bluuebunny/crossref_metadata_2025_split huggingface dataset:
The hospital‐sponsored ambulatory dental services program, part II: an evaluation of dental services
Authors: SCHOEN MAX H. , MARCUS MARVIN , KOCH ALMA L. 
Published: March 2008

ABSTRACTThis paper examines the appropriateness and continuity of dental care rendered by the 25 hospital facilities participating in the Hospital‐Sponsored Ambulatory Dental Services Program, a $10 million effort established by the Robert Wood Johnson Foundation from 1979 to 1983.Record review data on 5,200 patients in 13 of the hospitals show that a substantially greater number of patients entered as episodic users of the system in the final phase of the evaluation than in the baseline visit; fewer of these episodic patients made the transition to initial care in the final phase. A followup study on baseline patients indicates that only 28% of the sample had a visit after the year of first contact.The trend toward episodic care is reflected in a reduced amount of preventive and operative services from baseline to final assessments. Compared with a study of private practices in California, the emphasis on surgery in the hospitals is dramatic: a dental patient accessing a hospital clinic will lose approximately one tooth as compared with a half tooth in private practice. Private practices also perform more crown and fixed partial denture services and more services across‐the‐board than the hospital clinics.Telephone interviews show that overall patient satisfaction with the hospital dental services remained high during the study (87% to 89%). Fewer patients in the final sample, however, planned to return to the hospital for all or part of their care. These findings reveal that continuity of care is a problem for hospital dental clinics. The preponderance of episodic care raises questions as to the breadth of experience offered by these hospitals to general practice residents.
Oral complications in a patient with acute lymphocytic leukemia: a report of case
Authors: BEIRAGHI SORAYA , SANDERS BRIAN 
Published: March 2008

ABSTRACTHerpes viruses and Candida albicans are among the most common opportunistic pathogens infecting patients with neoplastic disease, especially those patients receiving cancer chemotherapy.Herpes virus infections have increased as treatment of oncological disease has become more aggressive and immunosuppression disorders have become more prevalent. Herpes simplex virus on the lips and mouth of a patient receiving chemotherapy can progress to multiple lesions in the mouth, larynx, and in rare instances can lead to pneumonitis and widely disseminated infection. The management and dental findings of a 13‐year‐old patient with acute lymphocytic leukemia are described.
Oral manifestations of Beckwith‐Wiedemann syndrome
Authors: SALMAN RICHARD A. 
Published: March 2008

ABSTRACTA report of case of a patient with Beckwith‐Wiedemann syndrome is presented. The macroglossia associated with the syndrome necessitated long‐term dental follow‐up to prevent and treat problems with occlusion, speech, and esthetic appearance that might develop. Early intervention might be required if feeding or respiratory difficulties, resulting from the macroglossia, arise. The diagnosis of the syndrome should alert the dentist to the increased incidence of intra‐abdominal malignancies and the need for periodic observation.
Development of a hospital‐based dental phobia clinic
Authors: RUBIN J. GORDON , KAPLAN ANDREW S. 
Published: March 2008

SummaryThe formation of a hospital‐based dental phobia clinic requires little initial outlay in terms of capital. It can provide badly needed care by accessing a group of patients that have not been able to receive dental care. A dental phobia clinic cam provide an additional facet of training to house staff and attending staff, using existing facilities. The hospital environment provides an appropriate setting for this specialized kind of care.
Guidelines for the use of local anesthetics in the dental treatment of patients who are susceptible to malignant hyperthermia
Authors: D'AMBROSIO JOSEPH , ADRAGNA MICHAEL C. 
Published: March 2008

ABSTRACTThere is controversy regarding the safe use of local anesthetics in patients who are susceptible to malignant hyperthermia undergoing dental treatment. This article reviews the literature for reports of malignant hyperthermia reactions under local and general anesthesia, and suggests a protocol for the management of these patients in the dental office.
An analysis of dental services based in the emergency room
Authors: SONIS STEPHEN T. , VALACHOVIC RICHARD W. 
Published: March 2008

ABSTRACTThis study evaluated the utilization, cost‐effectiveness, and marketing of emergency dental services in a 700‐bed university‐affiliated hospital. Sequential analysis of 445 emergency room dental visits was performed during a 3‐month period. Services were most used on weekend days by patients who had chief symptoms lasting varying lengths of time (43% had them 21 days). The majority of patients sought care for relief of pain. A diagnosis of infection was made in 82% of the patients. An analysis of costs, revenues, marketing, and service design is included.
The relationship of oral Candida tropicalis infection to systemic candidiasis in a patient with leukemia
Authors: REDDING SPENCER W. , RINALDI MICHAEL C. , HICKS JEFFERY L. 
Published: March 2008

ABSTRACTOropharyngeal candidiasis is an extremely common complication in patients receiving chemotherapy for leukemia. Candida tropicalis appears to be the major infectious agent when these patients develop candidemia. In this article, a case of C tropicalis fungemia with oropharyngeal manifestations is presented. The relationship of oropharyngeal candidiasis to oral candidal infection is discussed.
Age differences in responses to facial trauma
Authors: HAYMOND CREED , NICHOLSON CORNELIUS , KIYAK H. ASUMAN , TRIMBLE DOUGLAS 
Published: March 2008

ABSTRACTThis study examines age differences in causes, characteristics, and outcomes of facial trauma seen in a major trauma hospital. A retrospective analysis was undertaken of 615 cases of facial trauma that had occurred during a 5‐year period. The greatest proportion of patients were aged 20 to 29; those older than age 60 represented just 6.8% of the total cases. Gender differences were not observed in the oldest age groups. The oldest patients (older than 70 years) were more likely to have had pedestrian accidents and less likely to have been assaulted than other age groups. Older patients had more multiple injuries but fewer treatment procedures than other age groups. Significant differences were found in death rates; the older patients were more likely to die as a result of their injuries. Implications for patient management based on age and treatment needs are discussed.
Dental treatment needs among hospitalized adult mental patients
Authors: BARNES GEORGE P. , ALLEN EDWARD H. , PARKER WARREN A. , LYON THAYER C. , ARMENTROUT WILLIAM , COLE JAMES S. 
Published: March 2008

ABSTRACTThis survey determines the dental care needs of hospitalized adults with psychiatric and mental disorders. Comprehensive clinical and radiographic oral examinations, conducted on 33% of the patients in a large state mental hospital, found that extensive unmet needs existed in this population. The major requirements were for prophylaxes, calculus removal, and periodontal therapy. The patients' needs varied depending on several demographic factors, including length of hospitalization and psychiatric diagnoses.
Dental service use by older people living in long‐term care facilities
Authors: ETTINGER RONALD L. , BECK JAMES D. , MILLER JULIE A. , JAKOBSEN JANE 
Published: March 2008

ABSTRACTSince 1980, a mobile program has delivered dental care to 14 different long‐term care facilities that care for frail and functionally dependent older persons. These facilities lie within a 60‐mile radius of the University of Iowa College of Dentistry.This paper reports comparisons between characteristics of users versus nonusers of dental care in the program. Of the 853 residents in the long‐term care facility who were screened, it was determined that 66% would benefit from some type of dental care. When the residents and their families were approached for treatment permission, 48% of those recommended permitted treatment; treatment was completed on 38% of those persons recommended for treatment. No differences were observed in the distribution or diagnoses of major medical problems for the users versus nonusers of care. Recommended treatment was similar for users and nonusers in nursing homes. The majority of non‐users refused treatment because they or their families did not perceive a need for dental care.
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.SummaryPrevalence 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.
Mobile dental practice: financial considerations
Authors: Bronny Andrew T. 
Published: March 2008

SUMMARYComparison 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.
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.
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 recommendedSummaryA 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.
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 identifiedThis 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.
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.
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 facilitiesThis 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 oralhygiene 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.
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.
Pemphigus vulgaris—The potential for error: A case report
Authors: Harel‐Raviv Mili , Raviv Eli , Srolovitz Herbert , Gornitsky Mervyn 
Published: March 2008

The importance of correlation, referral, and collaboration between dermatology, or any other medical department, and the oral health profession is reported through a case presentation. A case of pemphigus vulgaris diagnosed from a tongue biopsy and confirmed by immunofluorescence is reported.The patient was treated for actinic keratosis of the scalp for 16 months due to inadequate biopsy material. The diagnostic value of proper biopsy material is stressed. The clinical manifestations leading to a misdiagnosis between actinic keratosis and pemphigus vulgaris are discussed.
The costs and consequences of neglected medically necessary oral care
Authors: White B. Alex 
Published: March 2008

Oral diseases and conditions may adversely affect general health, and certain medical conditions may have a negative effect on oral health.1–9 However, little attention has been given to assessing the economic costs and consequences associated with care that is a direct result of, or has a direct impact on, an underlying medical condition and/or its resulting therapy. The costs can be significant for patients; their families; third‐party payers such as insurance companies, Medicare, and Medicaid; and society. The health consequences of such conditions may dramatically affect function, morbidity, quality of life, and survival.This paper reviews one possible approach for identifying and measuring the costs and consequences associated with medically necessary oral health care and presents a framework for evaluating medically necessary oral health care. The paper also describes the cost components of care and the dimensions of health consequences. Finally, an example illustrates this approach.The summary information presented here is meant to offer concepts and ideas important in assessing the costs and health consequences associated with medically necessary oral health care. Individuals interested in a more detailed discussion of economic evaluation of health care programs and outcomes assessment are referred elsewhere.10–23This is the text of a presentation to the Consensus Conference on Medically Necessary Oral Health Care, Chicago, IL, April 29–30, 1995, sponsored by the National Alliance for Oral Hearth.