bluuebunny/crossref_metadata_2025 huggingface dataset:
Special oral concerns in people with severe and profound mental retardation
Authors: Dura Jason R. , Torsell A. Elizabeth , Heinzerling Robert A. , Mulick James A.
Published: March 2008

Dental patients with severe and profound mental impairments may engage in behaviors that adversely affect their oral health. Based on experience in a residential care facility, this report sensitizes dental practitioners, who are unfamiliar with the problems of these patients, to consequences of these behaviors.
Hyposalivatory drug use, whole stimulated salivary flow, and mouth dryness in older, long‐term care residents
Authors: Handelman Stanley L. , Baric Jean M. , Saunders Ralph H. , Espeland Mark A.
Published: March 2008

Drug‐induced hyposalivation has only been anecdotally related to various subjective and objective oral problems. The study described here of 157 residents of a long‐term care facility reports data on whole masticatory‐stimulated salivary flow rates, use of medications, and perceptions of symptoms associated with hyposalivation, including mouth and eye dryness, tooth sensitivity, chewing satisfaction, and taste and smell acuity.

One hundred and twelve residents (71%) were taking one or more drugs that induced hyposalivation. Salivary flow rates were lower in persons who were taking such drugs, and lowest in persons who were taking such drugs for a protracted period. Flow was also lower in females than males, and lower in persons institutionalized for long periods than in persons institutionalized for short periods. Persons who were taking drugs that induce hyposalivation were institutionalized longer, used more medications, had more health problems, were dissatisfied with chewing, and had fewer teeth than persons who were not taking such drugs. Persons who reported having mouth dryness also reported eye dryness and were dissatisfied with their chewing ability. Perceived mouth dryness was not related to salivary flow.

Prevalence of hyposalivatory drug use in a long‐term care facility is described. Several important independent variables, including gender, length of residency, number of nonhyposalivatory drugs used, and number of major health problems have been linked to reduced salivary flow, use of hyposalivatory drugs, and perception of mouth dry ness. Reduced salivary flow, use of hyposalivatory drugs, and perceived mouth dry‐ness have, in turn, been linked to symptoms that are commonly associated with hyposalivation, including perceived loss of smell, few teeth, dissatisfaction with chewing, and perceived eye dryness. Data indicate that reports of mouth dryness become more frequent and more severe with the number of hyposalivatory drugs used. Mean salivary flow rates declined as numbers of hyposalivatory drugs taken and period of use increased. Salivary flow rates were not found to be related to perceived mouth dryness.
Treating patients with nervous vomiting in the dental office by point‐stimulating therapy
Authors: Yugin Luo
Published: March 2008

Treating patients with nervous vomiting in the dental office is a difficult problem for dentists. An efficient method—point‐stimulating therapy—is recommended for dealing with such cases.
Overdentures for patients who are chronically ill: a 4‐year follow‐up
Authors: Markitziu Alice , Leviner Ephraim , Sela Mordechai
Published: March 2008

In 12 chronically ill patients, 14 overdentures were inserted. The status of the retained teeth and the denture‐supporting structures was evaluated annually for up to 4 years. The limitations and implications of this therapy as related to specific chronic diseases, medications, and patient behavior are emphasized. Based on short‐ and long‐term follow‐up, recommendations for the applicability of overdentures in systemically ill patients are offered.
Mobile dental practice: financial considerations
Authors: Bronny Andrew T.
Published: March 2008

Comparison has been made for startup and operating costs of mobile versus traditional dental practice. Economies in the mobile practice have been demonstrated. Some strategies were presented to help perpetuate those economies. Reimbursement mechanisms through Medicaid and Medicare were briefly examined in addition to present initiatives in health care reform. The financial aspects of mobile practice must be studied before implementation of this vital service so that the practitioner may be financially secure.
Oral hygiene levels and periodontal disease prevalence among residents with mental retardation at various residential settings
Authors: Thornton John B. , Al‐Zahid Suad , Campbell Vincent A. , Marchetti Allen , Bradley Edwin L.
Published: March 2008

This pilot study compared oral hygiene levels and periodontal disease prevalence among residents with mental retardation in a large traditional state institution, a small regional facility, and community group homes. Plaque scores and periodontal disease levels were high in all groups. However, there was a significant difference (P<0.05) among the group home residents, who had lower scores, than the other groups. These results indicate that preventive dental programs are necessary in new residential settings for individuals with mental retardation.
Model hospital outreach service
Authors: Cox Carol M.
Published: March 2008

The Outreach Dental Care Service of Swedish American Hospital, Rockford, IL, brings a hygienist to local long‐term care facilities, who provides prophylaxis, cleans partial dentures and complete dentures, plans individualized daily oral hygiene regimens, trains facility caregivers, and educates staff members.
Predictors of oral health behaviors among elderly Japanese Americans
Authors: Diehnelt Dawn , Kiyak H. Asuman , Beach Barbara H.
Published: March 2008

As part of a series of studies on oral health behaviors of older persons, 81 elderly Japanese Americans were interviewed regarding their dental service utilization patterns, oral health attitudes, and dental status. The sample consisted of 35 Issei (first generation) and 46 Nisei (second generation) Japanese Americans. Because of the significant age difference between the Issei and Nisei, it was difficult to examine generational differences between the two groups. When age differences were controlled, there was no difference between the two generations in interval since their last dental visit. However, reasons for dental visits differed between the two groups, with the Issei more likely to seek help with dentures or general restorative work while the Nisei were more likely to schedule appointments for dental check‐ups and cleaning. The best predictors of dental service utilization for the entire sample were the use of complete dentures, age, and education (R2= .38), but when the respondent's perceived importance of oral health was entered into the equation, this variable accounted for more variance than age or education. The combination of complete dentures, importance, and age accounted for 41% of the variance in recency of dental service utilization. Locus of control, the belief component of attitudes, and overall attitude scores did not add significantly to the prediction of dental utilization.
A comparison of prescription medication use by nursing home and homebound dental patients
Authors: Strayer Michael S. , Ibrahim Maged F.
Published: March 2008

The elderly consume a disproportionate number of prescription medications dispensed in the United States. Although medication use among nursing home residents has been documented, little information is available regarding the medication use of homebound elderly. This study compared the medication use of nursing home and homebound patients treated by a mobile dental homecare program. A total of 338 dental records were reviewed, identifying the number and type of medications used. In addition, medications with xerostomic potential were identified.
A clinical evaluation of the restoration of root surface caries
Authors: Levy Steven M. , Jensen Mark E.
Published: March 2008

Root surface caries is of growing importance because its prevalence increases with age, and the population of the United States is growing older while edentulism and tooth loss rates have declined. Few clinical studies have evaluated materials used for the restoration of active root caries lesions. This study evaluated a Type II glass ionomer cement and a microfilled composite resin, both placed in preparations without mechanical retention or acid etching of enamel, in the restoration of root caries.

Fifty adult volunteers with active root caries received one or both materials with the material chosen randomly. Patients were recalled after 24 months to evaluate restorations for retention, additional caries, marginal integrity, and overall clinical acceptability. Seventy‐seven restorations were available for re‐evaluation.

Forty‐five percent of the glass ionomer and 73% of the composite restorations were clinically acceptable after 24 months. Of the glass ionomers, 39% were fully retained compared with 73% of composite restorations. Among those partially or fully retained, 25% of the glass ionomer restorations had minimal loss of marginal integrity and 30% had extensive loss while 53% and 9% of composite restorations had minimal and extensive loss, respectively. Most restorations were clinically unacceptable because of restorative material loss.

Substantial numbers of glass ionomer cement and composite resin restorations were lost. This may be the result of difficulties in maintaining isolation and obtaining a proper gingival seal. Thus, routine use of mechanical retention is still highly recommended to reduce the loss of restorative material.
A survey of the availability of dental services to developmentally disabled persons residing in the community
Authors: Burtner A. Paul , Jones Jack S. , McNeal Donald R. , Low Debra W.
Published: March 2008

Public Law 88–164, enacted in 1963, has led to extensive deinstitutionalization of persons with mental retardation from a peak census of 194,650 in 1967 to 91,440 by 1988. This population now depends on the community‐based health care system for medical and dental care. A survey conducted to determine the availability of dental care to the developmentally disabled residing in group homes located in north central Florida indicated that 40% of caretakers experienced difficulty in locating dentists willing to provide comprehensive dental services for residents. According to the caretakers, although 75% of the residents were cooperative dental patients, dentists were reluctant to provide services for a variety of reasons, including financial disincentives, inadequate knowledge and preparation, and a lack of proper equipment necessary to treat this group of special patients.
A comparison of the oral health of persons with and without chronic mental illness in community settings
Authors: Stiefel Doris J. , Truelove Edmond L. , Menard Thomas W. , Anderson Virginia K. , Doyle Patricia E. , Mandel Lynn S.
Published: March 2008

Severe dental disease has been reported for patients receiving psychiatric treatment. This study compared the oral status of non‐institutionalized adults with chronic mental illness with a similar group without such history, and evaluated relative risk factors, for example, xerostomia, diet, hygiene, and poverty. A sample of 37 subjects with chronic mental illness (CMI) and 29 control subjects without mental illness were assessed for dental, medical and social history; head, neck, and oral soft tissue pathology; salivary flow; DMFS, gingivitis, loss of periodontal attachment, plaque, and calculus. The groups were equivalent in socioeconomic level, education, dental history, and home care. All subjects with CMI received psychotropic medications (mean of 3.8 drugs for 10.3 years). The CMI group had significantly higher incidence in the following variables: self‐reported dry mouth; consumption of carbonated beverages (P <.001); mucosal, lip, and tongue lesions (P <.01); coronal smooth surface caries (P<.001); severity of plaque (P<.001) and calculus (P<.01); and salivary flow (P<.05). No significant differences were evident in the M and F components of DMFS, in gingivitis or loss of attachment. The results indicate significant increases in risk factors and increased oral pathosis in persons with mental illness who live in community settings compared with a control group that showed dental neglect.
Multiple dental extractions using general anesthesia for a patient with Down and Eisenmenger syndromes and periodontal disease
Authors: Bozich John G. , Albert Thomas W.
Published: March 2008

A patient with Down syndrome and severe retardation and Eisenmenger syndrome sought dental treatment at the Oregon Health Sciences University Hospital Dental Service. Eisenmenger syndrome is a form of cyanotic congenital cardiovascular pulmonary disease. The cardiac structural abnormalities associated with Eisenmenger syndrome preclude the use of conscious sedation and predispose a patient to the development of bacterial endocarditis. A prophylactic antibiotic regimen is recommended for patients with Eisenmenger syndrome who are undergoing procedures that produce a transient bacteremia. This article reviews the appropriate measures necessary for the safe anesthetic, operative, and perioperative care of a severely compromised patient. It is based on an understanding of the patho physiology associated with Eisenmenger syndrome.
Interstitial radioactive implants for oral and oropharyngeal cancer: dentistry's role
Authors: Ill Paul Lee Salisbury , Stump Thomas E. , Randall Marcus E.
Published: March 2008

Five patients with oral or oropharyngeal cancer were treated with external beam radiation therapy and interstitial radioactive implants as part of their tumor management. The radiation oncologists used various radioisotopes and techniques for placement. Local anesthesia, and in most cases conscious sedation, were used instead of general anesthesia to insert the implants. The dental team, working in conjunction with the radiation oncologists, was able to provide this service which resulted in safe, cost‐effective care for the patients
The cause and management of burning mouth condition
Authors: Basker Robin M. , Main David M.G.
Published: March 2008

This paper reviews the clinical presentation and many causes of burning mouth condition. A diagnostic approach and some management procedures that include eliminating all oral irritants, correcting predisposing systemic disease, and most important of all, allaying anxiety that induces parafunctional mouth habits. The term “burning mouth condition” (BMC) is considered more appropriate than the word “syndrome” for this common and troublesome complaint
Evaluation of calculus accumulation in tube‐fed, mentally handicapped patients: the effects of oral hygiene status
Authors: Dicks Joseph L. , Banning Jill S.
Published: March 2008

A group of fifteen tube‐fed mentally handicapped subjects were compared with a similar group of fifteen nontube‐fed subjects to determine the rate of calculus formation during a 60‐day period of intensive oral hygiene care. The findings indicate that calculus formation is significantly more rapid in the tube‐fed group, although the oral hygiene levels of the tube‐fed group were superior. Nearly half (48%) of this calculus accumulated within the first 3 weeks. The calculus accumulation for both groups was lower than that indicated in a previous study where oral hygiene was poor
Gingival hyperplasia: a side effect of nifedipine and diltiazem
Authors: Fattore LaDeane , Stablein Michael , Bredfeldt Glen , Semla Todd , Moran Maureen , Doherty‐Greenberg Jean Marie
Published: March 2008

Currently, calcium channel blockers are being used increasingly for the treatment of hypertension in the elderly. Several case reports in the dental literature suggest that patients treated with the calcium channel blockers manifest gingival hyperplasia similar to that seen in patients taking phenytoin (Dilantin, Parke‐Davis). A small study of 89 patients undertaken at the Westside Veterans Administration Medical Center, Chicago seems to indicate that nifedipine and diltiazem do indeed cause gingival hyperplasia. A total of 83% of the patients studied receiving nifedipine showed evidence of hyperplastic tissue and 74% of those on diltiazem were found to have hyperplastic tissue
A toothbrushing aid for a quadriplegic patient
Authors: Spratley Martyn H
Published: March 2008

This brief technical report describes a simple device that holds a toothbrush for a quadriplegic patient. The device allowed the patient to complete his own daily oral hygiene
Research review of oral health status and service use among institutionalized older adults in the United States and Canada
Authors: Berkey Douglas B. , Berg Robert G. , Ettinger Ronald L. , Meskin Lawrence H.
Published: March 2008

United States and Canadian studies have reported that a relatively large proportion of the institutionalized, older adult population is afflicted with a host of dental diseases and rarely seeks dental services. Analysis of existing published information indicates areas of concern including the need for incidence data, consensus on appropriate measures, and samples that will provide representative and comprehensive information about compromised older adults, irrespective of institutional or homebound status.

Special emphasis should be placed on determining risk factors for dental disease, through longitudinal study of older adults.
Combined medical‐dental treatment of an epidermolysis bullosa patient
Authors: Camm Jeffrey H. , Gray Lt Col; Scott E. , Mayes Major; Thomas C.
Published: March 2008

Epidermolysis bullosa presents a wide range of clinical symptoms. In this case, a patient had recessive dys‐trophic epidermolysis bullosa that required dental treatment. Standard protocol modifications and medical considerations were required in preparation for general anesthesia. Postop erative follow‐up, including monitoring the relationship of the patient's disease state to dental health, is recommended

A patient with a debilitating disease, such as epidermolysis bullosa, is a challenge to the dentist wishing to provide optimal and comprehensive dental treatment. While tissue sloughing and bullae formation during treatment cannot be eliminated, the previously outlined protocol can limit the severity of it.

Medical assessment of these patients is mandatory to determine their overall health status. If indicated, a combination medical and dental procedure can be performed under general anesthesia, thereby limiting the number of stressful operations a patient may have to undergo.

Triannual dental examinations and continual re‐evaluation are necessary to promote continued dental health and recognition of early pathosis. Aggressive preventive measures are necessary to ensure the patient's future dental needs are minimal.
Self‐inflicted oral trauma: report of case
Authors: Shelter Barbara
Published: March 2008

An easily made, reusable mouth‐ guard suitable for comatose patients with neuropathologic chewing is presented. Its use is described for a comatose child with self‐inflicted tongue trauma.
Sociodemographics of homebound people in Kentucky
Authors: Williams John N. , Butters Janice M.
Published: March 2008

In this report, selected results are presented from the 1987 Kentucky Oral Health Survey, which acquired statewide data on the oral health status and practices of the noninstitutionalized population of Kentucky. In the 1987 epidemiological survey, Information about persons who were home‐ bound was also gathered through telephone and in‐person interviews. The results of that survey provided a relatively accurate estimate of the number of persons homebound In the state of Kentucky. Although the majority of this population was older than age 60, almost 21% were between the ages of 35 and 59. Household Income for persons who are homebound and the amount of money spent on dental care is significantly less than in households not reporting the presence of a person who is homebound. These findings provide baseline data for dentists and health planners interested in serving this population. Also, this data is pertinent to the formation of health policies to create accessible, affordable care for this growing segment of the population.
Pharmacotherapy in the geriatric population
Authors: Tomaselli Claudia E.
Published: March 2008

The geriatric population constitutes the largest group of consumers of medications in this country. Changes in the pharmacokinetic response to medications of this population are less predictable than in younger age groups, thereby resulting in adverse reactions and drug interactions in multidrug users. Dentists need to be aware of these changes as well as alterations in therapeutic responses to the medications most commonly used in dental treatment: sedatives, local anesthetics, analgesics, and antibiotics.
The use of vacuum‐molded polyvinyl acetate‐polyethylene copolymer (PVAC.PE) for a handicapped patient
Authors: Nunn June H. , Wood Ian
Published: March 2008

This paper provides a survey of recent literature on the use of mouth sticks for patients who have little or no use of their limbs. Criteria for mouth stick design, types of appliances, and the fabrication of such devices are described. Details are given of a case of a young child with arthrogryposis multiplex congenita, in whom a novel approach was used to allow the safe intra‐oral retention of writing implements
Informed consent and the geriatric dental patient
Authors: Odom John G. , Odom Sylvia S. , Jolly Daniel E.
Published: March 2008

Dental professionals are Increasingly aware of their ethical responsibility to permit patients to participate in treatment decisions through the Informed consent process. At the same time, growing numbers of geriatric patients present special challenges that can Jeopardize the use of informed consent. Consequently, the use of informed consent with geriatric patients warrants special analysis due to complicating factors such as patient passivity and questionable competency. This article establishes the relationship between the ethical principle of autonomy and informed consent while examining factors that must be present in order for a valid informed consent to be obtained. Additionally, the article addresses informed consent issues regarding competent patients, geriatric patients with fluctuating or uncertain competency, and patients who are clearly incompetent
A chemomechanical system for caries removal and glass ionomer cement to restore fixed partial denture abutments
Authors: Lu Dominic P.
Published: March 2008

When a fixed partial denture fails due to recurrent caries under the casting of the abutments, a remake process usually requires a great deal of cooperation, multiple lengthy appointments, and financial resources. Many patients with special needs may not have the cooperation, tolerance, and resources to support such treatment. This paper describes an alternative method that utilizes a chemomechanical system for caries removal followed by a conventional restorative material to treat those patients
Family member and guardian acceptance of dental services for nursing home residents
Authors: Warren John J. , Hand Jed S. , Kambhu Peter P.
Published: March 2008

The decision to utilize dental treatment often rests with a nursing home resident's family member or guardian, and factors associated with family member/guardian acceptance of dental services for residents have not been identified

This paper reports the results of a study which found that nearly 66% of nursing home residents' next of kin identified themselves as being primarily responsible for making health care decisions for the residents. Among these 109 resident/ next of kin pairs, utilization of dental services by the residents was associated with younger next of kin, next of kin with higher levels of education, and next of kin who perceived dental need for the resident. In addition, residents who were female, physically mobile, not mentally alert, dentate, and had fewer years of education had dental services accepted for them at a higher rate than did residents who were male, physically immobile, alert, edentulous, or had more years of education. Findings suggest that more effort should be directed at educating the next of kin of nursing home residents in the value of dental care among the elderly.
Cohort differences among aging populations: A challenge for the dental profession
Authors: Ettinger Ronald L.
Published: March 2008

The pattern of utilization of oral health services by older adults is changing as more older people maintain their natural teeth. Heterogenicity among persons aged 65 and older is probably greater than in any other period in the life cycle; however, all too often, all age groups over age 65 have been grouped together for program planning or data analysis. The socio‐dental and historical influences on five specific age cohorts born between 1905 and 1945 are presented so that dentists may better understand the differences in attitudes and expectations of these individuals when they seek treatment.
Identification of appropriate outcomes for an aging population
Authors: Dolan Teresa A.
Published: March 2008

Outcome measures are necessary for assessment of the appropriateness, quality, necessity for, and effectiveness of oral health care. With the growing number of older adults in the United States, it is appropriate to reflect on the unique characteristics of this segment of our society and how these characteristics may influence the identification of appropriate outcome measures. Older people often demonstrate multiple acute or chronic oral diseases with interrelated symptoms and clinical findings. Older persons are more likely to take medications with potentially adverse oral health effects. Patients experience a variety of disease processes over many years and have variable access to and experiences with the dental care system. These characteristics make the selection and interpretation of outcomes complex. Limitations of existing measures and considerations for the development of new outcomes measures specifically for older populations are reviewed.
Comparisons between dentist ratings and self‐ratings of dental appearance in an elderly population
Authors: Matthias Ruth E. , Atchison Kathryn A. , Schweitzer Stuart O. , Lubben James E. , Mayer‐Oakes Allison , Jong Fred De
Published: March 2008

Little is known about dental appearance in terms of the elderly population. The purpose of this paper is to compare self‐reported dental appearance with dentist‐rated appearance for individuals over 65. The subjects (N = 550) were participants in the Los Angeles based Medicare Screening and Health Promotion Trial. Most were female (57.3%), white (89.0%), and married (62.0%), with a mean age of 74.5 years. About one‐third had incomes greater than $25,000. Results are based on a 45 minute telephone interview and onsite dental screening.

Findings show that 40% of the self‐ratings on a five point scale were higher than the dentist ratings, and 22% were lower. Bivariate analyses showed that both sets of ratings were related to dental status variables, self‐reported health, and education. High self‐ratings were also associated with being white and having a positive mental health status, white high dentist ratings were associated with patients who were younger, married, and who had higher income and social network scores. Comparison of results from two multiple regressions showed unique predictors for the self‐ratings (marital status and GOHAI scores) and for the dentist ratings (sex and income). These discrepancies can raise barriers to effective treatment planning in the elderly, which could affect utilization and satisfaction.
A prospective survey of hospital ambulatory dental emergencies Part 1: Patient and emergency characteristics
Authors: Gibson Gary B. , Blasberg Bruce , Hill Steve J.
Published: March 2008

Part 1 of this study describes the dental disorders and patient characteristics of 253 patients who presented as dental emergencies to the University Hospital dental clinic, Vancouver, BC, during a three‐month period. Most patients had a true perception of what constitutes a dental emergency. Dental pain was the predominant reason for seeking help, and the pain existed for more than seven days prior to contact in more than 50% of patients. Patients were not always able to identify the number and location of painful teeth, and a perceived low cost for treatment was a major reason for contacting the hospital. Reliability of emergency patients in keeping scheduled appointments was very high. Almost 69% of patients did not see a dentist regularly. Referrals to the hospital dental service were most numerous in the summer months. Diagnosis of the complaints revealed infection to be the cause of pain in 76.7% of patients.
Dental management of a child with Huntington's Disease: Case report
Authors: da Fonseca Marcio A. , Walker Paul O.
Published: March 2008

Huntington's Disease is a chronic, progressive, hereditary disorder of unknown etiology. Onset occurs between 35 and 42 years of age and is characterized by chorea, behavioral changes, dementia, and irregular gait. Dyslalia is a common feature due to the severe darting movements of the tongue and head. Huntington's Disease is rarely diagnosed in children (less than 1% of all cases are documented in children under 10 years of age). This is a case report of an 11 year 5 month old white male, diagnosed at age 5, who was brought to the University of Minnesota Hospital Dental Clinic for an oral examination. The findings are presented, and the management of patients with Huntington's Disease is discussed.
Management of orofacial manifestations of parkinson's Disease with splint therapy: A case report
Authors: Durham Timothy M. , Hodges Eric D. , Henry Mithchell J. , Geasland John , Straub Peter
Published: March 2008

Patients with Parkinson's Disease display a number of orofacial manifestations. These manifestations are secondary to motor and sensory deficits, resulting in bradykinesia, muscle rigidity and tremor, and difficulties with speech, swallowing, proprioception, tactile sensitivity, and hard‐ and soft‐tissue trauma. This case describes the use of a bruxism splint which benefited a PD patient by diminishing the occurrence of orofacial pain secondary to muscle tremor and rigidity while reducing the cumulative damage to the oral structures common with the disease. The impact of therapy on sleep, speech, and swallowing difficulties is also discussed.
Nasopharyngeal carcinoma: A 15‐year retrospective study
Authors: Chapman Kenneth E. , Patton Lauren L.
Published: March 2008

Malignancy in the nasopharynx, although uncommon, Is potentially devastating because of the anatomy of the region and benign early symptoms, which result In infrequent early diagnosis. High‐dose radiation therapy, with fields including the oral structures, is the treatment of choice and may result In significant oral complications. This paper reviews 39 cases of nasopharyngeal carcinoma diagnosed at the University of North Carolina Hospitals over a 15‐year period. Patient demographics, histopathology, presenting signs and symptoms, stage at diagnosis, possible risk factors, treatment modalities, survival, side‐effects of therapy, and dental Intervention are reported.
A comparison of oral health in spinal cord injury and other disability groups
Authors: Stiefel Doris J. , Truelove Edmond L. , Persson Rigmor S. , Chin Mae M. , Mandel Lynn S.
Published: March 2008

A controlled pillot study determined oral heallth in persons with quadriplegia due to spinal cord injury, and compared dental disease rates in spinal cord injury and other disability groups. Seventeen adults with spinal cord injury and 17 controls were assessed for dental/medical/social history; manual function; head, neck, and oral lesions; salivary flow; DMFS; and gingivitis, periodontal pockets, plaque, and calculus. Findings were compared with those from prior studies according to the same protocol, for groups of similar age with mental retardation, cerebral palsy, traumatic brain injury, and chronic mental illness. No significant differences between spinal cord injury and control subjects were noted, except that fewer spinal cord injury subjects brushed daily or flossed (p < 0.05); dependent subjects tended to have more plaque and gingivitis than those brushing independently. Subjects with spinal cord injury and mental illness had less gingivitis than those with mental retardation and cerebral palsy (p < 0.001); on calculus, subjects with spinal cord injury ranked lower than subjects with mental illness (p < 0.05). On DFS, mentally ill subjects and those with traumatic brain injury ranked higher than mentally retarded and cerebral palsy groups, with spinal cord Injury subjects intermediate. Mentally retarded and traumatic‐brain‐injured subjects had fewer teeth than other groups (p < 0.05). The findings suggest differences in oral health status and oral care for various disabled populations.
Periodontal pocketing in HIV‐associated periodontitis
Authors: Epstein Joel B. , Leziy Sonja , Ransier Allison
Published: March 2008

Gingival and periodontal involvement has been described in individuals with Human Immunodeficiency Virus (HIV) infection. The manifestations often include erythematous gingivitis, necrotizing gingivitis, and periodontal involvement characterized by rampant loss of bone and soft tissue, resulting in recession without the formation of periodontal pockets. We present cases of HIV‐associated periodontitis (HIV‐P) in which advanced periodontal pocket formation was present. Periodontal disease may show a broad range of severity in patients with various T,4 helper cell counts.
Elderly nonrespondents to a mail survey: A telephone follow‐up
Authors: Strayer Michael , Kuthy Raymond , Sutton Scott
Published: March 2008

The most frequently used method to request and collect health‐related information has been the mail questionnaire. While self‐administered surveys offer a relatively low‐cost and convenient method for collecting health data, they have been unpopular among researchers because of concerns about low response rates and nonresponse bias. This study examines differences in demographic and health characteristics between mail survey respondents and nonrespondents who were subsequently interviewed by telephone. Subjects for this study had at least one health care encounter in 1990 from a Medicare‐waiver program. The telephone survey was conducted approximately two months after the last wave of a three‐wave mailing survey of this urban elderly population. No significant differences were found between telephone and mail respondents for demographic, socioeconomic, quality of life, or perceived oral health characteristics. However, mail respondents were more likely to be dentate and report better perceived general health than were the telephone respondents.
Drug prescription practices of hospital dentists
Authors: Rutkauskas John S.
Published: March 2008

Surveys were sent to the membership of the American Association of Hospital Dentists to evaluate their prescribing practices. The 295 surveys that were evaluated revealed that current pharmacological interventions are directed primarily to the elimination of pain and infection.

The respondents listed a wide variety of prescribed drug groups as well as numerous drugs within each drug group. Our respondents indicated that the future will necessitate a greater knowledge base in drug groups that today are not as widely used and recognized, such as antiviral and antifungal agents.
Oral hygiene care levels in Iowa intermediate care facilities
Authors: Kambhu Peter P. , Levy Steven M.
Published: March 2008

Oral hygiene care levels in lowa intermediate care facilities

This study was undertaken to improve understanding of current oral hygiene care practices in intermediate care facilities. Questionnaires were sent to directors of nursing of all licensed intermediate care facilities in Iowa. Results show that an estimated 57% of residents needed direct oral hygiene assistance. In all intermediate care facilities, the majority of direct oral hygiene care was provided by aides. Oral hygiene care was often not provided at an optimal level, and the main reasons reported for this lack of care were uncooperative residents (82%), lack of perceived need by aides (68%), and inadequate time/personnel(49%). Development and promotion of oral

hygiene care programs in intermediate care facilities must take into consideration the realities and problems involved. Otherwise, efforts to introduce or implement new or improved care programs will fail.
Removal of impacted third molars by oral/maxillofacial surgery and general dentistry residents
Authors: Handelman Stanley L. , Black Peter M. , Desjardins Paul , Gatlin Lonny , Simmons Leroy
Published: March 2008

The post‐operative symptoms of patients who had undergone third molar extractions by Oral/Maxillofacial Surgery (OMS) residents were compared with those of patients whose extractions were performed by General Dentistry (GD) residents. The OMS group had more extractions per visit and were more likely to use intravenous sedation than the GD‐treated group. No significant differences were found when the provider groups were compared by postoperative symptoms such as osteitis, infection, trismus, or paresthesia/dysthesia. The pain relief due to postoperative analgesics during the immediate 12‐hour period was higher for patients treated by GD residents. Multiple regression analysis revealed that this difference was due to the number of teeth extracted and the complexity of the surgical procedure, independent of type of provider.
Birth prevalence of cleft lip and palate in Colorado by sex distribution, seasonality, race/ethnicity, and geographic variation
Authors: Amidei Renea L. , Hamman Richard F. , Kassebaum Denise K. , Marshall Julie A.
Published: March 2008

An epidemiologic study was designed to describe the association of potential risk factors with the occurrence of cleft lip and palate (CL/P) births in Colorado for the years 1982–1988. There were 307 children out of 381, 175 live births identified, through birth certificate data, with a diagnosis of cleft palate or cleft lip with or without cleft palate. For this period, the birth prevalence was 0.82/1000. Male gender [odds ratio (OR) = 1.62, 95% confidence interval (CI) = 1.28, 2.04], white race (OR = 2.87, 95% CI = 1.52, 5.44), and non‐metropolitan residence (OR = 1.59, 95% CI = 1.23, 2.05) were each associated with an excess risk of having a cleft abnormality of any type at birth. No differences in the occurrence of cleft lip and palate were observed by month of birth, altitude of county of residence, or in Hispanic compared with non‐Hispanic newborns. Using information from the 1989 Colorado Registry for Children with Special Needs, there was little evidence of ascertainment bias on major factors of interest for the birth certificate data. Further studies are required to define the factors associated with excess risk of CL/P in non‐metropolitan areas.
Bond strength of double‐sided adhesive tapes used for facial prostheses
Authors: Polyzois Gregory L.
Published: March 2008

This study evaluated the tensile bond strengths of five silicone facial elastomers to human skin by use of five different double‐sided adhesive tapes. Discs of silicone elastomers were fixed in circular metal holders and glued to the inner aspect of a forearm with the various adhesive tapes. The specimens were pulled off 20 seconds after fixation by means of a universal testing machine at a cross‐head speed of 1 mm/min. Eight specimens of each silicone/tape combination were tested. Significant differences were observed among the various silicone/tape combinations. MDX4–4210® and Cosmesil® facial elastomers had the strongest bond to skin with the majority of adhesive tapes, whereas Silskin II®, Cosmesil HC2®, and RS 330T‐RTV® were the weakest. After the bond failure, tapes remained adhered to the skin and not to the silicone specimens.
Risk factors for and the prevention of root caries in older adults
Authors: Youngs Gina
Published: March 2008

With the absolute and relative number of elderly people rising in most countries, it is essential that dental practitioners be knowledgeable about the normal changes and disease processes that occur in aging individuals. Especially prevalent in the aging population is root surface caries. Several variables may increase the risk of developing root surface caries. Among these are poor oral hygiene, microbial plaque, periodontal disease, gender (male), coronal caries, dietary habits, xerostomia, low socio‐economic status, and infrequent dental visits. While each of these has an effect, plaque seems to have the greatest influence on the susceptibility of teeth to root decay. Improved oral hygiene and regular dental visits, combined with the use of fluoride, may continuously convert active root caries lesions to inactive. In fact, prophylactic programs are more effective in converting active to inactive rather than preventing the development of new lesions. The conscientious dental practitioner must identify his/her older patients at risk for developing root lesions and place a major emphasis on the prevention and treatment thereof.
Implications of giant cell arteritis in older adults
Authors: Mar Nelson J.
Published: March 2008

Giant cell arteritis, a vascular inflammatory disorder of unknown etiology, is most often observed in Caucasian females over age 50. The vascular changes, involving the cranial arteries, result in oral and perioral symptoms as well as headache and scalp tenderness. Since involvement of the ophthalmic artery can result in visual disturbances and sudden blindness, dentists must be familiar with the signs and symptoms of this condition and refer patients for immediate medical assessment and care. Oral corticosteroid therapy is the treatment of choice.
Oral side‐effects of the most frequently prescribed drugs
Authors: Smith Robert G. , Burtner A. Paul
Published: March 2008

Oral side‐effects and their respective prevalence rates for the 200 most frequently prescribed drugs for 1992, as measured by IMS America's National Prescription Audit is reviewed. Accounting for duplication due to brand and generic name listings, the actual number of different medications covered was 131. The results of this review are presented in a table and include the oral side‐effects and prevalences as reported in the literature. The three most frequent side‐effects encountered with these medications were xerostomia (80.5%), dysgeusia (47.5%), and stomatitis (33.9%). The included table should fill the need for a ready reference for dentists in monitoring and counseling patients regarding the potential oral side‐effects of the medications.
Dental condition and weight loss in institutionalized demented patients
Authors: Horn Valerie J. , Hodge WaveII C. , Treuer Joan P.
Published: March 2008

This reports the results of a retrospective clinical study evaluating the role of dentures on weight maintenance in an institutionalized demented population. Records of 57 demented long‐term (greater than 3 months) residents of the Department of Veterans Affairs Medical Center, Washington, DC, Nursing Home Care Unit were evaluated to determine body weight, mental acuity, independence in daily living, and dental condition. Fourteen (24%) of the patients possessed dentures, 19 (33%) were edentulous and functioned without dentures, while 24 patients (42%) were dentate. Overall mean weight change was ‐2.03 lbs ± 0.81 lbs in 3 months. There was no significant difference in weight loss based on dental condition. There was, however, an apparent correlation of weight loss and mental acuity. Thus, it was concluded that dentures did not influence weight maintenance among institutionalized demented patients.
Clinical and microbiological effects of chlorhexidine and arginine sustained‐release varnishes in the mentally retarded
Authors: Shapira Joseph , Sgan‐Cohen Harold D. , Stabholz Ayala , Sela Michael N. , Schurr Danny , Goultschin Josef
Published: March 2008

Local applications of sustained‐released varnishes of chlorhexidine and arginine were used in a controlled pilot study of 34 mentally retarded patients, ages 18–45, assigned to one of these groups: chlorhexidine (C), arginine (A), or placebo (P). A professional scaling followed by four weeks of professional brushing to reach a Plaque Index (PII) and Gingival Index (GI) of 1.0 at baseline preceded eight weeks of daily varnish application to the buccaI and labial surfaces of all teeth. Clinical parameters (PII and GI) and bacterial samples from selected teeth were collected at predetermined intervals. Four and eight weeks following the baseline, the PII was significantly different among the groups, with the lowest score in the chlorhexidine group. No significant differences among the three groups were noted for the GI. The chlorhexidine and arginine groups showed significant reductions (p < 0.05 and p < 0.01, respectively) in the number of S. mutans. The arginine group showed a nonsignificant increase in the number of S. sanguis. These results suggest that the topical antimicrobial agents may have some relevance to plaque control among patients with mental retardation.
Dental health status of mentally retarded adults with various living arrangements
Authors: Gabre Pia , Gahnberg Lars
Published: March 2008

During the last few years in Sweden, there has been a change in the way of living for the mentally retarded. There has been a gradual movement away from institutions toward a more integrated life within society. The aim of the present study was to examine the dental health of mentally retarded adults with different ways of living. Forty‐two subjects lived in an institution, 50 lived in integrated units, and 40 stayed in their own apartments or with their parents. All subjects had had regular dental care for at least ten years. The clinical examination was made by one dentist. The use of fluoride and chlorhexidine was recorded in addition to a microbiological examination. The results showed a higher caries prevalence and incidence in subjects with integrated living. Compared with other studies where the mentally retarded had had no regular dental care, the caries incidence and prevalence were lower in this study, and the number of missing teeth was lower. The prevalence of mutans streptococci was related to caries prevalence and incidence. High scores of mutans streptococci could be observed, even among subjects with a frequent use of chlorhexidine gel. The loss of alveolar bone was more pronounced for individuals living in the institution compared with that in individuals with other ways of living.
The growth of Postdoctoral General Dentistry programs
Authors: Handelman Stanley L. , Meyerowitz Cyril , Solomon Eric , Iranpour Bejan , Gatlin Lonny J. , Weaver Richard
Published: March 2008

From 1972 to 1990, the number of Postdoctoral General Dentistry (PGD) programs increased by 57% and enrollment increased by 131% for a total of 118 PGD programs and 1,367 positions. Although there has been some increase in military and Veterans Affairs (VA) programs, the major increase was in civilian programs. From 1972–78, the major impetus for growth was hospital sponsorship of General Practice Residency (GPR) programs. With federal funding of PGD programs, civilian GPR programs continued to be the main source of growth until the accreditation of Advanced Education in General Dentistry (AEGD) programs in 1981. Subsequently, almost all increases were in AEGD programs. Over the 12‐year period of federal funding (1978–90), there was an increase of 406 civilian PGD positions to make a total of 925 positions. The increase in enrollment directly attributable to federal funding was 242.

The “unmet demand” for PGD programs was estimated to be approximately 300 positions for 1990, from data derived from the Survey of Dental Seniors and the Matching Program. Assuming that the number of PGD positions continues to increase by 35 positions a year, as it has in the past 12 years, the unmet demand would be met in slightly less than 10 years. if, however, a postdoctoral year was mandated for licensure, the increase in the number of positions would be far short of projected need.