bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between place BANA reactivity and clinical parameters in subjects with mental disabilities
Authors: Figueiredo Luciene C. , Toledo Benedicto E.C. , Salvador Sergio L
Published: March 2008

The purpose of the present investigation was to determine whether subjects institutionalized with mental retardation have a relationship between pertodontal clinical parameters and the presence of the BANA‐positlve pertodontal pathogens Porphyromonas gingivalis, Treponema denticola, and Bacteroides forsythus In their subgingival plaques. Fifty Institutionalized subjects (25 patients with Down syndrome and 25 subjects with mental retardation) were matched with respect to age and sex. Pertodontal clinical parameters (Bleeding on Probing, BOP; Papillary Bleeding Score, PBS; and Probing Depth, PD) were obtained from 6 reference teeth (3, 8, 14, 19, 24, 30). In addition, subgingival plaque samples taken from the same 6 teeth were analyzed for the presence of the BANA‐posltlve species, by means of the chairslde BANA test. In both the patients with Down syndrome and the group with mental retardation, the presence of BANA‐posltlve plaques was significantly associated with bleeding on probing (p < 0.05) and increased probing depth (p < 0.01, Chlsquare).

Analysis of these data indicated that the BANA test could be used in combination with clinical criteria to diagnose a perlodontopathy anaerobic infection in Institutionalized subjects.

This study was supported by FAPESP, a Brazilian Research Foundation (Grant no. 96/3414–3).
Oral health needs of elderly short‐term patients in a geriatric department of a general hospital
Authors: Mersel Alexander , Babayof Itai , Rosin Arnold
Published: March 2008

The purpose of this study was to estimate the realistic dental needs of an elderly short‐stay patient in a geriatric department. One segment of the elderly population at risk for whom surveillance would appear extremely important are those admitted temporarily to the hospital for acute or acute‐on‐chronlc care. Little has been written about the oral needs of such patients. The study population was comprised of 468 patients of a geriatric department in a medical center examined by a dentist trained in gerodontics. An evaluation of the results showed that 65.3% needed direct oral hygiene assistance. Only 16.4% are able to participate in oral hygiene instruction; a few of them— 6.6%—had a need of prosthodontic treatment. A once‐weekly screening program was required to handle the oral problems, mainly Candida infections. Close cooperation with the ward staff is essential in order to develop and promote good oral hygiene for this very frail elderly population.
Behavior management and communication strategies for dental professionals when caring for patients with dementia
Authors: Chalmers Jane M.
Published: March 2008

The Impact of dementia and associated behavioral problems on the oral health of long‐term‐care‐facllity residents Is Increasing. The provision of oral hygiene care for these cognitlvely Impaired residents Is difficult and complex. Dental professionals and carers need good communication skills with cognltively Impaired residents, and specific strategies for the management and prevention of their behavioral problems. Newer philosophies of dementia care enable dental professionals and carers to use more Individualized and non‐pharmacological approaches for dental treatment and preventive oral care provision. This paper reviews behavior management and communication strategies from the dental literature, and newer techniques and Interventions from dementia research and literature.
Prevalence of elevated blood pressure in students attending a college oral health program
Authors: Pyle Marsha A. , Lalumandier James A. , Sawyer Danny R.
Published: March 2008

Physical evaluation of dental patients prior to treatment can reveal signs and symptoms of diagnosed and undiagnosed disease. This cross‐sectional study examined the prevalence of elevated blood pressure readings In a group of college students attending an annual oral health program. The data were collected at the annual session on one day in three consecutive years. While the risk of hypertension Increases with age, unless the blood pressure Is recorded In all adult patients, a significant number of occult high blood pressure readings may go undetected. Since untreated hypertension can cause morbidity and mortality in some patients, the recording of the blood pressure for all adult patients is indicated. The results of this study revealed that 56 of 416 (13.4%) college students with recorded blood pressure values had elevated blood pressure readings within the ranges of mild to severe elevations. Male gender was associated with elevated readings (x2= 18.57, p < 0.001). Self‐reported high blood pressure was associated with age differences, current care by a physician, and medication use. Routine recording of blood pressure is essential for the comprehensive evaluation of adult dental patients, regardless of age. Inconsistent application of physical evaluation principles based on age and disease‐related abnormalities may exclude younger Individuals at risk for occult disease and associated morbidity. Screening for blood pressure elevation, even In younger adult groups not usually associated with hypertensive disease, can Identify individuals needing further medical evaluation.
Scleroderma: oral manifestations and treatment challenges
Authors: Fischer Dena J. , Patton Lauren L.
Published: March 2008

Scleroderma is a connective tissue disorder of excess collagen production characterized by intense fibrosis of the skin, with internal organ involvement. A wide range of oral sequelae‐including microstomia, oral mucosal/glngival fibrosis, xerostomia, and mandibular bone resorption‐complicates maintenance of oral health and dental treatment. The literature is reviewed, and two cases are presented.
Microwave disinfection of dentures for the treatment of oral candidiasis
Authors: Banting David W. , Hill Scott A.
Published: March 2008

Thirty‐four institutionalized subjects (mean age, 81 years) with a positive test for C. albicans pseudohyphae were randomly assigned to test (microwave) and control (soak) groups. All subjects received the same course of topical antifungal medication (Nystatin 300,000 IU lozenges 3x daily for 14 days). Subjects in the microwave treatment group had their maxillary denture scrubbed and then microwaved for one minute at 850 Watts. This procedure was repeated three times. For subjects receiving the standard denture soak treatment, the nursing staff was instructed to disinfect the maxillary dentures in 0.2% chlorhexidine digluconate solution overnight for 14 days, changing the solution every two days. Infestation of the tissue surface of the maxillary denture with C. albicans progressively took place over the three‐month period following treatment such that 8 (53%) of the microwaved dentures and 16 (84%) of the soaked dentures demonstrated pseudohyphae as determined by Gram stain. Infection of the soft tissues with the hyphal form of C. albicans also increased with time. After three months, one (8%) patient in the microwave group and 12 (63%) patients in the denture soak group demonstrated pseudohyphae on the cytological smears. Re‐infestation of the denture surface and infection of the adjacent soft tissue were delayed dramatically in patients whose dentures were microwaved compared with those whose dentures were disinfected by being soaked in a chlorhexidine solution. However, microwave treatment is not recommended for all dentures and should be used with caution.
Oral health status of adults from a California regional center for developmental disabilities
Authors: Lindemann Robert , Zaschel‐Grob Diana , Opp Sheri , Lewis Mary Ann , Lewis Charles
Published: March 2008

The oral health status and treatment needs of developmentally disabled adults (18 years and older) from a Los Angeles Regional Center who live in a variety of settings were measured as part of a comprehensive study to determine their overall health status. A dental assessment was performed on a sample of 325 persons which was similar in demographic composition to the entire population at the center. Approximately 80% of clients reported a personal dentist of record, and 73% brushed their own teeth. Edentulism was 9%. The mean number of retained teeth per person was 22. Subjectively, 15.7% of the sample was rated as having “good” overall dental health, 77.7%“fair,” and 6.6%“poor.” The major reasons rendering fair or poor assessments were oral hygiene, clinical periodontal disease, and dental caries. More females than males were assessed as having “good” overall dental health. The overall appearance of the teeth for a majority of the sample (76.5%) was rated as “same as most.” Persons who brushed their own teeth had fewer missing teeth than those who did not. Persons with a dentist of record had fewer decayed and more filled teeth. Persons living at home with family or friends had a significantly lower DMFT index than those living independently or in facilities. In general, these findings are encouraging; however, caution must be exercised, since efforts to improve the oral health status of this population require continued attention.
Dental experience and self‐perceived dental care needs of patients with angioedema
Authors: Lodi Giovanni , Sardella Andrea , Bez Cristina , Demarosi Federica , Cicardi Marco , Carrassi Antonio
Published: March 2008

The purpose of this study was to investigate the self‐perceived dental care needs and dental experiences of patients with angioedema. At the 1998 annual meeting of the Voluntary Association for the Fight, Study and Treatment of Hereditary Angioedema (“Associazione volontaria per la lotta, lo studio e la terapia dell'angioedema ereditario”), a self‐administered questionnaire was distributed to participants affected by hereditary or acquired angioedema. Fifty‐seven persons completed the questionnaire (37 females, 20 males; mean age, 39 ± 17 yrs; range, 5–76). The vast majority (91%) had the hereditary form of the disease. One‐third of the respondents had some problems in obtaining oral treatment, with one person having been refused care. About half of the group had experienced an acute attack following dental treatment. Preventive measures needed improvement in about two‐thirds of respondents. More than half (58%) of the group perceived a need for dental care. We conclude that persons with angioedema may experience difficulty in obtaining dental treatment, a common cause of acute attacks.
One‐year compliance and effects of amine and stannous fluoride on some salivary biochemical constituents and oral microbes in institutionalized elderly
Authors: Meurman Jukka H. , Kari Kirsti , Äikäs Anne , Kallio Pekka
Published: March 2008

Due to old age and poor general health, the institutionalized elderly have often not been used as research subjects for the investigation of oral health protocols. Because the number of elderly is increasing, they are an important target group for the development of oral hygiene aids. This trial was designed to investigate whether the institutionalized elderly could succesfully use an amine‐fluoride‐ and stannous‐fluoride‐containing mouthwash and toothpaste during a 12‐month period. A dental hygienist visited the subjects weekly, instructed them, and recorded their self‐reported compliance. Plaque and saliva samples were taken at three‐month intervals. Some salivary biochemical constituents reflecting mucosal integrity were analyzed. The carrier status of Actinobacillus actinomycetem comitans, Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia, and Prevotella nigrescens was studied by the polymerase chain‐reaction method, and acidogenic bacteria and yeasts by dip‐slide methods (Orion Diagnostica, Espoo, Finland). Of those 98 subjects originally included, 44 elderly (30 women and 14 men; mean age, 81.7 ± 5.9 yrs) completed the trial. Their observations were positive or very positive regarding the use of mouthwash and toothpaste. The number of residents with P. gingivalis decreased statistically significantly throughout the trial, while the carrier status of the other periodontal bacteria and mutans streptococci remained on the same level. The number of subjects with high counts (≥ 105 cfu/mL) of yeasts decreased during the study: 26.2% at baseline, 9.1% one year later, respectively. Biochemical analyses of salivary immunoglobulins showed no effect on IgA and IgM levels, but IgG reduced significantly. Albumin and other salivary protein concentrations were found to have a decreasing tendency. Thus, the overall effect of the protocol was beneficial with regard to subjects' oral health as measured in this study. The residents were pleased to participate, but the number of drop‐outs was very high, confirming the expected difficulties with the utilization of a group of frail elderly as research subjects.
The Oral Care Link Nurse: a facilitator and educator for maintaining oral health for patients at the Royal Hospital for Neuro‐disability
Authors: Charteris Pamela , Kinsella Tracey
Published: March 2008

This paper describes an ongoing oral health education project developed and implemented at the Royal Hospital for Neuro‐disability (RHN) by the Dental Team. The Oral Care Link Nurse (OCLN) project was developed to assist the dental team in the promotion of oral care within the hospital. The Dental Team identified that, in addition to providing knowledge and skills to perform effective oral care, it is important that nursing staff retain positive attitudes and behavior toward providing that care. In conjunction with the Quality Assurance department, oral care guidelines were introduced throughout the hospital, with further input being focused on the training of at least one unqualified nursing auxiliary from each ward. These became the OCLN who were trained by the Dental Team to assist with the promotion of good oral care practices on the wards and to aid communication regarding patient oral health within the multidisciplinary team. Formal evaluation, by clinical audit, indicated that the project continued to improve the overall standard of oral care throughout the hospital. To ensure that this high standard continues, it is essential that continued support, commitment, and enthusiasm be given from the dental team and that support is constant.
A method of eliminating streak artifacts from metallic dental restorations in CTs of head and neck cancer patients
Authors: Odium Olva
Published: March 2008

The purpose of this report was to develop a method to reduce streak artifacts derived from dental restorations in CT‐imaging of the head and neck region. We selected six patients who were being treated for head and neck cancer and who had metal‐derived artifacts on their CT that limited pre‐ or post‐surgical visualization. The metal restorations were removed and replaced with non‐metallic composite resin restorations. The CT was repeated as required on completion of the procedures. The streak artifacts were completely eliminated in patients in whom radiolucent composite materials were used. Patients have been followed for 6–26 months with no complications or breakdown of the restorations. The substitution of radiolucent for metallic restorations in special cases should be considered as a solution to CT dental artifact problems.
The Surgeon General's Report and special‐needs patients: a framework for action for children and their caregivers
Authors: Slavkin Harold C.
Published: March 2008

The Surgeon General's Report, Oral Health in America, is the first comprehensive assessment of oral, dental, and craniofacial health in the history of our nation. The intent of this first‐ever Report is to alert Americans to the full meaning of oral health and its importance to general health and well‐being across the lifespan. Moreover, the Report has been released at a time in human history of enormous changes as well as opportunities. The convergence of public health policies, “quality of life” expectations, global informatics, a new century of biotechnology, the completion of the Human Genome Project, changes in the management of health care, and the acknowledgment of enormous health disparities herald a call to action. These profound dynamics particularly affect children and their caregivers and the multitude of social, economic, and health issues associated with special patients and developmental disabilities. This paper will highlight the issues, provide recommendations, and suggest a call to action.
Today's dental student is training for tomorrow's elderly baby boomer
Authors: Lee Susan J. , Nelson Linda P. , Lin Jarshen , Tom Franson , Brown Richard S. , Jones Judith A.
Published: March 2008

We are constantly reminded of the exploding elderly population and the increasing demand to meet their needs. But do we fully understand and appreciate the impact that this fastest‐growing segment of the population will have upon our profession? Whether we realize it or not, today's dental student is training for tomorrow's elderly baby boomer. The baby boomer generation is 76 million strong, representing 19 years worth of births spanning from 1946–1964. That makes the oldest baby boomer 55 years old and the youngest 37 years old. What does this all mean? That from 2011–2030, the age group of 65 years of age and older will make up approximately 22% of the population, vastly changing our patient population, not to mention a significant increase in patient load. The future holds promise for not only a busy career, but also potentially a financially rewarding one as well. To some extent, we are all going to be geriatric clinicians. There is little doubt that there will be a great demand for services in restorative dentistry, prosthodontic dentistry, endodontics, periodontics, oral surgery, and perhaps orthodontics. As the baby boomers benefited from fluoride and sanitation, more people have been able to maintain their dentition and health into their older years. Dental students graduating today will be only beginning the prime of their careers as the baby boomers make their introduction in full force in the year 2011.
Attitudes of dentists, working in Riyadh, toward people with a sensory impairment
Authors: AlSarheed Maha , Bedi Raman , Hunt Nigel P.
Published: March 2008

This study was conducted to determine the attitudes of dentists, working in Riyadh, toward people with a sensory impairment (SI), according to the Scale of Attitude Towards Disabled Persons (SADP). The SADP scale was modified to focus solely upon sensory impairment. The modified scale was pre‐tested and then incorporated into a self‐administered questionnaire. This was then administered to 600 dentists (response rate, 73.7%) working in the city of Riyadh, Saudi Arabia. The modified scale showed itself to be reliable, with a Chronbach's coefficient α 0.616 and four‐factor analysis, which accounted for 38.5% of the variance. Ninety‐four percent of the dentists were generally positive toward SI in the society. There were, however, significant variations in attitudes, with a more positive score for dentists who had worked for 30 years or more (p± 0.005), were specialists (p < 0.005), received little or no undergraduate training in this subject (p < 0.05), and who received their undergraduate training in Europe/North America (p < 0.001). However, in a stepwise regression model, all these variables were significant except for the years of practice. The modified SADP showed dentists, working in Saudi Arabia, having a positive attitude toward people with SI.
Mobile and portable dentistry: alternative treatment services for the elderly
Authors: Lee Erryn EJ. , Thomas Carrie Ann
Published: March 2008

With the rapidly expanding geriatric population in the United States, the demand for geriatric dentistry is rising. With the financial, transportation, and motivational barriers the geriatric population faces, it can be difficult for them to seek dental treatment in a traditional setting. Mobile and portable dental units can be used as alternative methods to provide dental care to the geriatric population. Mobile and portable dental units offer advantages such as providing community outreach, increasing personal satisfaction for geriatric clients and dental professionals, and providing dental care to those who would otherwise not receive treatment due to some of the barriers. Although mobile and portable dental units are ideal for long‐term facilities, disadvantages do exist in implementing the use of these systems. These include the initial cost of implementing such a unit, limitation of treatment options, the number of clients seen in a day, and maintenance for the unit. Until more research can be done to find ways to improve the quality of dental care for the geriatric population, these units seem to be a reasonable alternative to the traditional approach to providing the elderly with the dental care they require.
Special considerations for treating dental patients exhibiting the “Post‐polio Syndrome”
Authors: Haberle C. Brent , Stewart Arthur Van , Staat Robert H. , Gettleman Lawrence , Sleamaker Thomas F.
Published: March 2008

A condition called “Post‐polio Syndrome” (PPS) is a special type of neuromuscular disturbance that affects some elderly patients who had polio myelitis either as children or as young adults. It has been reported that approximately 1,600,000 polio survivors are alive today. Most will seek dental care, and up to half of the survivors will present with some form of PPS. This paper describes polio, its characteristics, and the long‐term consideration of PPS, and discusses the special clinical implications related to this condition. Special emphasis is placed on physical impairments, breathing problems, and difficulty swallowing. Also included are sections discussing such topics as patient scheduling, office design and housekeeping, patient management, oral hygiene, diagnostic procedures, drug and pain management, and general health considerations.
Delphi study to identify core competencies in geriatric dentistry
Authors: Dolan Teresa A. , Lauer Daniel S.
Published: March 2008

The Delphi technique and an expert panel of general practitioners were used to identify geriatric dentistry core competencies—the necessary knowledge, skills, and values of new graduates to meet the oral health needs of older patients. Of the 74 dentists solicited, 50 dentists agreed to participate, and 40 dentists returned two questionnaires. Respondents were mostly male, white, in solo practice, with a mean age of 51.6 (SD 7.4) years. The first survey asked the participants to identify at least three topics in geriatric dentistry that they believed to be essential to a dental curriculum to graduate competent practitioners who can effectively treat older patients. The 45 unique responses were used in the second questionnaire that asked the practitioners to rate the importance of each topic for inclusion in a curriculum. For the 29 items describing skills, respondents indicated how often they performed the skill in their practices. Finally, the respondents considered all 45 items, and selected the five most crucial topics. Overall, participants achieved good consensus as to core knowledge, skills, and values needed to provide general dental care to older patients.
lnter‐rater reliability of an oral assessment guide for elderly patients residing in a rehabilitation ward
Authors: Andersson Pia , Hallberg Ingalill R. , Renvert Stefan
Published: March 2008

The aim of this study was to test the inter‐rater reliability of a revised oral assessment guide (ROAG) for patients residing in a geriatric rehabilitation ward. A consecutive sample of 140 patients was recruited for the study. Oral assessments were performed for 133 newly admitted patients by one registered nurse (RN) during a period of six months. A dental hygienist (DH) carried out 103 oral assessments during the same half‐year. For 66 patients, the RN and the DH performed independent assessments. There was an agreement between the RN and the DH in the majority of the independent assessments, except for tongue and teeth/dentures. The percentage agreement exceeded 80 percent. Inter‐rater agreement measured by Cohen's Kappa coefficient ranged from moderate to very good and percentage agreement had a range of 58 to 91 percent. The agreement was highest in assessment of voice and swallowing (91%). Assessments of teeth and dentures seemed to be most difficult for the RN to evaluate. ROAG was found to be a clinically useful assessment tool. Additional education and training is needed to improve the reliability of the oral assessments and should include continuous support from a dental hygienist as well as a pictorial manual on how to use the ROAG.
The effect of polyol‐combinant saliva stimulants on S. mutans levels in plaque and saliva of patients with mental retardation
Authors: Mäkinen Kauko K. , Isotupa Kauko P. , Kivilompolo Taina , Mäkinen Pirkko‐Liisa , Murtomaa Satu , Petäjä Juhani , Toivanen Jukka , Söderling Eva
Published: March 2008

The effect of chewable saliva‐stimulants on Streptococcus mutans levels in dental plaque and paraffin‐stimulated whole saliva among participants who were mentally disabled was investigated. Over 64‐days, 98 participants chewed one of four saliva‐stimulating tablets five times/day. The tablets contained one of the following: xylitol (X) or sorbitol (S), or 1:1 mixtures of xylitol and erythritol (XE) or sorbitol and erythritol (SE). Consumption of xylitol and sorbitol in Groups X and S was 5.4 grams/day/ subject, and of each polyol in Groups XE and SE, consumption was 2.7 g/day/subject. Interproximal dental plaque and stimulated whole saliva were sampled at baseline, at Day 36, and Day 64. There was a statistically significant reduction of S. mutans in plaque and saliva counts in Groups X and XE. The percentage of S. mutans in total streptococci increased significantly in dental plaque in Group S but decreased in the other groups. The results suggest that xylitol‐containing saliva stimulants may be more effective than sorbitol‐containing products in controlling some caries‐associated parameters in people who are mentally disabled. Also a relationship may exist between the pentitol‐type xylitol and S. mutans, and erythritol may exert a specific biochemical effect on this organism, although further studies are needed.
Evaluation of health questionnaires used in dentistry
Authors: Veltrini Vanessa Cristina , Capelozza Ana Lúcia Alvares , Damante José Humberto
Published: March 2008

An evaluation of a patient's general health before dental treatment is necessary to identify any systemic conditions, which may influence treatment and allow the dentist to evaluate risks, and reduce possible complications. Of the 860 dentists contacted by mail, 112 provided health questionnaires used in their offices. The authors evaluated the information in these questionnaires by describing content and rating them according to the importance of each topic. Questions were divided into categories and compared against a standard list of health‐related topics. The authors also assessed the questionnaires based on dentists' area of specialization and length of clinical experience. It was not possible to establish a statistically significant correlation between the quality of a health questionnaire and dentists' specialty or length of experience; however, the questionnaires used by periodontists were rated as more comprehensive than those adopted by pedodontists (p < 0. 05). Overall, the topics asked about most frequently were allergies, diabetes, and patient drug use.
Dental findings in 4‐, 14‐, and 25‐to 35‐year‐old Hong Kong residents with mental and physical disabilities
Authors: Donnell David O , Sheiham Aubrey , Wai Yeung Kim
Published: March 2008

This study was designed to collect baseline data on dental status of 4‐, 14‐ and 25‐ to 35‐year‐old Hong Kong residents who were mentally impaired and physically disabled. Participants were randomly selected from figures derived from a pilot survey, and dentally examined. The mean dmft/DMFT scores were 1.25, 2.27, and 5.23 (Missing component of 3.02), respectively. There was no correlation between caries experience and physical mobility, mental impairment, or sex in any age group. No visible plaque was found in 85.1% of 4 year olds (n = 309), 52.3% 14 year olds (n = 174), and 36.2% 25 to 35 year olds (n = 264). Visible plaque was recorded for 13.6% 4 year olds, 30.5% 14 year olds, and 47% 25 to 35 year olds. Abundant plaque was detected in 1.4% 4 year olds, 17.2% 14 year olds, and 15.8% 25 to 35 year olds. No calculus was observed in the 4 year olds, but 20.2% of 14 year olds had calculus as did 56.3% of the 25 to 35 year olds.
A comparison of perceived injection pain with and without anesthetic between elderly and young female subjects
Authors: Carr Michele P. , France Rebecca P. , Horton John E.
Published: March 2008

Several reports have indicated that the perception toward pain declines with age. However, since pain thresholds have been reported to be lower in females than in males, studies to detect pain perception may be more sensitive in females. In dental care, the injection of local anesthetics with a needle is used to abrogate subsequent pain from treatment. However, the anomaly of using one potentially painful procedure to prevent subsequent pain often hinders patients from seeking dental care. The purpose of this study was to evaluate the perception of pain from needle‐sticks with and without anesthetic between young and elderly female subjects. We compared the perception of pain stimulated by needle‐sticks without (NS) and with (NS‐I) 0.3 mL of local anesthetic injected into the oral mucosal tissues of a group of 20 young females (aged 19–24 yrs) and a group of 18 elderly females (aged 70–75 yrs). A Verbal Pain Scale (VPS; descriptors assigned, 0–4) and a Visual Analogue Scale (VAS; 0–10 cm) were used to measure pain intensity. Statistical analyses by AN OVA and Fisher's Exact Test were used where appropriate. The VPS and VAS scores for perception of pain in elderly females were lower than the scores from the younger subjects. No differences between Ns and Ns‐I in either age group were found. Study limitations included potential periodic hormonal imbalances in both groups of females as well as untested diminished cognitive function in elderly subjects. However, we conclude, with the noted cautions, that pain perception between the two groups was not significantly different.
Oral health in the elderly with non‐insulin‐dependent diabetes mellitus
Authors: Zielinski Marzenna B. , Fedele Denise , Forman Lloyd J. , Pomerantz Sherry C.
Published: March 2008

Non‐insulin‐dependent diabetes mellitus (NIDDM) is a common endocrine disease affecting the elderly in particular. Long‐term complications involve the vasculature; vision, renal, and neural function; and the periodontium. Knowledge about the oral health of the elderly and the effects of NIDDM is limited. The objective of this study was to compare the oral health of patients aged 60+ years, who have NIDDM, with patients who do not have NIDDM. To evaluate oral health, we recorded retention and condition of the teeth, periodontal health, and condition of the oral mucosa. We also assessed oral hygiene, smoking history, regularity of dental checkups, and medication use. The study group was selected from among patients who came to the ambulatory care clinic at University of Medicine and Dentistry, New Jersey, Center for Aging with a diagnosis of NIDDM. The control group, which did not have NIDDM, was selected from among the same patient group and was matched for age and gender. Patients with severe dementia, those having fewer than 10 teeth or those who were in need of antibiotic prophylaxis were excluded from the study. Patients underwent a short interview and a clinical evaluation. Our study involved 32 elderly adults with NIDDM and 40 elderly adults who did not have NIDDM. Both groups had similar oral hygiene levels and regularity of professional dental care. In addition, the plasma glucose levels among the study group were well controlled. This study did not show statistically significant differences in oral health parameters between participants with diabetes and those in a control group.
The effect of a disinfectant/ coolant irrigant on microbes isolated from dental unit water lines
Authors: Epstein Joel B. , Dawson J.R. , Buivids Ilze A. , Wong Bea , Le Nhu D.
Published: March 2008

The purpose of this study was to assess water samples from a hospital dental clinic to determine whether a disinfectant/coolant irrigant containing chlorhexidine (Lines,tm Micrylium Laborator‐ies) affects the presence of microbial organisms in dental unit waterlines. Water samples from three hospital dental operatories were collected at baseline and after overnight treatment with a disinfectant‐containing irrigant followed by sterile water irrigation. Saliva of treated patients and sterile water rinse specimens were collected from the waterlines of these operatories for three consecutive days, then weekly for eight weeks after treatment. Specimens were cultured to identify total heterotrophic plate counts as well as presence of Pseudomonas aeruginosa and Candida species. Baseline organism counts varied from 103 to 105 colony‐forming units per milliliter. After treatment, no organisms were detected in waterline discharge. Decontamination of dental unit waterlines is possible using a disinfectant/irrigant followed by sterile water irrigation. The potential for contamination of the lines from patients' saliva may have been reduced due to use of anti‐retraction valves and the disinfectant/sterile water irrigation, as conducted in this study.
General and oral characteristics in Rett syndrome
Authors: Magalhães Marina H. C. G. , Kawamura Juliana Y. , Araújo Luiz C. A.
Published: March 2008

Rett syndrome (RS) is a neurodegenerative disorder characterized by developmental arrest of parts of the brain. It is an X chromosome‐linked condition which affects females almost exclusively. Recent reports have been generated concerning the multidisciplinary management of individuals exhibiting Rett syndrome. The aim of the present report was to provide an update on the oral manifestations of the disorder. We evaluated the general and oral characteristics of RS in 13 female patients. The most frequent manifestations were stereotyped hand movements and bruxism. The treatment we carried out included the use of biteplanes and acupuncture.
Development of a systematic oral care program for frail elderly persons
Authors: Sumi Yasunori , Nakamura Yasunori , Michiwaki Yukihiro
Published: March 2008

The purpose of this study was to develop, implement and evaluate a systematic oral care program for community‐dwelling‐dependent or institutionalized elderly adults. The study group consisted of 20 dependent elderly adults of which 15 were living in the community and five were in a nursing home. After eight weeks of systematic oral care, the plaque and gingival indices were scored and compared with baseline measurements. Also at the end of the study, caregivers completed a questionnaire that assessed their perspective on the advantages, disadvantages, burden and fatigue in providing the systematic oral care program. The results of this study demonstrate that a systematic oral care program reduced plaque and gingival indices for the subjects as well as reducing the caregivers' burden and fatigue in providing daily oral care.
A survey assessing the impact of a hosPital‐based General Practice Residency Program on dentists and dents I practice
Authors: Tejani Asif , Epstein Joel B. , Gibson Gary , Le Nhu
Published: March 2008

The purpose of this survey was to evaluate the outcome of completing a general practice hospital‐based dental residency program. A survey was mailed to all individuals who had completed a general practice residency program (resident) between 1980 and 1996 and to dentists who had not completed a hospital program (undergraduate). The responses were evaluated by Fisher's exact test. Seventy‐four percent of the resident group and 68% from the undergraduate sample group returned the questionnaire. Approximately half the residents were in general dental practice. Twenty‐six percent were involved in specialty dentistry, 7% in hospital dentistry, and 20% in teaching at a dental school. Of the undergraduate dentists, more than three‐quarters were in general practice, 5% were entered into specialty programs, 1% were involved in hospital dentistry, and 15% taught at a dental school. Half of the residents held staff privileges in a hospital or ambulatory setting, compared with 16% of undergraduates. Forty‐three percent of the residents provided consultation in a hospital or long‐term‐care facility, compared with 21% of the undergraduates. Practice characteristics suggested enhanced clinical skills in oral surgery, periodontics, emergency dental care, and oral medicine/pathology in those completing the hospital program. The findings of this study confirm that the outcome of completing a hospital program is a change in practice profile, site of practice, services for complex patients, and continuing involvement in teaching.
Dental status and satisfaction with oral function in a sample of community‐dwelling elderly people in Japan
Authors: Ikebe Kazunori , Nokubi Takashi , Ettinger Ronald L. , Namba Hidekazu , Tanioka Nozomu , Iwase Kateuya , Ono Takahiro
Published: March 2008

The purpose of this study was to determine the influence of dental status on oral function and satisfaction among a group of independently living elderly persons in an urban area of Japan. The study sample consisted of participants of the Senior Citizens' College from 1995 to 1999. Their dental status and oral satisfaction were measured by a questionnaire. The number of usable questionnaires was 3967, or 80.8% of the total sample. The mean age of the subjects was 66.5 ± 4.3 years, and 52.2% were male. Twenty‐nine percent of them had a natural dentition, and 7.0% were edentulous in both jaws. The prevalence of edentulism in the study sample was significantly lower (p<0.01) than that for the national survey. Overall, 66.4% of the subjects were satisfied with their ability to chew, 56.2% with the appearance of their teeth, 63.1% with their ability to speak clearly, and 76.5% with their ability to taste food. For complete‐denture wearers, the greatest dissatisfaction was with speech (28.5%); however, for the RPD wearers, it was with chewing ability (21.7%). Sixty‐one percent of complete‐denture wearers reported that they were satisfied with their chewing ability, but only 11% of them could eat all three of the evaluated foods without difficulty. The multiple stepwise logistic regression analyses showed that both dental status and self‐assessed general health had a significant association with dissatisfaction with all four oral functions and self‐assessed impairment of chewing ability. There were significant associations between the elderly subjects' dental status and oral function.
Smith‐Lemli‐Opitz syndrome: a review, case report and dental implications
Authors: Muzzin Kathleen B. , Harper Lisa F.
Published: March 2008

Smith‐Lemli‐Opitz syndrome (SLOS) is an autosomal recessive developmental disorder characterized by multiple congenital malformations, dysmorphic craniofacial features, and mental impairment. SLOS is caused by a deficiency of the enzyme 7‐dehydrocholesterol Δ7 reductase which converts 7‐dehyrocholesterol to cholesterol. This error results in elevated serum levels of 7‐dehydrocholesterol and decreased levels of serum cholesterol. This article describes the clinical features and medical treatment of SLOS. A case report is included, with recommended guidelines for providing safe and comprehensive dental care for individuals with SLOS.
Oral manifestations of renal osteodystrophy: case report and review of the literature
Authors: Antonelli John R. , Hottei Timothy L.
Published: March 2008

Renal osteodystrophy, characterized by uneven bone growth and demineralization, is described. Oral manifestations of the disorder are described, and the value of dental radiographs in early detection of renal osteodystrophy is noted. A case report of a patient with severe oral complications, which resulted from long‐standing end‐stage renal disease and secondary hyperparathyroidism, is presented. Giant cell lesions of hyperparathyroidism, referred to as brown tumors (which may be associated with pain and swelling), are the key clinical oral manifestations and are the most dramatic dental radiographic finding in patients with renal osteodystrophy. Bone changes may include loss of lamina dura, giant cell lesions of hyperparathyroidism, and bone demineralization. The dentist's role in detection, assessment, and treatment is stressed.
Dental status of women with gestational diabetes on a Greek island
Authors: Mittas Efthymios , Erevnidou Katerina , Kefalogiannis Nikos , Vlachonikolis Loannis , Helidonis Emmanuel
Published: March 2008

This study evaluated the dental tissues in pregnant women with gestational diabetes. The study group consisted of 39 pregnant women with gestational diabetes and the control group included 62 pregnant women without the disorder. The plaque index, decayed, missing and filled teeth (DMF index) and the relationship of these measures to a series of variables (socio‐demographic, oral hygiene and diet) were evaluated. Clinical evaluation was performed during 34–36 weeks of pregnancy. The plaque index and DMF were increased among women with gestational diabetes compared with control patients but the differences were not significant (p= 0.167 and p= 0.436, respectively). The DMF increased with respect to age (p < 0.001) and frequency of snacks before pregnancy (p= 0.058). The DMF and plaque index decreased (p= 0.031 and p= 0.004, respectively) among women with a higher level of education. This study detected no significant differences in dental status between pregnant women with gestational diabetes and pregnant women without the disorder.
The prevalence of periodontal disease measures in elderly adults, aged 79 and older
Authors: Levy Steven M. , Warren John J. , Chowdhury Jyoti , DeBus Becky , Watkins Cathy A. , Cowen Howard J. , Kirchner H. Lester , Hand Jed S.
Published: March 2008

From 1996‐98, we examined 449 adults (mean age 85 years) from the 1982 Iowa 65+ Rural Health Study, in the field using headlight, mirror, and periodontal probe. Ninety‐six of the 342 dentate subjects were excluded from the follow‐up examination due to contraindications to probing, and 10 could not be assessed due to refusals, fatigue or other reasons. For all remaining subjects (n=236), attachment loss, defined as recession plus probing depth, was determined at four sites per tooth. Ninety‐one percent of the subjects had at least one site with 4+ mm of attachment loss, 45% had one or more sites with attachment loss of 6+ mm, and 15% had 8+ mm of attachment loss. Moderate periodontal disease is prevalent among very old dentate adults while advanced periodontal disease is much less prevalent, suggesting that most periodontal treatment needed by this age group can be provided by general dentists and dental hygienists rather than periodontists.
Unprovoked periodontal hemorrhage, life‐threatening anemia and idiopathic thrombocytopenia purpura: an unusual case report
Authors: Owais Zaidoon , Dane John , Cumming Christopher G.
Published: March 2008

Spontaneous gingival bleeding can occasionally be the only sign of systemic bleeding problems. The diagnosis and management of such conditions may challenge the skills of both the hematologist and the oral physician. We present this patient because of several confusing phenomena that were encountered: unprovoked periodontal hemorrhage, which endangered the life of an otherwise asymptomatic young adult male; (especially unusual was a platelet count above 150,000 cells per microliter of blood), and presentation of idiopathic thrombocytopenia purpura through spontaneous periodontal hemorrhage alone. This case history also highlights the fact that medical intervention to correct the underlying aberration of hemostasis is necessary for local dental measures to successfully stop bleeding. In contrast with the definition of thrombocytopenia, the “within normal” count of platelets should not exclude the possibility of idiopathic thrombocytopenia purpura; a fact that, if ignored, can make the diagnosis and management of bleeding troublesome.
BOOK REVIEW
Authors: Sharp Helen M.
Published: March 2008

Book reviewed in this article:

Dental Ethics at Chairside: Professional Principles and Practical Applications (2nd Edition) David T. Ozar and David J. Sokol Georgetown
Periodontal disease and mortality in an aged population
Authors: Ajwani Shilpi , Mattila Kimmo J. , Tilvis Reijo S. , Ainamo Anja
Published: March 2008

We investigated the relationship between periodontitis and mortality in home‐dwelling individuals aged (75+ years), considering potential confounders including C‐reactive protein levels. This study involved 364 individuals, originally part of the Helsinki Ageing Study cohort, who underwent medical and dental examinations in 1990 and were followed for five years. After five years, 52 of the 175 dentate subjects had died. Using univariate analysis, the association between baseline periodontitis and mortality was of borderline significance. After controlling for the common risk factors, periodontitis more than doubled the risk of cardiovascular disease‐related mortality (HR 2.28, CI 1.03–5.05). The increase in total mortality was, however, not statistically significant (HR 1.43, CI 0.81‐2.50). Subjects who were edentulous had higher mortality than those who were dentate without periodontitis, but the difference was not statistically significant. A baseline CRP level above 3 mg/l was associated with high mortality; but this effect was significant only among individuals with periodontitis. These results suggest that periodontitis influences the pathogenesis and outcome of cardiovascular disease, especially in individuals who also have evidence of a systemic inflammatory reaction.
General anesthesia for developmentally disabled dental care patients: a comparison of reinforced laryngeal mask airway and endotracheal intubation anesthesia
Authors: Hung Wei‐Te , Hsu Shih‐Che , Kao Chai‐Tze
Published: March 2008

Providing dental care for developmentally disabled patients who require general anesthesia is challenging for both dentists and anesthesiologists. This study aimed to compare the efficacy of two anesthetic methods for dental care. The researchers retrospectively analyzed morbidity data following anesthesia using either a reinforced laryngeal mask airway (LMA) or endotracheal intubation anesthesia for a two‐year time period. The subjects were developmentally disabled patients receiving dental care. Statistical analyses were by unpaired student t‐tests and chisquare tests. Patients were who anesthetized with a reinforced laryngeal mask airway had a significantly shorter recovery period and lower postanesthetic complication rates when compared to patients undergoing endotracheal intubation anesthesia. Although hypoxemia (SPO2 90%) during dental care occurred more frequently when using the reinforced laryngeal mask airway, the difference was not significant. Nausea and vomiting were the major complications in the postanesthetic care unit and after discharge. When complication rates were compared in the two patient groups, nausea and vomiting were significantly higher during postanesthetic care and after discharge in the intubated group. In conclusion, reinforced laryngeal mask airway provides general anesthesia with less risk of side effects for developmentally disabled patients undergoing dental care.