bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibition of bovine α‐glucosidase by Castanospermum australe and its effect on the biochemical identification of heterozygotes for generalised glycogenosis type II (Pompe's disease) in cattle
Authors: REICHMANN K G , TWIST J O , McKENZIE R A , ROWAN K J
Published: March 2008

SUMMARY: All 18 2‐year‐old Brahman bulls grazing in a paddock containing Castanospermum australe trees were diagnosed as heterozygotes for Pompe's disease by measurement of mononuclear cell a‐glucosidase activity. However, removal of the bulls to a paddock free of C. australe and retesting 2 months later indicated that 15 were homozygous normal.

An in vitro assay demonstrated that a crude aqueous extract of seeds from these C. australe trees contained a potent inhibitor of mononuclear cell a‐glucosidase.

Two Hereford steers were dosed with 0.6 g C. australe seed/kg bodyweight for 6 days. The α–glucosidase activity in blood mononuclear cells declined to 5% of normal within 48 h of commencement of dosing.

It was therefore assumed that the bulls had consumed C. australe seeds. A means of differentiating true heterozygotes from animals consuming the toxic seed, using the ratio of plasma α‐glucosidase activity at pH 5.6 to that at pH 3.7, is proposed. Aust Vet J 64: 274–276
COMMENT
Authors: ADAMS BRIAN S.
Published: March 2008

Dr. Brian S. Adams is a recent graduate of the University of California, San Francisco, School of Dentistry, and a fellow in geriatric dentistry of the division of general dentistry. He was asked to critique Dr. Foley's perceptive, thoughtful paper.
Design of a postdoctoral training program in the treatment of children with congenital orofacial clefts
Authors: RANALLI DENNIS N.
Published: March 2008

The increasing treatment responsibilities of the practicing pedodontist have placed new demands on postdoctoral training programs. To meet one of these challenges, the department of pedodontics at the University of Pittsburgh School of Dental Medicine, with the cooperation of Cleft Palate Center, has incorporated a program in the treatment of children with congenital orofacial clefts into its postdoctoral pedodontic training. This paper describes the structure of the program and discusses the integration of the didactic and clinical phases.
Treatment of a traumatic ulcer on a handicapped individual: a case report
Authors: DAWSON LOWELL R. , HOFFMAN JEFFREY A.
Published: March 2008

Ulcerations of oral mucosa caused by trauma or irritation are not uncommon. Irritation of tissues by fractured teeth or rough restorations often results in ulcerations. Additionally, oral habits have been reported to produce untoward tissue response.1 Fortunately, most traumatic oral ulcerations respond rapidly and favorably to removal of the source of irritation. In the case of handicapped individuals, removal of the causative factor may be difficult because of the inability to communicate and cooperate. This is particularly true when the oral lesion is caused by habitual behavior. Some habits may have serious sequela. Phelan and others2 reported on a deaf‐mute child who had the habit of thumbsucking. Blood loss from an ulceration precipitated by this habit resulted in hospitali‐zation and fluid replacement.

The case reported in this paper identifies an unusual problem found in a 9‐year‐old child with excessive lip sucking that perpetuated a large lip ulceration.
Management of oral self‐mutilation in neurologically impaired children
Authors: FENTON SANFORD J.
Published: March 2008

The function and fabrication of a removable acrylic dental appliance useful in the hospital management of neurologically impaired patients who are unconsciously traumatizing their oral soft tissues has been described. This acrylic appliance is readily fabricated on a plas ter cast obtained from an alginate impression of the maxillary arch.

The basic appliance design is a modification of the standard maxillary orthodontic retainer. The modification involves the placement of additional acrylic resin to cover the occlusal and facial surfaces of all the maxillary teeth. This configuration prevents the buccal mucosa and lips from becoming trapped between the maxillary and mandibular teeth. Extra acrylic resin is placed bilaterally over the occlusal surface of the last tooth in the arch. The additional acrylic resin opens the bite, thereby preventing self‐inflicted trauma to the tongue. Primary retention of the dental appliance is accomplished via a labial bow and strategically placed ball clasps. The appliance is maintained in the patient's mouth until the episodes of oral muscular activity are controlled.
Managing a dental program within a rapidly changing industry
Authors: OSTENBERG PAUL VAN , DELANEY DONALD F. , SALLEY JOHN J.
Published: March 2008

Dr. Van Ostenberg is associate director of the hospital‐sponsored ambulatory dental services program sponsored by The Robert Wood Johnson Foundation and administered by Virginia Commonwealth University. Mr. DeLaney is research assistant to the program. Dr. Salley is program director; vice president for research; and dean of Graduate Studies, Virginia Commonwealth University. Requests for reprints should be sent to Dr. Van Ostenberg, Virginia Commonwealth University, Box 148, MCV Station, 1000 E Marshall St, Richmond, Va 23298.

The aim of this paper has been to present some of the more standard hospital accounting terms and concepts, to illustrate how they can be used in profiling a dental department, and to discuss seven exercises that reveal the depth of understanding department heads pf the future will have to command.

Times have changed and will continue to change: there is no way to alter that fact. The management perspective of a dental department can not be through a historical “haz”xswhich clouds the realities of tomorrow. The changes necessary t o meet those realities must be clearly visualized. There are two choices of ways to manage the necessary change. One way is imitative, with a wait‐and‐see attitude and at the last moment, copying what is thought to work; the other way is to be innovative‐defining, recombining, managing, and projecting resources to meet the demands of a complex and turbulent environment. There really is not a choice between these ways if hospital dentistry is to remain vital through the 1980s.
An index for assessment of oral health in the edentulous population
Authors: BLOEM THOMAS J. , RAZZOOG MICHAEL E.
Published: March 2008

Success or failure of prosthodontic treatment, in terms of comfort and function, is linked to tissue health. To date, no baseline indication of inflammatory status hzs been available to objectively evaluate preprosthetic tissue preparation. The Prosthodontic Tissue Index (PTI) was developed in a manner similar to periodontal indexes, to provide objective clinical evaluation of basal supporting tissueS. At the University of Michigan, 150 patients who were edentulous in one or both arches were examined and asked a series of questions relating to their prosthetic history. The inflammatory status of basal seat tissues was scored according t o defined observable inflammatory changes.

Inflammation status was charted on a grid delineated by major areas of denture support for each arch. In 97% of patients examined, inflammatory changes requiring some degree of preprosthetic management were found. Tissue abnormalities other than inflammation that required specific management were noted in 62% of the patientS. Although nearly all patients registered problems relative t o their prostheses, most were not aware of the extent of their tis‐sue changes.

Dental care should be concerned with the preservation of health and function in the middle and older ageS. Principal epidemiological characteristics of the edentulous population showed that: most patients with complete dentures have pathologic tissue changes that require treatment; and tissue changes have little relation t o a patient's perception of denture success or personal oral health status.
Psychiatric implications in the treatment of the geriatric dental patient
Authors: Levenson Alvin J.
Published: March 2008

These papers were presented at the First Interdisciplinary Conference on Gerontology, held on May 21–22, 1982, in Houston.
Geriatric dentistry: a new speciality or a set of special skills for the general practitioner?
Authors: CARLSON MARILYN R.
Published: March 2008

This paper won second place in the first annual Arthur Elfenbaum Essay Contest, sponsored by the American Society for Geriatric Dentistry.
A survey of hospital ambulatory dental programs in Massachusetts
Authors: Siegal Mark D. , Allukian Myron
Published: March 2008

A statewide mail survey of hospital ambulatory dental programs in Massachusetts was conducted for FY 80.Of the state's 123 short‐stay hospitals, 105 reported ambulatory dental visits but only 21 had dental clinics. The 141,410 ambulatory dental visits at these hospitals with dental clinics represented 79% of all dental patient visits in hospitals and approximately l.2% of visits in all settings statewide. Most of these hospitals were in the Greater Boston area and all but three hospital dental clinics provided general dental care. Unfortunately, responses were usually based on estimates rather than actual data.
Management of dentin dysplasia and facial disharmony
Authors: Chamberlain Barbara B. , Hayward J. R.
Published: March 2008

Patients with unusual congenital dental anomalies are often referred to the hospital dentistry team for evaluation and treatment recommendations. Communication between oral surgeon, orthodontist, pedodontist, periodontist, and prosthodontist after a combined single examination may simplify the treatment alternatives and save the patient the frustration and confusion of seeking treatment from a number of specialists. When necessary, com‐ bined treatment can be efficiently coordinated at the original consultation appointment. The recommendations of each specialist are then recorded together in the hospital record. This' simplifies follow‐up treatment and allows for easy transfer of information should the patient move to another location. In complex treat‐ ment cases, the pooling of dental specialist re‐ sources may permit conservatism and answer the patient's needs with lifetime perspectives.
An instrument to assess dental students' attitudes toward the handicapped
Authors: Lee Mickey M. , Sonis Andrew L.
Published: March 2008

1associate professor, office of instructional services
A survey of hospital ambulatory dental programs in Massachusetts Part 1: an overview
Authors: Siegal Mark D. , Allukian Myron
Published: March 2008

A mail survey of ambulatory dental programs at all 123 short‐stay hospitals in Massachusetts was conducted for the 1980 fiscal year. The major findings were as follows.

Of the 122 responding hospitals, 105 (86%) reported having ambulatory dental visits, 2 1 (20%) of which had dental clinics. The remaining 84 (80%) hospitals provided dental care in surgical day care units, emergency rooms, or both, as did most hospitals with dental clinics. The 177,93 1 reported hospital ambulatory dental visits accounted for approximately 1.6% ambulatory dental visits in all settings, statewide. Approximately 69% of hospital ambulatory dental visits statewide took place in the 21 dental clinics, 21% in surgical day care units, and 10% in emergency rooms. Approxi‐ mately 66% of dental clinic visits were for gen‐ era1 dental care and represented less than 1% of ambulatory dental visits in all settings, statewide.

Most hospitals with dental clinics were con‐ centrated in major urban centers. Hospitals in the Greater Boston area accounted for 75% of all ambulatory dental visits and 87% of dental clinic visits, statewide.

To properly assess the hospital's role as a dental care resource to a community, general dental care services in community hospital dental clinics should be distinguished from other types of hospital dental care. Our study accomplished this by categorizing ambulatory dental visits according to the types of services provided, the types of hospitals at which they were provided, and the hospital settings in which they were provided.

The data suggest that the significance of hospital ambulatory dental programs is not in the amount of dental care that they provide statewide but the types of services offered and their importance to dentally underserved inner city communities.
Oral health care for the aged veteran
Authors: Lloyd Patrick M.
Published: March 2008

Oral health care of the aged veteran is concerned with recognizing its influence on the patient's total health status. This is effectively accomplished by the use of the team approach to address the patient's unique and diversified needs. Developing an appreciation for the services offered by each member of the health care team ensures a comprehensive assessment, a well‐tolerated plan of treatment, and a favorable prognosis.
Diabetes mellitus: medical and dental considerations
Authors: ROTHWELL BRUCE R. , RICHARD ELDON L.
Published: March 2008

Diabetes mellitus is challenging to the clinician, researcher, and patient because of its complex pathogenesis, questionable cause, and often frustrating course of treatment. The two relatively distinct forms, adult‐onset and juvenile‐onset diabetes, can be considered separately because their cause, clinical course, and treatment is often radically different. Adult‐onset diabetes is most commonly seen in middle‐aged, overweight individuals and is generally easily managed by diet control and weight reduction. The chronic complications are rare, and patients experience a normal lifespan. Juvenile‐onset diabetes affects younger individuals and is associated with the classic triad of diabetes: polydipsia, polyuria, and polyphagia. Its course is more acute and associated with greater swings in blood glucose. Although insulin is the treatment of choice, maintenance of normoglycemia is often difficult. The chronic complications of diabetic neuropathologic, retinopathologic, and angiopathologic conditions, relatively constant features of juvenile‐onset diabetes, are somewhat independent of insulin control. The fasting blood glucose and oral glucose tolerance tests are used to diagnose diabetes, and the level of urine sugar is used as a measure of control.

Specific oral problems have been noted with higher frequency in the diabetic population. The caries pattern seen in diabetics is related to xerostomia and results in rapidly advancing decay, affecting smooth and interdental surfaces. Periodontal disease is more common in diabetics, especially poorly controlled insulin‐dependent diabetics. These patients are more prone to the development of acute periodontal problems such as abscesses and the chronic, often rapidly progressive, destruction of the periodontal support apparatus. Dental treatment is directed toward the prevention of caries and periodontal disease through periodic dental care, daily use of topical fluoride, and meticulous oral hygiene.
Management of self‐inflicted oral trauma: report of case
Authors: FABIANO JUDE A. , THINES TERRENCE J. , MARGARONE JOSEPH E.
Published: March 2008

A simple and effective appliance was fabricated to prevent self‐inflicted oral trauma in a patient with MS. Its advantages over more complex appliances are its mild effects on phonetics, eating patterns, and esthetics.
Improved access to nonambulatory dental patients using extension tubing
Authors: ZOCCHI MARIO , JONES JUDITH A. , NIESSEN LINDA C. , PAIGE STEPHEN
Published: March 2008

In the absence of mobile equipment, access to dental services for nonambulatory people can be aided. A method of construction is described for both high‐speed, air‐water and high velocity evacuation. The extension device requires minimal maintenance and has not needed repairs. The extension devices also improved comfort of the dental staff.
Fractured condyle artifact
Authors: FLAXMAN NORMAN A.
Published: March 2008

A patient treated for routine dental care had a medical history of temporoman‐dibular joint trauma. A pretreatment panoramic radiograph showed evidence of a fractured condyle; however, further radiographic testing showed no fracture and that the original fracture seen was an artifact. This artifact may have been caused by superimposition of ear cartilage over the mandibular condyle during radiography.

By coincidence, the patient was injured in an area that fit the original radiographic observation of a condylar fracture. However, it would be rare to find a condyle with the distal portion fractured at the angle indicated on the radiograph, and unusual for such a condition to remain undetected for 9 years. Remodeling of the bone would have been expected, and this would affect the appearance of the supposed fracture.
Gender differences in suprathreshold taste scaling ability in an older population
Authors: WEISFUSE DEBORAH , CATALANOTTO FRANK A. , KAMEN SAUL
Published: March 2008

Taste sensitivity was evaluated by suprathreshold scaling of six concentrations each of sodium chloride, sucrose, citric acid, and quinine hydrochloride. Magnitude estimation was used as the method of scaling. The study group was composed of 22 males and 19 females were either patients (institutionalized) or staff members of the Jewish Institute for Geriatric Care.

Data from each patient were used to compute individual slopes and Y‐intercepts of the log to log transformations for each solution sequence. The mean age of the persons who were institutionalized was significantly higher than that of the staff members. In addition, the mean age of the females was 10 years older than that of the males. The older adult males seemed to have impaired taste function that resulted in significant decreases in total perceived intensity of several taste solutions. No significant differences were shown in taste ability between the relatively healthy younger staff member subjects and the older, more infirm, institutionalized subjects.
Caries experience and level of restorative care among a handicapped population in Israel
Authors: MANN JONATHAN , CARLIN YAEL , CALL RICHARD L. , LAVIE GABRIEL , WOLNERMAN JOSEPH S. , GARFUNKEL ADI A.
Published: March 2008

A total of 43 patients, aged 3 to 22. who have handicapping conditions were examined to determine caries level, level of restorative care, and oral hygiene. A strong correlation was found between caries and oral hygiene levels. No significant differences were found in caries levels between males and females, and low percentage of dental treatment received was found in the examined population.

More emphasis should be put into the undergraduate curriculum on the treatment of handicapped populations, and that additional funding should be allocated to provide basic preventive care.
The effect of dental education and dental treatment on the dental status of a handicapped population: a longitudinal study
Authors: MANN JONATHAN , WOLNERMAN JOSEPH S. , LAVIE GABRIEL , CARLIN YAEL , MEIR SHIRLEY , GARFUNKEL ADI A.
Published: March 2008

Thirty‐nine patients, aged 3 to 22, who have handicapping conditions were examined twice in a range of 1 1/2 years to determine oral hygiene level, periodontal treatment needs, and level of caries. During this period, each patient was given periodontal treatment, including scaling, caries treatment, and oral health education, which also was given to hospital staff members. Findings showed a slight increase in the DMF rate, a minor improvement in oral hygiene, and a significant reduction in periodontal treatment needs. The results showed that without cooperation of the staff members, a dental education program would not succeed in this setting.
Dental treatment in the child with acute leukemia: report of case
Authors: GOODMAN ELIZABETH D. , KAUFMAN ELIEZER , GALILI DAN
Published: March 2008

Dental treatment for the child with active leukemia may be considered a complex of dental, hematological, and behavior management factors that must be coordinated to provide a vital service to a vulnerable group of patients. This paper outlines the treatment implemented for such a patient.
Stimulated saliva and microbial growth in older adults
Authors: LASSILA VEIJO P.
Published: March 2008

The flow rate, pH, buffering capacity, and viscosity of stimulated whole saliva of 54 noninstitutionalized older people were determined. The subjects all wore removable dentures, complete or partial, and were 73 years old and older. The salivary flow rate of the men was found to be higher than that of the women, and particularly low buffering capacity values were observed in the men. Seventy percent of this population used one or several medications. Those subjects using medications had a decreased flow rate and an increased salivary viscosity. The occurrence of high Lactobacillus and yeast counts was connected with the low flow rate and the high viscosity of saliva.
Silver‐Russell syndrome: a report of case
Authors: BULLEN CARL B. , RUBENSTEIN LORETTA K.
Published: March 2008

A case of an 8‐year‐old female with Silver‐Russell syndrome is presented. The clinical and radiographic manifestations of this syndrome are reviewed. The patient was treated for severely carious teeth and loss of space in the posterior quadrants. The treatment was complicated by the patient's small mouth and crowded dentition. Early eruption of the permanent teeth was noted and thought to be related to the syndrome but the literature did not confirm or contradict this possible theory. Treatment was aimed at restoring the remaining restorable teeth, preventing further space loss, and improving oral hygiene.
Oral rehabilitation of the burn patient with severe microstomia: a report of case
Authors: DAHLBERG ROBERT C. , MOLINE DAVID O.
Published: March 2008

Dental treatment of patients after second and third degree facial burns with subsequent oral constricture can present challenging treatment considerations. A case is presented involving complete oral rehabilitation and a review of the literature on management of second and third degree burns.
Physical abuse of a suspected emotionally disturbed child: a report of case
Authors: SARAVIA MARIO E.
Published: March 2008

A 5‐year, 6‐month old black male came to the dental office for routine restorative dentistry. There were no orofacial signs of physical abuse. Because of the patient's previous uncontrollable behavior, a sedative premedication was administered intramuscularly into the left buttock. The injection site revealed several bruises. Further examination of lower back, buttocks, and legs showed a multitude of bruises. Dentists and auxiliary personnel should not limit their examination to the orofacial complex when administering medications to other parts of the body.
The hospital‐sponsored ambulatory dental services program, part I: an evaluation of patient access
Authors: KOCH ALMA L. , SCHOEN MAX H. , MARCUS MARVIN
Published: March 2008

This article describes patient access to the Hospital‐Sponsored Ambulatory Dental Services Program (HSADSP), a 4‐year effort initiated in 1979 by the Robert Wood Johnson Foundation. A major goal of the program was to provide comprehensive general dental care to underserved populations. Independent samples of 2,600 patients each, in 13 of the hospitals (200 patients per institution), were assessed at the beginning and end of the program to ascertain changes in dental care resulting from the expansion of the dental facilities and the support of general practice residents.

According to data compiled by the evaluation team, patient volume increased by more than 15% from the first year of the program (baseline sample) to the period preceding the fourth year (final sample). Although the proportion of underserved patients accessing the program was high in both periods, the percentages of “special” patients, minority members, and the poor all decreased slightly during the study. At the same time, the proportion of episodic patients increased by 15% and the number of patients with private dental insurance increased at a lower rate than the national average. Counter to prior expectations, only about 20% to 35% of new patients accessing the dental clinics used the sponsoring hospital as a source of medical care, either inpatient or outpatient.

The gains made in patient access to the HSADSP were lower than anticipated. There is little evidence that many of these hospital‐based general practices and residency programs would be able to sustain economic viability without innovative financing techniques or direct subsidy.
Oral health and the patient with dementia
Authors: Niessen Linda C. , Jones Judith A.
Published: March 2008

SUMMARY

Approximately 1.5 million people in the US have Alzheimer's disease. As the older population increases, the number of persons with Alzheimer's disease will also increase. The goal of the dental care provider, for these persons, is to maintain oral health despite a setting of physical and cognitive decline. Providing dental care to patients with a dementing illness will require modification of patient management techniques, particularly a greater use of nonverbal communication and an alteration in verbal communication patterns. Appropriate treatment planning and aggressive prevention are critical to the maintenance of their oral health.
Newer restorative materials for the older adult
Authors: Rupp Nelson W.
Published: March 2008

SUMMARY

Because of the recently introduced glass ionomer cements and improvements in composite materials we have greatly improved our capability to deliver functional and esthetic dentistry and are in a better position today, than ever before, to supply comprehensive functional as well as esthetic dental treatment.
Prevention of self‐inflicted trauma: dental intervention to prevent chronic lip chewing by a patient with a diagnosis of progressive bulbar palsy
Authors: ROVER BILLY C. , MORGANO STEVEN M.
Published: March 2008

An appliance is used as a beginning in the prevention of self‐mutilative oral behavior. The patient in the case reported here required a quick solution to a severe problem of self‐inflicted trauma. The design presented here can be improved on or an altogether new approach may be developed.
The immunoperoxidase method for the rapid diagnosis of intraoral herpes simplex virus infection in patients receiving bone marrow transplants
Authors: FLAITZ CATHERINE M. , HAMMOND HAROLD L.
Published: March 2008

Bone marrow transplant patients (N = 12) with oral lesions consistent with herpes simplex virus (HSV) infection were studied to compare the sensitivity of two rapid cytodiagnostic methods with viral cultures. Routine viral cultures and exfoliative cytology smears were prepared for microscopic evaluation using the Papanicolaou method and an immmunoperoxidase staining technique for detection of HSV type 1.

Patients with a positive viral culture (N = 10) showed positive staining for HSV, using the immunoperoxidase technique. Multinucleated giant epithelial cells were observed in only seven of the ten positive specimens, using the Papanicolaou method. The results from this preliminary study suggest that the immunoperoxidase method may provide the dentist with a reliable and rapid approach for the diagnosis of intraoral HSV.
Successful use of a feeding obturator for an infant with a cleft palate
Authors: GOLDBERG WENDY B. , FERGUSON FRED S. , MILES RICHARD J.
Published: March 2008

The report of case presents the postnatal and early infancy period for a child born with a cleft of the soft palate. The infant was admitted to the hospital several times for failure to thrive as a result of feeding difficulties. The feeding problems resulted from both the cleft and a lack of consistent and concerted effort by the family to nourish the infant. When the child was 3 months old, a feeding obturator was constructed that resulted in improvement in the child's weight gain. The feeding problems of an infant with a cleft palate and the pressures that these problems present to the parents are discussed.
A communications seminar series for general practice residents
Authors: CLASSMAN PAUL , BRODY HARVEY , FEIGENBAUM ELLIOTT
Published: March 2008

This article describes a seminar series for general practice residents dealing with communication, interpersonal relations, self‐image, and patient‐dentist interactions. Objectives, content, and methods of evaluation are presented.
Maternal perceptions of child behavior: handicappec versus nonhandicapped
Authors: WILSON STEPHEN , SCHRECK ANN
Published: March 2008

This study compares the ratings of child behavior in short stories by mothers of children with handicapping conditions versus those whose children had no handicapping conditions. Each of the mothers rated 12 short stories or vignettes and indicated their self‐perceived level of stress. The results showed that the mothers of children with handicapping conditions expressed significantly greater stress levels and rated inappropriate child behavior in a more tolerant fashion than the mothers of children without handicapping conditions. This information may be of value to the dentist who treats patients with handicapping conditions, and it provides a greater understanding of the mothers' concerns and daily life stresses.
The patient with cancer: social and clinical perspectives for the dentist
Authors: STRAUSS RONALD P.
Published: March 2008

Dentists can have a significant role in the care of individuals with cancer. They detect and provide treatment for patients with head and neck cancer and routinely provide oral care to patients who have other forms of cancer. This paper addresses the social, clinical, and psychological responses to cancer and considers the patient's understandings of prevention, diagnosis, and treatment. The findings in this paper are based on intensive interviews with 42 patients with cancer and family members, sociological participant‐observation of oral and maxillofacial rehabilitation of the patient with head and neck cancer in major teaching hospital settings, and a review of the literature. Cancer was associated with an uncertain course and prognosis, made more problematic by imagery, fear, and fatalism. Patient behaviors, including delayed care seeking, are related to understandings of cancer and the social and family interactions that may occur around the disease. Professional role dilemmas, strategies toward informing patients of their cancer, and dealing with death are considered as issues dentists may face in care of the patient with cancer.
Patient death and bereavement: what is the dentist's role?
Authors: CHIODO GARY T. , TOLLE SUSAN W.
Published: March 2008

The dentist's role following a patient's death has not been examined to date; neither has the attrition rate of a dental practice because of deaths of patients belonging to that practice. This topic was explored through a survey of 400 Oregon dentists. Seventy‐two percent of dentists in active practice who participated in the survey had at least one patient death each year; the mean number of patient deaths per year was five. Following these deaths, most dentists reported providing some type of emotional support to the bereaved survivors. Dentists send sympathy cards 72% of the time and attend funerals 27% of the time; 55% of dentists regard the majority of their patient deaths as unexpected. These deaths are a source of emotional stress for dentists, as are subsequent discussions with survivors. Only 3% of the respondents reported having received formal education in death and bereavement, and 66% of dentists believe that some type of education in dying and bereavement should be included in dental school
An impression procedure for the neonatal patient with a cleft palate
Authors: LIPP MITCHELL J. , LUBIT ERWIN C.
Published: March 2008

An impression procedure for the neonatal patient with a cleft palate is described. The procedure has been used at Beth Israel Medical Center, New York City, for the past 10 years and has been proved safe, reliable, and precise.
Ensuring the rights of persons with disabilities
Authors: Dart Justin W.
Published: March 2008

The following keynote address by Justin Dart, chair, congressional Task Force on the Rights and Empowerment of Americans with Disabilities, was presented Aug 8 in Philadelphia during the ninth congress of the International Association of Dentistry for the Handicapped.
Toxic epidermal necrolysis
Authors: Cohen S. Gary , Click Michael , Schaeffer Virpi H.
Published: March 2008

Toxic epidermal necrolysis is a potentially fatal dermatological disease. Large bullae covering extensive areas of the body cause continuous exfoliation of skin, which requires immediate medical attention. Intraoral manifestations may precede cutaneous lesions. Two cases with different treatment protocols are presented,
The need for and utility of dental services among people with severe disabilities
Authors: Kimmelrnan Benedict B.
Published: March 2008

The Following report was presented during a meeting of the Rehabilitation Services Administration For constituents, educators, and service provider agencies and organizations, Oct 24, 1988, at George Washington University, Washington, DC.
The dental manager's role in a hospital
Authors: Wasserman Burton S. , Laster Gail
Published: March 2008

Ten years ago, the administrative leadership of Booth Memorial Medical Center recognized the institution's potential for growth in a rapidly changing economic environment. A decision was made to develop strong middle management to encourage excellence, efficiency, and accountability.

It was determined that the strength of the midsection of the hospital's administration could keep the hospital stable and lean, to withstand the pressures of inflation and regulatory restraints.
An ambulance rotation as part of the general practice residency program
Authors: Wasserman Burton S. , Jenal Theodore J. , Cavanaugh Patrick J.
Published: March 2008

This article describes a unique educational experience by using the ambulance as an extension of emergency medicine training for a general practice resident. The rotation enables the resident to deliver independent and spontaneous medical care in an emergent setting. A specific set of educational objectives were developed and used for this rotation.
Special Concern: Clinical decision making in evaluating patients: a process study
Authors: Ettinger Ronald L. , Beck James D. , Martin Wendy E.
Published: March 2008

A volunteer patient was examined by five dentists experienced in caring for geriatric patients. The patient and dentist interaction was videotaped and reviewed to evaluate a previously generated hypothesis regarding the diagnosis process. This descriptive study suggests that dentists experienced in geriatric care did assess and evaluate a wide range of patient characteristics. However, they did not follow the previously hypothesized process in arriving at an appropriate treatment plan. Instead, they relied heavily on past experiences with similar situations. The possible implications of this process for treatment planning and teaching of geriatric dentistry are discussed.
Effects of age and removable artificial dentition on taste
Authors: Wayler Alan H. , Perlmuter Lawrence C. , Cardello Armand V. , Jones Judith A. , Chauncey Howard H.
Published: March 2008

Sodium chloride and sucrose gustatory recognition thresholds, suprathreshold taste intensity function, and sucrose suprathreshold taste preference in healthy adult males with removable artificial dentition were compared with persons having natural dentition. In addition, several inorganic salivary constituents were evaluated for their possible relationship with these modalities.

The 75 participants studied were divided into two age and two dentition groups: less than 65 years versus 65 years and older; and natural dentition only versus either removable partial dentures or complete artificial dentition. Recognition threshold and suprathreshold psychophysical functions were assessed using aqueous solutions of sodium chloride and sucrose. Suprathreshold hedonic judgments were also determined for sucrose. Samples of stimulated parotid saliva were analyzed for sodium, potassium, and bicarbonate.

As age increased, a statistically significant decrease was noted in the exponent of the psychophysical function for sodium chloride. A similar, but nonsignificant, trend was observed for sucrose, which was complicated by an interaction between age and dentition status. For sodium chloride, recognition thresholds tended to be higher for older persons with removable partial and complete dentures. However, no statistically significant effect was observed on the sucrose threshold or hedonic response as a result of dentition status. Analysis of several parotid saliva constituents showed no statistically significant effect caused by age or dentition status and correlations noted among the psychophysical measures appeared to be fortuitous.
Detecting diabetes in an elderly dental patient population
Authors: Mulligan Roseann , Lipson Loren G. , Heaton Sydney G.
Published: March 2008

The prevalence of both diagnosed and undiagnosed diabetes, a disease which has a significant impact on dental care delivery, increases with age. Because of these two factors, the dental practitioner must pay special attention to the detection of diabetes in this age group. This paper describes a study that validates the use of a simple blood test in conjunction with a questionnaire as a method to detect undiagnosed diabetes in an elderly dental patient population.
Oral herpes simplex virus infection with cardiac transplantation
Authors: Redding Spencer W. , Gordon Sharon M.
Published: March 2008

Oral herpes simplex virus infection is a common complication of cardiac transplantation. Lesions are secondary to reactivation of the virus, are atypical in appearance, and can involve any oral and perioral surface. Diagnosis on clinical grounds is difficult and should be confirmed with laboratory testing. A case report and review of the literature are presented to support the features of this infection.
Oral mucosal lichenoid reaction to sulfamethoxazole
Authors: Bronny Andrew T. , Thies Robert M.
Published: March 2008

A clinical case of oral mucosal lichenoid reaction to sulfamethoxazole in a dental patient with complicating medical conditions is described. Although the relationship between oral mucosal lichenoid reaction and sulfa drugs has not been documented previously, the patient's lichenoid reaction corresponded with sulfamethoxazole use, and improved when the drug was discontinued. Reactions of this type should be monitored so that treatment and preventive measures may be instituted.
Self‐inflicted oral trauma: report of case
Authors: Croglio David P. , Thines Terrence J. , Fleischer Michael S. , Anders Patrick L.
Published: March 2008

Self‐inflicted oral trauma is often encountered in patients who lack cerebral control over the masticatory cycle. Many factors must be considered in treatment, and a variety of appliances may be fabricated to prevent injury to oral structures. This case report documents the use of a soft acrylic appliance in treatment of a comatose patient who showed ruminatory reflex chewing.

This case report demonstrated successful use of a soft acrylic mouthguard material as an intraoral appliance. The appliance was designed and fabricated in accordance with previously mentioned guidelines (Table). Fabrication, insertion, and maintenance was uncomplicated and noninvasive. Periodic examinations over a 6‐month period have demonstrated resolution of the oral lesion and a high level of tolerance of the appliance.
Gingival effects of prescription medications among adult dental patients
Authors: McClain Deedee L. , Bader James D. , Daniel Susan J. , Sams Darlene H.
Published: March 2008

The relationship between self‐reported medication use (exposure to one or more drugs with anticipated gingival effect — antidepressants, diuretics, antihypertensives, hormones) and four measures of gingival conditions (plaque index, gingival index, calculus index, maximum CPITN score) was examined among 594 patients in 35 dental practices in two North Carolina counties. Patients with long‐term medication use were compared to patients without long‐term use on four measures of gingival condition. When controlling for sex and age within age group, medication use was a significant predictor (P < 0.05) for elevated gingival and plaque index scores among the white less than 65 group. For the white 65+ group (n = 90), medication use was not a significant predictor for any index score
A comparison of medical histories reported by dental patients and their physicians
Authors: Levy Steven M. , Jakobsen Jane R.
Published: March 2008

This paper reports on the comparison of 104 patient‐provided medical histories and those provided by the patients' physicians. Patient‐provided histories were obtained using a written health questionnaire with verbal follow‐up. At the level of specific medical conditions, patients and physicians agreed only about half of the time, whereas there was better agreement by systemic disease category (average agreement 77%). Both patients and physicians reported systemic conditions not reported by the other, indicating that neither patients nor physicians can be relied on as the sole source of medical history information. Whenever there is a complex medical history or uncertainty about the completeness of the patient's knowledge and reporting of their medical history, contacts with the patient's physician(s) are indicated
Clinical trials in special care populations: some methodological issues requiring attention with limited group sizes
Authors: Heifetz Stanley B.
Published: March 2008

As many researchers have experienced, studying special patient populations can be particularly challenging. The problem of heterogeneity of the experimental material that can plague any research design becomes even more prominent when studying special patients because of limited group sizes. Dr. Stanley B. Heifetz, former acting chief of clinical trials at NIDR, offers SCD readers some guidelines to avoid the pitfalls of inadequate research methods
Dentists' willingness to provide care for patients with developmental disabilities
Authors: Ferguson Fred S. , Berentsen Barbara , Richardson Peggy S.
Published: March 2008

This paper reports the results of a survey of School of Dental Medicine graduates at State University of New York at Stony Brook, regarding their willingness to treat patients with developmental disabilities in private practice. It also explored the influence of the DCDD program.
Dental management of the patient with obsessive‐compulsive disorder
Authors: Friedlander Arthur H. , Serafetinides E.A.
Published: March 2008

Individuals with obsessive‐compulsive disorder frequently manifest bizarre behaviors that contribute to the oral disease development. The medications used to manage the disorder can cause profound xerostomia and compound the magnitude of oral pathology. The patient's behavioral alterations and drug therapy might require dental treatment modifications.
Caries levels, Streptococcus mutans counts, salivary pH, and periodontal treatment needs of adult Down syndrome patients
Authors: Shapira Joseph , Stabholz Ayala , Schurr Danny , Sela Michael N. , Mann Jonathan
Published: March 2008

The prevalence of dental caries and periodontal treatment needs in an institutionalized Down syndrome (DS) population was examined as well as the relationship between caries prevalence, salivary pH and salivary levels of Streptococcus mutans. Twelve patients with DS, aged 20 to 48, were compared with two similar age and gender control groups: healthy, and non‐Down institutionalized mentally retarded patients. The pH levels did not differ significantly among the three groups. As to periodontal needs expressed by the CPITN, the institutionalized groups had the highest needs compared with the healthy group. Down adults, who were cariesfree, had significantly lower S. mutans counts compared with the patients with caries. In addition, the cariesfree patients with DS had much lower CPITN scores compared with the patients with caries.
Maxillofacial plasmacytoma resulting in intraoral hemorrhage in a patient with multiple myeloma
Authors: Sirois David A. , Cohen S. Gary , Greenberg Martin S.
Published: March 2008

Oral symptoms of multiple myeloma are common. A patient with refractory multiple myeloma is described because of his unusual orofacial manifestations, including severe intraoral hemorrhage, a massive, erosive maxillofacial lesion with extension into the cranial fossa, and rapid growth of a large intraoral mass.

This case report describes the presentation and management of a patient with end‐stage multiple myeloma and severe intraoral hemorrhage. It is interesting because of the rapid growth of the mass, the extension into the para‐nasal sinuses and cranial fossa, and the threatening intraoral hemorrhage. The noninvasive management of this patient's bleeding and evaluation of the mass was essential to minimize the possibility of exacerbating the life‐threatening hemorrhage.
A comparison between fluconazole tablets and clotrimazole troches for the treatment of thrush in HIV infection
Authors: Redding Spencer W. , Farinacci George C. , Smith Jean A. , Fothergill Annette W. , Rinaldi Michael G.
Published: March 2008

Fluconazole, a newly available triazole, has been evaluated extensively as a treatment for thrush. It has been effective in the treatment of this condition in patients with HIV infection. Clotrimazole troches have been a common treatment for thrush in patients with HIV infection for several years. This study compared the efficacy and safety of fluconazole 100 mg tablets once per day versus clotrimazole 10 mg troches five times per day in the treatment of thrush in patients with HIV infection. Patients were evaluated at baseline, day 7, 14, 28, and 42. The following parameters were evaluated: clinical cure, colonization at the end of treatment, relapse at day 28, and relapse at day 42. Side effects including liver enzyme values were also monitored. Clinical cure was superior with fluconazole tablets than with clotrimazole troches. Also, rates of colonization at the end of therapy and relapse at days 28 and 42 were less with fluconazole tablets than with clotrimazole troches. However, these differences were not statistically significant. Patient compliance with fluconazole was superior to that of clotrimazole. This difference was statistically significant. Both fluconazole tablets and clotrimazole troches are effective in treating thrush in patients with HIV infection. The avoidance of multiple‐per‐day dosing would appear to favor fluconazole.
Dental care in psychiatric hospitals in the Netherlands
Authors: ter Horst Guusje
Published: March 2008

This study determined the method of organization of dental care In psychiatric hospitals in the Netherlands, investigated patients' dental problems, and examined hospital nurses' role in prevention and diagnosis of dental problems. A bad oral condition, bad oral hygiene, and badly fitting dentures were the problems most frequently noticed. If the patients neglected brushing their teeth, 70% of the nurses interviewed never took over, 20% sometimes did, and 8% always did. It was concluded that, although most psychiatric hospitals had their own dental clinic or alternative dental facilities, adequate dental care had not yet been realized everywhere. The role of the nursing staff in preventing and diagnosing dental disease can further be strengthened
Suspected inappropriate secretion of antidiuretic hormone in a male with mental retardation
Authors: Steelman Robert , Holmes Douglas
Published: March 2008

The syndrome of Inappropriate secretion of antidiuretic hormone (SIADH) Is a disorder In which a sustained release of antidiuretic hormone occurs because of certain diseases, pharmacological agents, or trauma. Fluid volume expands with a resultant hyponatremia which, depending on the degree, may be asymptomatic or result In death. This case report describes a 38‐year‐old male in whom SIADH was strongly suspected secondary to Tegretol therapy to control a seizure disorder. Medical consultation Is imperative for these patients before administering a fluid challenge during general anesthesia.