bluuebunny/crossref_metadata_2025_split huggingface dataset:
A thermoplastic mouthstick appliance
Authors: LEINBACH THOMAS E. 
Published: March 2008

ABSTRACTRehabilitation of quadriplegic patients is a significant challenge to health care resources in this country. Many of these patients need to use mouthstick appliances to control their environments. To be sure that the mouthstick appliance is available to any patient in need of it, the technology and affordability must be improved. A method is described for construction of an inexpensive and physiologically sound appliance.
ADH ad hoc committee report: the use of restraints in the delivery of dental care for the handicapped—legal, ethical, and medical considerations
Authors: FENTON SANFORD J. , FENTON LORING I. , KIMMELMAN BENEDICT B. , SHELLHART W. CRAIG , SHEFF MICHAEL C. , SCOTT JURATE P. , STAGGERS JULIE A. , PORTUGAL BRIAN V. 
Published: March 2008

ABSTRACTPresented is the final report of the Ad Hoc Committee on the Use of Physical Restraints. The report discusses legal, ethical, and medical issues of physical restraint of patients. Conclusions included: there is no consensus among the states on definition of restraint—dental practitioners should check with their own states for currrent rulings; the current national view is that restraint should only be used when absolutely necessary, and the least restrictive form should be used, and it shall not be used as punishment or for the convenience of the staff; use of restraint is acceptable dental practice when appropriately used for behavior control of patients with developmentally disabling conditions; documentation is required; physical restraint should cause no physical injury; and informed consent should be used, after checking with authorities as to proper form.
A sedation technique for autistic patients who require dental treatment
Authors: LOWE OARIONA , JEDRYCHOWSKI JOSEPH R. 
Published: March 2008

ABSTRACTA description of the patient with autism is presented along with the problems faced by dental care personnel in the treatment of these patients. A study of the use of a progressive sedation technique describes effectiveness, dosages, and levels of treatability. Results show that sedation using hydroxyzine pamoate/diazepam combination as pre‐medication and N2O/O2 analgesia is an acceptable technique for sedation in these patients.
The status of geriatric education in dental hygiene curricula
Authors: HUTCHINSON MICHELLE 
Published: March 2008

ABSTRACTTo assess the status of geriatric education in dental hygiene curricula, a pretested survey was sent to a 55% random sample of the 198 US dental hygiene programs. Of the 109 surveys mailed, a 90% response rate showed that geriatric didactic material is most frequently presented via occasional lectures, rather than in a formal course or an organized series of presentations. Seventy‐five percent of the programs have a geriatric clinical component. Baccalaureate programs and programs longer than 2 years are more likely than associate programs and programs shorter than 2 years, respectively, to teach geriatrics in a more formalized setting. There is no significant difference in the way geriatric material is presented between hygiene programs that are and are not within dental schools.
Behavioral influences of rectal diazepam in solution on dental patients with mentally and physically handicapping conditions
Authors: DINER MURRAY H. , FORTIN RAYMOND C. , MARCOUX DPs, PAUL. , LEGAULT VICTOR 
Published: March 2008

ABSTRACTThe hypothesis of this study was to determine whether the use of rectal diazepam in solution would effectively modify the uncooperative behavior of patients with mentally and physically handicapping conditions during dental treatment. The sample consisted of 42 patients with mild to severe mentally handicapping conditions, 4 to 31 years old, who live in a homecare center. Supragingival and subgingival scaling and prophylaxis were attempted during a 5‐minute period and the patient's behavior was assessed. Conscious sedation using a rectal solution of diazepam (Stesolid) was used for those patients with voluntary or involuntary uncooperative behavior that prevented treatment. Twenty‐two subjects (52.4%) were treated without diazepam. The rectal solution of diazepam proved to be a significantly (P < .01) effective agent for behavior modification permitting the successful treatment of 16 (80%) of the 20 remaining subjects. The following behaviors were significantly modified: places hand(s) or arm(s) in front of mouth (P < .01); does not open mouth, lips held firmly together (P < 05); turns head to one side or side to side (P < 05); attempts to grab instruments (P < .05). No relationship was found between the results and the variables of medical history, gender, age, weight, quantity of diazepam administered, routine medication, pulse rate, blood pressure, and respiration.
Use of the periodontal ligament injection in dental care of the patient with hemophilia—a clinical evaluation
Authors: SPULLER RICHARD L. 
Published: March 2008

ABSTRACTThe PDL injection can be effective when used in the dental patient who has hemophilia. In the case reported here, no postoperative complications related to hemorrhage or hematoma formation were recorded. The PDL injection offers the patient with hemophilia improved anesthetic reliability without factor administration for routine dental procedures.
Training dental and nondental professionals together: the oral health gerontology fellows program
Authors: HOLTZMAN JOSEPH M. , BOMBERG THOMAS J. , BERKEY DOUGLAS B. , ENTWISTLE BEVERLY A. 
Published: March 2008

ABSTRACTThis project demonstrated the feasibility of training dental and nondental professionals to develop and implement programs in oral health care of older adults. Eight self‐guided study modules were developed and tested. Trainees drawn from dentistry, dental hygiene, nursing, and planning/administration completed a 6‐month individualized training program under the guidance of faculty mentors. Program structure, content, and implications are discussed.
A comparison of two mobile treatment programs for the homebound and nursing home patient
Authors: CASAMASSIMO PAUL S. , COFFEE LARRY M. , LEVITON FRED J. 
Published: March 2008

ABSTRACTTwo mobile treatment programs using portable equipment transported in vans to serve homebound persons in Denver and Chicago are compared for types of patients treated, use by local dentists, types of services provided, fees generated, and costs involved in operation during the 2‐year period (1985–86). Both programs treated a similar, largely nursing home‐based white female population that was predominantly older. Volunteer dentist participation varied greatly, with more than twice the number of dentists using the service in Chicago. Both programs accomplished essentially the same number of visits for the biennium studied, with 1,324 for Chicago and 1,320 for Denver. The Denver program was more efficient, generating more visits each time a dentist used the program. The services provided in total were about the same for both programs, with Denver generating 4,887 procedures and Chicago 4,602 for the biennium, but Denver had a more favorable ratio of diagnostic to treatment services. The costs of both programs were close, averaging about $60,000 per year. Denver was able to generate far more in equivalent fees than Chicago for the biennium, but Chicago dentists donated a greater percentage of services (67) than did Denver dentists (62).
The relationship of growth hormone to alveolar ridge atrophy in an older male nursing home population
Authors: GOLDBERG ALLEN FRED , MATTSON DALE E. , RUDMAN DANIEL 
Published: March 2008

ABSTRACTAlveolar bone development has been shown by other investigators to be sensitive to growth hormone concentration in both humans and rodents. Many elderly people are deficient in growth hormone. The cyclic variation in plasma growth hormone concentration that complicates growth hormone measurement is not seen in the plasma somatomedin C (SmC) concentration. Furthermore, SmC is a dependable indicator of growth hormone secretion. It has been established that an SmC level of 0.24 or less is associated with decreased muscle mass and kidney size. We have investigated the relationship of the alveolar bone/supporting (basal) bone (A/B) ratio to the SmC in an elderly male population. These data suggest that growth hormone secretion is not the sole determinant of alveolar bone retention.
Hereditary angioedema: report of case
Authors: Phillips Keith M. , Click Michael , Cohen S. Gary 
Published: March 2008

Hereditary angioedema (HAE) is a life‐threatening disorder triggered by trauma or stress, which causes various organ systems to become edematous. Most mortality is observed secondary to laryngeal edema, caused by dental manipulation. This disorder requires special medical management before dental treatment. Some drugs also exacerbate the disorder. Current methods of treating patients with HAE are presented.SummaryThe patient discussed here was treated prophylactically on a short‐term basis, which consisted of C1NH replacement through 2 u FFP 12 hours before surgery, the morning of surgery, and the morning after surgery. Short‐term therapy was administered in conjunction with long‐term therapy, which consisted of 600 to 900 mg danazol daily. Severe edema was effectively treated with 4 to 6 mg intravenous EACA every 6 hours, and 4 mL racemic epinephrine every hour.Because dental treatment can be life‐threatening to patients with HAE, it is important for dental practitioners to thoroughly examine patients and their medical histories, to recognize signs of the disorder. Because acute airway edema is common in these patients, dental therapy is best delivered in a hospital or where emergency treatment is accessible.
Parents' perception of access to dental care for children with handicapping conditions
Authors: Finger Stephen T. , Jedrychowski Joseph R. 
Published: March 2008

Access to dentistry for people with handicapping conditions may be influenced by attitudes within the dental team, financial considerations, self‐image problems, medical conditions, or physical access. This paper reports on a survey of the parents or guardians of children with handicapping conditions regarding perceptions of possible problems in obtaining dental care.Almost half of the respondents to this survey reported having problems in obtaining dental treatment for their child or in accessing the building. Respondents with problems in obtaining dental care were more likely to have longer periods between dental treatment visits, have had an extraction at their last dental visit, be treated at a hospital, be treated with sedative agents, not have insurance, report their child's dental problems were more severe than other problems, and have terminated their education at an earlier age.
Palliation of radiation‐related mucositis
Authors: Rothwell Bruce R. , Spektor Wendy Schultz 
Published: March 2008

Oral mucositis associated with head and neck radiotherapy can substantially hinder completion of cancer therapy. Alleviation of this often severe stomatitis can provide enhanced patient comfort and facilitate appropriate care.A double‐blind format was used in a pilot project to measure, against a control rinse, the effectiveness of an oral rinse consisting of hydrocortisone, nystatin, tetracycline, and diphenhydramine in controlling radiation‐related mucositis. A combination of clinical evaluation and patient responses to a questionnaire was used to judge the results of the topical medications.Patients using the experimental medication developed less mucositis than did patients in the control group.
Minimizing risk of infection using a carbon dioxide laser
Authors: Miller Craig S. , Triplett Robert G. 
Published: March 2008

The carbon dioxide laser is a surgical device increasingly important to dentistry. The advantages of laser use in the treatment of oral disease have been well documented. Such benefits include bloodless incisions, accurate tissue destruction, reduced pain, minimal swelling, excellent hemostasis, and limited postoperative tissue morbidity. Little information exists currently regarding laser use in the management of medically complex patients, most notably patients with infectious diseases. This article reports the use of the carbon dioxide laser for reducing the risks of disease transmission in the surgical management of an human immunodeficiency virus (HIV) seropositive patient.SummaryThe CO2 laser is a surgical instrument gaining increased recognition in dentistry. Because this tool offers important infection control advantages, the laser is recommended for use in the surgical care of patients who harbor bloodborne pathogens. By reducing the risks of occupational transmission, unwarranted fears are minimized concerning the management of infectious patients.
Effects of medication on parotid salivary flow rates in an individual with dementia of the Alzheimer type
Authors: Fedele Denise J. , Jones Judith A. , Volicer Ladislav , Harz Lawrence R. , Oppenheim Frank G. 
Published: March 2008

Effects of medication on parotid salivary flow rates in an individual with dementia of the Alzheimer typeData available on the relationship between salivary function and specific drug therapy are sparse. We measured unstimulated and stimulated parotid salivary flow rates associated with the drug therapies. Our ancillary study design is an N = 1 double‐blind randomized controlled trial in which the patient undergoes a series of treatment blocks of either placebo or active treatment. The purpose of the parent N of 1 study was to find the “best single drug” treatment for a resistive patient diagnosed with dementia of the Alzheimer type.This study demonstrates that thiothixene was associated with inconsistent effects on parotid flow. Oxazepam had no effect on his parotid function, and diphenhydramine hydrochloride had inconsistent but generally negative effects. The data also show that this individual with dementia of the Alzheimer type had lower baseline unstimulated and stimulated parotid salivary flow rates when compared with mean “normal” values; however, flow rates were above the lowest 10th percentile of “normal” volunteers.
The measurement of mandibular cortical bone height in osteoporotic vs. non‐osteoporotic postmenopausal women
Authors: Watson E. Lea , Katz R.V. , Adelezzi R. , Gift Helen C. , Dunn S.M. 
Published: March 2008

The asymptomatic progression of osteoporosis, in conjunction with the possibility of catastrophic disability, makes this disorder a major public health priority.Various body sites, including the mandible, have shown susceptibility to decreasing bone density. In 1986, Benson et al. proposed a radiomor‐phometric technique called the Panoramic Mandibular Index (PMI) as an inexpensive, noninvasive dental technique for osteoporosis screening, although no osteoporotic subjects were included in their study.The purpose of our study was to determine whether osteoporotic postmenopausal women would show a decrease in mandibular cortical bone height, as measured by the PMI Index, when compared with nonosteoporotic postmenopausal women.Seventy‐two Caucasian females (33 cases/39 controls), aged 54–71 years old, were selected through records and screening via a dual‐energy x‐ray absorptiometry scan (LUNAR‐DEXATM).ANOVA analysis Indicated no differences in the mean PMI between case and control groups (0.37 ± 0.15 and 0.38 ± 0.13, respectively; p = 0.69). Other techniques, such as computer digitized radiography, should be explored to test the validity of the PMI.
Compliance with fluoride gel use in irradiated patients
Authors: Epstein Joel B. , van der Meij Erik H. , Emerton Sue M. , Le Nhu D. , Stevenson‐Moore Peter 
Published: March 2008

Patients who undergo radiation therapy that includes the salivary glands frequently experience severe xerostomia. The standard of care for these patients who have natural teeth has become daily application of fluoride by means of custom‐fabricated carriers. The purpose of this study was to determine patient compliance with fluoride gel application using carriers.Using a structured verbal questionnaire, we interviewed 76 patients who had completed radiation therapy for head and neck cancer. Thirty of these patients were seen regularly in the dental clinic of the Cancer Agency (group 1); the remaining 46 were not seen on a regular basis (group 2).Overall, 43% of patients reported using fluoride gel regularly (once a day). In group 1, 67% of patients used fluoride regularly, as did 28% of patients in group 2 (p = 0.001). There were no significant differences between the groups in frequency of toothbrushing and use of dental floss. Compliance with the use of fluoride in carriers was not associated with differences in other oral care measures in the two groups, which suggests that fluoride application in carriers achieves limited compliance in relation to daily oral health care measures. Regular follow‐up of patients after radiation therapy is needed to assess their need for, and compliance with, daily fluoride application.
Medical and functional status changes among nursing facility residents: Implications for dentistry
Authors: Kambhu Peter P. , Warren John J. , Hand Jed S. , Levy Steven M. , Cowen Howard J. 
Published: March 2008

This paper reports the results of a study that investigated changes in the medical and functional status of nursing facility residents over a 2.9‐year period. Sixty‐seven residents from 10 nursing facilities were included in the study, which demonstrated that the residents' medical and functional status deteriorated during this period. These changes adversely affected the residents' ability to receive recommended dental treatment, suggesting that early, definitive, and often aggressive treatment approaches be used in providing services to these individuals.SummaryThis study found that the health status of 67 residents of a long‐term care facility declined markedly over a three‐year period. Based on these findings, we recommend that dental care for institutionalized older adults be provided as soon as possible after problems are diagnosed, and that treatment planning should account for the likelihood that opportunities for the provision of care may decrease with time. However, in the treatment of individual nursing facility patients, the experience and professional judgment of the dentist will continue to be critical in determining an appropriate course of action.
Assessing the patient at risk for oral squamous cell carcinoma
Authors: Epstein Joel B. , Scully Crispian 
Published: March 2008

Patients and health care workers require continuing education to promote knowledge of the signs, symptoms, and risk factors for oral cancer. This paper reviews the literature assessing diagnostic tools that are currently available or being developed, in order to assist in the biopsy site selection and subsequent diagnosis of patients at risk for oral cancer. There is a general consensus that oral examination of patients at risk for oral squamous cell carcinoma (SCC) should be conducted on a routine basis. However, there can be false‐positive and false‐negative findings. Toluidine blue has been shown to be useful as an adjunct to the clinical examination when used by experienced clinicians. Exfoliative cytology is not currently used as a routine measure for the evaluation of lesions of the oral mucosa, but further development and the application of biologic markers to cytologic specimens may increase its value. Fluorescent imaging of malignant lesions of the oral mucosa has been shown to be sensitive and specific in animal models but thus far has been reported in only one human trial.The sensitivity and specificity of these techniques when used by general practitioners need to be assessed. Further, none of the above procedures has yet been shown to be a cost‐effective public health measure in screening for oral cancer.
Amlodipine‐induced gingival overgrowth: periodontal responses to stopping and restarting the drug
Authors: Morisaki Ichijiro , Dol Shizuka , Ueda Katsura , Amano Atsuo , Hayashi Mikiko , Mihara Joji 
Published: March 2008

ABSTRACTA case history of a woman with gingival overgrowth (GO) induced by amlodipine is presented. A 49‐year‐old Japanese woman, who was taking amlodipine, had gingival overgrowth and swelling on examination. No specific periodontal treatment was provided to the patient for the GO; however, the amlodipine was replaced with an ACE inhibitor after consultation with her medical practitioner. Within two months, the suspension of amlodipine resulted in a significant improvement in her periodontal condition. Failure to control the hypertension caused the physician to re‐prescribe amlodipine. After three months, the gingival overgrowth returned; however, its severity was less when compared with the original periodontal condition, due to reduction in drug dose and periodontal therapy. This experience suggests that temporary suspension of a drug which can induce GO can improve the periodontal condition without the aid of surgical treatment.
Prevalence of numeric anomalies in the permanent dentition of patients with Down syndrome
Authors: Acerbi Andrea Goes , de Freitas Cládio , de Magalhaes Marina Helena Cury Gallottfni 
Published: March 2008

ABSTRACTThe purpose of this study was to evaluate the prevalence of numeric anomalies in the permanent dentition of patients with Down syndrome by means of panoramic radiographs. The sample consisted of panoramic radiographs from 70 subjects. We examiend the radiographs to detect hypodontia as well as supernumerary teeth. Our results confirm the high prevalence of hypodontia among patients with Down syndrome (60%), mostly with mild expression. The teeth most often missing were the upper lateral incisors, usually bilaterally, followed by the lower second premolars and upper second premolars. Supernumerary teeth were seen in 6% of the subjects, and the concomitant occurrence of hypodontia and supernumerary teeth occurred in one patient.
Tetralogy of Fallot: an overview, case report, and discussion of dental implications
Authors: Spivack Evan 
Published: March 2008

ABSTRACTTetralogy of Fallot (TOF) is the most common cause of cyanotic heart disease. The anatomic defects comprising TOF lead to the systemic circulation of oxygen‐poor (desaturated) blood, resulting in symptoms of cyanosis, polycythemia, and hypoxia. Untreated, most patients with this disorder die during childhood. Surgical treatment aimed at correcting the defects is currently recommended for infants. Long‐term studies have reported good results with this approach. The case history of a four‐year‐old male with uncorrected tetralogy of Fallot is presented. The patient required extensive dental treatment prior to scheduled cardiac catheterization. The dental findings and plan of care for this patient are detailed, and attention is given to the role of the medical work‐up, preoperative antibiotics, and sedatives. It is stressed that the dental treatment plan for patients with tetralogy of Fallot must take into account the patients' medical status both prior to and following corrective surgical procedures.