement of claims. Methods This study investigated all dental patient insurance claims in Finland during 2000-2011. The injury cases were grouped as (K00-K08) according to the International Classification of Diseases (ICD-10). Calendar year, claimant's age and gender, dental disease group and health service sector were the explanatory factors and the outcome was the decision of a claim. Multiple logistic regression modelling was used in the statistical analyses. Results The total number of decisions related to dental claims at the PIC in 2000-2011 was 7662, of which women claimed a clear majority (72%). Diseases of the pulp and periapical tissues (K04) and dental caries (K02) were the major disease groups (both 29%). Of the claims 40% were eligible for reimbursement, 27% were classified as insignificant or unavoidable injuries and 32% were rejected for other reasons. The proportion of reimbursed claims declined during the period. Patients from the private sector were more likely to be eligible for compensation than were those from the public sector (OR = 1.89, 95% CI = 1.71-2.10). Conclusions The number of dental patient insurance claims in Finland clearly rose, while the proportion of reimbursed claims declined. More claims received compensation in the private sector than in the public sector.
Foo, Peter; Sampson, Wayne; Roberts, Rachel; Jamieson, Lisa; David, David
The objectives of this study were to compare the ratings of professionals and laypeople with and without a cleft regarding the facial aesthetics of adult patients previously treated for orofacial clefting. The necessity for further treatment, as perceived by the respective groups, is also compared. The design of the study was a cross-sectional study. Professionals (two plastic surgeons, one dentist, one orthodontist, and one psychologist) and laypeople (one male and one female adult without a cleft and one male and one female adult with a cleft) were recruited to rate photographs of 80 non-syndromic cleft patients treated by the Australian Craniofacial Unit from 1975 to 2009. Facial aesthetics were measured by a visual analogue scale (VAS; 0-100 mm). High values indicated good aesthetics. Necessity for further treatment was also measured by a VAS (0-100 mm). High values indicated high perceived need for further treatment. The professionals rated facial aesthetics significantly lower and had a lower perception of need for further treatment than the raters with and without a cleft. The laypeople with a cleft rated facial aesthetics significantly higher and had a lower perceived need for further treatment than laypeople without a cleft. The non-surgical professionals rated facial aesthetics significantly lower and had a lower perceived need for further treatment than the surgical professionals. Differences exist in the facial aesthetics ratings and perceived need for further surgery between professionals and laypeople with and without a cleft. This should be considered when managing cleft treatment expectations.
Martins, Renata Castro; Seijo, Marília Oliveira Saraiva; Ferreira, Efigênia Ferreira; Paiva, Saul Martins; Ribeiro Sobrinho, Antônio Paulino
This study evaluated the perceptions of Brazilian undergraduate dental students about the endodontic treatments performed using NiTi rotary instruments and hand stainless steel. Data were collected using a questionnaire administered to undergraduate dental students enrolled in endodontic disciplines. The students were divided into 3 groups: G1, students who had treated straight canals with SS hand instruments; G2, students who had treated curved canals with SS hand instruments; and G3, students who had treated both straight and curved canals with NiTi rotary instruments. The number of endodontic treatments performed, types of treated teeth, students' learning, time spent, encountered difficulties, quality of endodontic treatment and characteristics of the employed technique were analyzed. There was a 91.3% rate of return for the questionnaires. Mandibular molars were the most frequently treated teeth, followed by maxillary incisors. The Kruskal-Wallis test showed no differences in learning (p=0.528) or in the characteristics of the technique employed (p=0.560) among the three groups. G3 students performed a greater number of endodontic treatments (p<0.001) in a smaller time (p<0.001) than did G1 and G2 students. Difficulties were reported primarily by students in G2 and G3 compared with G1 (p=0.048). The quality of endodontic treatments differed only between G1 and G2 (p=0.045). The use of NiTi rotary instruments should be included in undergraduate dental curriculum, contributing to the increase of patients assisted and consequently to improve the clinical experience of the students.
Hartzler, Bryan; Rabun, Carl
Treatment community reluctance toward contingency management (CM) may be better understood by eliciting views of its feasibility, effectiveness, and transportability when social versus financial incentives are utilized. This mixed method study involved individual staff interviews representing three personnel tiers (an executive, clinical supervisor, and two front-line clinicians) at 16 opiate treatment programs. Interviews included Likert ratings of feasibility, effectiveness, and transportability of each incentive type, and content analysis of corresponding interviewee narrative. Multi-level modeling analyses indicated that social incentives were perceived more feasible, more effective, and more transportable than financial incentives, with results pervading personnel tier. Content analysis suggested that the more positive perception of social incentives was most often due to expected logistical advantages, positive impacts on patient quality-of-life, and philosophical congruence among staff. Weaker perception of financial incentives was most often influenced by concerns about costs, patient dissatisfaction, and staff philosophical incongruence. Implications for CM dissemination are discussed.
Hartzler, Bryan; Rabun, Carl
Treatment community reluctance toward contingency management (CM) may be better understood by eliciting views of its feasibility, effectiveness, and transportability when social vs. financial incentives are utilized. This mixed method study involved individual staff interviews representing three personnel tiers (an executive, clinical supervisor, and two front-line clinicians) at 16 opiate treatment programs. Interviews included Likert ratings of feasibility, effectiveness, and transportability of each incentive type, and content analysis of corresponding interviewee narrative. Multi-level modeling analyses indicated that social incentives were perceived more feasible, more effective, and more transportable than financial incentives, with results pervading personnel tier. Content analysis suggested the more positive perception of social incentives was most often due to expected logistical advantages, positive impacts on patient quality-of-life, and philosophical congruence among staff. Weaker perception of financial incentives was most often influenced by concerns about costs, patient dissatisfaction, and staff philosophical incongruence. Implications for CM dissemination are discussed. PMID:23506780
Asl Aminabadi, Naser; Erfanparast, Leila; Sohrabi, Azin; Ghertasi Oskouei, Sina; Naghili, Armaghan
Background and aims Dental practitioners have numerous methods to control anxiety and pain in children, and distracting the child appears to be the most common technique used for behavior management during dental procedures. The aim of the present study was to evaluate the influence of using virtual reality eyeglasses on severity of pain and anxiety during dental procedures in pediatric patients. Materials and methods This study included 120 healthy children aged 4-6 years. Children with no previous anxiety disorder were randomly divided into two groups, each consisting of 60 children. The study consisted of 3 consecutive treatment sessions. During the first visit fluoride therapy was carried out in both groups. In the next sessions, the groups received restorative treatment with and without virtual reality eyeglasses in a randomized single-blind-controlled crossover fashion. Then at the end of each session the subjects’ pain severity was assessed using Wong Baker FACES Pain Rating Scale and state anxiety was measured by Faces version of the Modified Child Dental Anxiety Scale [MCDAS (f)]. Results There was a significant decrease in pain perception (P < 0.001) and state anxiety scores (P < 0.001) with the use of virtual reality eyeglasses during dental treatment. Conclusion Results of this study showed that virtual reality eyeglasses can successfully decrease pain perception and state anxiety during dental treatment. Trial registration number: 201103126036N1. PMID:23277857
Moore, Roland S.; Cunradi, Carol B.; Duke, Michael R.; Galvin, Deborah
This mixed method paper assessed interrelationships of unfair treatment at work, stress, and problem drinking amongst a sample of U.S. Navy careerists. Survey data from current drinkers (n=2380) were analyzed, along with qualitative interviews from a quota sample of 81. More women than men (51.4% vs. 16.2%) reported gender unfair treatment; approximately 20% of respondents reported ethnic/racial unfair treatment. Unfair treatment was associated with likelihood of problem drinking, but associations were attenuated after adjusting for frequency of work problems and expecting alcohol to alleviate stress. Qualitative results revealed contexts of unfair treatment within bureaucratic structures, tradition, norms, and role modeling. PMID:24729946
Booker, Jordan A; Ollendick, Thomas H; Dunsmore, Julie C; Greene, Ross W
Our objective in this study was to examine the moderating influence of parent-child relationship quality (as viewed by the child) on associations between conduct problems and treatment responses for children with oppositional defiant disorder (ODD). To date, few studies have considered children's perceptions of relationship quality with parents in clinical contexts even though extant studies show the importance of this factor in children's behavioral adjustment in non-clinical settings. In this study, 123 children (ages 7 - 14 years, 61.8% male, 83.7% white) who fulfilled DSM-IV criteria for ODD received one of two psychosocial treatments: Parent Management Training or Collaborative & Proactive Solutions. In an earlier study, both treatments were found to be effective and equivalent in treatment outcomes (Ollendick et al., in press). In the current study, pre-treatment maternal reports of conduct problems and pre-treatment child reports of relations with parents were used to predict outcomes in ODD symptoms and their severity following treatment. Elevated reports of children's conduct problems were associated with attenuated reductions in both ODD symptoms and their severity. Perceived relationship quality with parents moderated the ties between conduct problems and outcomes in ODD severity but not the number of symptoms. Mother reports of elevated conduct problems predicted attenuated treatment response only when children viewed relationship quality with their parents as poorer. When children viewed the relationship as higher quality, they did not show an attenuated treatment response, regardless of reported conduct problems. The current findings underscore the importance of children's perspectives in treatment response and reductions in externalizing child behaviors.
Borreani, Elena; Wright, Desmond; Scambler, Sasha; Gallagher, Jennifer E
Background Older people are increasingly retaining their natural teeth but at higher risk of oral disease with resultant impact on their quality of life. Socially deprived people are more at risk of oral disease and yet less likely to take up care. Health organisations in England and Wales are exploring new ways to commission and provide dental care services in general and for vulnerable groups in particular. This study was undertaken to investigate barriers to dental care perceived by older people in socially deprived inner city area where uptake of care was low and identify methods for minimising barriers in older people in support of oral health. Methods A qualitative dual-methodological approach, utilising both focus groups and individual interviews, was used in this research. Participants, older people and carers of older people, were recruited using purposive sampling through day centres and community groups in the inner city boroughs of Lambeth, Southwark and Lewisham in South London. A topic guide was utilised to guide qualitative data collection. Informants' views were recorded on tape and in field notes. The data were transcribed and analysed using Framework Methodology. Results Thirty-nine older people and/or their carers participated in focus groups. Active barriers to dental care in older people fell into five main categories: cost, fear, availability, accessibility and characteristics of the dentist. Lack of perception of a need for dental care was a common 'passive barrier' amongst denture wearers in particular. The cost of dental treatment, fear of care and perceived availability of dental services emerged to influence significantly dental attendance. Minimising barriers involves three levels of action to be taken: individual actions (such as persistence in finding available care following identification of need), system changes (including reducing costs, improving information, ensuring appropriate timing and location of care, and good patient
Al-Sabbagh, Mohanad; Okeson, Jeffrey P; Bertoli, Elizangela; Medynski, Denielle C; Khalaf, Mohd W
Nerve trauma caused by dental implant placement is associated with altered sensation and chronic pain. Complete or partial loss of sensation is often reported by patients who have experienced nerve trauma during implant surgery. Some patients report persistent pain and neurosurgery disturbance long after the normal healing time has passed. In addition, neuropathic pain is reported after implant surgery. Practitioners who place dental implants must be familiar with the differential diagnosis, prevention, and management of neuropathic pain. This article provides insights into the prevention and management of neurosensory deficits and chronic persistent neuropathic pain and considerations for patient referral.
Rosén, Birgitta; Olavi, Göran; Birkhed, Dowen; Edvardsson, Stig; Egelberg, Jan
A long-term study in adults at a public dental clinic in Sweden was initiated to evaluate the relative effectiveness of prophylactic treatments on the progression of dental caries and periodontal discase. With treatments scheduled every 3rd, 6th, 12th or 18th month, this report presents results on caries for the 3-month, 6-month and 18-month groups, and evaluates the impact of various caries-related risk factors. Caries increment over approximately 5 years was determined by adding clinical and radiographic findings of manifest primary and secondary caries during the study. Overall caries activity among all 105 participating individuals was low to moderate. No significant differences for caries on any of the various tooth surfaces or for total caries were observed among the three groups. Multiple regression analysis with 5-year caries increment as dependent variable showed that the following factors had a statistically significant association with caries increment: percentage filled surfaces at baseline examination, dietary score, plaque score, and number of mutans streptococci and lactobacilli in saliva. Non-significant factors included number of preventive treatments provided during the 5-year interval. The results of this long-term trial suggest that preventive treatments as often as every 3 6 months may not be justified in the case of patients with low to moderate caries activity.
Lordo, Danielle N.; Bertolin, Madison; Sudikoff, Eliana L.; Keith, Cierra; Braddock, Barbara; Kaufman, David A. S.
The current study examined the effectiveness of a social skills treatment (PEERS) for improving socio-emotional competencies in a sample of high-functioning adolescents with ASD. Neuropsychological and self- and parent-report measures assessing social, emotional, and behavioral functioning were administered before and after treatment. Following…
Gordon, Robert M.
Both volunteer and nonvolunteer subjects were randomly assigned to one of two conditions. In the choice condition, subjects were led to believe that they had a choice, and in the second condition subjects were denied the choice of treatment. Volunteer subjects who were given a choice significantly valued the treatment more. (Author)
Woodmansey, Karl F.
Dental anxiety remains a pervasive barrier to dental treatment for many individuals, including college-age patients. In this article, the author reviews dental anxiety and examines the usefulness of assessment instruments for identifying dental anxiety. Using 2 unique assessment instruments, he examines the prevalence of dental anxiety in his…
Stiefel, Doris J.; Truelove, Edmond L.
A five-year project of postgraduate training in dentistry for patients with severe disabilities resulted in significant cognitive and confidence gains for the participating dentists, dental hygienists, and assistants. Over 75 percent of the graduates were found to actively apply their training, especially in academic dentistry. (MSE)
Biswas, Sujata; Bowler, Ian C J W; Bunch, Christopher; Prendergast, Bernard; Webster, Daniel P
We report what we believe is the first reported case of Streptococcus mutans endocarditis complicated by vertebral discitis. The case is particularly interesting and topical as it occurred in a patient with pre-existing cardiac valvular disease who had recently had a dental procedure without antibiotic prophylaxis following a dramatic shift in the UK guidelines.
... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for..., and periodontal disease will be considered service-connected solely for the purpose of establishing... will consider each defective or missing tooth and each disease of the teeth and periodontal...
Silberman, Stephen L.; And Others
A new test developed by the University of Mississippi School of Dentistry that included videotape, visual aids, and relevant dental data as part of the exam is reported. The degree of student anxiety before, during, and after the examination was measured. A videotaped segment simulating a case history was used. (Author/MLW)
Zhang, Xiaowei; Liang, Jingping
The pathogenesis of pulpal and periapical diseases is related with not only bacterial infection but also physicochemical irritations such as trauma and thermal changes. During orthodontic therapy, the application of orthodontic forces on teeth may produce a series of changes in periodontal ligament, alveolar bone and pulpo-dentinal complex. This article reviewed the influences of orthodontic therapy on dental pulp and periapical tissues.
... totally disabled due to a service-connected disability. (b) Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities, but may... will consider each defective or missing tooth and each disease of the teeth and periodontal...
Lemon, Sherry; Reveal, Marge
A survey of 138 dental hygiene programs gathered information on didactic and clinical experiences for preparing students to treat patients with mental illnesses. Although most curricula addressed the issue, inadequate time was allotted. Over half did not provide oral care to these patients; few felt the community's need was met. (MSE)
Kondo, Y; Yamashita, A; Suzuki, K; Omura, I; Yamauchi, J I
In this study, the durability of adhesion between an adhesive resin (Panavia EX) and dental alloys (gold or Ni-Cr) were examined in regard to thermal cycling, immersion, either in water (70 degrees C or 100 degrees C) or in sodium chloride solutions (pH was 3, 7 and 9). An favourable adhesive strength, such as 450-500 kgf/cm2, was obtained even after 24 hours immersion in 37 degrees C water, when the surface pre-treatment of the alloy was done with either Sn- or composite (TMSAC/Sn or PVC/Sn)-plating. However, during the durability test, the adhesive strength has decreased to such on extent, that about 60% of early strength with Sn-plating and 80% with TMSAC/Sn composite plating. But, with PVC/Sn composite-plating, more than 90% of the early strength was maintained. In regard to the pH of the corrosive solution, no apparent difference was observed regarding the above mentioned adhesive characteristics.
Genina, Elina A; Titorenko, Vladimir A; Belikov, Andrey V; Bashkatov, Alexey N; Tuchin, Valery V
The efficacy of blue light-emitting toothbrushes (B-LETBs) (405 to 420 nm, power density 2 mW/cm(2)) for reduction of dental plaques and gingival inflammation has been evaluated. Microbiological study has shown the multifactor therapeutic action of the B-LETBs on oral pathological microflora: in addition to partial mechanical removal of bacteria, photodynamic action suppresses them up to 97.5%. In the pilot clinical studies, subjects with mild to moderate gingivitis have been randomly divided into two groups: a treatment group that used the B-LETBs and a control group that used standard toothbrushes. Indices of plaque, gingival bleeding, and inflammation have been evaluated. A significant improvement of all dental indices in comparison with the baseline (by 59%, 66%, and 82% for plaque, gingival bleeding, and inflammation, respectively) has been found. The treatment group has demonstrated up to 50% improvement relative to the control group. We have proposed the B-LETBs to serve for prevention of gingivitis or as an alternative to conventional antibiotic treatment of this disease due to their effectiveness and the absence of drug side effects and bacterial resistance.
Pandey, Vijayendra; Chandra, Subhash; Dilip Kumar, H. P.; Gupta, Ashish; Bhandari, Poonam Preet; Rathod, Pankaj
Objective: Maintenance of meticulous oral health practices is critical for patients who are under orthodontic treatment as failure to do so can result in deterioration of periodontal health. Thus, the present study was commenced to assess dental negligence and oral health status among patients undergoing orthodontic treatment using dental neglect scale (DNS) questionnaire. Materials and Methods: The present cross-sectional study was planned and carried out among the 40 patients undergoing fixed orthodontic treatment. The study comprised of two questionnaires, one was close-ended questionnaire which consisted of questions regarding patient practice in maintenance of oral health and other questionnaire comprised of DNS followed by examination of oral hygiene status using Oral Hygiene Index Simplified. Data so obtained were subjected to analysis using SPSS version 20 and Chi-square test was used to statistically analyze data with P < 0.05 regarded as a statistically significant value. Results: The present study revealed that 63% among the studied orthodontic patients brushed once daily, 26% brushed twice daily, and 11% brushed thrice. About one-fourth was using brush with soft bristles and only 9% among the respondents used interdental aids. Data revealed positive correlation between DNS and oral hygiene index-simplified score with P < 0.05. Conclusion: The present study found that less frequency of brushing, rinsing mouth, and eating sticky and hard food can be attributed to self-neglect of the orthodontic patients. PMID:27114950
Genina, Elina A.; Titorenko, Vladimir A.; Belikov, Andrey V.; Bashkatov, Alexey N.; Tuchin, Valery V.
The efficacy of blue light-emitting toothbrushes (B-LETBs) (405 to 420 nm, power density 2 mW/cm2) for reduction of dental plaques and gingival inflammation has been evaluated. Microbiological study has shown the multifactor therapeutic action of the B-LETBs on oral pathological microflora: in addition to partial mechanical removal of bacteria, photodynamic action suppresses them up to 97.5%. In the pilot clinical studies, subjects with mild to moderate gingivitis have been randomly divided into two groups: a treatment group that used the B-LETBs and a control group that used standard toothbrushes. Indices of plaque, gingival bleeding, and inflammation have been evaluated. A significant improvement of all dental indices in comparison with the baseline (by 59%, 66%, and 82% for plaque, gingival bleeding, and inflammation, respectively) has been found. The treatment group has demonstrated up to 50% improvement relative to the control group. We have proposed the B-LETBs to serve for prevention of gingivitis or as an alternative to conventional antibiotic treatment of this disease due to their effectiveness and the absence of drug side effects and bacterial resistance.
ten Cate, J M; Imfeld, T
Although reports on dental erosion have always appeared in the dental literature, there is currently a growing interest among researchers and clinicians. Potential risk factors for dental erosion are changed lifestyle and eating patterns, with increased consumption of acidic foods and beverages. Various gastrointestinal and eating disorders expose the dentition to frequent contacts with very acidic gastric content, which may lead to erosion. Whether these factors indeed lead, on a population scale, to a higher prevalence and incidence of erosion is yet to be established. This article summarizes the different aspects of the prevalence, pathology, etiology, assessment, prevention and treatment of dental erosion, and concludes with recommendations for future research.
Ma, Joyce L. C.; Lai, Kelly
Although family therapy has become highly acceptable in the West, its applicability and acceptability for Chinese adolescents and young women with anorexia nervosa (AN) remains unknown. In this article, we report the results of a qualitative study using post-treatment in-depth interviews to understand the subjective perceptions of sufferers of AN…
Wimberly, Sarah R.; Carver, Charles S.; Laurenceau, Jean-Philippe; Harris, Suzanne D.; Antoni, Michael H.
Two studies examined breast cancer patients' perceptions of their partners' reactions to their diagnosis and treatment as influences on 3 aspects of patients' well-being: psychosexual adjustment, emotional distress, and marital satisfaction. Study 1, cross-sectional, indicated that partner initiation of sex, frequency of sex, a positive 1st sexual…
Reimer, Wilbert L.; Mathieu, Tina
Thirty-four (34) federally sentenced sex offenders in British Columbia were surveyed using the Yalom (1995) 12 therapeutic factors presented in a 60-item questionnaire Likert format, as well as a semi-structured interview regarding their perceptions of which curative factors were most beneficial to them in treatment. The mean scores for catharsis…
Shrestha, N; Acharya, J; Sagtani, A R; Shrestha, R; Shrestha, S
Dental caries occurrence, distribution, oral health status and corresponding treatment needs in 12 - 15 year old children are useful tools for evaluation of oral health. Dental caries status along with its treatment needs was recorded according to World Health Organization (WHO) index (1997) in 366 children from five schools within Jorpati Village Development Committee (VDC), Kathmandu. Dental caries was diagnosed in 156 (42.6%) children, out of which 122 (78.21%) had caries in permanent teeth, 26 (16.67%) had caries in primary teeth, and 8 (5.13%) had caries in both dentition. The age wise distribution of dental caries showed the highest prevalence among 12 year old students (23.8%) and the lowest among 15 year olds (3.8%). Among the female students (177), 43.5% showed presence of dental caries, while the prevalence among male students (179) was 41.8%.Out of the total number of teeth affected by dental caries (336), 273 (81.25%) were permanent teeth and 63 (18.75%) were primary teeth. The intra arch distribution of dental caries in permanent as well as primary dentition was statistically significant (P < 0.05). Restorative treatment (89.38%) was the main need in permanent dentition, and endodontic treatment (60.32%) in primary dentition. Chronologic enamel hypoplasia was found in 14 (3.83%) of the total population, and 62 (16.94%) required oral prophylaxis. These findings are significant as they can initiate further research in this area, which may help establish reliable baseline data for implementation of preventive oral health programs.
Dental radiography is a necessary diagnostic modality in small animal practice. It is not possible to accurately assess and diagnose tooth resorption, periodontal disease, endodontic disease, neoplasia and injury without it. Dental radiography is also necessary for treatment and assessment of the patient postoperatively.
Ramponi, Denise R
Dental problems are a common complaint in emergency departments in the United States. There are a wide variety of dental issues addressed in emergency department visits such as dental caries, loose teeth, dental trauma, gingival infections, and dry socket syndrome. Review of the most common dental blocks and dental procedures will allow the practitioner the opportunity to make the patient more comfortable and reduce the amount of analgesia the patient will need upon discharge. Familiarity with the dental equipment, tooth, and mouth anatomy will help prepare the practitioner for to perform these dental procedures.
Emre, Seker; Mehmet, Ali Kilicarslan; Serdar, Polat; Emre, Ozkir; Suat, Pat
This study aimed to evaluate the surface roughness and wetting properties of various dental prosthetic materials after different durations of non-thermal atmospheric plasma (NTAP) treatment. One hundred and sixty discs of titanium (Ti) (n:40), cobalt chromium (Co-Cr) (n:40), yttrium stabilized tetragonal zirconia polycrystals (Y-TZP) (n:40) and polymethylmethacrylate (PMMA) (n:40) materials were machined and smoothed with silicon carbide papers. The surface roughness was evaluated in a control group and in groups with different plasma exposure times [1-3-5 s]. The average surface roughness (Ra) and contact angle (CA) measurements were recorded via an atomic force microscope (AFM) and tensiometer, respectively. Surface changes were examined with a scanning electron microscope (SEM). Data were analyzed with two-way analysis of variance (ANOVA) and the Tukey HSD test α=0.05). According to the results, the NTAP surface treatment significantly affected the roughness and wettability properties (P < 0.05). SEM images reveal that more grooves were present in the NTAP groups. With an increase in the NTAP application time, an apparent increment was observed for Ra, except in the PMMA group, and a remarkable reduction in CA was observed in all groups. It is concluded that the NTAP technology could enhance the roughening and wetting performance of various dental materials. supported by the Department of Scientific Research, Eskisehir Osmangazi University, Turkey (No. 201441045)
Hall, David L
The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in nursing home residents now averages 20-35%. This includes both numerous asymptomatic mostly unidentified carriers, and the occasional patient with an active infection. Among the most common sites for positive MRSA colonization are the nares and mouth (saliva). Ohio State University (OSU) dental students perform routine restorative dental care onsite in local nursing homes using portable equipment including handpieces that can generate aerosols. Using a series of cultured test swabs and plates, this pilot study suggests that protection for both dental health care personnel and patients are provided by the following: 1. universal barrier precautions (for example, gloves, gowns, masks, hats, facial shields, glasses), 2. surface disinfectants, 3. pre-op 0.12% chlorhexidene mouth rinses, 4. high volume evacuation, 5. perioral skin scrubs. Additional infection control methods, techniques and equipment were evaluated and compared including rubber dam isolation, hand excavation and bond technique, high-speed air turbine and electric "high" speed handpiece. There was no indication of a special tendency or heightened ability of MRSA to aerosolize.
Garey, Lorra; Bakhshaie, Jafar; Vujanovic, Anka A; Reitzel, Lorraine R; Schmidt, Norman B; Zvolensky, Michael J
Trauma exposure and smoking co-occur at an alarmingly high rate. However, there is little understanding of the mechanisms underlying this clinically significant relation. The present study examined perceived stress as an explanatory mechanism linking posttraumatic stress symptom severity and smoking-specific avoidance/inflexibility, perceived barriers to smoking cessation, and negative affect reduction/negative reinforcement expectancies from smoking among trauma-exposed smokers. Participants were trauma-exposed, treatment-seeking daily cigarette smokers (n=179; 48.0% female; Mage=41.17; SD=12.55). Results indicated that posttraumatic stress symptom severity had an indirect significant effect on each of the dependent variables via perceived stress. The present results provide empirical support that perceived stress may be an underlying mechanism that indirectly explains posttraumatic symptoms relation to smoking-specific avoidance/inflexibility, perceived barriers to smoking cessation, and negative affect reduction/negative reinforcement expectancies among trauma-exposed smokers. These findings suggest that there may be clinical utility in targeting perceived stress among trauma-exposed smokers via stress management psychoeducation and skills training.
Marachlioglou, C R M Z; Dos Santos, J F F; Cunha, V P P; Marchini, Leonardo
There is a poor association between the dentist's evaluation of denture quality and patients' satisfaction with their dentures. Possible differences between dental professionals and patients' expectations might help explain differences in outcome evaluations. This study compared scores given by a dentist, a dental technician and patients for their expectations before and their final evaluation after complete dentures treatment. Twenty completely edentulous patients, a prosthodontist and a dental technician provided scores for the expected aesthetic and functional results of their dentures based on a visual analogue scale at baseline. Post-treatment completion ratings were given after adjustments, by dentist and patients. The dental technician provided post-treatment completion ratings after completing the dentures. The patients had higher expectations than the dental technician and the dentist perceived for both aesthetic and function (P < 0.001). The patients also presented higher post-treatment completion ratings than the dental professionals perceived for final aesthetics (P = 0.016, Kendall's W = 0.207) and function (P = 0.002, Kendall's W = 0.303). Only the dentist presented a statistically significant difference between expectations (lower) and final (higher) outcomes for aesthetics (P = 0.017) and function (P = 0.003). There was no correlation between expectations and post-treatment completion ratings according to the patients' age. There was also no correlation between the patients' gender and expectation scores. Patients presented higher expectations regarding their dentures than dental professionals. The dentist believed that dentures would bring fewer benefits than patients did, but his perception of denture benefits post-treatment was significantly higher than his expectations.
Krieger, Elena; Wegener, Joachim; Wagner, Wilfried; Hornikel, Sandra; Wehrbein, Heinrich
Functional and esthetic results can improve significantly when a combined prosthodontic-orthodontic treatment approach is employed in cases requiring extensive oral rehabilitation. The patient presented in this case report was treated in his late teens with dental implants as a replacement for his maxillary incisors. Ten years later, the entire maxillary anterior segment was in infraocclusion compared to the rest of the dentition and lip line. Since prosthodontic follow-up treatment alone could not achieve an optimal functional and esthetic outcome, the patient was treated orthodontically prior to renewing the restoration. A fixed appliance was used to intrude the mandibular anterior teeth as well as vertically align the infrapositioned maxillary lateral incisors.
CASAGLIA, A.; DE DOMINICIS, P.; ARCURI, L.; GARGARI, M.; OTTRIA, L.
SUMMARY This paper is the first article in a new series on digital dental photography. Part 1 defines the aims and objectives of dental photography for examination, diagnosis and treatment planning, legal and forensic documentation, publishing, education, marketing and communication with patients, dental team members, colleagues and dental laboratory. PMID:28042424
Efficacy of a Low Dose of Hydrogen Peroxide (Peroxy Ag⁺) for Continuous Treatment of Dental Unit Water Lines: Challenge Test with Legionella pneumophila Serogroup 1 in a Simulated Dental Unit Waterline.
Ditommaso, Savina; Giacomuzzi, Monica; Ricciardi, Elisa; Zotti, Carla M
This study was designed to examine the in vitro bactericidal activity of hydrogen peroxide against Legionella. We tested hydrogen peroxide (Peroxy Ag⁺) at 600 ppm to evaluate Legionella survival in a simulated dental treatment water system equipped with Water Hygienization Equipment (W.H.E.) device that was artificially contaminated. When Legionella pneumophila serogroup (sg) 1 was exposed to Peroxy Ag⁺ for 60 min we obtained a two decimal log reduction. High antimicrobial efficacy was obtained with extended periods of exposure: four decimal log reduction at 75 min and five decimal log reduction at 15 h of exposure. Involving a simulation device (Peroxy Ag⁺ is flushed into the simulation dental unit waterlines (DUWL)) we obtained an average reduction of 85% of Legionella load. The product is effective in reducing the number of Legionella cells after 75 min of contact time (99.997%) in the simulator device under test conditions. The Peroxy Ag⁺ treatment is safe for continuous use in the dental water supply system (i.e., it is safe for patient contact), so it could be used as a preventive option, and it may be useful in long-term treatments, alone or coupled with a daily or periodic shock treatment.
Efficacy of a Low Dose of Hydrogen Peroxide (Peroxy Ag+) for Continuous Treatment of Dental Unit Water Lines: Challenge Test with Legionella pneumophila Serogroup 1 in a Simulated Dental Unit Waterline
Ditommaso, Savina; Giacomuzzi, Monica; Ricciardi, Elisa; Zotti, Carla M.
This study was designed to examine the in vitro bactericidal activity of hydrogen peroxide against Legionella. We tested hydrogen peroxide (Peroxy Ag+) at 600 ppm to evaluate Legionella survival in a simulated dental treatment water system equipped with Water Hygienization Equipment (W.H.E.) device that was artificially contaminated. When Legionella pneumophila serogroup (sg) 1 was exposed to Peroxy Ag+ for 60 min we obtained a two decimal log reduction. High antimicrobial efficacy was obtained with extended periods of exposure: four decimal log reduction at 75 min and five decimal log reduction at 15 h of exposure. Involving a simulation device (Peroxy Ag+ is flushed into the simulation dental unit waterlines (DUWL)) we obtained an average reduction of 85% of Legionella load. The product is effective in reducing the number of Legionella cells after 75 min of contact time (99.997%) in the simulator device under test conditions. The Peroxy Ag+ treatment is safe for continuous use in the dental water supply system (i.e., it is safe for patient contact), so it could be used as a preventive option, and it may be useful in long-term treatments, alone or coupled with a daily or periodic shock treatment. PMID:27455299
Visser, Susanna N.; Kramer, Dennis; Snyder, Angela B.; Sebian, Joyce; McGiboney, Garry; Handler, Arden
Objective Evaluate the relationship between school climate and ADHD medication treatment among adolescents in Medicaid in Georgia (GA). Methods School climate and Medicaid claims data were aggregated for 159 GA counties. County-level school climate percentile and medicated ADHD prevalence were calculated. T-tests and regression evaluated the relationship between school climate, medicated ADHD, and demographics, weighted by county population. Poorer 2008 school climate (<25th percentile) was regressed on 2011 medicated ADHD prevalence, controlling for potential confounders. Results The prevalence of medicated ADHD was 7.8% among Medicaid-enrolled GA adolescents. The average county-level prevalence of medicated ADHD was 10.0% (SD=2.9%). Poorer school climate was associated with lower rates of medicated ADHD (p<0.0001) and with demographics accounted for 50% of the county variation in medicated ADHD. Conclusions School climate is associated with medicated ADHD among adolescents in Medicaid. Additional research may reveal whether high medicated ADHD may reflect a lack of access to non-pharmacological therapies. PMID:25710947
Yang, Claus; Liu Tianxiao; Jennelle, Richard L.; Ryu, Janice K.; Vijayakumar, Srinivasan; Purdy, James A.; Chen, Allen M.
The purpose of this study was to demonstrate the potential utility of megavoltage fan-beam computed tomography (MV-FBCT) for treatment planning in a patient undergoing helical tomotherapy for nasopharyngeal carcinoma in the presence of extensive dental artifact. A 28-year-old female with locally advanced nasopharyngeal carcinoma presented for radiation therapy. Due to the extensiveness of the dental artifact present in the oral cavity kV-CT scan acquired at simulation, which made treatment planning impossible on tomotherapy planning system, MV-FBCT imaging was obtained using the HI-ART tomotherapy treatment machine, with the patient in the treatment position, and this information was registered with her original kV-CT scan for the purposes of structure delineation, dose calculation, and treatment planning. To validate the feasibility of the MV-FBCT-generated treatment plan, an electron density CT phantom (model 465, Gammex Inc., Middleton, WI) was scanned using MV-FBCT to obtain CT number to density table. Additionally, both a 'cheese' phantom (which came with the tomotherapy treatment machine) with 2 inserted ion chambers and a generic phantom called Quasar phantom (Modus Medical Devices Inc., London, ON, Canada) with one inserted chamber were used to confirm dosimetric accuracy. The MV-FBCT could be used to clearly visualize anatomy in the region of the dental artifact and provide sufficient soft-tissue contrast to assist in the delineation of normal tissue structures and fat planes. With the elimination of the dental artifact, the MV-FBCT images allowed more accurate dose calculation by the tomotherapy system. It was confirmed that the phantom material density was determined correctly by the tomotherapy MV-FBCT number to density table. The ion chamber measurements agreed with the calculations from the MV-FBCT generated phantom plan within 2%. MV-FBCT may be useful in radiation treatment planning for nasopharyngeal cancer patients in the setting of extensive
Rabenau, H F; Nentwig, G H; Doerr, H W
In dentistry it is of primary importance to take into consideration microbial transfer due to the nature of the construction of rotating dental instruments. This aspect was the starting point for our research with the question whether or not sterilisation is fundamentally necessary for slow and high speed hand pieces to make them "safe" out of a virological point of view, or whether a thermal disinfection could also possibly be adequate for this purpose. In this context, we tested the efficiency of the cleaning and disinfection capacity of an automated steam disinfection and sterilisation unit (Sirona Hygiene Center, Siemens, AG, Bensheim) intended to the hygienic treatment of dental instruments with respect to viruses. In model tests the corresponding instruments were experimentally infected with herpes simplex virus type 1 (HSV) and simian vacuoling virus (SV40). As indicator systems we used for both cell cultures (measurement of the degree of infectiosity) and (for HSV) polymerase chain reactions (PCR; determination of viral nucleic acids). In the tests for (residual) infectiosity after thermal disinfection (as an isolated step of the Hygienic Centre) and also for a combination of cleaning and subsequent thermal disinfection (also after protein application), no infectious virus could be found in the interior of the slow handpieces and turbines tested. In opposite to this, infectious HSV and SV40 could be found after completion of every isolated cleaning program in the turbine (in all three ducts) and in the slow handpiece (only in the gearbox duct in the case of HSV, and in the case of SV40 also in the water and air ducts in very small amounts). The PCR analyses showed that no nucleic acids could be found in both instruments (in the air and water ducts) following a practice-relevant combination of cleaning and disinfection, but that PCR-positive signals were obtained for the larger-volume gearbox and drive and return air ducts in 1 or 2 of 3 test samples. The
Bortoluzzi, Marcelo Carlos; Manfro, Rafael; Nardi, Anderson
OBJECTIVE: The aim of this study was to (1) observe the extent to which hemodynamic and glucose measurements change in patients submitted to a dental procedure with and without a local anesthetic and a vasoconstrictor (LAVA; 2% mepivacaine with adrenaline 1∶100,000) and (2) correlate those parameters with the patients' anxiety levels. METHOD: This was an unblinded, random, prospective, and observational study with paired groups. Patients were evaluated during two different consultations during which they either did or did not receive a local anesthetic/vasoconstrictor. RESULTS: Thirty‐seven patients ranging in age from 18 to 45 years (mean 30.4 ± 5.5 years) were evaluated. Hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, heart rate, and glucose levels, did not change significantly in healthy patients, regardless of whether a LAVA was administered during the dental treatment. CONCLUSION: The patients' anxiety statuses neither varied significantly nor showed any correlation with the studied hemodynamic parameters and glucose levels, regardless of whether local anesthetics were used. PMID:21120297
Calixto, Giovana Maria Fioramonti; Garcia, Matheus Henrique; Cilli, Eduardo Maffud; Chiavacci, Leila Aparecida; Chorilli, Marlus
Dental caries, mainly caused by the adhesion of Streptococcus mutans to pellicle-coated tooth surfaces, is an important public health problem worldwide. A synthetic peptide (p1025) corresponding to residues 1025-1044 of the adhesin can inhibit this binding. Peptides are particularly susceptible to the biological environment; therefore, a p1025 peptide-loaded liquid crystalline system (LCS) consisting of tea tree oil as the oil phase, polyoxypropylene-(5)-polyoxyethylene-(20)-cetyl alcohol as the surfactant, and water or 0.5% polycarbophil polymer dispersions as the aqueous phase was employed as a drug delivery platform. This system exhibited anticaries and bioadhesive properties and provided a protective environment to p1025 at the site of action, thereby modulating its action, prolonging its contact with the teeth, and decreasing the frequency of administration. LCSs were characterized by polarized light microscopy (PLM), small-angle X-ray scattering (SAXS), and rheological, texture, and bioadhesive tests. PLM and SAXS revealed the presence of hexagonal liquid crystalline phases and microemulsions. Rheological analyses demonstrated that the addition of polymer dispersions favored characteristics such as shear thinning and thixotropy, hence improving buccal application. Bioadhesion tests showed that polymer dispersions contributed to the adhesion onto the teeth. Taken together, LCS could provide a novel pharmaceutical nanotechnology platform for dental caries treatment.
Smucler, Roman; Mazanek, Jiri
In clinical praxis we must treat patients with some relative or absolute contraindications every day. Need of hospitalization, antibiotics, hemostyptics and complex examinations makes dentoalveolar and maxillofacial surgery in those cases quite expensive. Combination of Nd:YAG and Er:YAG laser gives us new possibilities. We can help some untreatable patients or transfer care from hospital to dental office. We have been trying to solve contraindications for laser therapy five years. In the center of our work are disorders of blood coagulation, immunity and metabolism. Nd:YAG laser is very useful in coagulation and vaporization of dental gum hypertrophies, benign and malign tumors in case of chronic anticoagulation therapy and immunosupress / in combination for example- after heart transplantation /. Special chapter is the care of patients with disseminated tumors. Er:YAG laser large solve big lesions because of minimal invasivity of course but for small benign tumors are recidives is ideal. Better and quicker healing make new standard of patients' cooperation. Generally fashionable and more comfortable laser treatment minimize need of general anesthesia. After five years we use complex laser therapy in our routine. Aim of our new work is to find ideal combination of cutting lasers to minimize classical complications of laser surgery / carbonization, long and secondary healing /.
Yu, Qing Song; Li, H.; Ritts, A. C.; Yang, B.; Chen, M.; Hong, L.; Xu, C.; Yao, X.; Wang, Y.
This paper reviews our recent research results of using non-thermal atmospheric plasmas for oral bacterial deactivation and for composite restoration improvement. Oral bacteria of Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus) with an initial bacterial population density between 1.0 × 108 and 5.0 × 108 cfu/ml were seeded on various media and their survivability with plasma exposure was examined. The plasma exposure time for a 99.9999% cell reduction was less than 15 s for S. mutans and within 5 min for L. acidophilus. To evaluate the dentin/composite interfacial bonding, extracted unerupted human third molars were used by removing the crowns and etching the exposed dentin surfaces with 35% phosphoric acid gel. After dental composite application and light curing, the teeth were then sectioned into micro-bars as the specimens for microtensile test. Student Newman Keuls (SNK) tests showed that the bonding strength of the composite restoration to peripheral dentin was significantly increased (by 64%) after 30 s plasma treatment of the dentin surfaces. These findings indicated that non-thermal atmospheric plasma technology is very promising for dental clinical applications.
Rana, Meenakshi Chauhan; Solanki, Swati; Pujari, Sudarshan C; Shaw, Eisha; Sharma, Swati; Anand, Abhishek; Singh, Harkanwal Preet
Background: In patients undergoing head and neck surgery for various pathologic conditions, implants are one of the best restorative options and are increasing widely used. Therefore, we evaluated the success of dental implants in the irradiated jaws of patients following treatment of oral cancer oral cancer treated patients. Materials and Methods: Data of oral cancer treated patients was collected retrospectively from 2002 to 2008. We took 46 oral cancer treated patients in which implants were placed in irradiated jaws for rehabilitation. Results: It was found that out of 162 dental implants placed, 52 failed. Furthermore, there was no variation in the implant survival rate in between both the jaws. Radiation dose of <50 Gy units also showed significantly increased amount of implant survival rate. Conclusions: Implant survival is multifactorial and depends upon a number of factors like level of radiation exposure in that area, time gap between last radiation doses etc., Further research is required in this field to improve the esthetics and quality of life of cancer treated patients. PMID:27843270
Ghanem, Henry; Abi-Nader, Samer
PURPOSE A survey was conducted to assess the impact of a TED-like educational session on participants' willingness to accept dental implant therapy. MATERIALS AND METHODS Volunteers interested in having information about dental implant therapies were recruited and asked to complete a two-part survey before and after an educational session. The initial survey elicited demographic information, self-perceived knowledge on dental implants and willingness to this kind of treatment. A "TED-style" presentation that provided information about dental implant treatments was conducted before asking the participants to complete a second set of questions assessing the impact of the session. RESULTS The survey was completed by 104 individuals, 78.8% were women and the mean age was 66.5±10.8. Before the educational session, 76.0% of the participants refused dental implants mainly due to lack of knowledge. After the educational session, the rejection of dental implants decreased by almost four folds to 20.2%. CONCLUSION This study proved that an educational intervention can significantly increase willingness to accept treatment with dental implants in a segment of the population who is interested in having information about dental implant therapy. Furthermore, educational interventions, such as TED-like talks, might be useful to increase popular awareness on dental implant therapy. PMID:26816573
Parker, Alexander S; Al Botros, Rehab; Kinnear, Sophie L; Snowden, Michael E; McKelvey, Kim; Ashcroft, Alexander T; Carvell, Mel; Joiner, Andrew; Peruffo, Massimo; Philpotts, Carol; Unwin, Patrick R
A combination of scanning electrochemical cell microscopy (SECCM) and atomic force microscopy (AFM) is used to quantitatively study the acid-induced dissolution of dental enamel. A micron-scale liquid meniscus formed at the end of a dual barrelled pipette, which constitutes the SECCM probe, is brought into contact with the enamel surface for a defined period. Dissolution occurs at the interface of the meniscus and the enamel surface, under conditions of well-defined mass transport, creating etch pits that are then analysed via AFM. This technique is applied to bovine dental enamel, and the effect of various treatments of the enamel surface on acid dissolution (1mM HNO3) is studied. The treatments investigated are zinc ions, fluoride ions and the two combined. A finite element method (FEM) simulation of SECCM mass transport and interfacial reactivity, allows the intrinsic rate constant for acid-induced dissolution to be quantitatively determined. The dissolution of enamel, in terms of Ca(2+) flux ( [Formula: see text] ), is first order with respect to the interfacial proton concentration and given by the following rate law: [Formula: see text] , with k0=0.099±0.008cms(-1). Treating the enamel with either fluoride or zinc ions slows the dissolution rate, although in this model system the partly protective barrier only extends around 10-20nm into the enamel surface, so that after a period of a few seconds dissolution of modified surfaces tends towards that of native enamel. A combination of both treatments exhibits the greatest protection to the enamel surface, but the effect is again transient.
Gupta, Devanand; Momin, Rizwan K; Mathur, Ayush; Srinivas, Kavuri Teja; Jain, Ankita; Dommaraju, Neelima; Dalai, Deepak Ranjan; Gupta, Rajendra Kumar
Background: Dental problems in the preschool children are neglected by their parents as the deciduous teeth are going to shed off, and hence considered to be of no importance and more of economic burden if attended to them. Aims: This study was to determine the caries prevalence in preschool children (3-5-year-old) of rural Moradabad district, to analyze the specific pattern of dental caries experience in this population and to assess the treatment needs among them. Material and Methods: Children within the age group of 3-5 years attending Anganwadi centers of rural Moradabad district were included in the study. Caries diagnosis was based on decayed, extracted, filled surface (defs) and the treatment needs were recorded using World Health Organization (WHO) oral health assessment form 1997. Results: Out of 1,500 children examined, 48.7% males and 52.6% females did not require any treatment. The mean decayed, extracted, filled teeth (deft) value was found to be significantly high in 5-year-old participants when compared to 3-year-old participants (P < 0.01). Majority of the children required one surface filling followed by two surface fillings, caries arresting sealant care, extraction, crown bridge element, pulp care, and space maintainer. Conclusion: The most common pattern was pit and fissure, then maxillary anterior pattern, posterior proximal pattern, and posterior buccal lingual smooth surface pattern. The mean deft value was higher in males as compared to females. There is a greater need for oral health education among parents and teachers. PMID:25973401
Chesnokov, V A; Chesnokova, M G; Mironov, A Iu; Turchaninov, D V; Kriga, A S
The application of Bayes theorem in medical diagnostic includes such important step as derivation for every symptom and diagnosis data values of finite or a posteriori probability of presence of germ, for instance S. sanguis, in patients receiving orthodontic treatment. This value expresses importance of the given symptoms for detection of germ presence. In the implemented studies the Bayes theorem was applied to evaluate probability of presence of particular germ in particular concentration (degree of semination, CO) under concrete symptom group. The rates were used to calculate probability of presence of cariesgenic streptococcus S. mutans and S. sanguis in prospect patient. The rates were calculated for the group with fixed orthodontic apparatuses. The high degree of risk of development of caries in children under orthodontic treatment is conditioned by a whole complex of existing unfavorable factors present in oral cavity. Hence, a powerful negative potential to develop expressed cariesgenic situation in oral cavity is present. The analysis of medical data of patients with distal occlusion was applied using Bayes theorem from the point of view their diagnostic value. The study established 36 symptoms, factors, risk factors and background diseases common in case of distal occlusion in children. The probability to detect the mentioned characteristics and likelihood ratio under different degree of concentration of cariesgenic Streptococcus mutans and Streptococcus sanguis in dental plaque of children was considered. The establishment of character of likelihood ratio for different qualitative content of streptococcus in case of isolation from biotope of dental plaque permitted to determine the informative characteristics. The Bayesian model can be applied in clinics as a computer program to process incoming information about patients with distal occlusion under active orthodontic treatment. The developed diagnostic algorithm in a fast and simple mode of clinical
Daubländer, Monika; Kämmerer, Peer W; Willershausen, Brita; Leckel, Michael; Lauer, Hans-Christoph; Buff, Siegmar; Rösl, Benita
The addition of epinephrine in dental local anaesthesia results in a longer and deeper anaesthesia under almost ischemic conditions. For short-time dental treatments, epinephrine-reduced anaesthetics may offer shorter and more individual anaesthesia with reduced potential side effects. The aim of this study was a clinical evaluation of anaesthetic potency and adverse effects of an epinephrine-reduced articaine formulation in dental patients undergoing short-time routine treatment. In a prospective clinical, not interventional, study between January 2008 and February 2009, 908 patients undergoing short-time dental treatment in five medical centers were anaesthetized with 4% articaine 1:400,000 epinephrine (Ubistesin, 3M/ESPE, Seefeld, Germany). Efficacy and safety in clinical use were evaluated. A follow-up after 1 day was conducted by telephone survey. A mean amount of 1.3-ml anaesthetic solution was needed to achieve a complete or sufficient anaesthesia in 97% (n = 876) of cases. A second injection had to be done in 3.7% (n = 34) before and in 11.9% (n = 108) during treatment. Here, the second injection had to be applied after a mean of 48.6 min. The mean duration of soft tissue anaesthesia after infiltration was 146.6 min, after nerve block 187.7 min. The painful treatment took a mean of 50.2 min and the total treatment time summed up to 68.8 min. In 1.7% cases (n = 15), unwanted side effects were observed. The results indicate that a lower concentration of epinephrine in combination with the 4% articaine solution leads to a high success rate of efficacy. The clinical use of a 4% articaine 1:400,000 epinephrine solution can be stated as safe and effective in short dental routine treatments. Reconsiderations concerning limitations of indication or additional contraindications are not necessary.
Sandholzer, Michael A; Sui, Tan; Korsunsky, Alexander M; Walmsley, Anthony Damien; Lumley, Philip J; Landini, Gabriel
Micro- and ultrastructural analysis of burned skeletal remains is crucial for obtaining a reliable estimation of cremation temperature. Earlier studies mainly focused on heat-induced changes in bone tissue, while this study extends this research to human dental tissues using a novel quantitative analytical approach. Twelve tooth sections were burned at 400-900°C (30-min exposure, increments of 100°C). Subsequent combined small- and wide-angle X-ray scattering (SAXS/WAXS) experiments were performed at the Diamond Light Source synchrotron facility, where 28 scattering patterns were collected within each tooth section. In comparison with the control sample, an increase in mean crystal thickness was found in burned dentine (2.8-fold) and enamel (1.4-fold), however at a smaller rate than reported earlier for bone tissue (5-10.7-fold). The results provide a structural reference for traditional X-ray scattering methods and emphasize the need to investigate bone and dental tissues separately to obtain a reliable estimation of cremation temperature.
Bowen, Denise M
Dental hygiene is defined as the science and practice of the recognition, treatment and prevention of oral diseases. The history of dental hygiene research is considered in the context of the development of the discipline and an emerging infrastructure. Research-related events supporting the growth and maturation of the profession are considered from the early years to the most recent. The benefits of preventive oral health services provided by dental hygienists have been supported by research, and the practice of dental hygiene has expanded as a result of research findings since its inception 100 years ago. Dental hygienists' engagement in research, however, did not begin until the 1960s as research associates or administrators, primarily with dental researchers as primary investigators. The Journal of Dental Hygiene (JDH) has provided information for dental hygiene practice since 1927, and has been the primary venue for dissemination of dental hygiene research since 1945. Graduate education in dental hygiene at the master's degree level and the work of early dental hygiene researchers led to the first conference on dental hygiene research in 1982. Over 30 years later, dental hygiene has established a meta-paradigm and defined conceptual models, built an initial infrastructure to support research endeavors and contributed much to the development of dental hygiene as a unique discipline. A doctoral degree in the discipline, continued theory-based research, initiatives to foster collaborations between dental hygiene and other researchers and enhanced capabilities to attract funding to support large scale studies are goals that must be attained through the efforts of future researchers to address the needs for additional development in the discipline of dental hygiene. Dental hygiene research supports the growing discipline and its value to society.
Frost, P; Williams, C A
Periodontal disease and chronic gingivitis/stomatitis are the most common feline dental diseases. With routine dental care and increased emphasis on home oral hygiene, these diseases can be controlled. Cats can be seen with a number of other dental disorders, and improved treatment methods such as restorations of early subgingival resorptive lesions, endodontic therapy, and orthodontic therapy can be performed successfully. More study and research are necessary about the gingivitis/stomatitis syndrome and subgingival resorptive lesions so that improved prevention and treatment recommendations can be made.
Taner, Tülin Ugur; Ciger, Semra; El, Hakan; Germeç, Derya; Es, Alphan
The purpose of this study was to evaluate longitudinal arch width and form changes and to define arch form types with a new computerized method. Maxillary and mandibular models of 21 Class II Division 1 patients were examined before treatment (T(0)), after treatment (T(1)), and an average of 3 years after retention (T(2)). Arch width measurements were made directly on scanned images of maxillary and mandibular models. Arch form changes at T(0)-T(1) and T(1)-T(2) were evaluated by superimposing the computer-generated Bezier arch curves with a computer program. Types of dental arch forms were defined by superimposing them with the pentamorphic arch system, which included 5 different types of arch forms: normal, ovoid, tapered, narrow ovoid, and narrow tapered. Maxillary arch widths were increased during orthodontic treatment. Mandibular posterior arch widths were also increased. The expansion of the mandibular arch forms was less than in the maxillary arch forms. Arch width changes were generally stable, except for reduction in maxillary and mandibular interlateral, inter-first premolar, and mandibular intercanine widths. Pretreatment maxillary arch forms were mostly tapered; mandibular arch forms were tapered and narrow tapered. In maxillary arch forms, 76% of the treatment changes were maintained. Mandibular arch form was maintained in 67% of the sample, both during treatment and after retention. In mandibular arches, 71% of orthodontically induced arch form changes were maintained.
Baker, G J
The objectives of the equine dental physical examination are to detect and quantify oral and dental disorders, to propose and carry out their treatment, and to implement management programs. The veterinarian should be able to offer a prognosis and to detail any future treatment or management plans that may be required. These objectives should take into account the cost of these procedures, and the veterinarian should be prepared to offer a cost-benefit analysis of the problem and the proposed cures.
Lawson, Nathaniel C.; Gilbert, Gregg H.; Funkhouser, Ellen; Eleazer, Paul D.; Benjamin, Paul L.; Worley, Donald C.
Introduction A preliminary study done by a National Dental Practice-Based Research Network precursor observed that 44% of general dentists (GDs) reported always using a rubber dam (RD) during root canal treatment (RCT). This full-scale study quantified use of all isolation techniques, including RD use. Methods Network practitioners completed a questionnaire about isolation techniques used during RCT. Network Enrollment Questionnaire data provided practitioner characteristics. Results 1,490 of 1,716 eligible GDs participated (87%); 697 (47%) reported always using a RD. This percentage varied by tooth type. These GDs were more likely to always use a RD: do not own a private practice; perform less than 10 RCT/month; have postgraduate training. Conclusions Most GDs do not use a RD all the time. Ironically, RDs are used more frequently by GDs who do not perform molar RCT. RD use varies with tooth type and certain dentist, practice, and patient characteristics. PMID:26015159
Zhao, Wei; Zhao, Qi
About 2000 years ago, our country already had a record about mouth washing. It was one of the earliest countries that invented teeth brushing and the toothbrush. It mentioned many kinds of effective techniques of teeth protection and health improvment such as swallowing the saliva, knocking the teeth and practising Qigong. About 3000 years ago, our country already had records about dental disease and had established the specialty of stomatology and dentistry in the Tang dynasty. The methods of treating toothache by acupuncture and external medicine, treating caries by arsenic trioxide and using silver paste to fill the teeth, using artificial teeth for restoration, and treating periodontosis by teeth-cleaning techniques all took the lead in the world. Traditional Chinese Medicines are still used today to treat toothache and periodontosis in clinic.
Vogel, Robert E
Dental implants have been considered an acceptable form of dental treatment since the early 1980s. A number of studies have been published describing impression techniques for dental implants. Many of the techniques described are so complex that they may seem daunting to the average restorative dentist. Most general practitioners do not wish to attempt to restore dental implants. This article describes a very simple, yet extremely accurate, technique for making impressions of dental implant fixtures.
Jaffe, N.; Toth, B.B.; Hoar, R.E.; Ried, H.L.; Sullivan, M.P.; McNeese, M.D.
Sixty-eight long-term survivors of childhood cancer were evaluated for dental and maxillofacial abnormalities. Forty-five patients had received maxillofacial radiation for lymphoma, leukemia, rhabdomyosarcoma, and miscellaneous tumors. Forty-three of the 45 patients and the remaining 23 who had not received maxillofacial radiation also received chemotherapy. Dental and maxillofacial abnormalities were detected in 37 of the 45 (82%) radiated patients. Dental abnormalities comprised foreshortening and blunting of roots, incomplete calcification, premature closure of apices, delayed or arrested tooth development, and caries. Maxillofacial abnormalities comprised trismus, abnormal occlusal relationships, and facial deformities. The abnormalities were more severe in those patients who received radiation at an earlier age and at higher dosages. Possible chemotherapeutic effects in five of 23 patients who received treatment for tumors located outside the head and neck region comprised acquired amelogenesis imperfecta, microdontia of bicuspid teeth, and a tendency toward thinning of roots with an enlarged pulp chamber. Dental and maxillofacial abnormalities should be recognized as a major consequence of maxillofacial radiation in long-term survivors of childhood cancer, and attempts to minimize or eliminate such sequelae should involve an effective interaction between radiation therapists, and medical and dental oncologists.
Solomon, Deborah; Katz, Ralph V; Bush, Anneke C; Farley, Victoria K; McGerr, Trevor J; Min, Hoon; Carbonella, Anthony M; Kayne, Joseph D
This study sought to determine whether the self-perceived image of a young adult's anterior dental esthetics is linked with periodontal health, dental caries, and oral hygiene practices. Two hundred subjects were assessed via a clinical examination, including intraoral photographs. The subjects were questioned about their demographics and oral hygiene practices and given the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) to measure their self-perceived variables related to dental esthetics. A high PIDAQ score indicates a negative image of one's own dental esthetics, while a low PIDAQ score indicates a positive outlook. A self-perceived negative psychosocial impact of anterior dental esthetics was detected in subjects with higher levels of dental caries and visible gingival inflammation in the anterior region of the mouth.
Ncama, Busisiwe Purity
Background Access to healthcare is an important public health concept and has been traditionally measured by using population level parameters, such as availability, distribution and proximity of the health facilities in relation to the population. However, client based factors such as their expectations, experiences and perceptions which impact their evaluations of health care access were not well studied and integrated into health policy frameworks and implementation programs. Objective This study aimed to investigate factors associated with perceived access to HIV/AIDS Treatment and care services in Wolaita Zone, Ethiopia. Methods A cross-sectional survey was conducted on 492 people living with HIV, with 411 using ART and 81 using pre-ART services accessed at six public sector health facilities from November 2014 to March 2015. Data were analyzed using the ologit function of STATA. The variables explored consisted of socio-demographic and health characteristics, type of health facility, type of care, distance, waiting time, healthcare responsiveness, transportation convenience, satisfaction with service, quality of care, financial fairness, out of pocket expenses and HIV disclosure. Results Of the 492 participants, 294 (59.8%) were females and 198 (40.2%) were males, with a mean age of 38.8 years. 23.0% and 12.2% believed they had ‘good’ or ‘very good’ access respectively, and 64.8% indicated lower ratings. In the multivariate analysis, distance from the health facility, type of care, HIV clinical stage, out of pocket expenses, employment status, type of care, HIV disclosure and perceived transportation score were not associated with the perceived access (PA). With a unit increment in satisfaction, perceived quality of care, health system responsiveness, transportation convenience and perceived financial fairness scores, the odds of providing higher rating of PA increased by 29.0% (p<0.001), 6.0%(p<0.01), 100.0% (p<0.001), 9.0% (p<0.05) and 6.0% (p<0
du Toit, Nicole; Rucker, Bayard A
Changes in normal equine dental anatomy with age result in dental disease specific to the geriatric horse. The culmination of dental disease throughout the life of a horse often results in advanced dental disease. Treatment of specific dental disease conditions has to be adapted for older horses to compensate for reduction in reserve crown and occlusal enamel. Ensuring oral comfort and maximizing masticatory ability are the mainstays of geriatric dental treatment. Recognition of dental disease common to older horses ensures that correct treatment is applied. Older patients often require long-term management changes, such as dietary modification, to manage dental disease effectively.
Thilander, B; Pena, L; Infante, C; Parada, S S; de Mayorga, C
The aim of the study was to assess the prevalence of malocclusion in a population of Bogotanian children and adolescents in terms of different degrees of severity in relation to sex and specific stages of dental development, in order to evaluate the need for orthodontic treatment in this part of Colombia. A sample of 4724 children (5-17 years of age) was randomly selected from a population that attended the Dental Health Service; none had been orthodontically treated. Based on their dental stages the subjects were grouped into deciduous, early mixed, late mixed and permanent dentition. The registrations were performed according to a method by Björk et al. (1964). The need for orthodontic treatment was evaluated according to an index used by the Swedish National Board of Health. The results showed that 88 per cent of the subjects had some type of anomaly, from mild to severe, half of them recorded as occlusal anomalies, one-third as space discrepancies, and one-fifth as dental anomalies. No clear sex differences were noted, except for maxillary overjet, spacing, tooth size (all more frequent in boys), and crowding (more frequent in girls). Occlusal anomalies and space discrepancies varied in the different dental developmental periods, as did tipped and rotated teeth. Little need for orthodontic treatment was found in 35 per cent and moderate need in 30 per cent. A great need was estimated in 20 per cent, comprising children with prenormal occlusion, maxillary overjet, or overbite (> 6 mm), posterior unilateral crossbite with midline deviation (> 2 mm), severe crowding or spacing, congenitally missing maxillary incisors, impacted maxillary canines or anterior open bite (> 3 mm in the permanent dentition). Urgent need for treatment was estimated to be 3 per cent, comprising subjects with extreme post- and pre-normal occlusion, impacted maxillary incisors or extensive aplasia.
Bracho-Troconis, C; Colon, P; Bartout, J D; Bienvenu, Y
The mercury content of dental amalgams is a controversial subject with regard to the biological properties of these materials. The object of this study is to optimize the thermal treatments performed on an experimental powder in order to obtain a low mercury ratio (41% by weight) while preserving the desirable clinical qualities of the material. Using atomized powder, two types of thermal treatments are performed: A1, to obtain a partially annealed structure and A2, to obtain a complete homogenization. The kinetics of the amalgamation reaction is mainly evaluated by X-ray diffraction to identify the newly formed phases as a function of setting time. Mechanical properties are evaluated according to the ISO norms at 37 degrees C. Metallographical examination of the amalgams shows a Ag-Hg phase which acts as a matrix incorporating the Cu-Sn and Ag-Sn compounds. The setting kinetics of the A1 amalgams is linear and slightly more rapid than that of the A2 amalgam. The mechanical properties of the amalgams are significantly improved regarding the higher mercury content commercial amalgams. A specific thermal treatment permits us to slow down the diffusion of mercury between the different intermetallic compounds into the powder. The final amalgam composition, thus, most approaches the stoechiometric ratio calculated from a quaternary diagram.
Al-Omari, Wael M
Background General dental practitioners provide the majority of endodontic treatment in Jordan. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists in North Jordan, in order to evaluate and improve the quality of current practice. Methods A questionnaire was posted to all registered general dental practitioners working in private practice in Irbid Governate in North Jordan (n = 181). The questionnaire included information on methods, materials and techniques used in endodontic treatment. Results Reply rate was 72% (n = 131). The results demonstrated that only five dentists used rubber dam occasionally and not routinely. The majority used cotton rolls for isolation solely or in combination with a high volume saliva ejector (n = 116). The most widely used irrigants were sodium hypochlorite and hydrogen peroxide, which were used by 32.9% (n = 43) and 33.6% (n = 44) of the respondents, respectively. Forty eight percent of the respondents (n = 61) used the cold lateral condensation technique for canal obturation, 31.3% (n = 41) used single cone, 9.9% (n = 13) used vertical condensation and 12.2% (n = 16) used paste or cement only for the obturation. The majority used zinc oxide eugenol as a sealer (72.5%). All, but one, respondents used hand instruments for canal preparation and the technique of choice was step back (52.7%). More than 50% (n = 70) of the dentists took one radiograph for determining the working length, whilst 22.9% (n = 30) did not take any radiograph at all. Most practitioners performed treatment in three visits for teeth with two or more root canals, and in two visits for teeth with a single root canal. Conclusions This study indicates that dentists practicing in North Jordan do not comply with international quality standards and do not use recently introduced techniques. Many clinicians never take a radiograph for determining the working length and never used rubber dam
... help keep the dental office running smoothly. Important Qualities Detail oriented. Dental assistants must follow specific rules and protocols, such as infection control procedures, when helping dentists treat patients. Assistants also ...
Linden, G J
This study investigated the extent of and reasons for variation in the periodontal referral patterns of general dental practitioners in Northern Ireland. A questionnaire was circulated to all general dental practitioners in Northern Ireland. This questionnaire investigated the management of periodontal disease in the general dental service and referral for specialist periodontal advice and treatment. A usable return was made by 355 (68%) of those surveyed. The mean number of periodontal referrals by each respondent in the past year was 6.5 (SD 7.7), range 0 to 80. Backward stepwise logistic regression analysis indicated that independent predictors of high referral rate were practice location close to the referral centre (p<0.0001); dissatisfaction with ability to treat periodontal disease under the National Health Service (p=0.001); that previous refusals of referral had not dissuaded a dentist from continuing to offer referral (p=0.002); not offering root planing as a treatment (p=0.005); and perceived inadequate postgraduate education in periodontology (p=0.03). It is concluded that considerable variation exists between general dental practitioners working in Northern Ireland in relation to the referral of patients for specialist periodontal advice and treatment. It is further concluded that in many cases non-disease factors, such as the accessibility of the specialist service, have powerful effects on the decisions made by dentists and patients in relation to periodontal referral.
Mail, Noor; Al-Ghamdi, S.; Saoudi, A.; Albarakati, Y.; Ahmad Khan, M.; Saeedi, F.; Safadi, N.
Purpose: The presence of high-density material in the oral cavity creates dose perturbation in both downstream and upstream directions at the surfaces of dental filling materials (DFM). In this study, the authors have investigated the effect of DFM on head and neck RapidArc treatment plans and delivery. Solutions are proposed to address (1) the issue of downstream dose perturbation, which might cause target under dosage, and (2) to reduce the upstream dose from DFM which may be the primary source of mucositis. In addition, an investigation of the clinical role of a custom-made plastic dental mold/gutter (PDM) in sparing the oral mucosa and tongue reaction is outlined.Methods: The influence of the dental filling artifacts on dose distribution was investigated using a geometrically well-defined head and neck intensity modulated radiation therapy (IMRT) verification phantom (PTW, Freiberg, Germany) with DFM inserts called amalgam, which contained 50% mercury, 25% silver, 14% tin, 8% copper, and 3% other trace metals. Three RapidArc plans were generated in the Varian Eclipse System to treat the oral cavity using the same computer tomography (CT) dataset, including (1) a raw CT image, (2) a streaking artifacts region, which was replaced with a mask of 10 HU, and (3) a 2 cm-thick 6000 HU virtual filter [a volume created in treatment planning system to compensate for beam attenuation, where the thickness of this virtual filter is based on the measured percent depth dose (PDD) data and Eclipse calculation]. The dose delivery for the three plans was verified using Gafchromic-EBT2 film measurements. The custom-made PDM technique to reduce backscatter dose was clinically tested on four head and neck cancer patients (T3, N1, M0) with DFM, two patients with PDM and the other two patients without PDM. The thickness calculation of the PDM toward the mucosa and tongue was purely based on the measured upstream dose. Patients’ with oral mucosal reaction was clinically examined
Singhal, Astha; Chattopadhyay, Amit; Garcia, A Isabel; Adams, Amy B; Cheng, Diana
To examine prenatal dental care needs, utilization and oral health counseling among Maryland women who delivered a live infant during 2001-2003 and identify the factors associated with having a dental visit and having an unmet dental need during pregnancy. Pregnancy Risk Assessment Monitoring System is an ongoing population based surveillance system that collects information of women's attitudes and experiences before, during, and shortly after pregnancy. Logistic regression was used to model dental visits and unmet dental need using predictor variables for Maryland 2001-2003 births. Less than half of all women reported having a dental visit and receiving oral health advice during pregnancy. Twenty-five percent of women reported a need for dental care, of which 33 % did not receive dental care despite their perceived need. Multivariate modeling revealed that racial minorities, women who were not married and those with annual income <$40,000 were least likely to have a dental visit. Women who were not married, had low annual income, were older than 40 years of age, had an unintended pregnancy and received prenatal care later than desired were most likely to have an unmet dental need during pregnancy. Despite reported needs and existing recommendations to include oral health as a component of prenatal care, less than half of pregnant women have a dental visit during their pregnancy. One-third of women with a dental problem did not have a dental visit highlighting the unmet need for dental care during pregnancy.
Menzies, Robert A; Easley, Jack
Dental surgeries refer to procedures that affect the dental tissues or their supporting structures. With the development of specific, efficacious, and conservative treatments, morbidity risks have been lowered and chances of benefiting the health of equids improved. Advances in quality of sedation, analgesia, and locoregional anesthesia allow a majority of dental surgeries to be performed in the standing patient. This update focuses on an orthograde endodontic technique, a minimally invasive buccotomy technique, with the potential to combine it with a transbuccal screw extraction technique, and revisits the AO pinless external fixator for fractures of the body of the mandible.
Nicolosi, Liliana; Lewin, Pablo; Winter, Gustavo; Medina, Fabiana; Carballo, Juan; Martinez-, Carlos; Rubio, María
The aim of this study was to determine changes in arterial pressure (AP) and heart rate (HR) during dental treatment under local infiltration anesthesia (LIA) in patients with controlled arterial hypertension (AHT) versus normotensive patients. A longitudinal comparative study involving repeated measurements in well-controlled hypertensive (cases) and normotensive patients (controls) was conducted. All patients received standardized preventive periodontal treatment under LIA (1.8 ml of 4% articaine with 1:100000 L-Adrenaline). AP and HR were determined at 5 different phases of treatment. The study comprised 82 patients, 46.3% of whom were hypertensive, 61% were female. Systolic (SAP) and diastolic (DAP) arterial pressure and HR increased as the procedure advanced and then returned to initial values in both groups. Average HR values were lower in normotensive than in hypertensive patients (p < 0.001). Significant differences in AP and HR were observed among initial, mid-procedure, and final values (p < 0.001). Both groups exhibited highest SAP values post-LIA administration (p < 0.01). Average HR was higher in normotensive than in hypertensive patients. The hypertensive patients tended to develop AHT (> 140/90 mmHg) more frequently throughout the procedure (p = 0.002), SHOWING a 4.93-fold higher risk. Logistic regression analysis showed that sex (p < 0.032) and AH (p < 0.007) were associated with a tendency to develop AHT during treatment. Controlled hypertensive patients with normal AP values at the onset of dental treatment were found to be at a 5-fold higher risk of developing AHT during the course of dental treatment under local infiltration anesthesia. The observed increases in AP, however, did not reach clinically significant levels. The HR values tended to increase with the progress of dental treatment in all patients. HR was lower in hypertensive patients probably due a drug effect.
Shah, Altaf Hussain; Khalil, Hesham Saleh; Kola, Mohammed Zaheer
Automated Implantable Cardioverter Defibrillators (AICD), simply known as an Implantable Cardioverter Defibrillator (ICD), has been used in patients for more than 30 years. An Implantable Cardioverter Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at a risk of sudden cardiac death due to ventricular fibrillation, ventricular tachycardia or any such related event. Typically, patients with these types of occurrences are on anticoagulant therapy. The desired International Normalized Ratio (INR) for these patients is in the range of 2-3 to prevent any subsequent cardiac event. These patients possess a challenge to the dentist in many ways, especially during oral surgical procedures, and these challenges include risk of sudden death, control of post-operative bleeding and pain. This article presents the dental management of a 60 year-old person with an ICD and concomitant anticoagulant therapy. The patient was on multiple medications and was treated for a grossly neglected mouth with multiple carious root stumps. This case report outlines the important issues in managing patients fitted with an ICD device and at a risk of sudden cardiac death.
Shah, Altaf Hussain; Khalil, Hesham Saleh; Kola, Mohammed Zaheer
Automated Implantable Cardioverter Defibrillators (AICD), simply known as an Implantable Cardioverter Defibrillator (ICD), has been used in patients for more than 30 years. An Implantable Cardioverter Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at a risk of sudden cardiac death due to ventricular fibrillation, ventricular tachycardia or any such related event. Typically, patients with these types of occurrences are on anticoagulant therapy. The desired International Normalized Ratio (INR) for these patients is in the range of 2–3 to prevent any subsequent cardiac event. These patients possess a challenge to the dentist in many ways, especially during oral surgical procedures, and these challenges include risk of sudden death, control of post-operative bleeding and pain. This article presents the dental management of a 60 year-old person with an ICD and concomitant anticoagulant therapy. The patient was on multiple medications and was treated for a grossly neglected mouth with multiple carious root stumps. This case report outlines the important issues in managing patients fitted with an ICD device and at a risk of sudden cardiac death. PMID:26236132
Nicholson, Dawn; Blodgett, Kris; Braga, Charles; Finkbeiner, Larry; Fourrier, Jeanne; George, John; Gregg, Robert; Honigman, Allen; Houser, Bruce; Lamas, William; Lehrman, Neal; Linden, Eric; McCarthy, Delwin; McCawley, Tom; McCormick, Randy; Marcus, Ed; Noraian, Kirk; Rubelman, Peter; Salama, Maurice; Saunders, Steven; Seamons, Brandon; Thein, David; Toms, Michael; Vassos, George; Harris, David M.
A large percentage of dental implants experience complications, most commonly, infection leading to peri-implantitis and peri-mucositis, inflammatory disease involving pathogen contamination. It presents with radiographic findings of crestal bone loss. At this time there appears to be no compelling evidence for an effective intervention. The LANAP protocol is a FDA cleared surgical protocol that produces new attachment and bone regeneration when applied to periodontally infected natural teeth. The LANAP protocol and laser dosimetry have been modified to treat ailing and failing implants. Twenty-one clinicians who have been trained to perform the LANAP protocol and the LAPIPTM protocol have volunteered 26 LAPIP case reports. The time from implant to intervention ranges from 3 months to 16 years. Post-LAPIP radiographs range from 2-48 months. Ten cases were excluded for technical reasons. All 16 remaining cases provide radiographic evidence of increase in crestal bone mass around the implant and, when reported, probe depth reductions. All treating clinicians report control of the infection, reversal of bone loss and rescue of the incumbent implant. Although the success/failure rate cannot be judged from these data, any successes in this area deserve reporting and further study.
Kaviani, Nasser; Ashrafi, Sanaz; Jabbarifar, Seyed Ebrahim; Ghaffari, Elham
Statement of the Problem Some children do not show an appropriate cooperation with their dentist. A number of them cannot be managed by local anesthesia and the usual techniques used to control behaviors, so further steps are required to control their pain and anxiety. Pharmaceutical control is recommended through sedation or general anesthesia. Purpose This study was aimed to evaluate two groups of drugs in intravenous sedation method. Materials and Method In this clinical trial intervention study, patients were randomly divided into two groups of 18 and 20 and each group received either intravenous midazolam-ketamine or midazolam-fentanyl. During the procedure, 0.25mg midazolam was administered to both groups if needed. The scores of intraoperative sedation and operation conditions were evaluated and recorded by dental sedation teacher groups (DSTG) system in the 10th, 20th, 30th and 40th minutes of the operation. The results were analyzed by SPSS (version 16) using independent T-test, Wilcoxon, Mann-Whitney and Pearson Chi-Square tests as appropriated. Results There was no significant difference between the two groups in sedation period (p= 0.55), recovery time (p= 0.18), Frankl score (p= 0.83(, score of intraoperative sedation and operating conditions (p> 0.05), and sedation complications (p= 0.612). In addition, no complication occurred in recovery. Conclusion There was no significant difference between the two drug groups; both were appropriate in controlling children’s behavior. PMID:26106632
Montiel-Company, José-María; Pinho, Teresa; Almerich-Silla, José-Manuel
Introduction and Objectives: The objectives were to assess the relationship between perceived smile aesthetics and perceived psychological impact as measured by the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and their own perception of it using the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) and a Visual Analog Scale (VAS); relate the IOTN-AC and VAS to the PIDAQ; and study the predictive capacity of the scales for psychological impact. Material and Methods: A cross-sectional study was conducted in 447 college students in Spain and Portugal (average age 20.4 years, 33.1% men and 66.9% women). The online self-completed surveys used the recently-validated Spanish and Portuguese versions of the PIDAQ to assess the self–reported psychological impact of the students’ dental aesthetics and IOTN-AC and an ad hoc 100 mm VAS for their perception of their dental aesthetics. Results: PIDAQ was linearly correlated with IOTN AC and VAS. Pearson’s coefficient was 0.55 for PIDAQ and IOTN-AC (CI 95% 0.48-0.61) and -0.72 for PIDAQ and VAS (CI 95% -0.66 - -0.76). VAS and IOTN-AC were predictive variables in a linear regression model of the total PIDAQ score. The VAS diagnosed individuals whose dental aesthetics had a self-perceived psychological impact (area under the curve 0.827, CI 95% 0.787-0.868) more precisely than the IOTN-AC (area under the curve 0.742, CI 95% 0. 696-0.788). Conclusions: In adults patients, there is a significant linear relationship between perceived smile aesthetics and self-perceived psychological impact. Key words:Visual Analog Scale, Index of Orthodontic Treatment Need, malocclusion, psychological, aesthetics. PMID:25810834
Kim, J-W; Park, S; Kim, B-N; Shin, M-S; Cho, S-C; Kim, J-H; Son, J-W; Shin, Y-M; Chung, U-S; Han, D-H
Given the shortage of studies on parental perceived benefits of OROS-methylphenidate treatment in Asian populations, we assessed parental response to OROS-methylphenidate treatment of Korean children with attention-deficit/hyperactivity disorder (ADHD), in relation to children's academic performance and behavioral symptoms as well as parental rearing stress and depressive symptoms.We enrolled 132 medication-naïve children with ADHD into a multicenter, open-label, 12-week trial of OROS-MPH. The outcome measures were the ADHD rating scale-IV (ADHD-RS), the comprehensive attention test and academic performance rating scale, and the clinical global impression (CGI)-severity/improvement instrument (for the children) and Beck depression inventory and parenting stress index (for their parents).We found parent-perceived improvements in children's ADHD-related behavioral symptoms and academic function and their parents' depressive symptoms and parenting stress. Investigator-rated ADHD symptoms and subjects' neuropsychological function were also improved (p<0.001).Parents of Korean children with ADHD perceive that OROS-methylphenidate treatment improves their children's academic function and behavior as well as their own child-rearing stress and emotional state. These findings must be interpreted with caution, due to a non-comparative open-label trial.
Kanegane, Kazue; Penha, Sibele S; Munhoz, Carolina D; Rocha, Rodney G
Dental anxiety is still prevalent, despite advances in treatment, and affects the utilization of health care services. The purpose of this cross-sectional study was to determine if patients with different degrees of dental anxiety and pain undergoing emergency dental care have different stress reactions as measured by salivary cortisol. Seventy three patients completed the modified dental anxiety scale (MDAS), and described any previous dental traumatic experience. Their socio-demographic characteristics were also recorded. They also rated pain intensity on a 100 mm visual analogue scale (VAS). A saliva sample was collected before the procedure, and analyzed by enzyme immunoassay. Thirty patients were dentally anxious and forty one complained of pain. In this sample, dental anxiety was not related to gender, age, educational level and family income; however, a previous traumatic event was related to dental anxiety. There was no association between salivary cortisol concentrations and gender or dental anxiety. Patients with pain showed higher cortisol levels. When gathering patient information, the dentist should note patients' negative dental experiences in order to provide more effective, less traumatic treatment.
Colston, Bill W.; Sathyam, Ujwal S.; Dasilva, Luiz B.; Everett, Matthew J.; Stroeve, Pieter; Otis, L. L.
We present here the first in vivo optical coherence tomography (OCT) images of human dental tissue. A novel dental optical coherence tomography system has been developed. This system incorporates the interferometer sample arm and transverse scanning optics into a handpiece that can be used intraorally to image human dental tissues. The average imaging depth of this system varied from 3 mm in hard tissues to 1.5 mm in soft tissues. We discuss the application of this imaging system for dentistry and illustrate the potential of our dental OCT system for diagnosis of periodontal disease, detection of caries, and evaluation of dental restorations.
Purpose Decision-making by dental and medical experts can be influenced by their biases, interests, and experiences, and academic arguments about controversial issues may additionally be considered indirect experiences capable of affecting decision-making. This study reports on the use of interactive communication devices to evaluate preferences and flexibility in decision-making among dental care providers who attended two distinct academic conferences. Methods Two debates were presented by a team of two lecturers at two academic conferences (focusing on periodontology and implant dentistry, respectively) and the audience members of each session were surveyed. Before each lecture, two case modules about the diagnosis and treatment of multirooted molar lesions were provided, and interactive communication devices were used to collect responses about decision-making preferences in treatment planning immediately before and after a debate about treatment strategies. Results In total, 81 and 84 completed answers from both conferences were obtained for the first and second case modules, respectively. The preferred treatment plan differed significantly according to the focus of the conference, and a tendency emerged for the clinicians participating in each conference to express uniform preferences. However, attending the debates resulted in significant changes in decision-making preferences regardless of the conference focus or the characteristics of the participants. Conclusions Our findings suggest that providing continuing education via debates on controversial issues may be effective in widening conceptual knowledge and reducing biases among experts in the dental and medical fields. PMID:27382505
Bernson, Jenny M; Elfström, Magnus L; Hakeberg, Magnus
The aim of the present study was to investigate dental coping strategies, general anxiety, and depression in relation to regularity of dental treatment among persons with either regular dental care or phobic avoidance, whilst controlling for sociodemographic factors. Psychometric questionnaires on dental anxiety, dental coping strategies, general anxiety, and depression were delivered to 263 adult patients with dental phobic avoidance behavior who were seeking help from a specialized dental fear clinic and to 141 adult patients with dental anxiety who were receiving regular dental care from various public dental clinics. The results showed that the levels of dental and general anxiety and of depression were significantly higher among irregular attendees compared with regular attendees. Irregular attendees admitted fewer adaptive coping strategies. Predictive of irregular dental care were gender, dental anxiety, general anxiety, and the nonuse of the coping strategy 'optimism'. This study further confirms earlier preliminary results that the use of optimistic thinking is predictive for regular dental attendance habits and that male gender is a risk factor for irregular attendance. Moreover, this study adds that a high level of general anxiety indicates a higher risk for irregular dental care.
Panayotov, Ivan V; Collart-Dutilleul, Pierre-Yves; Salehi, Hamideh; Martin, Marta; Végh, Attila; Yachouh, Jacques; Vladimirov, Boyan; Sipos, Péter; Szalontai, Balázs; Gergely, Csilla; Cuisinier, Frédéric J G
Further development of biomaterials is expected as advanced therapeutic products must be compliant to good manufacturing practice regulations. A spraying method for building-up polyelectrolyte films followed by the deposition of dental pulp cells by spraying is presented. Physical treatments of UV irradiation and a drying/wetting process are applied to the system. Structural changes and elasticity modifications of the obtained coatings are revealed by atomic force microscopy and by Raman spectroscopy. This procedure results in thicker, rougher and stiffer film. The initially ordered structure composed of mainly α helices is transformed into random/β-structures. The treatment enhanced dental pulp cell adhesion and proliferation, suggesting that this system is promising for medical applications.
Buitrago-Vera, Pedro; Solá-Ruiz, María F.; Ferrer-García, Juan C.
Etiological treatment of peri-implantitis aims to reduce the bacterial load within the peri-implant pocket and decontaminate the implant surface in order to promote osseointegration. The aim of this literature review was to evaluate the efficacy of different methods of implant surface decontamination. A search was conducted using the PubMed (Medline) database, which identified 36 articles including in vivo and in vitro studies, and reviews of different decontamination systems (chemical, mechanical, laser and photodynamic therapies). There is sufficient consensus that, for the treatment of peri-implant infections, the mechanical removal of biofilm from the implant surface should be supplemented by chemical decontamination with surgical access. However, more long-term research is needed to confirm this and to establish treatment protocols responding to different implant characterics. Key words:Peri-implantitis, treatment, decontamination, implant surface, laser. PMID:23986023
... (Authority: 38 U.S.C. 1712) (b) The treatment will not involve replacement of a missing tooth noted at the... that a tooth was extracted or lost on active duty. (c) Individuals whose entire tour of duty...
... (Authority: 38 U.S.C. 1712) (b) The treatment will not involve replacement of a missing tooth noted at the... that a tooth was extracted or lost on active duty. (c) Individuals whose entire tour of duty...
... (Authority: 38 U.S.C. 1712) (b) The treatment will not involve replacement of a missing tooth noted at the... that a tooth was extracted or lost on active duty. (c) Individuals whose entire tour of duty...
Wouters, Sofie; Doumen, Sarah; Germeijs, Veerle; Colpin, Hilde; Verschueren, Karine
Contingent self-esteem (i.e., the degree to which one's self-esteem is dependent on meeting particular conditions) has been shown to predict a wide range of psychosocial and academic problems. This study extends previous research on contingent self-esteem by examining the predictive role of perceived parenting dimensions in a sample of early…
Bagheri, Hossein; Aghajani, Farzaneh
Objectives: This study aimed to evaluate the effect of different ceramic surface treatments after machining grinding on the biaxial flexural strength (BFS) of machinable dental ceramics with different crystalline phases. Materials and Methods: Disk-shape specimens (10mm in diameter and 1.3mm in thickness) of machinable ceramic cores (two silica-based and one zirconia-based ceramics) were prepared. Each type of the ceramic surfaces was then randomly treated (n=15) with different treatments as follows: 1) machined finish as control, 2) machined finish and sandblasting with alumina, and 3) machined finish and hydrofluoric acid etching for the leucite and lithium disilicate-based ceramics, and for the zirconia; 1) machined finish and post-sintered as control, 2) machined finish, post-sintered, and sandblasting, and 3) machined finish, post-sintered, and Nd;YAG laser irradiation. The BFS were measured in a universal testing machine. Data based were analyzed by ANOVA and Tukey’s multiple comparisons post-hoc test (α=0.05). Results: The mean BFS of machined finish only surfaces for leucite ceramic was significantly higher than that of sandblasted (P=0.001) and acid etched surfaces (P=0.005). A significantly lower BFS was found after sandblasting for lithium disilicate compared with that of other groups (P<0.05). Sandblasting significantly increased the BFS for the zirconia (P<0.05), but the BFS was significantly decreased after laser irradiation (P<0.05). Conclusions: The BFS of the machinable ceramics was affected by the type of ceramic material and surface treatment method. Sandblasting with alumina was detrimental to the strength of only silica-based ceramics. Nd:YAG laser irradiation may lead to substantial strength degradation of zirconia. PMID:27148372
Rosen, Evan B; Donoff, R Bruce; Riedy, Christine A
There has historically been limited development and utilization of patient-reported outcome measures (PROMs) in clinical dentistry. However, in recent years PROMs have been recognized by other health care fields as valuable in the comprehensive assessment of patient outcomes. The aim of this study was to survey deans of U.S. dental schools to better understand their vision for the role of PROMs in the field of dentistry. A 13-question online survey was emailed to the deans of the 64 accredited U.S. dental schools at the time to gather their opinions about the value of patient-reported outcomes in dentistry. The survey consisted of questions in 12 domains such as treatment planning, perceived success/complications of surgery, identification/management of dental pain, psychological and oral function, and insurance payment/reimbursement. Of the 64 deans, 33 responses were received (51.5% response rate), but three surveys were excluded due to incomplete answers, resulting in a final response rate of 46.8%. All respondents reported there was value in utilization of PROMs for understanding a patient's satisfaction of a procedure, a patient's perceived success of dental surgery, identifying dental pain, and managing dental pain. However, there was disagreement among the respondents about utilization of PROMs for the purpose of determining insurance payment and/or reimbursement. Additional steps should be taken to develop clinically appropriate PROMs for dentistry and to determine the appropriate situations in which to use dental PROMs. This study suggests that PROMs should be incorporated into dental school curricula as they will likely play a role in future comprehensive treatment assessment.
Galindo, Daniel F; Butura, Caesar C
This manuscript describes the reconstruction of a maxillary anterior segment using immediate implant placement and immediate implant loading techniques, aided by computer-guided implant treatment software and stereolithographic models and surgical templates, in a patient with a history of eating disorder. Her medical and dental histories did not make her a candidate for the use of conventional 2-stage implant surgery and restorative procedures along with an interim removable prosthesis.
Mellado-Valero, Ana; Buitrago-Vera, Pedro; Solá-Ruiz, María-Fernanda; Ferrer-García, Juan-Carlos
Etiological treatment of peri-implantitis aims to reduce the bacterial load within the peri-implant pocket and decontaminate the implant surface in order to promote osseointegration. The aim of this literature review was to evaluate the efficacy of different methods of implant surface decontamination. A search was conducted using the PubMed (Medline) database, which identified 36 articles including in vivo and in vitro studies, and reviews of different decontamination systems (chemical, mechanical, laser and photodynamic therapies). There is sufficient consensus that, for the treatment of peri-implant infections, the mechanical removal of biofilm from the implant surface should be supplemented by chemical decontamination with surgical access. However, more long-term research is needed to confirm this and to establish treatment protocols responding to different implant characterics.
Austin, R. S.; Mullen, F.; Bartlett, D. W.
The application of surface topography measurement and characterization within dental materials science is highly active and rapidly developing, in line with many modern industries. Surface measurement and structuring is used extensively within oral and dental science to optimize the optical, tribological and biological performance of natural and biomimetic dental materials. Although there has historically been little standardization in the use and reporting of surface metrology instrumentation and software, the dental industry is beginning to adopt modern areal measurement and characterization techniques, especially as the dental industry is increasingly adopting digital impressioning techniques in order to leverage CAD/CAM technologies for the design and construction of dental restorations. As dental treatment becomes increasingly digitized and reliant on advanced technologies such as dental implants, wider adoption of standardized surface topography and characterization techniques will become evermore essential. The dental research community welcomes the advances that are being made in surface topography measurement science towards realizing this ultimate goal.
Bergman, Yoav S; Grosberg, Dafna
Background The use of online health-related social networks for support, peer-to-peer connections, and obtaining health information has increased dramatically. Participation in an online health-related social network can enhance patients’ self-efficacy and empowerment, as they are given knowledge and tools to manage their chronic health condition more effectively. Thus, we can deduce that patient activation, the extent to which individuals are able to manage their own health care, also increases. However, little is known about the effects of participation in online health-related social networks and patient activation on the perceived usefulness of a website across disease groups. Objective The intent of the study was to evaluate the effects and benefits of participation in an online health-related social network and to determine which variables predict perceived site usefulness, while examining patient activation. Methods Data were collected from “Camoni”, the first health-related social network in the Hebrew language. It offers medical advice, including blogs, forums, support groups, internal mail, chats, and an opportunity to consult with experts. This study focused on the site’s five largest and most active communities: diabetes, heart disease, kidney disease, spinal injury, and depression/anxiety. Recruitment was conducted during a three-month period in which a link to the study questionnaire was displayed on the Camoni home page. Three questionnaires were used: a 13-item measure of perceived usefulness (Cronbach alpha=.93) to estimate the extent to which an individual found the website helpful and informative, a 9-item measure of active involvement in the website (Cronbach alpha=.84), and The Patient Activation Measure (PAM-13, Cronbach alpha=.86), which assesses a patient’s level of active participation in his or her health care. Results There were 296 participants. Men 30-39 years of age scored higher in active involvement than those 40-49 years
..., and periodontal disease will be considered service-connected solely for the purpose of establishing... will consider each defective or missing tooth and each disease of the teeth and periodontal tissues... be considered service-connected for treatment purposes: (1) Calculus; (2) Acute periodontal...
Xie, Haifeng; Shen, Shuping; Qian, Mengke; Zhang, Feimin; Chen, Chen; Tay, Franklin R.
The aim of this study was to evaluate the effects of hydrofluoric (HF) acid, acetic acid, and citric acid treatments on the physical properties and structure of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) at ambient temperature. In total, 110 bar-shaped zirconia specimens were randomly assigned to 11 groups. The specimens in the control group (C) received no surface treatment, while those in the Cage group were hydrothermally aged at 134°C and 0.2 MPa for 20 h. Ten specimens each were immersed at ambient temperature in 5% and 40% HF acid for 2 h (40HF0), 1 day (5HF1, 40HF1), and 5 days (5HF5, 40HF5), while 10 each were immersed at ambient temperature in 10% acetic acid and 20% citric acid for 7 (AC7, CI7) and 14 days (AC14, CI14). X-ray diffraction (XRD) was used to quantitatively estimate the monoclinic phase. Furthermore, flexural strength, surface roughness, and surface Vickers hardness were measured after treatment. Scanning electron microscopy (SEM) was used to characterize the surface morphology. The Cage group specimens exhibited an increased monoclinic phase and flexural strength. Furthermore, 40% HF acid immersion decreased the flexural strength and surface hardness and deteriorated the surface finish, while 5% HF acid immersion only decreased the surface hardness. All the HF acid-immersed specimens showed an etched surface texture on SEM observations, while the other groups did not. These findings suggest that the treatment of Y-TZP with 40% HF acid at ambient temperature causes potential damage, while treatment with 5% HF acid, acetic acid, and citric acid is safe. PMID:26301413
Wright, F A
In this study of 200 New Zealand schoolchildren aged 7-13 years, a questionnaire interview was used to gain information related to estimating dental anxiety and general illness anxiety. Information related to sociodemographic differences, belief differences, and an estimate of potential health behaviour was also collected. Oral examinations were performed and the number of dental restorations present recorded. Dental anxiety was associated with memory of pain during a dental visit. The number of restorations present, and a history of pain during a dental visit, were important predictors of illness anxiety. Neither dental anxiety nor illness anxiety operating alone provided an estimate of future dental health behaviour. Dental anxiety and illness anxiety operated through a complex interplay of variables. A stepwise multiple regression technique was used to determine the possible pathways to potential dental health behaviour. Perceived vulnerability to dental caries and perceived severity of dental disease were important in the prediction of potential denture wearing; school attended and ethnic background were useful predictors of potential extraction seeking; and school grade and level of perceived internal control were predictors of potential preventive visitation.
Segura-Egea, Juan J.; Córdoba-Arenas, Sara; Jiménez-Guerra, Alvaro; Monsalve-Guil, Loreto; López-López, José
Objectives: To study the dental status and treatment needs of institutionalized older adults with chronic mental illness compared to a non-psychiatric control sample. Study Design: The sample size was 100, in which 50 were psychogeriatric patients (study group; SG) classified according to DSM-IV, with a mean age of 69.6 ± 6.7 years, and 50 non-psychiatric patients (control group; CG), with a mean age of 68.3 ± 6.9 years. Clinical oral health examinations were conducted and caries were recorded clinically using the Decayed, Missing and Filled Teeth Index (DMFT). Results were analyzed statistically using the Student’s t-test or analysis of variance. Results: Caries prevalence was 58% and 62% in SG and CG, respectively. DMFT index was 28.3 ± 6.6 in SG and 21.4 ± 6.07 in CG (p < 0.01). Mean number of decayed teeth was higher in SG (3.1) compared to CG (1.8) (p=0.047). Mean number of missing teeth were 25.2 and 16.4 in SG and CG respectively (p<0.05). DMFT scores were higher in SG in all the age groups (p < 0.01). Mean number of teeth per person needing treatment was 3.4 in SG and 1.9 in CG (p= 0.037). The need for restorative dental care was significantly lower in the SG (0.8 teeth per person) than in the CG (1.7 teeth per person) (p = 0.043). Conclusions: Institutionalized psychiatric patients have significantly worse dental status and more dental treatment needs than non-psychiatric patients. Key words:Gerodontology, oral health, older adult, psychiatric patients, schizophrenia. PMID:23229258
Sastri, Murlidhar R; Tanpure, Vijaysinh Ramchandra; Palagi, Firoz Babu; Shinde, Sagar Kundlik; Ladhe, Kapil; Polepalle, Tejaswin
Background: General dental practitioners and non-orthodontic specialty can play an essential role of education and motivation of their patients about the principles and practice of orthodontic treatment; which can be very beneficial to the patient’s lifestyle. It is, therefore, important to identify their level of knowledge and attitude toward orthodontic treatment. This study was planned to study this aspect in the form of comparative analysis in general dental practitioners and other specialties (except orthodontia) in dentistry. Materials and Methods: The study was done on 78 dentists, which was divided into two groups. Group I consisted of 46 general dental practitioners and Group II consisted of 32 non-orthodontic specialties. The study was carried out with the help of 21 questionnaires, which consisted of 13 questions of orthodontic knowledge and 08 questions about the attitude toward orthodontic practice. The scores were calculated, and statistical analysis was done with the help of IBM SPSS statistics 20, using Student’s t-test. Results: The comparative analysis showed highly significant difference of knowledge and attitude score between general dental practitioners and non-orthodontic specialties (Student’s t-test, P < 0.001). Also the comparison was made between male and female practitioners, who showed more scores in case of male practitioners; but the difference was not significant statistically (Student’s t-test, P > 0.01). Conclusion: The results of the study were moderately satisfactory, and it showed the need for increased clinically oriented education of practice and concepts of orthodontic treatment. PMID:25878478
Sundqvist, Bertil; Wenneberg, Bengt; Magnusson, Tomas
The aim of this study was to investigate if a TMD-trained general dental practitioner could individually predict actual treatment outcome in selected patients diagnosed with temporomandibular disorders (TMD) with similar results as a TMD specialist. The patients were examined, individually predicted, treatment planned, treated and had their treatment outcome evaluated by the therapist, respectively. Out of 2618 patients referred to a TMD specialist clinic, 1086 patients started treatment. They were all divided into Muscle or Mainly TMJ symptoms. Prediction of the treatment outcome as Good or Dubious was based on the patient's history, the clinical and, sometimes, radiological findings. The degree of improvement was graded using a Numeric Rating Scale 0-100. A clinical important improvement, defined as an improvement of initial complaints of 50% or more, was judged as a correct prediction of Good treatment outcome. Seven-hundred-sixty-nine patients treated by the TMD specialist (Sample 1) was compared with 164 patients treated by the TMD-trained general dental practitioner (Sample 2). For patients with Muscle symptoms in Sample 1, a 50% improvement or more was reached by 93% of those predicted Good and 57% of those predicted Dubious. The corresponding figures in Sample 2 were 100% and 82%, respectively. In Sample 1, patients with Mainly TMJ symptoms reached a 50% improvement or more in 94% of those with prediction Good and 73% of those predicted Dubious. In Sample 2 the figures were 100% and 87%, respectively. ATMD-trained general dental practitioner could individually predict treatment outcome with similar results as a TMD specialist in selected patients diagnosed with TMD. Whether the method is possible to generalize has to be investigated further.
Wu, Shengjun; Miao, Danmin; Zhu, Xia; Luo, Zhengxue; Liu, Xufeng
This his article reports the findings of a study conducted to investigate the personality types of Chinese dental school applicants. The Chinese version of the Myers-Briggs Type Indicator (MBTI) (Form G) was used to assess the personality styles of 332 dental school applicants from the mainland of China. The results of the MBTI for Chinese dental school applicants were compared with a previous study of applicants from the U.K. A higher percentage of this group of Chinese applicants scored higher for Introversion (I) than Extroversion (E); both Chinese and English applicants preferred Judging (J) to Perceiving (P). The dominant personality types in Chinese applicants were ISTJ, ESTJ, and ISFP. The findings suggest that the personality types of Chinese dental students may be somewhat different from the personality profiles exhibited by dental students from other nations. The findings may be of value to individuals who desire to investigate personality type differences among dental students with different cultural backgrounds.
Mueller, P O; Lowder, M Q
Dental sepsis or periapical abscess formation constitutes a large percentage of dental conditions that afflict horses. Dental sepsis occurs when the pulp chamber of the tooth is exposed to the oral cavity or external environment, allowing bacterial localization with resulting infection. Although acute, primary, septic pulpitis in horses is rare, dental sepsis often results from colonization of the pulp chamber with pathogenic bacteria secondary to maleruption or impaction of teeth with secondary alveolar bone lysis, primary fractures of the tooth, mandible, or maxilla, periodontal disease, or infundibular necrosis. The sequela to pulpal infection are extensions into the periradicular tissues and mandibular or maxillary periapical abscess formation.
Turner, Lena; Mupparapu, Muralidhar; Akintoye, Sunday O
Objectives Oropharyngeal cancer (OPC) is the 6th most common cancer worldwide. Focus on risk factors, improved diagnostic methods and effective management strategies have made it possible to successfully treat OPC. However, the 5-year survival rate has not improved for several years due to multiple treatment complications, tissue morbidity, loss of function and diminished quality of life. Survivors are faced with complications like oral mucositis, hyposalivation, osteoradionecrosis; tissue fibrosis, morbidity from jaw resection; disfigurement and loss of function that further diminish quality of life. The aim of this review is to highlight major complications associated with treatment of OPC via a literature search and review of available options for identification and management of these complications. Data Sources Relevant publications on oral complications of OPC therapy were thoroughly reviewed from the literature published between the years 1988 and 2012. Material and Method We evaluated reported incidence, prevalence and risk factors for oral complications of chemotherapy and radiotherapy for OPC. The authors conducted electronic search using English language databases namely PubMed Plus, Medline (Pre-Medline and Medline), Cochrane Database of systematic reviews (evidence-based medicine), Dentistry & Oral sciences source, AccessScience, Embase, Evidence-Based Medicine Reviews Multifile, Google Scholar, ISI Journal Citation Reports, Ovid Multi-Database. Conclusion We identified the most common complications associated with the treatment of oral cancers. Based on the information gathered, there is evidence that survival of OPC extends beyond eradication of the diseased tissue. Understanding the potential treatment complications and utilizing available resources to prevent and minimize them are important. Caring for OPC survivors should be a multidisciplinary team approach involving the dentist, oncologist, internist and social worker to improve the currently
health status and treatment needs were collected. Need for orthodontic care and sealants was included. Restorative needs were identified as recurrent ...and Source of Patient 4.1.5 Intensity and Severity of Periodontal Treatment Needs by Demographics and Source of Patient 4.1.6 Orthodontic Treatment...Severity of Restorative Treatment Needs by Demographics 4.4.2 Prevalence of Sealant Needs by Demographics 4.4.3 Orthodontic Treatment Needs by Demographics
von Salis-Soglio, Marcella; Stübinger, Stefan; Sidler, Michéle; Klein, Karina; Ferguson, Stephen J.; Kämpf, Käthi; Zlinszky, Katalin; Buchini, Sabrina; Curno, Richard; Péchy, Péter; Aronsson, Bjorn-Owe; von Rechenberg, Brigitte
The aim of the present study was to evaluate a new multi-phosphonate surface treatment (SurfLink®) in an unloaded sheep model. Treated implants were compared to control implants in terms of bone to implant contact (BIC), bone formation, and biomechanical stability. The study used two types of implants (rough or machined surface finish) each with either the multi-phosphonate Wet or Dry treatment or no treatment (control) for a total of six groups. Animals were sacrificed after 2, 8, and 52 weeks. No adverse events were observed at any time point. At two weeks, removal torque showed significantly higher values for the multi-phosphonate treated rough surface (+32% and +29%, Dry and Wet, respectively) compared to rough control. At 52 weeks, a significantly higher removal torque was observed for the multi-phosphonate treated machined surfaces (+37% and 23%, Dry and Wet, respectively). The multi-phosphonate treated groups showed a positive tendency for higher BIC with time and increased new-old bone ratio at eight weeks. SEM images revealed greater amounts of organic materials on the multi-phosphonate treated compared to control implants, with the bone fracture (from the torque test) appearing within the bone rather than at the bone to implant interface as it occurred for control implants. PMID:25215424
Bowen, Denise M
The purpose of Linking Research to Clinical Practice is to present evidence based information to clinical dental hygienists so that they can make informed decisions regarding patient treatment and recommendations. Each issue will feature a different topic area of importance to clinical dental hygienists with A BOTTOM LINE to translate the research findings into clinical application.
Zioło, Anna; Mielnik-Błaszczak, Maria
On the grounds of literature and own clinical experience, pathological changes in epilepitic patients have been described. Dental management procedures in these patients have also been presented. The unquestionable importance of prophylaxis, which may markedly minimize the impact of epilepsy on the incidence of mouth diseases, has been emphasised. It has also been stated that epileptic patients should receive specialised and integrated dental treatment.
Baginska, Joanna; Wilczynska-Borawska, Magdalena
Almost one fourth of traumatic dental injuries occur at schools or in their surroundings. Prevalence of tooth avulsion varies from 0.5% to 16% of all cases of dental trauma. Children with dental avulsion may seek help from school nurses so they should be able to provide first-aid treatment. However, many studies showed that the general level of…
Weintraub, G S; Weintraub, A M
In 1977, a survey of American and Canadian dental schools was conducted by Weintraub to determine the delegation of laboratory procedures in preclinical and clinical complete and removable partial denture programs. This was performed in light of challenges raised to the value of requiring dental students, rather than laboratory technicians, to perform the various laboratory procedures involved in the fabrication of complete and removable partial dentures. Since 1977, the rate of edentulism has declined in the United States, and fewer edentulous patients have sought regular dental care. In addition, approximately 20% fewer curriculum hours have been spent in dental schools in removable prosthodontic instruction; a declining number of graduating dental students have felt comfortable with their level of knowledge of removable prosthodontics, especially complete dentures, and have performed fewer removable prosthodontic procedures in practice because of a perceived lack of treatment cost-effectiveness. The present study, an 18-year follow-up to the 1977 survey, was designed to determine if such trends toward a de-emphasis on removable prosthodontic treatment have affected the mechanisms of instruction in and the extent to which dental schools instruct students about removable-prosthodontics laboratory procedures. The 1995 survey was mailed to 53 American dental schools. Forty-six schools returned the completed survey, for a response rate of 87%. Results showed that the relative amount of material presented to students in clinical removable prosthodontics programs increased, primarily through the enhancement of laboratory technician support, both in-house and commercial, of student clinical removable prosthodontic laboratory procedures. The increase was greater than in preclinical removable prosthodontic programs, which were described in a companion article. The conflict between these outcomes and the call by the dental community, as well as that of the 1995 Institute
Weintraub, A M; Weintraub, G S
In 1977, a survey of American and Canadian dental schools was conducted by Weintraub to determine the delegation of laboratory procedures in preclinical and clinical complete and removable partial denture programs. This was performed in light of challenges raised to the value of requiring dental students, rather than laboratory technicians, to perform the various laboratory procedures involved in the fabrication of complete and removable partial dentures. Since 1977, the rate of edentulism has declined in the United States, and fewer edentulous patients have sought regular dental care. In addition, approximately 20% fewer curriculum hours have been spent in dental schools in removable prosthodontic instruction; a declining number of graduating dental students have felt comfortable with their level of knowledge of removable prosthodontics, especially complete dentures, and have performed fewer removable prosthodontic procedures in practice because of a perceived lack of treatment cost-effectiveness. The present study, an 18-year follow-up to the 1977 survey, was designed to determine if such trends toward a deemphasis on removable prosthodontic treatment have affected the mechanisms of instruction in and the extent to which dental schools instruct students about removable prosthodontics laboratory procedures. The 1995 survey was mailed to 53 American dental schools. Forty-six schools returned the completed survey, for a response rate of 87%. Results showed that the proportion of schools with removable prosthodontic preclinical programs, especially those in removable partial dentures, increased, as did the relative amount of material presented to students in these programs. This was accomplished primarily through the enhancement of laboratory technician support, both in-house and commercial, of student preclinical removable prosthodontic laboratory procedures. The conflict between these outcomes and the call by the dental community, as well as that of the 1995
Aguirre Aguilar, Antonio Armando; Rios Caro, Teresa Etelvina; Huamán Saavedra, Jorge; França, Cristiane Miranda; Fernandes, Kristianne Porta Santos; Mesquita-Ferrari, Raquel Agnelli; Bussadori, Sandra Kalil
The purpose of this study is to compare atraumatic restorative treatment (ART) with the conventional rotational restorative method (CM) to determine in both cases the total time required for the procedure, the cost, the presence of pain, and the behavior of pediatric patients in Peru. Of the 30 children selected for the study, half received ART and restoration with glass ionomer cement and the other half, CM and restoration with amalgam. The study parameters were the times required to remove the decayed tissue and to complete the entire procedure, the total cost of the procedure, the presence of pain, and the patient's behavior during treatment. Significant differences were found between the two techniques in all parameters, except for the patient's behavior. Although removing the decayed tissue was faster with the CM, the entire procedure was faster with ART, which, moreover, was significantly less expensive and less painful than the CM. The results indicated that ART is a very good alternative due to its low cost and acceptance by the children.
Seibt, Creta Elisa; Munerato, Maria Cristina
Syphilis is an infectious disease caused by the bacterium Treponema pallidum. Syphilis has three clinical stages and may present various oral manifestations, mainly at the secondary stage. The disease mimics other more common oral mucosa lesions, going undiagnosed and with no proper treatment. Despite the advancements in medicine toward prevention, diagnosis, and treatment syphilis remains a public health problem worldwide. In this sense, dental surgeons should be able to identify the most common manifestations of the disease in the oral cavity, pointing to the role of this professional in prevention and diagnosis. This study describes a case series of seven patients with secondary syphilis presenting different oral manifestations.
Ohio State Univ., Columbus. Center on Education and Training for Employment.
This document, which is designed for use in developing a tech prep competency profile for the occupation of dental hygienist, lists technical competencies and competency builders for 13 units pertinent to the health technologies cluster in general and 9 units specific to the occupation of dental hygienist. The following skill areas are covered in…
Tarakji, Bassel; Gazal, Giath; Al-Maweri, Sadeq Ali; Azzeghaiby, Saleh Nasser; Alaizari, Nader
Recurrent aphthous stomatitis (RAS) is a well-known oral disease with unclear etiopathogenesis for which symptomatic therapy is only available. This kind of study aimed to highlight the main points that the general practitioners should be taken in their consideration. We have collected our data from PubMed line from 1972 to 2011. Our criteria included the papers that refer to the general predisposing factors, and the general treatment of RAS. Some papers which indicated to the specific details related to RAS that needed a consultant or specialist in Oral Medicine have not included. There is no clear guideline of the etiology, diagnosis, and management of RAS; therefore, the majority of the general practitioners refer most of the cases to appropriate specialist. PMID:26028911
Nixdorf, Donald R.; Law, Alan S.; John, Mike T.; Sobieh, Radwa M.; Kohli, Richie; Nguyen, Ruby H.N.
Introduction Pain present 6 months following root canal treatment (RCT) may be either of odontogenic or nonodontogenic origin. This is importance because treatments and prognoses are different; therefore the aim of this study was to provide specific diagnoses of patients reporting pain 6 months after receiving initial orthograde RCT. Methods We enrolled patients from the Midwest region of an existing prospective observational study of pain after RCT. Pain at 6 months was defined as ≥1 day of pain and average pain intensity of at least 1/10 over the preceding month. An Endodontist and an Orofacial Pain practitioner independently performed clinical evaluations, which included periapical and cone-beam CT radiographs, to determine diagnoses. Results Thirty-eight out of the 354 eligible patients in the geographic area (11%) met the pain criteria, with 19 (50%) consenting to be clinically evaluated. As the sole reason for pain, 7 patients (37%) were given odontogenic diagnoses (4 involving the RCT tooth, 3 involving an adjacent tooth). Eight patients (42%) were given nonodontogenic pain diagnoses (7 from referred temporomandibular disorder (TMD) pain, 1 from persistent dentoalveolar pain disorder (PDAP)). Two patients (11%) had both odontogenic and nonodontogenic diagnoses, while 2 (11%) no longer fit the pain criteria at the time of the clinical evaluation. Conclusion Patients reporting “tooth” pain 6 months following RCT had a nonodontogenic pain diagnosis accounting for some of this pain, with TMD being the most frequent nonodonotgenic diagnosis. Dentists should have the necessary knowledge to differentiate between these diagnoses to adequately manage their patients. PMID:25732400
Young, John; Gosbee, John; Billica, Roger
The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.
Zohrabian, Vahe M; Sonick, Michael; Hwang, Debby; Abrahams, James J
Dental implants restore function to near normal in partially or completely edentulous patients. A root-form implant is the most frequently used type of dental implant today. The basis for dental implants is osseointegration, in which osteoblasts grow and directly integrate with the surface of titanium posts surgically embedded into the jaw. Radiologic assessment is critical in the preoperative evaluation of the dental implant patient, as the exact height, width, and contour of the alveolar ridge must be determined. Moreover, the precise locations of the maxillary sinuses and mandibular canals, as well as their relationships to the site of implant surgery must be ascertained. As such, radiologists must be familiar with implant design and surgical placement, as well as augmentation procedures utilized in those patients with insufficient bone in the maxilla and mandible to support dental implants.
. The most obvious changes were at the most lateral alar-bases. The difference in lateral displacement profoundly influenced the perception of a more rounded nose. There were no predictive correlations between the changes. Patients with narrow and constrained nostrils can benefit from these changes with respect to the subjective experience of nasal obstruction. It is questionable whether an alar-cinch suture will prevent widening at the alar-base. The 3D superimposition applied in Study II is a reliable method, circumventing projection and measurement errors. In conclusion, SARME and orthodontic treatment normalize the transverse deficiency, with long-term stability. SARME has a favourable effect on the subjective perception of nasal respiration. SARME significantly affects dental, skeletal and nasal structures.
Voicu, Georgeta; Popa, Alexandru Mihai; Badanoiu, Alina Ioana; Iordache, Florin
In this study the sol-gel process was used to synthesize a precursor mixture for the preparation of silicate cement, also called mineral trioxide aggregate (MTA) cement. This mixture was thermally treated under two different conditions (1400 °C/2 h and 1450 °C/3 h) followed by rapid cooling in air. The resulted material (clinker) was ground for one hour in a laboratory planetary mill (v = 150 rot/min), in order to obtain the MTA cements. The setting time and mechanical properties, in vitro induction of apatite formation by soaking in simulated body fluid (SBF) and cytocompatibility of the MTA cements were assessed in this study. The hardening processes, nature of the reaction products and the microstructural characteristics were also investigated. The anhydrous and hydrated cements were characterized by different techniques e.g., X-ray diffraction (XRD), scanning electron microscopy (SEM), infrared spectroscopy (FT-IR) and thermal analysis (DTA-DTG-TG). The setting time of the MTA cement obtained by thermal treatment at 1400 °C/2 h (MTA1) was 55 min and 15 min for the MTA cement obtained at 1450 °C/3 h (MTA2). The compressive strength values were 18.5 MPa (MTA1) and 22.9 MPa (MTA2). Both MTA cements showed good bioactivity (assessed by an in vitro test), good cytocompatibility and stimulatory effect on the proliferation of cells.
Levrini, Luca; Sacchi, Franco; Milano, Francesca; Polimeni, Antonella; Cozza, Paolo; Bernkopf, Edoardo; Segù, Marzia; Zucconi, Marco; Vicini, Claudio; Brunello, Enrico
Summary Background The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. Methods With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. Results Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. Conclusions The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options. PMID:26941893
Cengiz, Servi Burcak
The pregnant woman who presents for dental care requires special consideration. This article reviews physiologic changes associated with pregnancy and current considerations for the dental treatment of pregnant dental patients, as well as for pregnant dental professionals. The limitations and safety of commonly used drugs and anesthetics are discussed. Recommendations for prenatal oral counseling are presented.
Hussain, Shaun A; Zhou, Raymond; Jacobson, Catherine; Weng, Julius; Cheng, Emily; Lay, Johnson; Hung, Phoebe; Lerner, Jason T; Sankar, Raman
There is a great need for safe and effective therapies for treatment of infantile spasms (IS) and Lennox-Gastaut syndrome (LGS). Based on anecdotal reports and limited experience in an open-label trial, cannabidiol (CBD) has received tremendous attention as a potential treatment for pediatric epilepsy, especially Dravet syndrome. However, there is scant evidence of specific utility for treatment of IS and LGS. We sought to document the experiences of children with IS and/or LGS who have been treated with CBD-enriched cannabis preparations. We conducted a brief online survey of parents who administered CBD-enriched cannabis preparations for the treatment of their children's epilepsy. We specifically recruited parents of children with IS and LGS and focused on perceived efficacy, dosage, and tolerability. Survey respondents included 117 parents of children with epilepsy (including 53 with IS or LGS) who had administered CBD products to their children. Perceived efficacy and tolerability were similar across etiologic subgroups. Eighty-five percent of all parents reported a reduction in seizure frequency, and 14% reported complete seizure freedom. Epilepsy was characterized as highly refractory with median latency from epilepsy onset to CBD initiation of five years, during which the patient's seizures failed to improve after a median of eight antiseizure medication trials. The median duration and the median dosage of CBD exposure were 6.8 months and 4.3mg/kg/day, respectively. Reported side effects were far less common during CBD exposure, with the exception of increased appetite (30%). A high proportion of respondents reported improvement in sleep (53%), alertness (71%), and mood (63%) during CBD therapy. Although this study suggests a potential role for CBD in the treatment of refractory childhood epilepsy including IS and LGS, it does not represent compelling evidence of efficacy or safety. From a methodological standpoint, this study is extraordinarily vulnerable
dos Santos, Isis Rodrigues Menezes; Moreira, Ana Cristina Azevedo; Costa, Myrela Galvão Cardoso; Barbosa, Marcelo de Castellucci e
Objective This study aimed at assessing, in vivo, whether the prior use of 0.12% chlorhexidine as mouthwash would decrease air contamination caused by aerosolized sodium bicarbonate during dental prophylaxis. The study was conducted with 23 patients aged between 10 and 40 years old who were randomly selected and undergoing fixed orthodontic treatment. Methods The study was divided into two phases (T1 and T2) with a 30-day interval in between. In both phases, dental prophylaxis was performed with aerosolized sodium bicarbonate jetted to the upper and lower arches for 4 minutes. In T1, 10 minutes before the prophylaxis procedure, the participants used distilled water as mouthwash for one minute; whereas in T2, mouthwash was performed with 0.12% chlorhexidine. Microbial samples were collected in BHI agar plates for microbiological analysis. Two dishes were positioned on the clinician (10 cm from the mouth) and a third one at 15 cm from the patient's mouth. The samples were incubated for 48 hours at 37°C. Results were expressed in colony-forming units (CFU). Results Statistical analysis carried out by means of Student's t test, as well as Wilconxon and Kruskal-Wallis tests revealed that the prior use of 0.12% chlorhexidine as mouthwash significantly reduced CFU in the three positions studied (P < 0.001). Conclusion The prior use of 0.12% chlorhexidine as mouthwash significantly reduced contamination caused by aerosolized sodium bicarbonate during dental prophylaxis in the orthodontic clinic. PMID:25162572
Banthia, Ruchi; Singh, Pallavi; Banthia, Priyank; Singh, Rajbhan; Gupta, Santosh; Raje, Sapna
Antiplatelet and anticoagulant agents have been extensively researched and developed as potential therapies in the prevention and management of arterial and venous thrombi. These medications are associated with an increase in bleeding time and risk of intraoperative and postoperative hemorrhage in the dental office. There is some controversy regarding whether these agents should be temporarily discontinued before dental procedures. In order to gain insight into this controversy, a survey of 50 cardiologists was conducted regarding suggested guidelines for dentists in the management of patients who are taking anticoagulant medication.
Alcañiz, M; Grau, V; Monserrat, C; Juan, C; Albalat, S
The detection and correction of malocclusions and other dental abnormalities is a significant area of work in orthodontic diagnosis. To assess the quality of occlusion between the teeth the orthodontist has to estimate distances between specific points located on the teeth of both arches. Distance measuring is based on the observation, by the orthodontist, of a plaster model of the mouth. Gathering of information required to make the diagnosis is a time consuming and costly operation. On the other hand, obtaining and manipulation of plaster casts constitute a huge problem in clinics, due to both the large space needed and high costs associated with plaster casts manufacturing. For this problem we present a new system for three-dimensional orthodontic treatment planning and movement of teeth. We describe a computer vision technique for the acquisition and processing of three-dimensional images of the profile of hydrocolloids dental imprints taken by mean of a own developed 3D laser scanner. Profile measurement is based on the triangulation method which detects deformation of the projection of a laser line on the dental imprints. The system is computer-controlled and designed to achieve depth and lateral resolutions of 0.1 mm and 0.2 mm, respectively, within a depth range of 40 mm. The developed diagnosis software system (named MAGALLANES) and the 3D laser scanner (named 3DENT) are both commercially available and have been designed to replace manual measurement methods, which use costly plaster models, with computer measurements methods and teeth movement simulation using cheap hydrocolloid dental wafers. This procedure will reduce the cost and acquisition time of orthodontic data and facilitate the conduct of epidemiological studies.
Hashemikamangar, Sedighe Sadat; Yazdanpanah, Farnoosh; Mirzaii, Mansoore; Yazdani, Reza; Karazifard, Mohammad Javad; Yasini, Esmaeil
The efficacy of methods like e-learning as a supplement to traditional face-to-face instruction needs to be evaluated in dental courses. This study aimed to assess the efficacy of posting case presentations on one of the educational websites of the virtual school of Tehran University of Medical Sciences called "SARMAD" to enhance the ability of senior dental students to diagnose tooth discolorations and offer treatment plans. This experimental study had a pre-test/post-test control group design and was conducted on 63 senior dental students. After filling out the primary questionnaire and obtaining a written informed consent, students participated in a pre-test and were then randomly divided into two groups of intervention and control. Fifteen case presentations were posted on the university website (SARMAD) during 6 weeks and discussed. Then, students participated in a post-test. Students' perspectives and their satisfaction with the website were assessed by a questionnaire. For ethical purposes, the same program was also offered to the controls. The post-test score was significantly higher than the pre-test score in the intervention group (P<0.001); but in the control group, the post-test score was only slightly higher than the pre-test score (P=0.128). In the intervention group, 70% stated that they would suggest this method as an efficient educational modality; 93.3% stated that this method would be beneficial as a supplement to conventional education; 16.7% ranked the SARMAD website excellent, 30% ranked it good, 33.3% acceptable, 16.7% moderate and 3.3 poor. It appears that this instructional modality may be efficiently used as a supplement to traditional instruction in undergraduate dental curricula.
Paryab, Mehrsa; Arab, Zeinab
Background: The aim of this study was to evaluate the effect of Filmed modeling in comparison with commonly used Tell-Show-Do technique (T.S.D) on the anxious and cooperative behavior of 4-6 years old children during dental practice. Materials and Methods: Forty six children aged 4-6 years were enrolled in this study and randomly allocated into two groups. Group I: At the first visit, the procedure of Tell-Show-Do, and at the second visit, the treatment procedures were performed by the dentist for the children. Group II: At the first visit, children watched a film consisting of the procedure of Tell-Show-Do performed on a child model. At the second visit, treatment procedures were performed. In both groups, during the treatment procedure, index of heart rate was measured and behaviors of children were recorded. The children's anxious and cooperative behaviors on the recordings were quantified according to Venham and Frankl rating scales, respectively. The data were compared between two groups using T-test method. All statistical references were made at 0.05. Results: There were no statistically significant differences in heart rate measures, clinical anxiety and cooperative behavior scores of children between the two groups (P = 0.6). Conclusion: Filmed modeling can be an efficient alternative method to Tell-Show-Do technique in pre-appointment preparation of the 4-6 years old children during dental treatment. PMID:25225565
Bhola, Rahul; Malhotra, Reema
Objectives The study aims to determine the degree of anxiety pertaining to dental procedures and various oral hygiene practices among college teenagers. Methods Corah's Modified Dental Anxiety Scale was administered on a randomly chosen sample of 100 Indian college students (50 males and 50 females) of Delhi University, belonging to the age group of 17–20 years. Results Descriptive statistical computations revealed 12.14 years as the mean age of first dental visit, with moderately high levels of anxiety (60.75%) for various dental procedures among the Indian teenagers and 5% lying in the “phobic or extremely anxious” category. With merely 4.16% people going for regular consultations, general check-ups evoked 78.3% anxiety and having an injection or a tooth removed was perceived as the most threatening. The sample subgroup not using mouthwash and mouthspray, smokers, and alcohol drinkers with improper oral hygiene practices experienced much higher anxiety towards routine dental procedures. Conclusion The majority of the Indian youngsters had an evasive attitude of delaying dental treatment. The core problems lay in deficient health care knowledge, lack of patient-sensitive pedagogy to train dental professionals, inaccessibility of services, and a dismissive attitude towards medical help. The feelings of fear and anxiety prevalent among the Indian youth offer significant insights into causes and preventive measures for future research and practice. Methods of education and motivation could be developed to dissipate the anxiety amongst Indian teenagers that prevent routine dental visits and maintenance of adequate oral hygiene. PMID:25379373
Wilder-Smith, Petra; Otis, Linda; Zhang, Jun; Chen, Zhongping
This chapter describes the applications of OCT for imaging in vivo dental and oral tissue. The oral cavity is a diverse environment that includes oral mucosa, gingival tissues, teeth and their supporting structures. Because OCT can image both hard and soft tissues of the oral cavity at high resolution, it offers the unique capacity to identity dental disease before destructive changes have progressed. OCT images depict clinically important anatomical features such as the location of soft tissue attachments, morphological changes in gingival tissue, tooth decay, enamel thickness and decay, as well as the structural integrity of dental restorations. OCT imaging allows for earlier intervention than is possible with current diagnostic modalities.
Machado, Geovanna C M; Daher, Anelise; Costa, Luciane R
Many parents rely on emergency services to deal with their children's dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children's age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children's mean age was 4.1 (SD 1.0) years (range 1-5 years) and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of "sex", the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5-0.8), radiography request (OR 3.8; 95% CI 1.7-8.2), medication prescribed (OR 7.5; 95% CI 4.9-11.5) and patient referred to another service (OR 5.7; 3.0-10.9). Many children with toothache received no oral procedure for pain relief.
van de Velde, W L; Schepers, R H; van Minnen, B
A 22-year old male was referred to the Department of Oral and Maxillofacial Surgery of a university clinic 2 months after he had sustained multiple traumatic injuries abroad because of an anterior malocclusion. The malocclusion was the sequel of an unrecognised, untreated, already consolidated paramedian mandibular fracture on the right and a fracture of the contralateral mandibular angle on the left. Preoperatively, a cobalt-chrome 3D-printed dental splint was prepared. Surgical correction of the malocclusion was carried out by segmental osteotomies of the mandible at the original fracture sites. This involved a vertical paramedian osteotomy on the right side and a unilateral sagittal split osteotomy on the left mandibular angle side. The mandibular segment was mobilised in the correct occlusion with the aid of the 3D-printed dental splint. The splint was fixed to the teeth with dental composite. The custom made 3D-printed dental splint is considered a promising procedural innovation in oral and maxillofacial surgery.
Loyola-Rodriguez, Juan Pablo; Pozos-Guillen, Amaury de Jesus; Hernandez-Hernandez, Felipe; Berumen-Maldonado, Rocio; Patiño-Marin, Nuria
Dental fluorosis is an endemic dental health problem around the world; so, it is important to develop clinical alternatives that are non-invasive and inexpensive. In this study, nightguard vital bleaching technique (NVBT), using carbamide and hydrogen peroxide as active agents, has shown itself to be effective in whitening teeth affected by dental fluorosis. Carbamide peroxide at 10 and 20% and hydrogen peroxide at 7.5% showed good clinical effectiveness in improving clinical appearence, but it is important to point out that clinical success is only in cases of class 1 to 3 of the Tooth Surface Index of Fluorosis. When comparing 10 and 20% concentrations of carbamide peroxide, there was no difference in the clinical effectiveness (p > 0.05); but when comparing both concentrations of carbamide peroxide against hydrogen peroxide, results showed that carbamide peroxide was more effective in whitening in cases of dental fluorosis, the difference being statistically significant (p < 0.05). NVBT has two advantages: it is a non-invasive technique and the relationship cost/benefit is excellent; only a few patients reported tenderness or mild tooth sensitivity.
Arnold, Janet; Shugars, Daniel A.
Surveys conducted to (1) investigate why dental hygienists choose to become dentists, (2) evaluate their success in dental school, (3) assess the experience of those who had entered dental school, and (4) gauge the level of interest among dental hygienists in applying to dental school are discussed. (Author/MLW)
Although pathophysiology, incidence, and factors associated with the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and management strategies for patients treated with bisphosphonates or patients with BRONJ are well-established, few guidelines or recommendations are available for patients with a history of successfully healed BRONJ. We present a case of successful dental implant treatment after healing of BRONJ in the same region of the jaw, and speculate that implant placement is possible after healing of BRONJ surgery in select cases. PMID:27429938
... few quick steps. There is no drilling or scraping of the molars. Your dentist will: Clean the ... Dental sealants. Updated October 19, 2016. ADA.org Web site. www.ada.org/en/member-center/oral- ...
... such as dental prosthetics, dental composites, dental impressions, dental adhesives, and other dental... prosthetics, dental composites, dental impressions, dental adhesives, and other dental materials to...
Oliveira, Lorenna Fonseca Braga de; Souza, João Gabriel Silva; Mendes, Rafael Inácio Pompeu; Oliveira, Rodrigo Caldeira Nunes; Oliveira, Carolina de Castro; Lima, Carolina Veloso; Martins, Andréa Maria Eleutério de Barros Lima
Our objective was to evaluate whether there is an association with the different levels of dental fluorosis and the presence of dental trauma amongst school children. A transversal study was conducted amongst school children from the age of 12. Dental examinations were conducted by 24 well trained and fully qualified dental surgeons. Data was collected from 36 randomly selected public schools amongst 89 schools in a municipality. The criteria used to diagnose dental fluorosis was based on the Dean's fluorosis Index and for diagnosing dental trauma we looked for clinical signs of crown fractures and dental avulsions. Multiple descriptive analysis, which was bivariate, was carried out. Amongst the 2,755 school children that took part in the study 1,089 (39.6%) were diagnosed with dental fluorosis and 106 (3.8%) had one tooth or more with dental trauma. We noted a high prevalence of dental fluorosis, independent of the level of severity, amongst individuals with one tooth or more who had dental trauma. This association was even more evident where there were severely high levels of fluorosis. We also noted that the presence of fluorosis was greater amongst those that actively paid more attention to discoloration on their teeth and who received treatment from a dental professional at their schools. Nevertheless dental fluorosis was associated with the presence of dental trauma, independent of its severity.
Cantrell, Lezlie M.
The purpose of this phenomenological study was to identify, compile, and describe how community college graduate dental hygienists perceived their initial dental hygiene curriculum preparation and how they subsequently adapted their curriculum preparation in order to perform their responsibilities in their first clinical dental hygiene job.…
Gaviria, Laura; Salcido, John Paul; Guda, Teja
Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evolution of dental implants. It also describes the types of implants that have been developed, and the parameters that are presently used in the design of dental implants. Finally, it describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis and design of the implants. PMID:24868501
Zettel-Watson, Laura; Ditto, Peter H.; Danks, Joseph H.; Smucker, William D.
This study examined the influence of surrogate gender on the accuracy of substituted judgments about the use of life-sustaining treatment in a sample of 249 older adults and their self-selected surrogate decision-makers. Overall, wives were more accurate than husbands at predicting their spouses' treatment wishes. Surrogates' perceptions of their…
Robinson, Baseemah J; Boyce, Ricardo A
There are myths surrounding pregnancy and the oral cavity, such as, "having a baby causes your gums to swell and your teeth to weaken," or "I don't need to see a dentist, there's nothing wrong with my teeth" or "with each child say bye to a tooth or two." All these myths are just that, myths. During pregnancy, women may experience pregnancy gingivitis or may suffer from pre-existing periodontal disease. The myth of tooth loss during pregnancy, according to the ADA (American Dental Association), has "no histological, chemical or radiographic evidence to support [it]". The biggest myth or misconception is that dental care is unnecessary during pregnancy, and until problems arise, some gravid women draw back from seeking dental treatment. Also, professionals sometimes shy away from care of the gravid patient for reasons associated with teratogenicity and fetotoxicity. Teratogenic effects take place from three to eight weeks after conception, and fetotoxicity can occur at the latter end of the initial trimester on to delivery, according to Donaldson and Goodchild, authors of Pregnancy, breast-feeding and drugs used in dentistry in JADA's (The Journal of the American Dental Association) August, 2012 issue. This article includes reasons dental treatment is regarded with caution; therefore, appropriate timing of dental care and suggested clinical recommendations as they relate to the pregnant patient are reviewed.
Shweta; Prakash, S Krishna
Dental abscess is a frequently occurring infectious process known to the health practice. The fate of the infection depends on the virulence of the bacteria, host resistance factors, and regional anatomy. Serious consequences arising from the spread of a dental abscess lead to significant morbidity and mortality. Acute dental abscess is polymicrobial, comprising of strict anaerobes, such as anaerobic cocci, Prevotella, Fusobacterium species, and facultative anaerobes, such as viridans group streptococci and the Streptococcus anginosus group. Numerous novel, uncultivable and fastidious organisms have been identified as potential pathogens with the use of non-culture techniques. The majority of localized dental abscesses respond to surgical treatment while the use of antimicrobials is limited to severe spreading infections. There is a need for good-quality clinical trials of sufficient size to identify the ideal treatment. The microbiology of the acute dentoalveolar abscess and its treatment in the light of improved culture and diagnostic methods are reviewed. PMID:24348613
Bradt, J; Teague, A
Anxiety is a significant issue in the dental care of adults and children. Dental anxiety often leads to avoidance of dental care which may result in significant deterioration of oral and dental health. Non-pharmacological anxiety management interventions such as music listening are increasingly used in dental care. Although efficacy for music's anxiolytic effects has been established for pre-operative anxiety, findings regarding the use of music listening for dental anxiety are inconclusive, especially for children. The use of music for passive distraction may not be adequate for children and highly anxious adults. Instead, interventions offered by a trained music therapist may be needed to optimize music's anxiolytic impact. Music therapy interventions are individualized to the patient's presenting needs and geared at enhancing patients' active engagement in the management of their anxiety. Interventions may include (i) active refocusing of attention, (ii) music-guided deep breathing, (iii) music-assisted relaxation, and (iv) music-guided imagery. In addition, music therapists can teach patients music-based anxiety management skills prior to dental treatments, offer them the opportunity to express emotions related to the upcoming procedure, and help them gain a sense of control and safety. Clinical guidelines for the use of music listening by dental practitioners are offered.
Gambhir, Ramandeep Singh; Brar, Prabhleen; Singh, Gurminder; Sofat, Anjali; Kakar, Heena
Oral health has a significant impact on the quality of life, appearance, and self-esteem of the people. Preventive dental visits help in the early detection and treatment of oral diseases. Dental care utilization can be defined as the percentage of the population who access dental services over a specified period of time. There are reports that dental patients only visit the dentist when in pain and never bother to return for follow-up in most cases. To improve oral health outcomes an adequate knowledge of the way the individuals use health services and the factors predictive of this behavior is essential. The interest in developing models explaining the utilization of dental services has increased; issues like dental anxiety, price, income, the distance a person had to travel to get care, and preference for preservation of teeth are treated as barriers in regular dental care. Published materials which pertain to the use of dental services by Indian population have been reviewed and analyzed in depth in the present study. Dental surgeons and dental health workers have to play an adequate role in facilitating public enlightenment that people may appreciate the need for regular dental care and make adequate and proper use of the available dental care facilities.
Olesova, V N; Uiba, V V; Novozemtseva, T N; Remizova, A A; Olesov, E E
The article analyzes the results of dental examination of employees with hazardous and normal working conditions in Atomenergomash enterprise with various dental care organization regimens and provides clear evidence of the effectiveness of serial attendances care in enterprise dental offices in terms of reduction in the dental treatment needs. Additional funding for departmental dental services was calculated by comparing the real cost of dental treatment and MHI tariffs allowing implementation of proposed dental care program.
Lopez, Rodrigo; Baelum, Vibeke
Background Dental treatment needs are commonly unmet among adolescents. It is therefore important to clarify the determinants of poor utilization of dental services among adolescents. Methods A total of 9,203 Chilean students aged 12–21 years provided information on dental visits, oral health related behavior, perceived oral health status, and socio-demographic determinants. School headmasters provided information on monthly tuition and annual fees. Based on the answers provided, three outcome variables were generated to reflect whether the respondent had visited the dentist during the past year or not; whether the last dental visit was due to symptoms; and whether the responded had ever been to a dentist. Aged adjusted multivariable logistic regression models were used to assess the influence of the covariates gender; oral health related behaviors (self-reported tooth brushing frequency & smoking habits); and measures of social position (annual education expenses; paternal income; and achieved parental education) on each outcome. Results Analyses showed that students who had not attended a dentist within the past year were more likely to be male (OR = 1.3); to report infrequent tooth brushing (OR = 1.3); to have a father without income (OR = 1.8); a mother with only primary school education (OR = 1.5); and were also more likely to report a poor oral health status (OR = 2.0), just as they were more likely to attend schools with lower tuition and fees (OR = 1.4). Students who consulted a dentist because of symptoms were more likely to have a father without income (OR = 1.4); to attend schools with low economic entry barriers (OR = 1.4); and they were more likely to report a poor oral health status (OR = 2.9). Students who had never visited a dentist were more likely to report infrequent tooth brushing (OR = 1.9) and to have lower socioeconomic positions independently of the indicator used. Conclusion The results demonstrate that socioeconomic and behavioral
Dental radiographs are critical for the complete assessment and treatment of dental diseases. Dental radiography is commonly used to evaluate congenital dental defects, periodontal disease, orthodontic manipulations, oral tumors, endodontic treatments, oral trauma, and any situation where an abnormality is suspected. Although standard radiographic equipment and film can be used to produce dental radiographs, dental X-ray equipment and film provide superior quality images and greater convenience of animal patient positioning. An understanding of normal dental radiographic anatomy is important when interpreting dental radiographs. Stage III periodontitis is the earliest stage of periodontal disease at which radiographic abnormalities become apparent. Bone loss associated with periodontal disease can be classified as either horizontal or vertical. Periapical radiolucencies can represent granulomas, cysts, or abscesses, whereas periapical radiodensities may represent sclerotic bone or condensing osteitis. Lytic lesions of the bone of the jaw often represent oral neoplasms. Neoplasms also can displace or disrupt teeth in the dental arch. Resorptive lesions can be external or internal and appear as radiolucent areas involving the external surface of the root or the pulp cavity, respectively. Feline dental resorptive lesions, also known as odontoclastic resorptions, are a specific form of dental resorptive lesions unique to cats.
Paolantonio, M; D'Archivio, D; Di Placido, G; Tumini, V; Di Peppe, G; Del Giglio Matarazzo, A; De Luca, M
As observed in previous case reports, dental rubber dam (DRD) can be utilized as a barrier membrane in the guided tissue regeneration (GTR) technique for the treatment of periodontal intrabony defects. The purpose of the present study was (1) to confirm the validity of DRD as a suitable material in regenerative procedures and (2) to compare, in a split-mouth clinical trial, the effectiveness of DRD-made membranes in the treatment of periodontal intrabony defects versus that of expanded polytetrafluoroethylene (e-PTFE) barriers. 22 systemically healthy non-smoker adult periodontitis patients (7 male, 15 female) aged between 35 to 58 years were selected for the study. In each patient, a couple of 2-3 wall intrabony defects, located in different quadrants, were treated by a GTR technique using DRD (test sites) and e-PTFE (control sites), respectively. Performing a strict control of the oral hygiene level and of the marginal gingival health during the whole period of study, clinical (pocket probing depth, PPD; probing attachment level, PAL; gingival recession, GR) and intrasurgical (depth of the defect's intraosseous component, IOC; level of the alveolar crest, ACL) parameters were recorded at baseline and at the 1-year re-entry procedure in each experimental site. Furthermore, the coronal level of the newly formed tissue from the base of the defect (NFTL) and the vertical bone gain (VBG) were calculated at the time of membrane removal and after the re-entry procedure respectively. Membranes were removed from both test and control sites after 5 weeks; however, exposure of the membrane always occurred in test sites whereas it was observed in only 6 out of 22 control sites, this fact leading to an incomplete coverage of the regenerated tissue by the gingival flap in 18 out of 22 test sites. In both test and control sites, a statistically significant improvement of clinical and intrasurgical parameters occurred at the end of the study period; however, a significantly
Machado, Geovanna C. M.; Daher, Anelise; Costa, Luciane R.
Many parents rely on emergency services to deal with their children’s dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children’s age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children’s mean age was 4.1 (SD 1.0) years (range 1–5 years) and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of “sex”, the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5–0.8), radiography request (OR 3.8; 95% CI 1.7–8.2), medication prescribed (OR 7.5; 95% CI 4.9–11.5) and patient referred to another service (OR 5.7; 3.0–10.9). Many children with toothache received no oral procedure for pain relief. PMID:25111875
Bacci, Christian; Maglione, Michele; Favero, Lorenzo; Perini, Alessandro; Di Lenarda, Roberto; Berengo, Mario; Zanon, Ezio
Following favourable results from a previous study, a large, multicentre, prospective, case-control study was performed to further assess the incidence of bleeding complications after dental extraction in patients taking oral anticoagulant therapy (OAT). Four hundred fifty-one patients being treated with warfarin who required dental extraction were compared with a control group of 449 non-anticoagulated subjects undergoing the same procedure. In the warfarin-treated group, the oral anticoagulant regimen was maintained unchanged, such that the patients had an International Normalised Ratio ranging between 1.8 and 4, and local haemostatic measures (i.e. fibrin sponges, silk sutures and gauzes saturated with tranexamic acid) were adopted. All the procedures were performed in an outpatient setting. Seven bleeding complications occurred in the OAT group and four in the control group; the difference in the number of bleeding events between the two groups was not statistically significant (OR=1.754; 95% CI 0.510 - 6.034; p=0.3727). No post-operative late bleeds requiring hospitalisation and/or blood transfusions were recorded, and the adjunctive local haemostatic measures were adequate to stop the bleeding. The results of our protocol applied in this large, multicenter study show that dental extractions can be performed easily and safely in anticoagulated outpatients without any modification of the ongoing anticoagulant therapy, thus minimising costs and reducing discomfort for patients.
Oscarsson, Nicklas; Arnell, Per; Lodding, Pär; Ricksten, Sven-Erik; Seeman-Lodding, Heléne
Purpose: In this prospective cohort study, the effects of hyperbaric oxygen treatment (HBOT) were evaluated concerning patient-perceived symptoms of late radiation-induced cystitis and proctitis secondary to radiation therapy for pelvic cancer. Methods and Materials: Thirty-nine patients, 35 men and 4 women with a mean age of 71 (range, 35-84) years were included after informed consent and institutional ethics approval. They had all been treated with radiation therapy for prostate (n=34), cervix (n=2), or rectal (n=3) cancer using external beam radiation at a dose of 25 to 75 Gy. Patients with hematuria requiring blood transfusion were excluded. The HBOT was delivered with 100% oxygen for 90 minutes at 2.0 to 2.4 atmospheres (ATA). Mean number of treatments was 36 (28-40). Symptoms were prospectively assessed using the Expanded Prostate Index Composite score before, during, and 6 to 12 months after HBOT. Results: The HBOT was successfully conducted, and symptoms were alleviated in 76% for patients with radiation cystitis, 89% for patients with radiation proctitis, and 88% of patients with combined cystitis and proctitis. Symptom reduction was demonstrated by an increased Expanded Prostate Index Composite score in the urinary domain from 50 ± 16 to 66 ± 20 after treatment (P<.001) and in the bowel domain from 48 ± 18 to 68 ± 18 after treatment (P<.001). For 31% of the patients with cystitis and 22% with proctitis, there were only trivial symptoms after HBOT. The improvement was sustained at follow-up in both domains 6 to 12 months after HBOT. No severe side effects were observed related to HBOT, and treatment compliance was high. Conclusions: HBOT can be an effective and safe treatment modality for late radiation therapy-induced soft tissue injuries in the pelvic region.
Shahrabani, Shosh; Benzion, Uri; Machnes, Yaffa; Gal, Assaf
Routine dental examinations for children are important for early diagnosis and treatment of dental problems. The level of dental morbidity among Israeli children is higher than the global average. A July 2010 reform of Israel's National Health Insurance Law gradually offers free dental services for children up to age 12. The study examines the use of dental services for children and the factors affecting mothers' decision to take their children for routine checkups. In addition, the study examines the impact of the reform on dental checkups for children in various populations groups. A national representative sample comprising 618 mothers of children aged 5-18 was surveyed by telephone. The survey integrated the principles of the health beliefs model and socio-demographic characteristics. The results show that mothers' decision to take their children for dental checkups is affected by their socio-demographic status and by their health beliefs with respect to dental health. After the reform, the frequency of children's dental checkups significantly increased among vulnerable populations. Therefore, the reform has helped reduce gaps in Israeli society regarding children's dental health. Raising families' awareness of the reform and of the importance of dental health care together with expanding national distribution of approved dental clinics can increase the frequency of dental checkups among children in Israel.
Keyes, Paul H.; Rams, Thomas E.
Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993
Ludwick, William E.; And Others
This report of one phase of a study concerned with seeking means of extending the success of dental officers through delegation of certain treatment procedures to auxiliary personnel focuses upon determining the amount of training dental assistants (termed dental technicians by the Navy) require in order to perform the treatment procedure…
Dobros, Katarzyna; Hajto-Bryk, Justyna; Wnek, Anna; Zarzecka, Joanna; Rzepka, Dominik
Background: The present study aimed to assess potential correlation between dental anxiety and overall dental status in adult patients, in consideration of the frequency of dental appointments and individual dental hygiene practices. Materials and Methods: Individual dental anxiety levels were assessed with the aid of the Corah’s dental anxiety scale (DAS). The study embraced 112 patients of the University Dental Clinic, Kraków. Following clinical and X-ray exams, respectively, decayed, missing and filled teeth (DMFT) index and dental treatment index (DTI) were computed for each study subject. Results: Mean DAS among the 112 subjects under study was 9.41 standard deviation (SD = 3.36). Mean DMFT value was 15.86 (SD = 7.00), whereas DTI value was 0.76 (SD = 0.27). The number of decayed teeth and an individual dental anxiety level were found to be correlated (r = 0.26). Higher dental anxiety correlated with lower DTI value (r = −0.22) and lesser frequency of dental appointments (r = 0.22). Conclusions: Individual dental anxiety level appears to impact overall dental status, frequency of dental appointments and everyday oral health practices. Every conceivable effort should therefore be undertaken with a view to effectively diminishing dental anxiety levels in the patients. How to cite the article: Dobros K, Hajto-Bryk J, Wnęk A, Zarzecka J, Rzepka D. The level of dental anxiety and dental status in adult patients. J Int Oral Health 2014;6(3):11-4. PMID:25083026
Klages, Ulrich; Bruckner, Aladàr; Zentner, Andrej
The aim of the present study was to explore the putative relationship between dental aesthetics and oral health-related quality of life (OHRQoL), taking into consideration the potential direct and moderating influence of private and public self-consciousness. The subjects of this cross-sectional survey were 148 university students. Dental aesthetics were assessed by means of the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). OHRQoL was estimated using a modification of the scales 'social appearance concern' and 'appearance disapproval', and a novel dental self-confidence scale. In addition, the private and public self-consciousness scales were used. Two-factor analyses of variance were carried out with high and low levels of dental aesthetics and private and public self-consciousness as the independent variables and the OHRQoL scales as the dependent variables. It was found that dental aesthetics had a direct effect on all OHRQoL scale values. Private self-consciousness was related to social appearance concern, while public self-consciousness was associated with both social appearance concern and appearance disapproval. An interaction effect was identified which showed that the impact of dental aesthetics on social appearance concern was stronger in respondents with high private and public self-consciousness than in low scoring subjects. The findings of the study suggest that minor differences in dental aesthetics may have a significant effect on perceived OHRQoL. This effect was more significant in subjects with high self-consciousness.
Burgess, Ralph C.
Dental caries is one of the most prevalent diseases afflicting mankind. It reached a peak in the 1950s but has been declining drastically in recent years in children and young adults. This article describes the three contributing factors in dental caries: microbial plaque, tooth susceptibility, and diet, and discusses practical preventive measures which help to reduce caries incidence. Some of these, such as vaccines and antimicrobial varnishes, are still in the research stages, while others, such as sucrose substitutes, low-calorie sweeteners, and limitation of frequency of sugar snacks are well established and can be promoted by family physicians. PMID:21253193
Meskin, Lawrence H.; And Others
A dental health program in an elementary school succeeded in identifying children considered to be "high risk" in oral health and, through treatment and education, significantly improved their dental health. (JD)
Zalyan, G; Zalyan, G
The author presents the method of mandibular fractures treatment--osteosynthesis by means of solcoseryl dental adhesive paste. The use of solcoseryl dental adhesive paste accelerates the incarnation of wound and prevents the surgical complications.
dos Santos Neto, Edson Theodoro; Oliveira, Adauto Emmerich; Zandonade, Eliana; Leal, Maria do Carmo
This study sought to evaluate the self-perceived response to dental care during prenatal assistance in the Unified Health System (SUS) in the Metropolitan Region of Vitória, Espírito Santo, Brazil. 1032 postpartum women were interviewed and 1006 prenatal records copied. Postpartum women's self-perceived response was measured by the Oral Health Index Profile-14. When an impact was identified, dental care rendered in educational, preventive and curative terms was considered adequate. When there was no impact, assistance was considered adequate in educational and preventive terms. The Chi-square test revealed an association between prenatal care and dental care. Oral health impact on quality of life was 14.7%. Dental care received by mothers in educational terms was rated at 41.3%, while in preventive terms it was 21% and in curative terms it was 16.6%. Six or more prenatal appointments coupled with educational activities was closely associated with adequate dental care (p < 0.05). Access to dental care is facilitated when pregnant women attend health services and become involved in educational activities during the prenatal period. Consequently, educational measures appear to indicate an improvement in prenatal care in the SUS.
Kellstein, D; Ott, D; Jayawardene, S; Fricke, J
This randomised, double-blind, placebo-controlled, parallel-group study compared the efficacy and tolerability of lumiracoxib (a novel COX-2 selective inhibitor) with rofecoxib, celecoxib and placebo in patients with moderate-to-severe post-operative dental pain. Following third molar extraction, patients received single oral doses of lumiracoxib 400 mg, rofecoxib 50 mg, celecoxib 200 mg or placebo (n = 355). Additional patients from a similar study, assigned to lumiracoxib, rofecoxib or placebo (n = 155), were included for analysis of the primary variable, Summed Pain Intensity Difference over the first 8 h post dose (SPID-8). For SPID-8, lumiracoxib was superior to rofecoxib (p < 0.05), celecoxib (p < 0.001) and placebo (p < 0.001). Lumiracoxib demonstrated the fastest onset of analgesia and the longest time to rescue medication use. Patient global evaluation of lumiracoxib was comparable to rofecoxib and superior to celecoxib and placebo. All treatments were well tolerated. Lumiracoxib 400 mg provides rapid, effective and sustained relief of post-operative dental pain, comparable or superior to rofecoxib.
Robertson, D; Smith, A J
The acute dental abscess is frequently underestimated in terms of its morbidity and mortality. The risk of potential serious consequences arising from the spread of a dental abscess is still relevant today with many hospital admissions for dental sepsis. The acute dental abscess is usually polymicrobial comprising facultative anaerobes, such as viridans group streptococci and the Streptococcus anginosus group, with predominantly strict anaerobes, such as anaerobic cocci, Prevotella and Fusobacterium species. The use of non-culture techniques has expanded our insight into the microbial diversity of the causative agents, identifying such organisms as Treponema species and anaerobic Gram-positive rods such as Bulleidia extructa, Cryptobacterium curtum and Mogibacterium timidum. Despite some reports of increasing antimicrobial resistance in isolates from acute dental infection, the vast majority of localized dental abscesses respond to surgical treatment, with antimicrobials limited to spreading and severe infections. The microbiology and treatment of the acute localized abscess and severe spreading odontogenic infections are reviewed.
Virtue, Shannon Myers; Pendergast, Laura; Tellez, Marisol; Waldron, Elizabeth; Ismail, Amid
The aims of this study were to identify noncognitive factors that dental faculty members perceived to contribute to dental students' success and to assess dental faculty members' ratings of the relative importance of these factors to academic performance, clinical performance, and overall success. Out of 184 eligible faculty members at one U.S. dental school, 43 respondents (23.3%) completed a survey in 2015-16. The survey asked respondents to rank the importance of seven noncognitive factors to academic performance, clinical performance, and overall success. Descriptive analysis was conducted to determine the ratings on importance of each noncognitive factor. Two additional open-ended questions asked faculty members to 1) think of dental students who performed very well and list the noncognitive factors they believed contributed to those students' success and 2) identify the two most important of those factors that contributed to success. Qualitative analysis was conducted to identify themes in the open-ended responses. The respondents rated professionalism and preparedness highest in importance for overall success. Preparedness was rated highest in importance for academic performance, and communication was highest in importance for clinical performance. Six themes were identified in the open-ended responses: communication/interpersonal skills, approach to learning, personal characteristics, professionalism, diverse experiences, and technical abilities. On both open-ended items, the most frequently cited noncognitive skill was communication/interpersonal skills followed by approach to learning. In this study, dental faculty members perceived communication, preparedness, and professionalism as important skills contributing to dental students' success.
Allergic reactions to dental materials and remedies cause stomatitis in the patient and a contact dermatitis in the dental personnel. Topical contact (acrylic resin denture materials, heat accumulation, plaques on the denture) and endogenic (symptom of internal and psychiatric illnesses) factors are the cause for denture sore mouth. In metallic alloys corrosions and electric currents can effect an irritation to the oral mucosa. The application of amalgam fillings can possibly result in a mercurialism. Dental remedies used for treatment of wounds and dental roots are potent sensitizers. Surface anesthetics with tetracaine are the most frequent contact allergens for dentists. Injectable local anesthetics produce anaphylactic type reactions as well as toxic side-effects in the patient.
Harrison, Peter L; Shaddox, Luciana M; Garvan, Cynthia W; Behar-Horenstein, Linda S
The high prevalence of distress among health professionals during their education has fostered increased interest in the study of student well-being. The aim of this study was to assess the self-perceived wellness of dental students and determine the relationship between factors affecting wellness and demographic variables. An online questionnaire was distributed to 334 first-through fourth-year dental students at one U.S. dental school. The questionnaire consisted of modified versions of the Perceived Wellness Survey, Medical Outcomes Study Social Support Survey, and Mental Health Inventory and also collected demographic information. The response rate was 78% (N=261). More than 80% of the respondents reported that they were happy all, most, or a good bit of the time. These students exhibited a strong sense of self-worth, were positive about their friendships, and perceived they had good social support. Less than 20% of respondents did not view their physical health as excellent and identified a lack of self-perceived wellness. First-year and single students reported statistically less social support. Students who were parents perceived their wellness less favorably. Hispanic and Asian students were less happy regarding their mental health than white and African American students. These findings suggest that students, especially Hispanic and Asian students, may benefit from programs that promote student well-being. Academic programs that encourage students to work together and promote peer-to-peer involvement may be beneficial, especially for first-year and single students.
Prados-Privado, María; Prados-Frutos, Juan Carlos; Manchón, Ángel; Rojo, Rosa; Felice, Pietro; Bea, José Antonio
Objective. To show how random variables concern fatigue behaviour by a probabilistic finite element method. Methods. Uncertainties on material properties due to the existence of defects that cause material elastic constant are not the same in the whole dental implant the dimensions of the structural element and load history have a decisive influence on the fatigue process and therefore on the life of a dental implant. In order to measure these uncertainties, we used a method based on Markoff chains, Bogdanoff and Kozin cumulative damage model, and probabilistic finite elements method. Results. The results have been obtained by conventional and probabilistic methods. Mathematical models obtained the same result regarding fatigue life;