bluuebunny/crossref_metadata_2025 huggingface dataset:
Care Needs of the Elderly Treated at a Dental School1
Authors: Barnes George P. , Tollefsbol Richard G. , Parker Warren A. , Nelson John F.
Published: July 2006

Increased longevity and recently intensified emphasis on gerodontology mandate that dental students'exposure to clinical care of the elderly be enhanced. The extent to which individual students can be exposed to geriatric dental care depends on the availability of elderly patients to dental school clinics and the treatment needs of these patients. The purposes of this study were (1) to determine the dental treatment needs of geriatric patients who seek care at a dental school, and (2) to ascertain if differences exist between the needs of older versus relatively young geriatric patients. Data collected on 128 elderly patients during a three month period indicate that 57% of the aged were either edentulous at examination or treatment planned to become edentulous and receive two full dentures. The remaining 43% were treatment planned to remain dentulous and receive therapies other than full upper and lower dentures. More older geriatric patients required full dentures than their younger cohorts. More young elderly required prophylaxes, scalings, root planing therapy, dental restorations, and partial dentures. Additional to their denture requirements, aged patients appear to have sufficient non‐prosthetic needs to allow for meaningful gerodontic experience by students.
Structure and Function in Aging Human Salivary Glands
Authors: Scott John
Published: July 2006

Degenerative structural changes develop in the secretory tissues of most salivary glands in man with advancing age. Quantitative studies have shown losses of a third or more in the parenchymal content of submandibular and labial glands and mostly these changes accrue steadily across the adult life span. The parotid appears less prone to such extensive change but currently only limited data are available for this gland. Positive correlations are evident between the age‐dependent decrements of secretory tissue and reductions in salivary flow rate for the submandibular and labial glands. The parotid, however, shows no functional correlation with the demonstrable tissue losses of old age. Future research should he directed at structural‐functional anomalies in aging glands and should seek to examine the changing demands on salivary structure and function within the wider context of the maintenance of oral health in the elderly.
Calcium Nutrition and the Aging Process: A Review
Authors: Ramazzotto Louis J. , Curro Frederick A. , Gates Paul E. , Paterson John A.
Published: July 2006

Adequate supply of calcium is essential for proper maintenance of the skeletal system. Recent studies suggest that, in the United States, dietary calcium in most women is inadequate to maintain skeletal integrity. Additionally, postmenopausal women will lose bone mass more rapidly because of estrogen deficiency and possibly tack of exercise. Severe loss of bone mass can result in several serious skeletal diseases, the most frequent of which is osteoporosis. This disease is a major contributor (25–30%) to hip fractures and spinal compression fractures in elderly people. Indirect sequelae of these fractures are responsible for 12% to 15% mortality in these patients within three months. Recent research indicates that osteoporitic bone loss may directly affect alveolar bone and may, in fact, exacerbate existing periodontally‐induced bone loss. This article will review the literature concerning physiological and biochemical parameters related to the absorption and metabolism of calcium with special emphasis on calcium alterations in the aging process. The following areas will be discussed: Ingestion, Absorption, Factors Effecting Absorption and Bone Maintenance, Calcium/Protein Interactions Affecting the Aging Process, Altered Bone States Associated with the Aging Person, Osteoporosis, Osteomalacia, Paget's Disease, Calcium Affecting Drug Action, and Calcium Affecting Alveolar Bone.
Self‐Assessed General Health and Dental Status Among the Elderly in a Swedish County
Authors: Palmqvist Sigvard , ÖSterberg Tor , Carlsson Gunnar E. , Mellström Dan
Published: July 2006

A random sample of non‐institutionalized elderly people in Örebro County, Sweden, has been examined. The present paper reports on the general health conditions obtained from interviews in this population and on the relation between general health and dental status. Eighty‐one percent of the clinically examined subjects considered that they were healthy or fairly healthy. A higher percentage of women as compared to men regarded themselves to be moderately or very ill. Women also used more drugs than men did. Only 6% did not feel strong enough for extensive dental treatment. Physically handicapped people used dental services less than the rest of the population did. Otherwise, general health seemed to have limited influence on the use of dental services. Subjects with better dental status reported less frequent illness, chronic diseases, and medication as compared to subjects with poorer dental status. The self‐assessed general health, also in the presence of age, sex, and residence variables, showed significant correlation with the dental status but not if socio‐economic variables were also included in a regression model.
The Coordination of Dentists and Physicians in Managing Adverse Oral Effects of Drug Therapy–Report of a Case
Authors: Levy Steven M.
Published: July 2006

Because people are living longer and older people generally use more medications than do the young, it is extremely important that the dentist be aware of the medications that are being taken by his/her patients as well as the reasons for the medications. Frequently, it may be necessary to consult with the patient's physician(s) in order to better understand the patient's medication history. This paper describes a case in which a patient was inappropriately following a long‐term course of antibiotic therapy when only a short‐term regimen had been intended by the patient's physician. The long‐term antibiotic use eventually predisposed the patient to oral candidosis. The dentist contacted the physician and referred the patient back to the physician for an alternative medical regimen. This case report emphasizes that patients may incorrectly interpret physician or dentist instructions concerning medication use. The dentist may be in an excellent position to identify medication errors and should contact the patient's physician whenever in doubt.
Dementia of the Alzheimer Type: An Oral and Biochemical Study1
Authors: Deville de Periere D. , Sanchez J. , Bertrand L. , Gonzalez L.
Published: July 2006

Alzheimer's disease, or pre‐senile dementia, may occur as early as 40 years. Pathologically, there is, besides a loss of brain weight, a conical atrophy with ventricular dilatation and typical microscopic lesions in the cortex and the hippocampus. Previously, the authors [Sanchez & Gonzalez, 1986] have studied the modifications of the amino acids (AA) composition in the cerebrospinal fluid (CSF), Even if some were increased without specificity, three of them were decreased significantly in this type of dementia (Serine, Glutamate and Aspartate). Twenty subjects were studied (15 with Alzheimer's disease and 5 non‐patients) having a mean age of 72 years. For each subject, two samples were tested (one blood and one saliva sample). In this study we tried to determine if our results would be similar to those previously obtained in the CSF, but in a different biological fluid, the saliva. Of the 13 AA of the saliva, tested by gas‐liquid chromatology (Spectra Physics 7100), 3 were increased significantly, and curiously, these were similar to those found to be decreased in CSF. We attempted to find the possible biological and oral repercussions of this dementia, which is the most frequent type in elderly patients.
Ethical Issues in Geriatric Dentistry
Authors: Wetle Terrie
Published: July 2006

Ethical issues involved in providing dental care to geriatric patients have generally been ignored in the practice and academic literatures. Elderly patients require special ethical consideration because of increased burden of illness, sensory deficits which may interfere with symptom interpretation and communication, fiscal constraints and ageism among both providers and patients. A taxonomy of ethical issues is provided including issues pertaining to the patient, the family, service providers, and the health care system. Suggestions are made for improving decision making in geriatric dental care.
A Review of Regional Studies on the Dental Health of Older Canadians1
Authors: Leake James L.
Published: July 2006

The last national survey of dental health in Canada was conducted in 1970–72 as part of the Nutrition Canada study. In that survey, 52% of Canadians over 60 were found to be edentulous. In 1980, epidemiologists in Quebec conducted the only provincewide, population‐based survey of seniors and found 72% were edentulous. In Ontario, published local or regional surveys and province‐wide interview data, obtained over the past 20 years, show that between 81% and 51% of those over 65 years of age were edentulous with the lower rates found in the more independently living, younger elderly, and in the more recent studies. Further, between 18% and 42.5% of those over 65 had visited a dentist in the previous year with higher rates among dentate and independently living elderly. Dental treatment needs were higher among the dentale and the institutionalized. These data are contrasted with recent findings from a population‐based study in East York, Ontario, and local data from British Columbia, Manitoba, and Prince Edward Island. The regional differences in health and the trends to increased life span, less edentulism and increased rates of visiting present challenges to Canadian policy makers and dental practitioners.
Trends in Oral Disease and Health1
Authors: Beck James D.
Published: July 2006

Geriatric dentistry researchers are building a basic knowledge basic pertaining to the oral health status of older adults. Important findings on the prevalence of disease that run counter to “conventional wisdom” surrounding the oral health of older adults are that edentulism is decreasing, that both coronal and root caries are prevalent, that serious periodontal disease is not as prevalent as thought, that chronological age is not strongly associated with disease in older adults, and that oral lesions, especially those related to dentures, are prevalent. An important finding has been that the majority of disease seems to occur in a minority of the population. While the prevalence of oral diseases have been shown to be associated with water fluoridation, systemic diseases, use of medications, social and behavioral factors, and a variety of other oral conditions, there is only preliminary information on the incidence of disease and actual risk factors. The data available on the incidence of disease come from a study of community‐dwelling older adults in Iowa, and these data generally confirm the prevalence results. Coronal and root caries are active in this older population with caries being the best predictor of tooth loss. Furthermore, most disease occurs in a high risk group. Multivariate models predicting people at highest risk for root and coronal caries implicate stress and anxiety, use of tobacco, and recent onset of illness as risk factors. In addition, preliminary results indicate that some dental conditions may be predictive of general health status.
Recent Clinical Research in Geriatric Dentistry1
Authors: Miller William A. , Karuza Jurgis
Published: July 2006

Current increased interest in gerontology/geriatrics has extended to various areas of dental clinical research. Dental science is still at the stage of defining many problems in this field and much emphasis is placed on epidemiological studies. Contemporary trends in clinical research are reviewed, including radiographic studies of the jaw, masticatory studies, and studies on xerostomia, periodontal disease, and root caries. An emerging priority for this research is to distinguish normal functional and morphological changes with age from pathogenic processes. A cooperative and multidisciplinary approach, spanning various disciplines and methodologies, seems to be one which will yield the most comprehensive picture of clinical changes in the elderly. Of particular interest is the recently funded dual contract to Buffalo, NY and San Antonio, TX for the study of periodontal diseases in older adults. A major emphasis has been placed on a multidisciplinary/interdisciplinary approach with focus on clinical, radiological, immunological, microbiological, nutritional and psychological‐social factors. While each may be considered separately, a greater emphasis is placed on the interaction of these parameters. Such a multidisciplinary project with two investigation sites needs detailed planning of the overall design and the cooperation of each discipline to insure the ultimate success of such a venture, particularly with regard to the reproducibility between the sites.
Qualitative Nutritional Intake Analysis of Older Adults with Sjogren's Syndrome
Authors: Rhodus Nelson L.
Published: July 2006

Previous studies support certain nutritional inadequacies in the diets of older adults. Studies also identify xerostomia as a contributor to inadequate lubrication, mastication, taste and swallowing. Prior to this study a relationship between xerostomia and inadequate nutritional intake has not been documented. This study qualitatively analyzed the diets of older adults with Sjogren's Syndrome (SS); (n= 28; mean age = 69.1), A control group of age‐sex‐physical status matched seniors; (n= 24; mean age = 68.2) was also analyzed. The presence of xerostomia was confirmed by both clinical and sialometric techniques for alt subjects. Subjects were interviewed, completed a five‐day diet record, and were interviewed again for quantitative analysis. The diets were then analyzed by computer for specific nutrient composition. The results indicated significant inadequacies at the p < 0.001 level for all the nutrients assessed in SS subject group as compared to both the controls and the RDAs. The significant differences were for: kilocalories, protein, fiber, potassium, vitamin A, vitamin C, vitamin B‐6, thiamin, riboflavin, iron, calcium and zinc. The most striking inadequacies (> 75% of all subjects) were for: fiber, vitamin B‐6, potassium, calcium and zinc. These results support an association between geriatric malnutrition and xerostomia. This study provides an important foundation for future research in the area of xerostomia in the aged.
Dental Hygienists' and Dental Hygiene Students' Attitudes Toward the Elderly
Authors: Mann Jonathan , Cross‐Poline Gail , Holtzman Joseph M. , Kaplan Ruth
Published: July 2006

Dental hygiene students' and graduates' attitudes toward the elderly were evaluated in two different countries representing two different cultures. Five dental hygiene programs in the U.S. and the only dental hygiene program in Israel were selected to participate in addition to graduates from both Colorado‐U.S. and Jerusalem‐Israel. A total of 180 dental hygiene students of which 44 were Israelis, 70 U.S. graduates, and 52 Israeli graduates, participated. Both American graduates and American dental hygiene students were found, based on the usage of the Rosencranz‐McNevin measure, to have significantly more positive attitudes toward the elderly as compared to the Israelis. Israeli and American dental hygiene students had a mean score of 120.92 and 105.96 respectively, Israeli graduates scored 122.39 and American graduates had a mean score of 105.09. The differences in culture, geriatric education in schools, and response to the survey according to what is most socially acceptable in the U.S. were the main reasons for these differences. Yet, it is hypothesized that these gaps in attitudes would decrease with the years, following the slow but stable “Americanization” of the Israeli society.
Methodological Issues Relative to the Quantification of Root Surface Caries1
Authors: DePaola P.F. , Soparkar P.M. , Kent R.L.
Published: July 2006

The purpose of this study was to assess the effect upon the quantification of root surface caries (RSC) of (1) the separation of the disease into its discrete clinical phases, (2) the confounding caused by the presence of restored abraded surfaces, and (3) the decision rule formulated for dealing with lesions and restorations which involve both crown and root. It was found that the apparent prevalence of RSC varied widely depending upon arbitrary decisions as to what stages of the disease were included in the measurement scheme. The addition of restorations (confined to the root) greatly enlarged the various disease measures, but probably also introduced some degree of error since there are several indications from the data and the clinical patterns of affected surfaces which suggest that some of the restored surfaces were formerly abraded rather than carious. The inclusion of lesions and restorations involving both root and crown produced another conspicuous increment in all disease measures, which is a cause for concern given that these components are included in some studies and ignored in others. These findings serve as the basis for several recommendations for future prevalence and incidence studies of RSC.
Morphological Changes in the Submandibular Gland of Aging Rats1
Authors: Slavin Bernard G. , Paule Wendelin J. , Bernick Sol
Published: July 2006

Age‐related histological changes in submandibular glands of 5‐, 15‐, and 24‐month‐old Sprague‐Dawley male rats were compared qualitatively using semi‐thin sections of epoxy‐embedded glands. Atrophy of acini and granular ducts with a concomitant hyperplasia of intercalated ducts were the dominant features seen in the 15‐ and 24‐month‐old glands compared to 5 months. In both aged groups (15 and 24 months) there appeared structures similar to terminal tubules normally seen during development. At 15 months irregular ducts consisting of a mixture of agranular cells and granular cells typical of granular ducts were found in continuity with the hyperplastic intercalated ducts. The significance of these age‐related morphological changes remains speculative.
Aging or Disease? Periodontal Changes and Treatment Considerations in the Older Dental Patient1
Authors: Johnson Bradley D. , Mulligan Kathleen , Asuman Kiyak H. , Marder Mitchell
Published: July 2006

The segment of our society over age 65 is growing, and many more of these people are keeping their teeth for a longer period of time. This suggests that there will be additional need for periodontal therapy in the future, but it also implies that disease‐related events must be distinguished from age‐related changes. Changes in the periodontium with aging are reviewed, and periodontal disease management strategies in the older patient are discussed.
The Diagnosis of Root Caries – A Review
Authors: Hellyer Paul , Lynch Edward
Published: July 2006

Interest in root caries has grown among dental caries research workers over the past 20 years. However, many studies, either in the fields of microbiology, pathology, epidemiology or clinical trials, have used differing definitions in their diagnosis of root caries. These differences mean that comparison between studies is difficult, if not impossible. Most of the criteria currently in use are neither sufficiently specific to allow the identification of the initial root caries lesion, not detailed enough to assess the progression of lesions. Furthermore, most definitions provide no information on treatment need within the populations studied. In this paper, the criteria which have been used to diagnose root caries, and their individual components – texture, cavitation, position, size, colour and radiolucency – are reviewed. It is concluded that there is a need to standardise terminology and definitions used for the diagnosis of root caries.
Comparing Older Adults' Perceived Need for Dental Care with a Normative Hierarchy of Needs1
Authors: Otchere D.F. , Leake J.L. , Locker D.
Published: July 2006

The elderly are reported to have poor perception of their need for dental care. In a secondary analysis of data from a community interview and clinical examination survey of older adults, we set out to determine the nature and extent of the inconsistency of perceived and normative needs. The data were gathered originally to estimate the oral health status and need for treatment among adults aged 50 and older in East York, Ontario. In the interview, participants responded to four questions dealing with their satisfaction with, and need for, dental care. Dentists conducted clinical examinations following WHO methods which included oral health status and treatment needs. Data were analyzed using SPSSPC +. We placed the clinical needs in order from urgent to no need, following ADA guidelines. The perceptions of subjects were then compared to this normative hierarchy using Kruskal‐Wallis analysis of variance. We found that participants' perceptions were closely associated with the normative hierarchy in all comparisons. Our results suggest that the concordance between perceived and normative needs is greater than previously reported.
The Measurement of Dynamic Latent Variables in Longitudinal Aging Research: Quantifying Adult Development
Authors: Collins Linda M.
Published: July 2006

Dynamic latent variables involve systematic intraindividual change over time. Although it seems natural to apply traditional measurement theory to dynamic latent variables, in fact this is often inappropriate. Traditional measurement theory is based on the idea of static latent variables and offers little guidance to the researcher who wishes to measure a dynamic latent variable with a high degree of accuracy and validity. It is the contention of this article that measurement of a dynamic latent variable must start from a clearly defined substantive theory about human development. Two approaches that take this perspective are presented; the longitudinal Guttman simplex (LGS), a measurement model for dynamic latent variables undergoing irreversible cumulative, unitary development; and latent transition analysis (LTA), a more general latent class measurement model.
Benefit related assessment of treatment need among institutionalised elderly people
Authors: Vigild M.
Published: July 2006

It has been assumed that improved oral health leads to a better quality of life for elderly people. It is, however, difficult to assess the benefit of oral health care, especially dental treatment in terms of life quality. The normative assessment, based solely on clinical diagnosis, often leads to an overestimation of the true need for treatment, especially among the ‘frail elderly’, some of whom do not want treatment, either because there is no perceived need or expressed demand. Others are very ill, and some in such a poor mental condition that they can not express any demand for treatment, and would probably not benefit from treatment e.g. new dentures. The realistic treatment need is an attempt to assess the true need for treatment in relation to the benefit provided. It is a combination of the normative need, the self‐perceived need, and the expressed demand for treatment, and takes into account the mental and physical state of the individual, as well as ethical considerations.
Implant therapy alternatives for geriatric edentulous patients
Authors: Zarb George A , Schmitt Adrianne
Published: July 2006

The predicament of being both elderly and edentulous undermines life quality for both patient and dentist. The former suffer because of morphological and functional compromises, the latter because of a dearth of safe and predictably successful clinical techniques. The introduction of the osseointegration technique suggested great promise for profoundly changing this predicament, but the specific merits of this approach have been mainly extrapolated ones. The purpose of this study was to examine the clinical success of treatment with osseointegration for patients who were 65 or older at the time of implant insertion. A second group of patients, who became 65 during the course of the study was also studied and the results recorded separately. Data regarding the longevity of implants and prosthodontic restorations and the numbers and types of problems encountered were recorded. The evidence suggests that the biological anchorage of tooth root analogues in elderly jaws is predicatbly successful and enhances the quality of life for geriatric patients who are edentulous.
Infective endocarditis and the dental practitioner
Authors: Davies Keren N.
Published: July 2006

This article reviews the relationship of dental treatment to infective endocarditis (IE). The current guidelines on the use of antibiotics in prophylaxis are also examined.
Oral care of people with disability: a qualitative exploration of the views of nursing staff
Authors: Weeks J.C. , Fiske J.
Published: July 2006

This study aimed to identify influences, attitudes and actions of nursing staff in relation to oral care for people with disabilities. Individual in‐depth interviews of twenty two nursing staff were conducted. Enabling and inhibiting factors in the reported attitudes, approaches and practices were identified. The main enabling factors were that nursing staff saw mouth care as part of their role and took an empathic and caring approach to its delivery. They aimed to make the residents socially acceptable, improve their self‐esteem and make their mouths clean and breath fresher. Inhibiting factors were: a lack of training, time constraints associated with workload, and poor understanding of the processes causing dental disease. The study concludes that improvements in oral care by nursing staff can be encouraged by working with nurses'attitudes, values and beliefs. Once the desired behaviour change has occurred then the lack of knowledge can be addressed.
The perceived importance of appearance and oral function, comfort and health for severely demented persons rated by relatives, nursing staff and hospital dentists
Authors: Nordenram Gunilla , Rönnberg Lisa , Winblad Bengt
Published: July 2006

Dental health is an aspect of the quality of life. Oral treatment goals for, the severely demented and the benefits of oral treatment are complex issues. Severely demented people can neither express their wishes nor make rational decisions about oral care. Acting “in the best interests” of a demented person who refuses or does not understand the purpose of treatment depends on what perspective and treatment priorities the advocate has. For oral treatment of a demented person the advocate may be a relative, a member of the ward staff or a hospital dentist. In a structured interview, the relatives of demented patients in a Stockholm hospital and members of the nursing staff were asked to rate the importance of goals for dental care. These ratings were also recorded for hospital dentists. In this study there was agreement on the importance of freedom from oral pain and fear of aspiration. Nursing personnel gave priority to aspects of good care such as being able to chew and enjoy eating. Relatives were also concerned with social behaviour and communication such as fresh breath, normal speech, and normal appearance. The ratings by the hospital dentists were generally lower which might reflect professional awareness of the limitations of treatment success implied by cognitive impairment.
Relationship between age and deposit of peritubular dentine
Authors: Kvaal S.I. , Koppang H.S. , Solheim T.
Published: July 2006

Peritubular dentine is a mineralised deposit formed centripetally in the dentine tubules with advancing age, so that the tubular diameter is smaller in teeth from older persons. The aim of the present study was to investigate the relationship between age in humans and the amount of peritubular dentine and the extent of the consequent obliteration of the tubules, and to find out whether this relationship was strong enough to be used as a parameter for age estimation. Fifty mandibular central and lateral human incisors were ground on the lingual aspect of the root and examined in a scanning electron microscope (SEM). The number of open tubules was counted and the diameter of the tubules measured both before and after etching with 35% orthophosphoric acid. The difference in the number of tubules in unetched and etched specimens was taken to be the number of occluded tubules, and the difference in radii before and after etching to be the thickness of peritubular dentine. The results did not demonstrate a significant relationship between age and the reduction in the number of tubules. One explanation might be that a certain age has to be reached before obliterated dentine tubules can be observed. The correlation between age and the thickness of peritubular dentine was not significant in teeth extracted because of periodontal disease, so these teeth were excluded from the regression analysis with age as the dependent variable. Only the thickness of peritubular dentine was included in the regression (r=0.69); this factor was a better indicator of age than the tubular diameter, but not so closely related to age that it can be recommended for general use in forensic and archaeological age estimations.
Xerostomia in older adults: a longitudinal study
Authors: Locker David
Published: July 2006

Although xerostomia in older adults has received substantial research attention, there have been few longitudinal studies of non‐patient populations. Consequently, little is known about the incidence or course of this condition among this group. This paper reports the results of a longitudinal study designed to address these issues. In 1989, data on xerostomia were collected from 907 randomly‐selected community dwelling adults aged 50 years and over. Three years later, 611 (71% of those presumed to be alive) were followed‐up and data on xerostomia collected again. At baseline, 15.5% of these 611 subjects reported xerostomia, while at follow‐up this had risen to 29.5%. The majority of the latter (115/180) were incident cases, reporting xerostomia only at follow‐up, while the remainder were chronic cases, reporting xerostomia at both baseline and follow‐up. A crude estimate of the three‐year incidence rate was 22.5%. In a logistic regression analysis, three baseline variables were associated with incidence; older subjects, those with one or more chronic medical conditions and those reporting their general health as poor were more likely to develop xerostomia. In a similar analysis, age was the only variable associated with chronicity, with older subjects more likely to be chronic cases. The data also suggest that the onset of xerostomia was associated with an increase in other oral symptoms and problems with eating, communication and social interaction.
The masseteric jaw‐jerk reflex in older dentate subjects and edentulous denture wearers
Authors: Kossioni A.E. , Karkazis H.C. , Molivdas P.‐A.
Published: July 2006

The aim of the present study was to investigate any variations in the jaw‐jerk reflex in edentulous subjects wearing complete dentures, compared to an age and sex‐matched dentate group. The reflex was elicited by chin taps in 22 older dentate subjects with mean age 61.3 years and in 22 denture wearers with mean age 63.1 years. Surface electromyographic recordings were obtained from the masseter muscle of the preferred chewing side during mandibular rest and at moderate clenching (40% of the individual maximum clenching masseteric EMG activity). A jaw‐jerk reflex was recorded in all subjects at least once, and its occurrence during clenching was reduced compared to rest. The occurrence of the reflex was however increased in the denture wearers in both experimental conditions, while minor differences were observed in the values for latency, duration and amplitude between the two dental status groups. These results suggest that under the present experimental conditions the periodontal ligament receptors might inhibit reflex activity. Multiple sensory interactions are expected in denture wearing. However a particular source of sensory feedback is provided by the stimulation of mucosal receptors from the acrylic denture base. Since the occurrence of the jaw‐jerk at clench in the denture wearers was also reduced compared to the rest experiments, a potential inhibitory effect of the mucosal receptors can be speculated. According to the findings in the present study the loss of teeth and the rehabilitation with complete dentures do not severely disrupt the reflex activity investigated.
Progressive changes in the pulpo‐dentinal complex and their clinical consequences
Authors: Burke F.M. , Samarawickrama D.Y.D.
Published: July 2006

With changes in the age structure and oral health in the population, changes in the pulpo‐dentinal complex are becoming more relevant clinically. Age‐related changes in the structure of dentine and pulp are reviewed. The influence of these changes on restorative dentistry are considered with particular emphasis on endodontics and the use of adhesive restorative materials.
Oral complaints and utilization of dental services in relation to general health factors in a 88‐year‐old Swedish population*
Authors: Lundgren M. , Österberg T. , Emilson G. , Steen B.
Published: July 2006

The aim of this study was to describe dental state, oral health problems, self‐assessed ability to perform oral hygiene and utilization of oral health services in a sample of 88‐year‐old people (n=374) and to relate these variables to functional ability, subjective health and drug consumption. The intention was also to Identify barriers to utilization of dental care in non‐institutionalized elderly people. The results of interviews showed that 46% of the subjects were dentate. Oral complaints were reported by 24% of the home living individuals. Poor health, medication and feelings of loneliness were factors associated with oral discomfort. Difficulties in performing oral hygiene activities were reported by 10% of the subjects and were correlated with functional impairments and feelings of loneliness. Utilization of dental services was correlated with dental state; 72% of the dentate and 8% of the edentulous subjects made regular dental visits. The main reason for not visiting a dentist was “no perceived need”. Independent of dental state, some factors were significantly correlated to low demand for dental services; these included feelings of loneliness, functional impairments and low school education.
The dental awareness and needs of a Parkinson's disease population
Authors: Clifford T. , Finnerty J.
Published: July 2006

The dental awareness and needs of a population with Parkinson's disease were assessed by means of postal questionnaires sent to members of Parkinson's disease societies of Belfast and London. A total of 228 valid replies were received representing a response rate of 31%. Results showed that dental problems were reported often, xerostomia and burning sensation being at least twice that of the general population. Satisfaction with dental care was high although it was significantly reduced in those with loose dentures and burning sensation. The results of this study support a greater participation by dentists in the planning and provision of healthcare for sufferer of Parkinson's disease.
Masticatory function in patients with xerostomia
Authors: Dusek M. , Simmons J. , Buschang P.H. , Al‐Hashimi I.
Published: July 2006

The effects of reduced salivary output in patients suffering from xerostomia on masticatory function has not been previously studied. This study compares masticatory performance and kinematic activity of patients suffering from xerostomia with age‐, sex‐, and number of occluding pairs‐matched healthy controls. Masticatory function was evaluated by assessment of chewing motion and muscle activity during chewing an artificial food (CutterSil®), chewing gum and swallowing a bolus of almond. Chewing motion was recorded with the Optotrak® computer system. Bilateral muscle activity of both masseter and anterior temporalis was recorded using surface electrodes. Results of this study revealed significant differences between patients and controls in their ability to process food and masticatory muscle activity. The majority of patients could not break down the artificial food, others had a larger median particle size than the controls. A significant difference was also observed in the number of chewing cycles required to swallow almonds, the patients required more than twice as many chews as the controls, P<0.001. The right masseter muscle displayed significantly less activity for the patient than the controls. These findings suggest that patients with xerostomia exhibit reduced ability to process food. The observed decline in masticatory performance is probably due to reduced activity of the muscles of mastication.
Factors related to the non‐attendance in a clinical oral health study on the home‐dwelling old elderly
Authors: Vehkalahti M. , Siukosaari P. , Ainamo A. , Tilvis R.
Published: July 2006

Objective:To evaluate how elderly home‐dwelling subjects’background factors, state of health, functional capacity and edentulousness related to their attendance in a comprehensive clinical dental study. Design:Cross‐sectional population study; interview and clinical dental data. Setting:The City of Helsinki; clinical dental examinations at the Institute of Dentistry, University of Helsinki. Subjects:600 elderly aged 76, 81 and 86 years, participants in the medical examinations in the Helsinki Ageing Study one year earlier, 81% being home‐dwelling. Measures: Age, gender, marital status, family structure, educational level, former line of work, self‐perceived general health, dentulousness, ability to move, sense of hearing, state of memory, clinical findings of dementia, other medical diagnoses, and intake of drugs. Outcome measure: Participation in clinical dental examinations. Results:The overall participation was 63% being reduced by high age and female gender, 75% of the 76‐year‐olds, but only 53% of those aged 81 or 86 years were clinically examined, figures were for men 72% and for women 60%. As shown by a multifactorial logit model, the strongest factors related to non‐participation were the home‐dwelling subjects’old age (OR=3.6), deteriorated ability to move (OR=5.3), clinically diagnosed symptoms of dementia (OR=4.1), or edentulousness (OR=2.5). Conclusion:Non‐participation selectively by those edentulous will lead to prevalence figures on numbers of teeth being too optimistic for the entire elderly population.
Alzheimer's disease, oral function and nutritional status
Authors: Nordenram G. , Ryd‐Kjellen E. , Johansson G. , Nordstrom G. , Winblad B.
Published: July 2006

Objectives:To study differences in nutritional, dental status and oral function between institutionalised patients with Alzheimer's disease and cognitively healthy elderly people living in the community. Design:Comparison was made between two groups, Alzheimer's disease sufferers and healthy controls, using established criteria for anthropometric, mental and dental state. Setting:An institution and residential area in Stockholm, Sweden. Subjects:Forty patients with Alzheimer's disease living in a nursing home and 40 age‐and gender‐matched control subjects living independently. Intervention:Dental status and anthropometric variables. Results:Overnutrition was less frequent among the demented than the controls and more demented were undernourished. Dental status was similar in the two groups with few edentulous subjects but only 2 of 7 edentulous subjects with Alzheimer's disease wore dentures. Having natural teeth and many functional oral zones is important for food consistency choice, but not for nutritional status. In the Alzheimer group, the stage of dementia has a strong association to the ability to eat unaided and an association with dental status. Conclusion:There are differences in nutritional status between Alzheimer patients in institutions and cognitively healthy elderly living at home. The choice of food consistency is correlated to dental status but nutritional status is not shown to be influenced by dental status. However, the ability to eat unaided is strongly correlated to cognitive status.
Legal Education: The Consumers' Perspective
Authors: Pipkin Ronald M.
Published: July 2006

This paper is the first in a series on data collected for the Law Student Activity Patterns Project. The project is one of several discrete studies in the research program in legal education of the American Bar Foundation, conducted at the request of the American Bar Association House of Delegates, with the advice and consultation of the Special Committee for the Study of Legal Education. A major purpose of this research is to develop an understanding of the professionalization of law students in behavioral terms, that is, in terms of patterned activities and time use. However, we will first present a series of initial reports analyzing data relevant to other general concerns about contemporary legal education.
The Scope of the Fourth Amendment: Privacy and the Police Use of Spies, Secret Agents, and Informers
Authors: Stone Geoffrey R.
Published: July 2006

This article has been produced under the Samuel Pool Weaver Constitutional Law Essay program, which is supported by trust funds given to the American Bar Foundation by the late Samuel Pool Weaver to encourage research and writing about the Constitution and its application to current problems. Under the terms of the program as presently structured, a constitutional law scholar is invited from time to time to write an essay on a subject agreed upon between the scholar and the American Bar Foundation. This is the first essay produced under the program's new format.
Styles of Delivery of Legal Services to the Poor: A Review Article
Authors: Brakel Samuel Jan
Published: July 2006

This article was stimulated by the publication of Toward Equal Justice: A Comparative Study of Legal Aid in Modern Societies, edited by Mauro Cappelletti, James Gordley, and Earl Johnson, Jr. (Dobbs Ferry, N.Y.: Oceana Publications, Inc., 1975), a recent and ambitious entry in the debate over alternative methods of delivering legal services to the poor. Brakel, the author of several publications in the field, feels that the portion written by Johnson, presenting the operational and research experience with legal services for the poor in this country, is one-sided and unsatisfactory and maintains that, through the process of critically examining the Johnson portion, it is possible to present a more balanced picture of the legal aid experience in the United States. This is important for the domestic audience as well as for the international readers whom the book seeks to address.
The Checking Value in First Amendment Theory
Authors: Blasi Vincent
Published: July 2006

The author examines the sources and premises of the idea that free expression has value in part because of the function it performs in checking the abuse of official power (the “checking value”) and explores how this checking value difyers from those values that have dominated First Amendment analysis since 1919. In addition, the author traces in some detail the uneven influence the checking value has had recently in three areas of First Amendment adjudication: civil actions f o r defamution; disputes arising from efforts by journalists to protect or establish relationships with news sources; and claims b y nonjournalists to a constitutional or statutory right to communicate directly to the public over major print or broadcast outlets. The author argues that the checking value must receive open, systematic consideration if it is to play a consistent part in adjudication and speculates on how such consideration of the checking value might help one think about a wide range of additional First Amendment questions.
Computer Power and Legal Reasoning: A Case Study of Judicial Decision Prediction in Zoning Amendment Cases
Authors: Haar Charles M. , Sawyer John P. , Cummings Stephen J.
Published: July 2006

While social scientists have long advocated the use of statistical methodology in legal analysis, its practical application has not been tested. Statistical models based on social science theories have been used to predict judicial decisions and explain court behavior, but the legal profession has failed to develop statistical models based on traditional legal theories and using data familiar to the lawyer. This article seeks to demonstrate by practical application of statistical methodologies, coupled with traditional legal research methods, that such research can produce important insight into a court's decision making and provide a useful model for predicting the probability of a favorable decision. The zoning amendment decisions of the Connecticut Supreme Court are the data base of this study, which also provides a comprehensive explanation of zoning amendment law in Connecticut as a backdrop against which to evaluate the insights gained by statistical analysis.
Legal Problems of People in Mental and Penal Institutions: An Exploratory Study
Authors: Brakel Samuel Jan
Published: July 2006

This exploratory study of the legal problems or needs of prisoners and mental hospital patients (the institutionalized) reveals the wide range and diversity in the perceptions of what the needs are and what the legal responses might be. It argues for the need to conduct research that first promotes our qualitative understanding of legal demand among the institutionalized, and it suggests the need to experiment with and do research on legal supply programs in the institutions. Only then can we begin to think about quantifying the needs and designing with some precision delivery programs based upon such quantitative information. The study also suggests the need for a lawyer role in the institutional context that departs from traditional role perceptions, both in terms of the approach taken to cases and clients and in terms of the substantive problems deemed deserving of legal attention.
Public Attitudes About Property Distribution at Death and Intestate Succession Laws in the United States
Authors: Fallows Mary Louis , Simon Rita J. , Rau William
Published: July 2006

Intestate succession statutes should reflect the distributive preferences of intestate decedents. To date, these distributive preferences could only be inferred from distributive patterns found in wills. This telephone survey of 750 persons living in Alabama, California, Massachusetts, Ohio, and Texas supplements prior will studies and provides new insights concerning public attitudes about property distribution at death. The distributive preferences of the respondents revealed few significant differences that could be attributed to age, education, income, wealth, or occupational status. Two other important findings of this study suggest that a modern intestacy statute should provide that (1) the surviving spouse inherit the entire estate in preference to the decedent's issue or family of orientation and (2) issue who are in the same generation share equally in the estate.
Special Masters in Institutional Litigation
Authors: Brakel Samuel Jan
Published: July 2006

Litigation concerning conditions in institutions such as prisons or mental hospitals does not stop at the issuance of a remedial decree. Steps must be taken to assure implementation. Increasingly, the courts are resorting to special masters to assist them in implementing such institutional reform. While the use of masters by courts is a firmly established tradition, the role assigned to masters in the institutional context is often an extraordinarily broad and intrusive one. As a result, serious questions have arisen about this new extra-traditional master role and about the applicability, the sufficiency, of the traditional rationales and restraints. This article is among the first in a small but developing body of literature that begins to examine the new master role and the questions concerning it.