bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Significance of Prescription Medication Usage Among Gerodontic Patients1
Authors: Nelson John F. , Barnes George P. , Tollefsbol Richard G. , Parker Warren A.
Published: July 2006

Increased longevity and the perceived increasing trend of prescribed drug usage in elderly patients mandate that dentists treating gerodontic individuals be acutely aware of the unique problems these factors present. This study was designed to elucidate the prevalence of prescription medication usage among geriatric dental patients including awareness of drugs used and the reasons for use as well as compliance in the consumption of the drug(s). Data was collected on a total of 163 elderly patients seen at the Baylor College of Dentistry, Department of Oral Diagnosis and Radiology.
The Occurrence of Retained Roots in Association with Oral Health Among the Adult Population of Finland1
Authors: Ranta Kari , Tuominen Risto , Paunio Ilkka
Published: July 2006

In the present study the association between the occurrence of retained roots and several oral status factors was studied using a representative sample of 8,000 Finnish adults 30 yrs of age and over. The overall prevalence rate of dentate subjects with roots was 21%, a rate consistently higher among men. In the age category 65+ yrs, the prevalence rate was 35%. Among subjects with at least one root the average number of roots was 2.7. Those having removable denture(s) and a number of filled teeth showed a decreased probability of having root(s). Among those having root(s) the greater number of roots was associated with increasing age and with increasing number of remaining and decayed teeth.
The Efficacy of Mucin‐Containing Artificial Saliva in Alleviating Symptoms of Xerostomia
Authors: Vissink A. , Schaub R.M.H. , van Rijn L.J. , 's‐Gravenmade E.J. , Panders A.K. , Vermey A.
Published: July 2006

The efficacy of a mucin‐coniaining saliva substitute was assessed in terms of changes in oral functioning and the psychic and social implications of these changes. Thirty‐nine patients with xerostomia filled out a questionnaire before application of the artificial saliva and after six weeks of usage. The artificial saliva was applied with a spray. From this study it was concluded that: (1) the application of the mucin‐containing saliva substitute reduced the sensation of a dry mouth and improved oral functions such as chewing, swallowing and speech (also less nocturnal oral discomfort was observed); (2) the subjects felt better about oral functioning using the saliva substitute; (3) patients using the mucin‐containing saliva substitute felt less restricted in their social activities (e.g. communication).
Incisor Abnormality of Senescence Accelerated Mouse (SAM)1
Authors: Sashima Mieko , Satoh Masanobu , Suzuki Atsumi
Published: July 2006

Incisor abnormalities such as loss of enamel color, hypoplasia of enamel, shortening and lengthening, irregular shape of edge, and fracture were often observed in SAM‐P/2/Iw (senescence accelerated mouse‐prone) more than 12 months old. On the other hand, for SAM‐R/1/lw (control) mice more than 20 months old, there were only a few instances of loss of enamel color. The incidence of incisor abnormality was significantly different between P/2/Iw and R/I/Iw. The onset of abnormality was also earlier in P/2/Iw. Histologically, dens in dente and odontoma‐like structures were occasionally found in the incisors of P/2/Iw. These findings add further supporting evidence that SAM‐P/2/Iw is truly senescence accelerated.
Professional Dental Care for Patients with Dementia
Authors: Niessen Linda C. , Jones Judith A.
Published: July 2006

Individuals with dementia present a significant challenge to the dental professional. The dental professional must meet the special needs of the patient with dementia with patience and a variety of non‐traditional skills, including treatment planning with caregivers and nonverbal communication to reassure disoriented patients. The goals of dental care for the patient with dementia are to restore and maintain oral health and prevent progression of oral disease. Because of the degenerative nature of dementia, the first dental visit for a patient with dementia may represent the patient's best cognitive functioning level. For this reason, the dental treatment plan should aim to restore oral function quickly and to institute an intensive preventive program. Practical guidelines for preventive diagnostic, and restorative care are provided. To illustrate these points, two cases are presented.
Sorbitol Gum in Xerostomics: The Effects on Dental Plaque pH and Salivary Flow Rates1
Authors: Markovic Nina , Abelson David C. , Mandel Irwin D.
Published: July 2006

Adequate salivary flow is important for patient comfort and maintenance of oral health. Xerostomia, or dry mouth, is a common clinical complaint. Masticatory and gustatory activity can stimulate salivary flow from functional salivary tissue and the use of sugarless mints and gums have been recommended to individuals who complain of xerostomia, but there are minimum clinical data. A clinical study assessing the effect on salivary flow rates and dental plaque pH of a sorbitol‐sweetened chewing gum in subjects with the complaint of xerostomia was conducted. The chewing of the gum in this present study stimulated salivary flow in the subjects with xerostomia. Statistically significant stimulated whole mouth and parotid salivary flow rate increases were found when compared to unstimulated whole mouth and parotid salivary flow rates. Chewing of the sorbitol‐sweetened gum also effectively reduced the drop in pH seen following the exposure to a fermentable carbohydrate. The findings of this present study indicate that chewing of a sorbitol‐sweetened gum may be of benefit to patients with the complaint of xerostomia.
Ethnic and Sex Variations in Dental Care Utilization Patterns in a Group of Malaysian Elderly
Authors: Razak Ishak A. , Ali Mohamed M.
Published: July 2006

The purpose of this study was to identify the ethnic and sex variations in the motives for seeking dental care in a group of Malaysian elderly. Three hundred and forty‐two patients aged 55 years and above who presented themselves for treatment for the first time at the Dental Faculty, University of Mayala, Kuala Lumpur in 1986 were screened for their chief dental complaints. Request for dentures and extractions and complaints of toothache were the more frequent dental motives in all the ethnic groups. However, there exist ethnic and sex variations among these dental complaints. The Chinese were found to be high utilizers of rehabilitative services whereas the Malays and Indians were more frequent utilizers of emergency services. The only consistent feature between sex among all the ethnic groups for the more frequent dental complaints was that more females complained of toothache than males.
Epidemiologic Changes in Older Adult Periodontal Disease1
Authors: Beck James D.
Published: July 2006

This paper reviews some past and current findings regarding the relationship between age and periodontal diseases in adults and speculates on the implications of more recent findings that show a lower prevalence of deep pocketing than previous studies and no dramatic increases in older adults. A conceptual framework for designing studies and analyzing data is presented. Using prevalence data from a household survey of older adults in Iowa, a multivariate analysis resulted in 41 percent of the variance in 3 + mm pickets being explained by dental, medical, and behavioral factors. If these correlates turn out to be risk factors, it seems that periodontal diseases must be considered in a larger context than is employed in most epidemiological and clinical investigations.
AIDS and HIV‐1 Infection: Clinical Entities in Geriatric Dentistry1
Authors: Ship Jonathan A. , Wolff Andy
Published: July 2006

The number of AIDS cases in individuals 50 years of age or older in the United States is reported to exceed 9000. Contaminated blood and blood transfusions are major contributors to HIV‐1 infection in this age group. Sexual transmission and infection through intravenous drug abuse are also potential avenues of HIV‐1 transmission in the older population. AIDS presents with a variety of clinical manifestations, including dementia, frequently seen in non‐HIV‐1‐infected older people. Neurological deficiencies associated with AIDS are very common and may lead to misdiagnosis in the elderly. The observed incubation period of HIV‐1 infection is longer than previously estimated, increasing the risk of older individuals exposed to HIV‐1 in the past to develop AIDS. Oral manifestations may present as one of the early clinical signs of AIDS. Little is known concerning AIDS in the geriatric population. It demands consideration by dental professionals treating older individuals belonging to one of the exposure categories of the disease.
Oral Health Status and Dental Needs in a Geriatric Institutionalized Population in Paris1
Authors: Mersel Alex
Published: July 2006

One hundred and forty‐two residents of a geriatric hospital in France were given an oral exam and interviewed by questionnaire regarding their backgrounds, physical health and oral hygiene habits. The residents suffered from many systemic diseases and drug intake was relatively high. Over fifty percent reported mouth dryness, especially at waking. Twenty‐three percent stated that they never brushed their teeth and the demand for dental services was low. Edentulousness was similar to those rates reported in Israel and the U.S. The majority of prostheses were rated by examiners as unacceptable and there were significant amounts of root and cervical caries in spite of the relatively high level of oral health care provided by the staff.
The Prevalence of Oral Mucosal Lesions in the Elderly in a Surgical Biopsy Population: A Retrospective Analysis of 4042 Cases1
Authors: Scott J. , Cheah S.B.
Published: July 2006

A series of over 4000 oral mucosal biopsy cases was examined in two age groups, elderly (≥ 65 years) and non‐elderly, and allocated between seven diagnostic categories. The data were analysed against the know age‐sex distribution of the general population of the Mersey Region from which the oral biopsy cases had been drawn. The distribution of diagnostic categories was significantly different between the two age groups. For all diagnostic categories except mucosal cysts (malignant and premalignant disease; benign keratoses; denture‐induced hyperplasia; benign proliferative lesions; lichen planus; and miscellaneous diseases) the age‐corrected prevalence was higher in elderly than non‐elderly with the greatest difference occurring in malignant/premalignant diseases (5.5‐fold higher prevalence in the elderly). The results suggested that in the Mersey Regional population the prevalence of oral mucosal disease, of a type and severity to warrant surgical removal of tissue, was 47% higher in the elderly than the non‐elderly. These results strongly support the notion that age exerts an important influence on the prevalence and pattern of oral mucosal disease in man.
The Prevalence of Candida albicans in Denture Wearers in an Israeli Geriatric Hospital1
Authors: Cardash H.S. , Helft M. , Shani A. , Marshak B.
Published: July 2006

Thirty‐seven patients wearing complete dentures were investigated for Candida albicans. Twenty‐five of the patients suffered from denture stomatitis and twelve had clinically normal mucosa. Candida albicans was isolated and identified from Sabouraud dextrose agar culture medium models constructed from impressions of the maxilla and from the upper dentures. The presence of Candida albicans was demonstrated in ail denture wearers suffering from denture stomatitis and in 82% of denture wearers in a control group. A higher concentration of Candida was found in the denture stomatitis group. Large quantities of Candida resided in the denture base and not in the palate. Candida was also found in the denture base in areas not related to the lesion. The concentration of Candida was related to denture cleanliness.
Age‐Progressive Changes in Pulp Widths and Root Lengths During Adulthood: A Study of American Blacks and Whites
Authors: Woods Marjorie A. , Robinson Quinton C. , Harris Edward F.
Published: July 2006

The intertwined effects of normal aging processes and time‐progressive diseases produce systematic changes in many oral and dental tissues. This cross‐sectional study of pulp dimensions and root lengths in sound teeth tested for changes with age in adulthood while controlling for differences in gender and race (black, white). Age was the paramount determinant of pulp size which decreases via the accumulation of secondary dentin. In some instances the rate of change increases in older adults with an inflection point at 35–40 years of age. In contrast, root lengths are statistically independent of age once gender (male > female) and race (black > white) are controlled. Causes of the lack of association with age are discussed.
A Clinical Survey of Oral Soft Tissue Lesions in Institutionalized Geriatric Patients in Israel1
Authors: Kaplan Ilana , Moskona David
Published: July 2006

A clinical survey of oral soft tissue lesions in 298 geriatric patients in Israel was conducted. White lesions were found in 9.5% of smokers and 2.19% of non‐smokers. Varicosities increased from 11.1 % to 41.1% between ages 50–99 years. Pigmentation hairy tongue, and papillary atrophy of the tongue all increased with age. Hairy tongue was found in 12.8% of men and 4 5% of women.
Perceptions About Oral Health and Utilization of Oral Health Care Services Among Urban Finnish Elderly1
Authors: Palin‐Palokas Tuija
Published: July 2006

A representative sample of urban elderly living at home were studied for their perceived problems of oral health, treatment need felt for these problems, and their utilization of oral health care services. The majority of these elderly were denture wearers. Nearly all of the denture‐wearing elderly had problems with their dentures, and about half of the dentate elderly had problems with their remaining teeth. The number of problems perceived increased with deteriorating health and decreasing income. Half of the elderly with denture problems and two‐thirds of those who had problems with remaining teeth felt they needed dental treatment. Multivariate analyses found the number of perceived problems, having some natural teeth, and perceived general health to be the most important determinants of their perceived treatment need. Although two‐thirds of the studied elderly felt no barriers to seeking treatment, only half of them had made their last dental visit less than five years ago. Having some teeth remaining, oral health education experiences, and income were found to be the best predictors of service utilization. Altogether, affective and cognitive factors rather than socio‐demographic differences appeared to determine the elderly's perceptions about treatment need and their actual utilization of dental services, emphasizing the necessity of oral health education approaches designed for the elderly.
Multi‐Modal Selection Effects in the Study of Adult Development: A Perspective on Multivariate, Replicated, Single‐Subject, Repeated Measures Designs
Authors: Nesselroade John R. , Jones Constance J.
Published: July 2006

Some of the selection issues that bear upon the conduct of research using multivariate, replicated, single‐subject repeated measures designs are examined and their implications for the study of developmental phenomena discussed. The choices of participants, variables, occasions of measurement, etc., made in the conduct of empirical research all involve some kind of selection. These choices, therefore, introduce selection effects into collected data which, in turn, threaten the generalizability of one's conclusions. Data analyzed for single subjects, for example, are suspect regarding generalizability to other individuals. While the limits of generalizability to persons is a concern to be taken seriously, the concern properly applies to all modes of data classification. Discussions of the importance of person selection emphasize representative sampling (of persons) and generalization to populations of persons. Attention to the selection of variables has led to a focus on multivariate approaches to measurement. For the developmentalist, the occasions mode, which is either implicitly or explicitly involved in definitions of change, is especially relevant to concerns about generalizability. Whether one considers stability or change, the effects of temporal selection ought to be a central concern in designing research.
Demography and dental needs, an international perspective
Authors: Ettinger Ronald L.
Published: July 2006

The population of the world is changing and the science dealing with the study of these changes in human populations, in terms of disease, health and mortality has been called demography. It can be understood to include the evaluation of the size, density, and distribution of populations including the influence of a variety of factors such as age and economics. This paper will review the distribution of the world's population with regard to age and utilization of dental care with particular emphasis on the older cohorts.
Caries incidence in patients with dementia
Authors: Jones Judith A. , Lavallee Nicole , Alman John , Sinclair Carolyn , Garcia Raul I.
Published: July 2006

One in ten persons over the age of 65 and as many as half the population aged 85 and over have Alzbeimer's disease. Review of the literature reveals substantial decrements in oral health in persons with dementia as measured by denture hygiene, coronal decayed, missing and filled teeth, filled teeth (cervical), percentage of the population with caries. Oral Hygiene Index‐simplified, and of sites with plaque, gingival bleeding and calculus. A study of caries incidence is described in 23 male veterans with moderate and advanced dementia of the Alzheimer's type, using a comparison group of male veterans from the Department of Veterans Affairs Dental Longitudinal Study, matching 2:1 for age, number of teeth and education. Baseline findings indicate significant differences in the numbers of coronal surfaces with decay, root decayed and/or filled teeth and root decayed and/or filled surfaces. Mean annual increments of coronal caries in the dementia group were 2.29±4.29 per 100 surfaces at risk, over twice that in the comparison group (0.88±1.14). For root caries, mean annual increments in the dementia group were 2.38±5.57 per 100 available surfaces, versus 0.31± 0.69 in the comparison group. Despite these large mean differences, the marked variability in these small samples statistical significance in caries increments between the two groups. The article concludes by suggesting some potential modifications to clinical trials of caries preventive agents and some overall research issues in populations with dementia.
Relationships between yeasts and primary root‐caries lesions.
Authors: Beighton David , Lynch Edward
Published: July 2006

A total of 447 primary root‐caries lesions from 169 dental patients was studied to determine the relationships between their clinical severity and the number and frequency of isolation of yeasts. Yeasts were isolated more frequently from soft lesions, from lesions at the gingival margin and from lesions deemed to require restoration. These associations may be due to the aciduricity and acido‐ genicity of yeasts but the relatively low numbers found do not support a pathogenic role for yeasts in the aetiology of root caries: at best they may be marker organisms of the most severe disease.
A study of some masticatory functions in 90‐year old subjects
Authors: Tzakis M. G. , Österberg T. , Carlsson G. E.
Published: July 2006

A group of 35 90‐year old subjects, randomly selected from the gerontologic population study in Göteborg (H‐70), were examined with respect to function and dysfunction of the masticatory system. The methods included a questionnaire, clinical examination and recording of bite force endurance and maximal bite force, measured in the central incisor region. Forty percent were edentulous, 29% were partially edentulous and wore a removable denture, while the others were dentate without removable prostheses. Signs and symptoms of temporomandibular disorders were mostly mild and infrequent, except TMJ crepitation which was recorded in 69% of the subjects. Maximal bite force was in general low (mean 94 N) but showed a great individual variation (range 10 to 410 N). Bite force endurance was also very variable (mean 72 s, range 10 to 205 s). None of the 35 subjects reported poor masticatory ability, but 2 said they could not chew all kinds of food. In spite of a reduced bite force this group of 90‐year olds considered their masticatory ability as good and most of them had no severe signs and symptoms of temporomandibular disorders.
EMG study on the effect of ageing on the human masseteric jaw‐jerk reflex
Authors: Kossioni A. E. , Karkazis H.C
Published: July 2006

The effect of age on the masseteric jaw‐jerk reflex was investigated in 22 young (11 males and 11 females with mean age 23.2 years) and 22 older dentate subjects (11 males and 11 females with mean age 61.3 years). Electromyographic (EMG) recordings were obtained, after chin taps, from the relaxed masseter muscle of the preferred chewing side, by use of a computerised recording and analysis system. With increasing age the occurrence of the reflex was reduced, the latency was increased, while the amplitude was decreased. Those findings are probably related to the general age related changes in the muscular tissue, the sense organs, the peripheral nerves and especially the central nervous system, Increased biological variance was also observed in the older subjects, as in most aspects of performance in the latent years. Furthermore, the effects of ageing were generally similar in men and women. The age‐related decrement in the monosynaptic reflex response is indicative of a generalised decline in the motor performance of the stomatognathic system and the decreased ability of the older dental patient to easily adapt to any dramatic changes in the sensory input.
The effect of Salinum on the symptoms of dry mouth: a pilot study
Authors: Johansson Gunvor , Andersson Gunilla , Attström Rolf , Glantz Per Olof , Larsson Kåre
Published: July 2006

The effect of a new saliva substitute. Salinum®, was tested in 37 patients with severe symptoms of reduced salivation. The majority of the patients had suffered from hyposalivation and dry mouth for more than 8 years. The saliva substitute consisted of a water soluble extract of linseed. The physical properties of this extract are similar to those of the glycoproteins of the salivary secretions. The patients used the saliva substitute for a seven days period. Prior to the use of the extract the patients reported that the most severe symptoms of decreased salivation were a feeling of dryness in the mouth and burning sensations in the tongue, pharynx and oesophagus, The majority of the patients reported that the use of Salinum reduced the symptoms of hyposalivation. Great variation in effect occurred from patient to patient. Generally the patients with the most severe symptoms experienced the greatest relief of the symptoms when they used Salinum. Although of short duration the results of this pilot study indicate that an extract of linseeds may compensate for some aspects of the consequences of reduced salivation. Further studies are needed to elucidate the feasibility of the extract as saliva replacement.
Muscle strength and mineral densities in the mandible
Authors: Klemetti Esa , Vainio Pauli , Kröger Heikki
Published: July 2006

Bone mineral density (BMD) in the femoral neck and lumbar spine was measured for 355 postmenopausal 48‐ to 56‐year‐old women and the BMD in five different regions in the mandible for 77. All 355 women were also classified according to the size of the masseter muscle. Both skeletal measures and the BMD of the buccal cortex distally from the foramen mentale were compared with the size of the masseter muscle. This study indicates that functional stress, caused by the masseter muscle, is involved in maintaining bone mineral density in edentulous regions of the mandible. Those individuals who are physically active or are bruxists may lose less mineral, after extractions of teeth, from those regions of the jaw bones where the muscles are attached.
Tomographic measurements of age changes in the human parotid gland
Authors: Drummond J.R. , Newton J.R , Abel R.W.
Published: July 2006

This study involved 48 subjects of both sexes with ages ranging from 22 years to 90 years. Computerised tomography was used to scan the right and left parotid gland. Gland mean density was calculated in Hounsfield units and regression graphs drawn. A significant fall in gland density was noted with subject age but no differences were noted between male and female subjects. A significant correlation was observed between the mean density of right and left glands in the same individuals. It is postulated that the fall in gland density is related an increase in fibro‐fatty tissue within the gland. This study provides evidence that age related changes occur in the human parotid gland from youth to old age. This work supports the earlier findings of Scott's who studied the superficial lobe of the parotid gland histologically and found an increase in adipose tissue in this area of the gland with age.
Nutrition, general health status and oral health status in hospitalised elders
Authors: Dormenval Valéric , Budtz‐Jørgensen Ejvind , Mojon Philippe , Bruyère André , Rapin Charles‐Henri
Published: July 2006

Biological malnutrition was assessed and correlated with salivary flow rates and oral health in 99 elderly, hospitalised non‐psychiatric patients. The indicators of protein malnutrition used were arm circumference and serum albumin level and the indicators of energy malnutrition the body mass‐index and the triceps skin‐fold thickness. Unstimulated and stimulated salivary flow rates were measured according to Sreebny et al.1. Of the patients, 40% showed severely and 46% moderately reduced serum albumin levels and the anthropometric measurements indicated malnutrition in about 50%. Unstimulated hyposialia ( 0.1 ml/min) and stimulated hyposialia ( 0.5 ml/min) were observed in 17% and 26.5%, respectively. Significant associations (P 0.05) were found between stimulated / unstimulated hyposialia and biological malnutrition. There was a negative relationship between the number of masticatory movements until swallowing a standard biscuit and skin fold thickness (P 0.05). Current weight loss and biological malnutrition were related to poor appetite (P 0.05). The study has confirmed poor general and oral health status as well as protein‐energy malnutrition among elderly hospitalised patients. This situation was associated with loss of appetite, reduced salivary flow rates and a certain impairment of masticatory function which could jeopardise the reversibility of malnutrition and lead to increased morbidity and mortality.
Oral health and treatment needs in a non‐institutionalized elderly population: Experience of a dental school associated geriatric clinic
Authors: Moskona David , Kaplan Ilana
Published: July 2006

The purpose of this study is to report oral and dental findings in a population of independent geriatric patients, who were treated at the Geriatric Dental Clinic, School of Dental Medicine, Tel Aviv University. The study group consisted of 221 patients, 31.2% males and 68.8% females. The mean age was 75.3 years. Of the patients, 75% were edentulous. The most frequent complaint was pain associated with wear of dentures, and the most frequent mucosal lesion was traumatic ulcer (51%). Most dentures were of poor quality (77%). The mean denture age was 9.7 years, increasing as the patient's age increased. Denture hygiene was good in 59%, fair in 11% and poor in 30%. The mean number of visits at the Geriatric Clinic was 5.5 per patient.
Whole saliva and the diagnosis of Sjögren's Syndrome: an evaluation of patients who complain of dry mouth and dry eyes. Part 2: Immunologic findings
Authors: Sreebny Leo , Zhu Wan Xing
Published: July 2006

Sjögren's Syndrome (SS) is a multisystem, autoimmune disease characterised by generalised desiccation, exocrine hypofunction and serologic abnormalities. Last year we showed that the antibodies which are quasi‐specific for diagnosis of SS, anti SS‐A/Ro and anti SS‐B/La, were present in the saliva of patients with this disease. Objective: To determine their presence in patients who complain of dry mouth and dry eyes. Setting:The study was conducted at the School of Dental Medicine, SUNY at Stony Brook. Patients: There were 49 patients (Mean Age= 54 ± 13 years). Tests: Serum was analysed for the SS and other antibodies with “Western Blot Autoantibody Strips”. Results:The findings showed that there was a strong correlation between the presence of the SS antibodies in the serum and the saliva. The SS antibodies were primarily found in the saliva of the patients whose resting and stimulated, whole saliva, flow rates were abnormally low. Antibodies to other autoimmune disease (Lupus, Seleroderma and Mixed Connective Tissue Disease) were also found in whole saliva. Conclusions: The findings in Part 1 of this study, of patients who had complained of dry mouth and dry eyes, suggest that those patients, who demonstrated low resting and stimulated flow rates and had lacrimal hypofunction, suffered from SS. The observation in this paper, that the whole saliva of these patients contains the SS antibodies, confirms this diagnosis. The data suggest that whole saliva can be used to establish the diagnosis of SS and other autoimmune diseases.
Sensory detection of food odour in relation to dental status, gender and age
Authors: Griep M. I. , Collys K. , Mets T.F. , Slop D. , Laska M. , Massart D.L.
Published: July 2006

The aim of this study was to investigate to what extent declining odour perception can be ascribed to dental status and oral hygiene habits, taking into account gender and age. Apparently healthy adults (n=182), ranging from 53 to 93 years (mean age=68.4) were tested. Information about oral hygiene habits (brushing teeth and cleaning dentures) and dental status was obtained by questionnaires. A validated objective procedure was used to measure sensory detection thresholds for isoamylacetate by an ascending method of limits. A significant negative correlation of odour perception with age was shown by the edentulous subjects which might reflect their wider age spread with many subjects over age 75. The evaluation of odour perception as a function of dental status shows no significant difference in odour perception between persons partial denture wearers, with natural teeth only or complete dentures. However, a tendency for lower odour perception was observed among male partial denture wearers, especially those reporting less frequent oral hygiene, which justifies further more detailed study.
A Select Bibliography of American Bar Foundation Research
Authors: Pederson Virgil L.
Published: July 2006

This bibliography of the American Bar Foundation's published research was compiled within definite limitations. The principal consideration was the provision of a historical record of the research product of the American Bar Foundation from its beginning.
The Class Action as an Antitrust Enforcement Device: The Chicago Experience (II)
Authors: DuVal Benjamin S.
Published: July 2006

Private treble damage actions have long been recognized to play a major role in antitrust enforcement. The present study evaluates the impact of the class action on private antitrust enforcement in one large commercial district, the Northern District of Illinois. Data were collected through attorney interviews and from the docket books and files of the clerk of the court on all antitrust treble damage actions not transferred to some other district that were filed from the inception of the amendment to rule 23 on July 1, 1966, through June 30, 1973.
The Class Action as an Antitrust Enforcement Device: The Chicago Experience (I)
Authors: DuVal Benjamin S.
Published: July 2006

The common question class action has been a source of division and controversy in the legal community. Hailed by its proponents as both a means for small claimants to obtain redress and a deterrent to corporate wrongdoing, the class action has been attacked by others as tantamount to “legalized blackmail” and as threatening to swamp the already overburdened judicial system with proceedings of extraordinary complexity. Two empirical studies of the class action have also reached diametrically opposed conclusions. A study by the American College of Trial Lawyers found that the common question class action suit “has mandated heavy expenditures of judicial time, effort and expense” and has sacrificed “procedural and substantive fairness to the party opposing the class,” while a study commissioned by the Senate Commerce Committee found that most class actions “proceed with reasonable smoothness in the Federal court.” Proposals to restrict the use of class actions have been advanced. While these proposals have not been adopted, the courts have increasingly limited the circumstances under which class actions may be maintained.
Governmental Risk Management in Public Policy and Legislation: Problems and Options
Authors: Pfennigstorf Werner
Published: July 2006

Governments, like business organizations, are exposed to risks of many kinds and have a wide range of options how to respond–from bearing the full risk themselves to obtaining full insurance coverage. The author discusses some of the traditional approaches to governmental risk management in the light of new and increasing risks–such as the liability risk–and the growing sophistication of risk management methods. He notes in particular how a government's risk management decisions differ from those of a business organization because of the unique characteristics of government entities: perpetual existence; taxing power; the need to prevent nepotism, bribery, and corruption in government administration; and political mandates and pressures of all kinds. These forces account for restrictive procurement rules and for various forms of “self-insurance” arrangements. The author finds, among other things, that in most states the rules have not kept pace with the multiplication of risks and the development of new risk management and insurance techniques, and that small and medium municipalities, especially, suffer from inadequate access to sound risk management services. On the basis of an examination of European municipal risk management practices, the author then suggests as an appropriate solution the formation of special mutual insurance organizations for municipal governments, controlled and administered by local government officials.
Regulation of Legal Service Plans
Authors: Pfennigstorf Werner , Kimball Spencer L.
Published: July 2006

Legal service plans, widely regarded as the key to better availability of legal services for Americans of moderate incomes, have not yet found their proper place in the legal and regulatory framework. Uncertainty about regulatory requirements threatens to hold up progress. This article presents the results of a three-year study of alternative approaches to the regulation of legal service plans. It analyzes the inherent dangers of various types of plans and suggests ways of providing adequate protection for consumers while preserving maximum freedom and flexibility for experimentation with new delivery systems. Specifically, the authors recommend the existing and time-tested system of insurance regulation as the most suitable model for plans having a significant risk-carrying element, subject, however, to appropriate amendments to accommodate the unique features of some kinds of plans, such as bar-sponsored nonprofit organizations, and with special procedures to ensure close cooperation with disciplinary authorities as far as the conduct of lawyers is concerned.

A volume containing all the principal and background papers prepared in this study, including a modified version of the present article, will be published by the American Bar Foundation as Legal Service Plans: Approaches to Regulation.
Educational Research and the Protection of Human Subjects
Authors: DuVal Benjamin S.
Published: July 2006

Educational research is increasingly subject to legal restrictions designed for the protection of human subjects of research. In this article the author discusses legal restrictions–both in the courts and under HEW regulations–on educational research, comparing these restrictions with those on biomedical research. He finds that although educational research in particular instances may give rise to suits for damages for invasion of privacy or intentional infliction of psychological distress, the legal issues relating to educational research will most often be resolved in proceedings before institutional review boards charged by HEW with the responsibility for passing upon proposals to conduct research on human subjects. He argues that the interests protected in proceedings before institutional review boards are not limited to those that have received judicial recognition in suits for damages. The author finds that the requirement that the informed consent of subjects be obtained presents difficult issues for educational research. He notes in particular the problems presented by research proposals that as an element of the research design contemplate the observation of subjects without their knowledge and the use of children as research subjects.
Psychotropic Medication and Competence to Stand Trial
Authors: Winick Bruce J.
Published: July 2006

At any given time, as many as 15,000 persons are hospitalized for study or treatment regarding their competence to stand trial. Although most of the defendants found incompetent to stand trial “could rapidly be returned to competence and so maintained were the facilities and treatments of modern psychiatry made available to them”, the impact of recent advances in psychiatry—particularly drug therapy—has not been fully absorbed by the legal system. Defendants restored to competence by psychotropic drugs frequently require ongoing medication. Some courts, mistakenly assuming that psychotropic drugs produce a “chemical sanity” that is unacceptable for participation in a trial, have adopted a practice—the “automatic bar rule”—of automatically prohibiting the return for trial of defendants under the influence of such drugs. A lack of statutory, regulatory, or judicial guidance leaves the question largely to the discretion of individual trial judges. This article critically examines the automatic bar rule in light of the effects of various psychotropic drugs and of the consequences of the rule both to defendants and to the state.
A Phantom Doctrine: The Origins and Effects of Just v. Marinette County
Authors: Bryden David P.
Published: July 2006

No branch of zoning law is more perplexing than the constitutional limits of the police power. How severely may the government reduce the value of land by regulation without compensating the owner? This issue has become particularly prominent during the last decade, as state and local governments have sought to preserve the landscape by novel and sometimes stringent land-use controls. Recently, some scholars have suggested that the familiar “diminution-of-value” test for determining when regulations become unconstitutional should be abandoned, even in cases where the prohibited use is not akin to a nuisance, and the effect of the regulation is to render the tract worthless. In Just v. Marinette County, the Wisconsin Supreme Court seemed to adopt this idea, declaring that development of a shoreland marsh may be forbidden irrespective of the economic impact on the landowner. Naturally, such decisions create the impression that property owners are regularly being sacrificed for the sake of environmental quality. But a study of Just's origins and effects reveals that in Wisconsin and Minnesota this impression of regulatory zeal is inaccurate. As a rule, all four of the counties studied allowed owners of shoreland marshes to fill enough of the marsh to make a remunerative use of the tract. Their main concern was not to preserve marshes but rather to attach erosion-control conditions to the fill permits. Cases in which a county, by denying a fill permit, drastically reduced the value of the land, have been extremely rare, even in the three Wisconsin counties studied, where under Just such denials are clearly constitutionally permissible. In these counties, it appears that ideology and politics, not constitutional law, are the major factors limiting the severity of conservancy zoning and consequently the extent to which this technique preserves open space. In jurisdictions where this is so, it seems likely that judicial decisions that permit the government to prohibit all remunerative uses are more likely to rationalize unjust treatment of an occasional landowner than to make a major contribution toward preserving environmental quality.
Coastal Land Management: An Introduction
Authors: Finnell Gilbert L.
Published: July 2006

During the 1970s, the “coastal zone”—that ecologically unique area where sea and land meet and strongly influence each other—has become a principal laboratory for experiments in new land management techniques. These coastal experiments are producing institutional arrangements that involve every level of government, and the implementation of the programs may well affect every citizen of the United States.
The Impact of Legal Education: An In-Depth Examination of Career-relevant Interests, Attitudes, and Personality Traits Among First-Year Law Students
Authors: Hedegard James M.
Published: July 2006

This article examines in detail patterns of change in career-relevant interests, attitudes, and personality characteristics among first-year students in one law school. The data presented suggest that a single entering law school class can be viewed as a varied group in terms of career plans and potential behavioral styles. Moreover, immersion in the law school environment may accentuate this initial variability. Although some studies have suggested that, overall, first-year law students experience a drop in law interests, including interests in altruistic and “socially conscious” career activities, the methods of analysis used in this study suggest alternative interpretations of some aspects of such changes. In addition, the author believes these methods shed greater light on the overall process of professional development in law school.
Law Professors: A Profile of the Teaching Branch of the Legal Profession
Authors: Fossum Donna
Published: July 2006

In the United States, law schools provide the principal route of entry into the legal profession. Indeed, education in a law school is the only experience that virtually all members of the modern legal profession have in common. The gatekeeping function of law schools places the nation's law teachers in a most influential position. Although law professors play a vital role in selecting and molding the members of the profession, little research has been done on them. This article presents the results of the American Bar Foundation's first major study of law teachers. The author finds them to be a most highly credentialed group of lawyers, the overwhelming majority of whom are graduates of a small group of elite law schools. She also finds that possession of a degree from one of these schools appears to be not only highly determinative of who become law teachers but also of the nature of teachers' academic careers.
The New Model Rules of Professional Conduct: Lawyer-Client Decision Making and the Role of Rules in Structuring the Lawyer-Client Dialogue
Authors: Spiegel Mark
Published: July 2006

Most discussions of lawyer-client decision making concern the difficult question of deciding when a lawyer must (or may) disregard his client's wishes because of conflict with some other significant interest outside the lawyer-client relationship. One of the ideological bases of the adversary system is a strong commitment to client control of decision making, which in theory must be balanced or reconciled with concerns about such control distorting the truthfinding functions of the legal system or causing harm to others. Little discussed until recently has been the fact that, despite this ideology, lawyers in many cases significantly control their clients' decisions and exert broad discretion over the means necessary to implement decisions.
Constitutional Limitations on State Tax Exportation
Authors: Hellerstein Walter
Published: July 2006

The notion that there are constitutional limitations on the power of the states to export their tax burdens to residents of other states has been the predicate of recent court challenges to state taxing schemes. The concept of state tax exportation and its implications for constitutional analysis have not, however, been systematically explored by the courts. The economics of state tax exportation suggest that a judicial inquiry into the extent of state tax exportation would be a formidable if not an insuperable task. And the Supreme Court, when recently confronted with an opportunity to constitutionalize a principle of excessive state tax exportation, flatly declined to do so. It is nevertheless possible that the concept of state tax exportation may have a role to play in constitutional analysis as a vague admonition to the states not to transgress some yet to be defined norms of fiscal balance in our federal system.
Administrative Justice in the Penitentiary: A Report on Inmate Grievance Procedures
Authors: Brakel Samuel Jan
Published: July 2006

The majority of prisons today have an internal grievance mechanism that gives inmates an opportunity to air complaints and seek solutions to individual and institution-wide problems. This study reports on the way the mechanism functions at two Illinois state prisons—one minimum security and one maximum security. The main findings are: (1) that the mechanism is heavily and repetitively used by only a portion of the inmate population, (2) that the grievances filed range widely in type as well as in merit, although it is clear that there is much frivolous activity, (3) that inmates win only a small percentage of their cases, either at the first-instance level or on appeal, and (4) that among both line prison staff (at least at one of the prisons) and inmates there is considerable dissatisfaction with the process, although a minority of prisoners and the higher echelon prison administrators can be counted on for more favorable assessments. The article goes on to compare these findings with the generally articulated objectives of the grievance process and concludes with a series of suggestions that have been made for improving its workings.
New Options for Lawyer Retirement Plans Under the Economic Recovery Tax Act of 1981
Authors: Nolan John S.
Published: July 2006

Recent changes in the tax laws governing retirement plans may offer significant tax advantages to lawyers and other self-employed persons. The author discusses the provisions of the Economic Recovery Tax Act of 1981 as they affect self-employed lawyers and compares them with the advantages that may be obtained by incorporation—both firm incorporation and individual incorporations within a firm. He explores a variety of tax issues, including important related Tax Court decisions, and makes recommendations with respect to adopting a strategy by a particular lawyer or firm.