Special Care in Dentistry via MedWorm.com

Oral vascular malformation in a patient with hereditary hemorrhagic telangiectasia: a case report

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

This article describes the treatment of a 64‐year‐old woman with a bleeding nodule, which was diagnosed as an arteriovenous malformation of the gingival mucosa. She was treated using sclerotherapy. Patients with HHT can be treated in the dental office and vascular malformations of these patients can be successfully managed with sclerotherapy, which eliminates the need for invasive surgical procedures and the possibility of postsurgical complications. (Source: Special Care in Dentistry)

Reviewers index

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

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Oral and Intravenous Bisphosphonate‐Induced Osteonecrosis of the Jaws: History, Etiology, Prevention, and Treatment

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

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Long‐Term Stability in Orthodontics

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

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Continuing Education Program

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

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A one‐year survey of inpatient dental consultations at a children's hospital

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

In conclusion, dentists play an important role in optimal management of certain hospital inpatients. (Source: Special Care in Dentistry)

Dental treatment of patients with systemic diseases compared to patients with developmental disabilities under general anesthesia

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

ABSTRACTThe medical and dental records were examined for 46 patients with systemic diseases (SD) and 75 patients with developmental disabilities (DD) aged 2–20 years, who had received dental treatment under general anesthesia (GA). Age, gender, decayed missing and filled teeth (dmft/DMFT), dental procedures, duration of GA, and posttreatment hospitalization were recorded. Before treatment, dental disease in the primary teeth was significantly higher among the group with SD (p= 0.04). In the permanent teeth, dental disease was higher among the group with DD, though not significantly. More teeth were restored, (p= 0.015) and total dmft (p= 0.043) was significantly higher among subjects with SD. In the permanent teeth, more extracted and more restored teeth and higher DMFT were noted among ...

A review of the oro‐dento‐facial characteristics of hereditary sensory and autonomic neuropathy type III (familial dysautonomia)

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

ABSTRACTThe oro‐dento‐facial features and dysfunction of children with hereditary sensory and autonomic neuropathy type III, known as familial dysautonomia or Riley–Day syndrome, was first described in the scientific literature in 1949. They include dental trauma; dental and soft tissue self‐mutilation; normal dental age; normal sequence and timing of eruption and exfoliation of teeth; smaller tooth size; different and disproportional tooth components; normal alveolar bone height; small jaws, mild crowding, and malocclusions. These persons have craniofacial morphology that is different from accepted norms but they resemble norms of their ethnic origin. The subjects can have gray, pale, shiny faces with an asymmetric suffering expression; frontal bossing, with eventual hypertelorism...

Oral vascular malformation in a patient with hereditary hemorrhagic telangiectasia: a case report

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

Decrease in oral health may be associated with length of time since beginning dialysis

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

ABSTRACTThe aim of this study was to evaluate how oral health is affected by the length of time a patient has been receiving hemodialysis (HD) treatment. Ninety‐four subjects participated in this study. Demographic, periodontal parameters, and decayed missing and filled teeth (DMFT) index were recorded by a trained and calibrated examiner. The subjects were divided into two groups: Group L (subjects who had been on HD for less than 36 months), and Group M (those who had been on HD for more than 37 months). In Group M, the mean probing depth was deeper (p= 0.01) and clinical attachment loss was significantly higher (p= 0.02) than subjects in Group L. The DMFT index score was also significantly higher in Group M (p= 0.03). A moderate correlation between length of time on HD and DMFT index,...

Surgical and implant‐supported fixed prosthetic treatment of a patient with ectodermal dysplasia: a case report

Special Care in Dentistry — Sun, 01 Jan 2012 05:00:00 +0100

This article stresses the importance of appropriate care in providing an acceptable quality of life for patients with ED. (Source: Special Care in Dentistry)

Continuing Education Program

Special Care in Dentistry — Tue, 01 Nov 2011 04:00:00 +0100

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Dentistry for Peruvian residents with special needs: a commentary

Special Care in Dentistry — Tue, 01 Nov 2011 04:00:00 +0100

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Improvement of mouth opening for a patient with fibrodysplasia ossificans progressiva: a case report

Special Care in Dentistry — Tue, 01 Nov 2011 04:00:00 +0100

ABSTRACTThe aim of this article is to describe the care of a patient with fibrodysplasia ossificans progressiva (FOP) and to provide dentists with a guide for how to safely care for patients with FOP. Treatment improved the patient's limited mouth opening.FOP is a rare autosomal dominant disorder characterized by congenital malformation of the fingers and toes by heterotopic ossification progressiva of the connective tissue. This ossification causes a limitation in osteoradicular mobility, mainly affecting the spine, shoulders, hips, and peripheral joints. The disease can manifest from pregnancy until adulthood, with no greater prevalence associated with race or gender. Although rare, the disease can be easily identified by its clinical features, and diagnosis can be confirmed by a radiogr...

Living with facial disfigurement—strategies for individuals and care management

Special Care in Dentistry — Tue, 01 Nov 2011 04:00:00 +0100

ABSTRACTIndividuals and families affected by craniofacial disorders have expressed dissatisfaction with their experiences in the healthcare system, with day care, and in school situations. To capture their views, focus group encounters were done in a group of young individuals with these disorders and in a group of parents whose children were affected. The aim was to synthesize their attitudes and experiences into improved strategies for parents, teenagers, and professionals in the healthcare system. Their views were compiled into a document that emphasizes the responsibilities of persons with craniofacial disorders and their parents to actively seek information on diagnosis and treatment options and to participate in decisions on therapy.The conclusion was that it is not lack of specific ...

The incidence of dental caries in children and adolescents who have cerebral palsy and are participating in a dental program in Brazil

Special Care in Dentistry — Tue, 01 Nov 2011 04:00:00 +0100

ABSTRACTThe aim of this study was to describe the incidence of caries among children and adolescents who have cerebral palsy. The authors conducted baseline and follow‐up dental examinations of 118 children and adolescents with cerebral palsy in a specialized healthcare unit in São Paulo, Brazil. Family care‐givers completed a questionnaire that provided socioeconomic and behavioral information. The analysis used multivari‐ate Poisson regression models adjusted for age.More than half (52.5%) of the subjects had at least one permanent or deciduous tooth affected by new caries during the longitudinal assessment (2004–2008). The incidence of caries was associated with the baseline prevalence of caries (incidence ratio = 1.92), a higher frequency of sugar intake (IR = 1.56), and havin...

The involvement of Iowa dentists in hospice care

Special Care in Dentistry — Tue, 01 Nov 2011 04:00:00 +0100

ABSTRACTThe relationships between dentist characteristics and professional education with involvement of Iowa dentists in hospice care were investigated. Using the 1999 Iowa Health Professional database, a survey requesting information regarding involvement in and training for care of hospice patients was mailed to all licensed dentists (N = 1,210). Two mailings yielded a 54.6% response rate. Of the 638 dentist respondents, the mean age was 47, 86% were male, 88% general dentists, and 295 (46%) reported providing some treatment for hospice patients. At least one dentist reported providing hospice patient care in 72 of Iowa's 99 counties. About 90% of dentists treating hospice patients were general practitioners.Males were more likely to provide treatment (p < 0.0313). Neither dentist ag...

Medical problems and oral care of patients with Down syndrome: a literature review

Special Care in Dentistry — Tue, 01 Nov 2011 04:00:00 +0100

This article presents a literature review of the primary medical conditions in patients with DS that may affect their general health care and the appropriate clinical delivery of oral health care. (Source: Special Care in Dentistry)

The development of the Coalition for Oral Health for the Aging

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

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SCDA 2011 Meeting Abstracts

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

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Get Sharp: Nonsurgical Periodontal Instrument Sharpening by Marisa Roncati

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

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Continuing Education Program

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

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Distraction osteogenesis in the maxilla for a patient with a repaired cleft lip and palate: A case report

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

ABSTRACTDistraction osteogenesis (DO) has gained wide acceptance as a viable modality for lengthening hypoplastic skeletal structures in the maxillofacial region. For patients with cleft lip and palate with skeletal maxillary deficiency, this technique has recently been applied extensively as an alternative to orthognathic surgical procedures. Decreased intraoperative morbidity and rates of postoperative midface regression along with esthically acceptable soft tissue profile are the main advantages of this procedure against traditional osteotomies. This case report documents the use of rigid external distraction (RED) in the treatment of a 20‐year‐old female patient with midface deficiency secondary to cleft lip and palate repair. (Source: Special Care in Dentistry)

Caries and periodontal disease in patients with Parkinson's disease

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

The objective of this study was to investigate the oral health of 101 patients with PD (mean age: 66.2 ± 10.5 years) and compare them to 75 control subjects (CO) (mean age 71 ± 10.53). Patients with PD had poorer oral health than the control group (papilla bleeding index: PD 6.97 ± 8.34; CO 2.12 ± 2.73). Lower frequencies of daily toothbrushing (PD: 1.69 ± 0.83; CO: 2.08 ± 0.80), longer time since the last dentist visit (PD: 1.94 ± 1.49; CO: 1.21 ± 0.60 years), and reduced salivary flow (PD: 2.69 ± 0.94; CO: 3.53 ±1.11 ml). All of these factors may be related to the gingival recession and tooth mobility found in our patients with PD. Individuals with PD, their caregivers, and their physicians need to focus more on their oral health and quality of oral hygiene. (Source: Special Ca...

Parents’ perspectives on a dental home for children with special health care needs

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

ABSTRACTThe authors surveyed parent‐leaders about aspects of a dental home for children with special health care needs (CSHCN). State leaders in two advocacy groups completed the survey; the response rate was 70.6% of all states. Two of the most highly rated aspects of a dental home, endorsed as “essential” by 89% of respondents, pertained to dentist–parent interactions: the dentist listens carefully to the family, and the dentist helps the family feel like a partner in treatment decisions. Likewise, 89% said it was essential that insurance coverage allows the child to see needed providers. Dentists’ lack of knowledge or willingness to treat CSHCN and refusal of Medicaid insurance coverage were identified as major barriers to care. More than 84% of respondents reported that paren...

National estimates of the characteristics of individuals infected with HIV who are likely to report and receive treatment for painful bleeding gums

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

This study examined the characteristics of persons reporting the symptom “painful bleeding gums” and their likelihood of accessing care. The study population consisted of persons receiving care for HIV as part of the HIV Cost and Services Utilization Study (HCSUS). In this national population, 5.3% reported painful bleeding gums. Significant differences in reporting painful bleeding gums were found between Hispanics/Whites, oral health status, and presence of other symptoms. Compared to younger persons, those in the middle age group were more likely to seek treatment, while persons with the highest CD4 counts were more likely to seek treatment than those with the lowest CD4 counts. This study showed that reporting painful bleeding gums was a function of ethnicity, other symptoms, and p...

Accidental aspiration in a patient with Parkinson's disease during implant‐supported prosthesis construction: A case report

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

This article reports on a case history of an elderly patient with Parkinson's disease (PD) who sought treatment at a private dental office. His chief complaint was “difficulty in eating due to an illfitting prosthesis.” Laboratory tests and oral radiographs were made. The surgical placement of an implant was done and, subsequently, an implant‐supported prosthesis was fitted for the patient. During the impression for the construction of the implant‐supported prosthesis, the patient accidentally aspirated the implant screwdriver. The object was found in the lower right lobe of the bronchus, and its removal was necessary in a hospital using bronchoscopy under general anesthesia.Patients with PD are considered at risk of aspirating and/or ingesting dental instruments. Short treatment p...

Sugar consumption and preference among Mexican, Chinese, and Nigerian immigrants to Texas

Special Care in Dentistry — Thu, 01 Sep 2011 04:00:00 +0100

ABSTRACTThis pilot study investigated the relationship between sugar consumption/ preference and the length of residence in the U.S. among certain immigrant groups.The study sample consisted of 213 volunteers from community organizations and church groups, of Nigerian (45%), Mexican (31%), and Chinese (24%) descent. Data were collected on demographics, sugar consumption/preference (24‐hour dietary recall), and oral health status. The age of respondents varied from 18 to 93 years with a mean age of 37.0 ± 11.7 years. The mean length of residence was 9.2 ± 7.2 years, and the mean sugar consumption was 122.4 ± 114.6 g/day. Immigrants from Mexico and Nigeria reported consuming more servings of sweets per day than the Chinese (p= .006); Mexican immigrants had the highest level of sugar pre...

Scientific Misconduct – How does it affect you?

Special Care in Dentistry — Thu, 30 Jun 2011 23:00:00 +0100

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Treating The Triad: Teeth, Muscles, TMJs by Dr. Giuseppe Cozzani, MD

Special Care in Dentistry — Thu, 30 Jun 2011 23:00:00 +0100

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Continuing Education Program

Special Care in Dentistry — Thu, 30 Jun 2011 23:00:00 +0100

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Use of a single implant to retain a mandibular complete overdenture on the compromised atrophic alveolar ridge: a case report

Special Care in Dentistry — Thu, 30 Jun 2011 23:00:00 +0100

ABSTRACT This case report illustrates some of the advantages gained by placing a single implant in the midline of the intersym‐physeal region of the mandible, which can be used to retain a complete mandibular overdenture in patients with a compromised atrophic mandible opposing a maxillary complete denture. This approach is a valid treatment option for patients with limited financial and therapeutic means.This case report, along with other evidence, demonstrates that a mandibular single implant‐retained overdenture is a viable treatment option for a specific group of patients. (Source: Special Care in Dentistry)

Dental status of patients with mental disorders in a Nigerian teaching hospital: a preliminary survey

Special Care in Dentistry — Thu, 30 Jun 2011 23:00:00 +0100

This study describes the dental status of 105 psychiatric outpatients in a Nigerian hospital. Information was obtained from subject interviews, medical records, and an oral examination to determine their dental caries and periodontal disease status.The oral hygiene status of the study participants was poor; the mean oral hygiene index score was 2.7 ± 1.20. The decayed, missing, and filled teeth ranged from 0 to 9 with a mean of 2.3 ± 2.28. Only five subjects (4.9%) had restorations and the mean number of filled teeth was .14 ± .67. The subjects’ age was significantly related to the mean oral hygiene score (p= .005), the mean gingival score (p= .006), and caries occurrence (p= .047). The oral health status of psychiatric patients in Nigeria is poor, indicating the need to provide oral ...

Radiographic changes of the jaws in HbSS and HbSC genotypes of sickle cell disease

Special Care in Dentistry — Thu, 30 Jun 2011 23:00:00 +0100

This study used panoramic radiographs to evaluate the presence of radiographic changes in the jaws of a population who had sickle cell disease (SCD). The authors compared the frequency of findings between subjects with and without SCD. Panoramic radiographs of 71 subjects with SCD (36 with HbSS and 35 with HbSC) and 52 healthy controls (HbAA) were evaluated for the presence of the following radiographic alterations: radiopaque areas, increased spacing of bony trabeculae, horizontal arrangement of bony trabeculae, and absence of mandibular canal corticalization. The control group had a significantly smaller number of all the radiographic features evaluated. Differences were not statistically significant between the groups with HbSS and HbSC, except for more trabecular spacing in the molar r...

In vitro antimicrobial effects of commercially available mouth‐wetting agents

Special Care in Dentistry — Thu, 30 Jun 2011 23:00:00 +0100

ABSTRACT Products have been developed to provide palliation for persons with dry mouth. In addition to mouth‐wetting agents, some products incorporate antimicrobial constituents with the goal of improving oral microbial defenses. The aim of this in vitro study was to investigate the potential antimicrobial and antifungal effects of two commercially available saliva substitutes on Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans by using the agar‐well diffusion method. Antimicrobial activity as measured by the size of the inhibition zone growth for S. mutans and L. acidophilus was observed only with Biotene Dry Mouth Oral Rinse® and BioXtra® gel. The zone of inhibition of Biotene Dry Mouth Oral Rinse was larger than that of BioXtra gel (p= 0.00, p < 0.01). No...

Editorial

Special Care in Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

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Continuing education program

Special Care in Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

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Successful prevention of oral self‐mutilation using a lip guard: a case report

Special Care in Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

This report describes the case of a girl, aged 19 months, whose lower lip injuries due to SIB were successfully treated through the use a combination of extraoral and intraoral prostheses. A custom‐made lip guard with a custom‐made adjustable head strap was effective in the management of the lip trauma. SIB was prevented and there was no recurrence even at the 17‐month follow‐up appointment. (Source: Special Care in Dentistry)

Management of the oral manifestations of senile purpura in an edentulous patient: a case report

Special Care in Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

ABSTRACTSenile purpura occurs because of a weakness of the vascular supporting tissues mainly caused by aging and is most often seen on the dorsal surface of the hands and the extensor surfaces of the forearms, and has also been observed in the oral mucosa of elderly patients. These red lesions present as sharply margined subcutaneous hemorrhagic spots and are due to trauma, such as damage to the endothelium of small blood vessels, or a coagulation defect. They can also be due to reduced perivascular support, or capillary fragility and permeability, or a combination of all of these factors. Oral manifestation of senile purpura can also be induced by long periods of medication use leading to fragile areas of the mucosa. The presence of senile purpura requires continuous follow‐up since dr...

Oral care and sensory sensitivities in children with autism spectrum disorders

Special Care in Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

ABSTRACTChildren with autism spectrum disorders (ASD) are at high risk for oral disease. The aim of this study was to examine the contribution of sensory processing problems to challenges in receiving oral care for children with ASD.A questionnaire was sent to the parents of 206 children with disabilities to test the hypotheses that children with ASD, relative to children with other disabilities, experience greater difficulty with home‐based and professional oral care, and that these difficulties may relate in part to sensory processing problems. The results partially supported these hypotheses. Compared to children with other disabilities, those with ASD had greater behavioral difficulties and sensory sensitivities that parents believed interfered with their child’s oral care. Among c...

Dental treatment needs in Dutch nursing homes offering integrated dental care

Special Care in Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

ABSTRACTThe purpose of this study was to determine the dental treatment needs of the residents in nursing homes (NHs) where integrated dental care has been offered without financial barriers.The dental status and surgical, prosthetic, restorative, and periodontal treatment needs were determined for 432 residents (average age 78.8 years) in three Dutch NHs. Although the subjects had no complaints, 72% had dental treatment needs. It was determined that treatment was necessary for 64% of the edentulous subjects (N = 316), 100% of the partially dentate subjects (N = 76), and 87% of the fully dentate subjects (N = 40).We concluded that when residents can no longer carry out oral hygiene independently, it is very difficult for them to maintain a level of oral health where their dental treatment ...

Comparison of perceptions of oral health‐related quality of life in adolescents affected with ectodermal dysplasias relative to caregivers

Special Care in Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

The objective of this study was to assess the perceived oral health‐related quality of life (OHQoL) of adolescents affected with one of the ectodermal dysplasias (EDs).Data were collected from 2003 to 2007 in a cross‐sectional study of a convenience sample of individuals affected by ED (n = 35) using the Child Perceptions Questionnaire (CPQ11–14) for children and the Parent‐Caregiver Perceptions Questionnaire for their caregivers. The main findings of this study were that individuals who were affected with ED in the older age group (15‐ to 19‐year‐olds) perceived more functional problems than younger individuals (11‐ to 14‐year‐olds) (p= .04). Females with ED (n = 13) perceived more emotional problems than males (n = 22; p= .01). Although caregivers tended to report sli...

An intervention to reduce care‐resistant behavior in persons with dementia during oral hygiene: a pilot study

Special Care in Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

ABSTRACTThe primary purpose of this pilot study was to test the feasibility of an intervention designed to reduce care‐resistant behaviors (CRBs) in persons with moderate‐to‐severe dementia during oral hygiene activities.The intervention, Managing Oral Hygiene Using Threat Reduction (MOUTh), combined best oral hygiene practices with CRB reduction techniques. Oral health was operationalized as the total score obtained from the Oral Health Assessment Tool (OHAT). CRB was measured using a refinement of the Resistiveness to Care Scale. Seven nursing home residents with dementia received twice daily mouth care for 14 days. The baseline OHAT mean score of 7.29 (SD = 1.25) improved to 1.00 (SD = 1.26, p < .001); CRB improved from 2.43 CRBs/minute (SD = 4.26) to 1.09 CRBs/minute (SD = 1.5...

Special care dentistry

Special Care in Dentistry — Tue, 01 Mar 2011 00:00:00 +0100

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Continuing education program

Special Care in Dentistry — Tue, 01 Mar 2011 00:00:00 +0100

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Toriello Carey syndrome: genetic, clinical, and oral considerations: a case report

Special Care in Dentistry — Tue, 01 Mar 2011 00:00:00 +0100

ABSTRACTToriello Carey syndrome is a rare recessive autosomal disease whose clinical manifestations are more evident in males. Some authors report that the general characteristics of this disease are agenesis of the corpus callosum, mental disability, convulsions, atrial septal defect, pulmonary artery stenosis, pyloric stenosis, and hypospadias. Facial and cranial alterations may occur, including hypertelorism, telecanthus, divergent strabismus, malformed ears, anteverted nares, retrognathism, and cleft palate. This paper reports on a 13‐year‐old male with Toriello Carey syndrome and leucoderma, and describes his oral problems and his dental care. (Source: Special Care in Dentistry)

Receipt of dental care and barriers encountered by persons with disabilities

Special Care in Dentistry — Tue, 01 Mar 2011 00:00:00 +0100

ABSTRACTA study was conducted to describe the receipt of dental care by patients with disabilities and to understand their perspective with regard to barriers to dental care. Subjects for this study were recruited among patients with disabilities seen at Carolinas Rehabilitation's outpatient clinic. A questionnaire consisting of 66 questions was completed by 344 subjects; with the topics related to both medical and dental care. Among the study population, 57.2% of subjects reported being seen by a dentist within the last 12 months, versus 67.3% before they became disabled. The last dental appointment was a routine examination for 59.5% of the respondents. Since becoming disabled, 16.6% of subjects reported problems receiving dental care. Financial challenges were the primary problem follow...

Oral health and oral motor function in children with cerebral palsy

Special Care in Dentistry — Tue, 01 Mar 2011 00:00:00 +0100

The objective of this study was to evaluate the influence of the type of cerebral palsy (CP) and oral motor function (OMF) on the oral health status of children and adolescents with CP in Teresina, Piauí, Brazil. The sample consisted of 52 children with CP, aged 7 to 18 years. The data were statistically analyzed using chi‐square tests. In 73.1% of the sample, the subjects’ caregivers carried out the daily oral care. There was a significant association between the frequency of daily care and the subject's level of oral hygiene (p= .037). A diagnosis of Class II malocclusion was made for 55.8% of the sample, and defects of enamel formation were found in 38.5% of the subjects. There was no significant correlation between DMFT (decayed, missing, filled teeth) and socioeconomic status of ...

Patterns of postoperative pain medication prescribing after invasive dental procedures

Special Care in Dentistry — Tue, 01 Mar 2011 00:00:00 +0100

ABSTRACTWe investigated disparities in the prescription of analgesics following dental procedures that were expected to cause acute postoperative pain. Patients over the age of 19 years who had been treated by surgical and/or endodontic dental procedures were included in this study. We reviewed 900 consecutive charts and abstracted data on procedures, patients, and providers. We used chi‐square and logistic regression models for analyses. There were 485 White subjects, 357 African American subjects included in this review; 81% of the African American and 78% of White patients received a postoperative narcotic prescription (p= .56). In multivariate regression models, patients over age 45 (p= .003), those with insurance that covered medication and those with preexisting pain (p= .004) were...

Perceptions of dental esthetics among older African Americans

Special Care in Dentistry — Tue, 01 Mar 2011 00:00:00 +0100

ABSTRACTOlder adults have greater potential for issues with the appearance of their teeth than other age groups. Conditions including missing teeth, fractured or missing restorations, and excessive tooth wear are common and may potentially affect individuals’ perceptions of their dental esthetics.These perceptions about dental conditions may be significant because previous research suggests that they may impact elders’ quality of life.The purpose of this study was to investigate the esthetic ranking of specific dental conditions by a population of African American elderly, utilizing methods similar to those of an earlier study of older Caucasians. These methods were designed to determine whether specific oral/facial and dental conditions were associated with similar perceptions of esth...

A practice transition for the better good

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

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Opinions on the provision of dental care in Iowa nursing homes

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

ABSTRACTUsing a stratified random sample, a questionnaire was mailed to 400 practicing dentists and 200 directors of nursing (DONs). Response rates were 58.3% for dentists and 50% for DONs. Dentists were representative of Iowa dentists, with 85% male, mean age 49.1 years, and 22.4 years in practice. All DONs were female, with mean age of 44.9 years. Of the participating dentists, 86% had provided dental care for nursing home residents, but the majority of care was completed in dental offices. Three‐quarters of dentists were somewhat/not interested in nursing home dentistry. Dentists and DONs held common perceptions of the most frequent problems related to care provision at nursing homes: low financial reimbursement, especially for Medicaid patients; no portable dental equipment; no suita...

Use of moderate sedation for a patient with Down syndrome, intellectual disability, and Eisenmenger syndrome: a case report

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

We report on the case history of a 38‐year‐old male patient with Down syndrome (DS), intellectual disability (ID), and ES. The patient was scheduled for extraction of the right maxillary second molar tooth. His physical health was poor. Following oxygenation, midazolam was administered intravenously very slowly until the optimum sedative level was obtained, with a total dosage of 3.5 mg. There were no marked changes in vital signs during the perioperative period, and the patient was discharged the same day.This case suggests that moderate or conscious sedation using midazolam for dental treatment of a patient with DS, ID, and ES was well tolerated. Several critical points are presented in this review. (Source: Special Care in Dentistry)

Salivary factors and dental plaque levels in relation to the general health of elderly residents in a long‐term care facility: a pilot study

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

ABSTRACTThe goal of this study was to examine salivary factors and formation of dental plaque in elderly subjects who were institutionalized and to relate these factors to general health and medication use.This cross‐sectional study consisted of 50 elderly individuals who were institutionalized and 25 healthy young volunteers who served as a reference group. For each subject, salivary flow rates, salivary pH, and buffering capacity were assessed. Baseline Plaque Index and Plaque Formation Rate Index were used as a measure of oral hygiene. Information on each patient's general health and medication use was acquired from the institution.An evaluation of the results of this study suggests that salivary protective qualities and dental plaque levels in the elderly subjects who were institutio...

Treating patients with Autism Spectrum Disorder—SCDA members’ attitudes and behavior

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

ABSTRACTThe goal of this study was to explore (a) the attitudes and behavior of members of the Special Care Dentistry Association (SCDA) who self‐identified as treating patients with Autism Spectrum Disorders (ASD) and (b) the relationship between their professional attitudes and behaviors concerning these patients.Data were collected from 75 SCDA members who responded to an anonymous web‐based survey on the SCDA website. The majority of respondents liked to treat children and adults with ASD (57%/56.9%). They treated approximately nine patients with ASD in an average week. The more they liked to treat children with ASD, the more patients with ASD they treated (r = .313; p = .018), and the more accommodations to overcome problems with communication, social interactions and aversion to ...

Dental utilization by adult Medicaid enrollees who have indicators of intellectual and developmental disabilities (IDD)

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

ABSTRACTThe purpose of this study was to determine dental utilization and type of dental services for Medicaid‐enrolled adults who had been identified as having intellectual and developmental disabilities (IDD). Using Iowa claims data, the authors identified adults who met any of five IDD criteria for inclusion during calendar year 2005. Service utilization rates, including use of preventive dental, routine restorative, and complex restorative services, were determined.Approximately 60% of adults with IDD had at least one dental visit in 2005. Among adults with at least one dental visit, 83% received a preventive service, 31% a routine restorative service, and 16% a complex dental service. Those age 65 and older had fewer preventive dental services than other age groups. In Iowa, dental ...

Home care dental practice business and clinical guidelines

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

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Financial—How to get paid by the patient or the facility

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

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The evolution of a new (unofficial) specialty: Dental Geriatrician

Special Care in Dentistry — Tue, 28 Dec 2010 00:00:00 +0100

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Continuing education program

Special Care in Dentistry — Mon, 01 Nov 2010 00:00:00 +0100

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Erratum

Special Care in Dentistry — Mon, 01 Nov 2010 00:00:00 +0100

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Recovery of Candida dubliniensis and other Candida species from the oral cavity of subjects with periodontitis who had well‐controlled and poorly controlled type 2 diabetes: a pilot study

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

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Continuing education program

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

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Effect of omega‐3 and vitamin E supplementation on dry mouth in patients with Sjögren's syndrome

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

ABSTRACT (Source: Special Care in Dentistry)

Oral health status and treatment needs of children attending special schools in South India: a comparative study

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

ABSTRACT (Source: Special Care in Dentistry)

Dental students’ perceived comfort and future willingness to treat underserved populations: surveys prior to and immediately after extramural experiences

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

ABSTRACT (Source: Special Care in Dentistry)

Ectrodactyly‐ectodermal dysplasia‐clefting syndrome: the oral hygiene management of a patient with EEC

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

ABSTRACT (Source: Special Care in Dentistry)

Larsen syndrome: a review of the literature and case report

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

ABSTRACT (Source: Special Care in Dentistry)

The importance of dental care for a child with severe congenital neutropenia: a case report

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

ABSTRACT (Source: Special Care in Dentistry)

An alternative impression technique for individuals with special care needs

Special Care in Dentistry — Thu, 30 Sep 2010 23:00:00 +0100

ABSTRACT (Source: Special Care in Dentistry)

Book review

Special Care in Dentistry — Tue, 31 Aug 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Reviewers index

Special Care in Dentistry — Tue, 31 Aug 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

ARTICLE: Recruitment of rural and cognitively impaired older adults for dental research

Special Care in Dentistry — Sat, 31 Jul 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

ARTICLE: Caries prevalence in patients with cerebral palsy and the burden of caring for them

Special Care in Dentistry — Sat, 31 Jul 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

ARTICLE: Does information about patients who are intellectually disabled translate into better cooperation during dental visits?

Special Care in Dentistry — Sat, 31 Jul 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

ARTICLE: Axenfeld–Rieger Syndrome (ARS): A review and case report

Special Care in Dentistry — Sat, 31 Jul 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

ARTICLE: Oral health status of older adults in Kentucky: results from the Kentucky Elder Oral Health Survey

Special Care in Dentistry — Sat, 31 Jul 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

ARTICLE: Oral health condition and treatment needs of Special Olympics athletes in Nigeria

Special Care in Dentistry — Sat, 31 Jul 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Continuing education program

Special Care in Dentistry — Sat, 31 Jul 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

EDITORIAL: How a broken tooth saved a life

Special Care in Dentistry — Wed, 30 Jun 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Health literacy—how does it impact your ability to treat your patients?

Special Care in Dentistry — Wed, 30 Jun 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Effect of spastic cerebral palsy on jaw‐closing muscles during clenching

Special Care in Dentistry — Wed, 30 Jun 2010 23:00:00 +0100

ABSTRACT (Source: Special Care in Dentistry)

SCDA 2010 Annual Meeting

Special Care in Dentistry — Thu, 17 Jun 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Clinical and microbiological evaluation of the use of toothpaste containing 1% chlorhexidine and the influence of motivation on oral hygiene in patients with motor deficiency

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

The objective of this study was to evaluate the clinical and microbiological efficacy of a toothpaste containing 1% chlorhexidine, which was used by patients with motor deficiency for 14 days. The reduction in plaque and gingival index and the impact on salivary microorganisms was evaluated. We conclude that the motivation of caregivers to carry out oral hygiene for patients with mental and motor deficiency is of great importance and is effective in reducing the formation of plaque as long as it is continuously reinforced. The use of chlorhexidine-containing toothpaste significantly reduced the plaque index and microorganism count between days 0 and 14. A reduction was also observed in the group that used a dentifrice without the chlorhexidine, but this difference was not significant. (Sou...

Tuberous sclerosis: a case report

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

Tuberous sclerosis is an inherited neurocutaneous disorder that occurs in approximately 1 in 7,500 live births. It is characterized by benign neoplasms of the skin, heart, kidneys, lungs, central nervous system, and mucosa. Oral lesions are usually fibrous in nature and most commonly occur on the anterior gingivae. Patients may suffer with epilepsy and learning difficulties, which may complicate dental management. When a 10-year-old girl with a history of tuberous sclerosis was brought in for a routine dental check-up, a leafy growth on the anterior gingiva was detected. An excisional biopsy was carried out. Histologically, the appearance was described as nonspecific, but was consistent with a diagnosis of tuberous sclerosis. Tuberous sclerosis is a rare condition that may exhibit oral man...

Necrotizing sialometaplasia in a patient who is HIV positive: a case report

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

Necrotizing sialometaplasia (NS) is a self-limiting, benign, inflammatory disease of the minor salivary glands of the hard palate. The main significance of the NS lesion lies in the fact that it may be mistaken for mucoepidermoid or squamous cell carcinoma. A case report is presented of a patient with NS who was HIV positive; the lesion was located in the minor salivary glands of the hard palate. Clinically, the lesion presented as a deep ulcer with slightly elevated irregular borders and a necrotic base in the hard palate. Histologically, the tissue was characterized by squamous metaplasia of ducts and acini, lobular coagulation necrosis, and pseudoepitheliomatous hyperplasia of the overlying epithelium. The lesion disappeared completely after 2 weeks. (Source: Special Care in Dentistry)

Effect of spastic cerebral palsy on jaw-closing muscles during clenching

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

The motor effort of jaw-closing muscles during maximal voluntary clenching (MVC) was compared between individuals with spastic cerebral palsy (CP) and nondisabled control subjects (CG). Bilateral electromyographic (EMG) activity of the anterior temporalis (AT) and masseter (MS) muscles was obtained during MVC in 22 subjects with CP and 29 nondisabled subjects. The oral functional status of the group with CP was evaluated using the Orofacial Motor Function Assessment Scale. The group with CP presented lower bilateral EMG activity during MVC compared to the control group for both AT and MS muscles. Comparisons of AT and MS EMG activity showed no difference in muscular effort. Subgroups with CP who were only slightly and very slightly orally impaired had a higher bilateral AT EMG activity com...

Cost as a barrier to dental care among people with disabilities: a report from the Florida behavioral risk factor surveillance system

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

This study reports on cost of care as a barrier to oral health care. Data from the 2007 Florida Behavioral Risk Factor Surveillance System (BRFSS) were used (n = 33,777). Respondents who reported activity limitation or the use of special equipment were considered to have a disability. Lack of access to dental care due to cost during the past year was assessed. More individuals with a disability reported not seeing a dentist due to cost versus people without disabilities (30% vs. 16%). After adjusting for confounding variables, Floridians with disabilities were 60% more likely to report cost as a barrier to dental care (OR = 1.60, 95% CI 1.32[ndash]1.94). Cost of dental care is an access to oral health barrier for Floridians with disabilities. Improving access to dental care for this popula...

Factors associated with reported need for dental care among people who are homeless using assistance programs

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

A retrospective secondary data analysis of the National Survey of Homeless Assistance Providers and Clients database was conducted to identify the demographic characteristics and correlates associated with reported need for dental care among people who are homeless in the United States. Overall, 10% of people who were homeless reported that dental care was their most needed service. Of these, 17% had a dental visit within the previous 12 months, 52% were racial/ethnic minorities, 76% lived in a central city, and 26% were veterans. The unadjusted odds for reporting a need for dental care was highest among veterans who were homeless and those whose last dental visit occurred more than 12 months ago. Compared to nonveterans who were homeless, veterans had twice the adjusted odds for reporting...

Factors that limit access to dental care for adults with spinal cord injury

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

This study investigated dental care service utilization among adults with spinal cord injury (SCI) and identified barriers and other factors affecting utilization among this population. There were 192 subjects with SCI who participated in the oral health survey assessing dental care service utilization and they were compared with subjects from the 2004 Behavioral Risk Factors Surveillance System (BRFSS). There was no significant difference in the proportion of subjects with SCI who visited the dentist for any reason in the past year compared to the general population (65.5% vs. 68.8%, p= .350). However, subjects with SCI were less likely to go to the dentist for a dental cleaning in the past year compared to the general population (54.6% vs. 69.4%, p < .001). The three most commonly report...

Continuing education program

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Health literacy—how does it impact your ability to treat your patients?

Special Care in Dentistry — Wed, 16 Jun 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Continuing education program

Special Care in Dentistry — Mon, 03 May 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Letter to the editor

Special Care in Dentistry — Mon, 12 Apr 2010 23:00:00 +0100

(Source: Special Care in Dentistry)

Iowa intermediate care facilities: An evaluation of care providers'attitudes toward oral hygiene care

Special Care in Dentistry — Sun, 11 Apr 2010 23:00:00 +0100

This study investigated the oral hygiene care (OHC) activities and attitudes of care providers in Intermediate Care Facilities for the Mentally Retarded (ICF/MR) in the state of Iowa. Questionnaires were distributed to care providers employed at three ICF/MRs. About 98% of the staff ranked OHC as important to extremely important for residents. Twenty-three percent disliked OHC occasionally or more frequently. Lack of time and lack of staff were the main reasons preventing care providers from assisting residents with OHC. Residents' behaviors resulted in inadequate OHC for 64.9%, and 49% of residents required complete assistance with OHC. Most common OHC difficulties reported were residents biting the toothbrush, refusing OHC, or not opening their mouths. Subjects reported spending 3.0 minu...

Oral healthcare access and adequacy in alternative long-term care facilities

Special Care in Dentistry — Sun, 11 Apr 2010 23:00:00 +0100

This study was undertaken to determine practices and perceived barriers to access related to oral health by surveying administrators in Michigan alternative long-term care facilities (ALTCF). A 24-item questionnaire was mailed to all 2,275 Michigan ALTCF serving residents aged 60+. Facility response rate was 22% (n = 508). Eleven percent of facilities had a written dental care plan; 18% stated a dentist examined new residents; and 19% of facilities had an agreement with a dentist to come to the facility, with 52% of those being for emergency care only. The greatest perceived barriers were willingness of general and specialty dentists to treat residents at the nursing facility and/or private offices as well as financial concerns. Substantial barriers to care were uniformly perceived. Oral h...

A description of two surgical and anesthetic management techniques used for a patient with fibrodysplasia ossificans progressiva

Special Care in Dentistry — Sun, 11 Apr 2010 23:00:00 +0100

This report outlines the management of a patient with FOP who had ankylosis of the temporomandibular joint and progressive ossification of the neck structures. The patient underwent two different surgical and anesthetic procedures within a 10-year period to manage his oral pain. The authors compare the surgical techniques, osteotomy versus the more conservative buccal approach, anesthesia techniques, and conventional intubation versus sedated fiberoptic intubation. This report emphasizes the importance of a less invasive surgical technique and an appropriate anesthetic management that reduces the risks, cost, and morbidity associated with routine surgical management of patients with FOP. (Source: Special Care in Dentistry)

Periodontal health in Down syndrome: Contributions of mental disability, personal, and professional dental care

Special Care in Dentistry — Sun, 11 Apr 2010 23:00:00 +0100

Fifty-five dentate patients with Down syndrome (DS) and 74 with mental disability non-Down (MR) were compared to 88 control subjects. Subjects in the MR and Control groups were matched by gender and ethnicity to subjects with DS. All subjects were nonsmokers. Periodontal evaluation included plaque index (PI), gingival index (GI), bleeding on probing (BOP), and clinical periodontal attachment levels. Caries and missing teeth were recorded. Measures of personal dental hygiene and the frequency of professional dental care were also recorded. Most subjects brushed their teeth at least once per day, but did not floss. Both groups with DS and MR had significantly more missing teeth, more BOP, and higher GI and PI levels than the control group. Patients with DS had more attachment loss (AL) than ...

Comprehensive dental services for an underserved and medically compromised population provided through a community partnership and service learning

Special Care in Dentistry — Sun, 11 Apr 2010 23:00:00 +0100

The University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco established a comprehensive dental care program at Laguna Honda Hospital, a public, skilled nursing facility. The program had three goals: (1) to provide dental students and residents an opportunity to provide oral health care for adults who were frail and medically compromised who could not come into the clinics, (2) to increase students' access to patients who needed removable prosthodontics, and (3) to fulfill Pacific's commitment to public service. Laguna Honda and Pacific pooled their resources to bring comprehensive dental care to patients who were not able to access the dental school clinics. The long-term goals are to restore and maintain the oral health of those who reside in the facility, and to ...

Oral health of patients with intellectual disabilities: A systematic review

Special Care in Dentistry — Sun, 11 Apr 2010 23:00:00 +0100

A systematic review of original studies was conducted to determine if differences in oral health exist between adults who have intellectual disabilities (ID) and the general population. Electronic searching identified 27 studies that met the inclusion criteria. These studies were assessed for strength of evidence. People with ID have poorer oral hygiene and higher prevalence and greater severity of periodontal disease. Caries rates in people with ID are the same as or lower than the general population. However, the rates of untreated caries are consistently higher in people with ID. Two subgroups at especially high risk for oral health problems are people with Down syndrome and people unable to cooperate for routine dental care. Evidence supports the need to develop strategies to increase ...

Dental management of a patient with Rubinstein–Taybi syndrome

Special Care in Dentistry — Sun, 11 Apr 2010 23:00:00 +0100

Rubinstein[ndash]Taybi syndrome (RTS) occurs in one out of 300,000 individuals. It is mainly characterized by a delay in growth, psychomotor retardation, duplication of the distal phalanx of the thumbs, typical facial dimorphism, a risk of cancer, and multiple dental abnormalities. This case report describes the dental management of a 13-year-old female with RTS, who had multiple dental problems such as caries, periodontal disease, and a severe malocclusion. Physical findings were similar to those previously described in other reports. Dental treatment was carried out under sedation due to the patient's inability to cooperate during dental treatment. After 3 years of follow-up there were no new caries and the periodontal health had improved. (Source: Special Care in Dentistry)

Oral health coordinators in long-term care—a pilot study

Special Care in Dentistry — Wed, 17 Feb 2010 00:00:00 +0100

This pilot project tested a curricular and systems approach to improving the oral health care of nursing home residents in three facilities in New Hampshire. An oral health coordinator (OHC) was appointed in each facility to act as a liaison between nursing and dental staff, provide resources for nursing assistants, and ensure staff delivery of residents' daily oral care. During the study, residents' oral health status was assessed at four intervals and ongoing training was provided to nursing staff. At the conclusion of the pilot study, an evaluation of the results indicated an improvement in oral hygiene in all facilities. The role of the OHC showed promise when that person was active in holding nursing staff accountable for daily oral care of the residents. (Source: Special Care in Dent...

Irsogladine Maleate in the management of recurrent aphthous stomatitis:A pilot study

Special Care in Dentistry — Fri, 12 Feb 2010 00:00:00 +0100

(Source: Special Care in Dentistry)

Characteristics of individuals with hydrocephalus and their dental care needs

Special Care in Dentistry — Thu, 11 Feb 2010 00:00:00 +0100

Hydrocephalus is considered a congenital disease affecting the central nervous system, and is characterized by accumulation of cerebrospinal fluid in the lateral ventricles of the brain causing progressive ventricular dilatation. This review paper reports on the oral characteristics of persons with hydrocephalus and discusses their dental care needs. It has been reported that patients with hydrocephalus can present chronological changes in the eruption of their teeth, changes in the occlusion, greater accumulation of plaque, and have a higher caries prevalence. Regular dental visits are needed to control caries as well as to educate the caretakers about oral hygiene for children with hydrocephalus. In addition, the dental practitioner should be careful not to put pressure on the ventricula...

Oral mutans streptococci levels following use of a xylitol mouth rinse: a double-blind, randomized, controlled clinical trial

Special Care in Dentistry — Thu, 11 Feb 2010 00:00:00 +0100

This study evaluated the effect of xylitol rinse on mutans streptococci (MS) levels in the mouth. One hundred and five subjects with high salivary MS levels were randomly assigned to one of three groups. Subjects in the positive control group (N = 35) chewed two xylitol gum pellets for at least 5 minutes three times daily (xylitol dose: 4.3g/day). The experimental group (N = 36) rinsed with 20 mL of an aqueous solution of xylitol twice daily for 60 seconds (dose: 4.4g/day). The negative control group (N = 34) used neither product. No attempt was made to change the subjects' diet. Mean MS levels at baseline were 5.6 (0.1) in positive control, 5.4 (0.1) in experimental, and 5.5 (0.1) in negative control groups. After 3 months, MS levels were 4.4 (0.2), 4.4 (0.2), and 4.9 (0.2), respectively....

Factors associated with the use of emergency dental care facilities in a French public hospital

Special Care in Dentistry — Thu, 11 Feb 2010 00:00:00 +0100

This study was undertaken to qualitatively analyze patients' profiles and to identify the sociodemographic and oral health factors associated with emergency visits to the public dental service in Montpellier, France. A cross-sectional survey was conducted in the dental care service at Montpellier Hospital. Socioeconomic and clinical variables were compared between the patients using the emergency dental care service and those utilizing the general dental services, which were by appointment. An evaluation of the results indicated that younger patients and people from lower socioeconomic groups used the emergency dental service more frequently. Unemployed people (OR = 1.60) and manual workers (OR = 1.86) were also more likely to use this service. The need for treatment of caries was signific...

Drug-induced gingival enlargement: Biofilm control and surgical therapy with gallium–aluminum–arsenide (GaAlAs) diode laser—A 2-year follow-up

Special Care in Dentistry — Thu, 11 Feb 2010 00:00:00 +0100

This report describes the initial protocol, the gingivectomy, and a 2-year follow-up. A diode laser was used as an effective and safe method to remove the patient's overgrown gingival tissue. (Source: Special Care in Dentistry)

Access to dental care—parents' and caregivers' views on dental treatment services for people with disabilities

Special Care in Dentistry — Thu, 11 Feb 2010 00:00:00 +0100

This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector. (Source: Special Care in Dentistry)

Bisphosphonate-associated osteonecrosis of the jaw,with healing after teriparatide:a review of the literature and a case report

Special Care in Dentistry — Thu, 11 Feb 2010 00:00:00 +0100

This paper reports the case history of a patient who had bisphosphonate-associated osteonecrosis of the jaw (ONJ) in which adjunctive treatment with teriparatide was used. The patient was treated for 5 years with alendronate for osteoporosis and developed ONJ after extraction of maxillary teeth. An implant was placed at the site of the extracted teeth. The pathology report confirmed the clinical diagnosis of ONJ; treatment was changed from alendronate to teriparatide and the ONJ resolved. To our knowledge, this is the third case history reported in the literature in which teriparatide was successfully used as adjunct therapy in ONJ because it has an anabolic effect and presumed role in accelerating bone healing. ONJ is a serious but infrequent condition that has been recently associated wi...

Continuing education program

Special Care in Dentistry — Thu, 11 Feb 2010 00:00:00 +0100

(Source: Special Care in Dentistry)

Book Review: Handbook of Essential Information for Hospital Dental Leaders

Special Care in Dentistry — Mon, 21 Dec 2009 00:00:00 +0100

(Source: Special Care in Dentistry)

Special care dentistry on a global scale

Special Care in Dentistry — Mon, 21 Dec 2009 00:00:00 +0100

(Source: Special Care in Dentistry)

An assessment of the dental health of chronic institutionalized patients with psychiatric disease in Israel

Special Care in Dentistry — Tue, 08 Dec 2009 00:00:00 +0100

This study assessed the oral health and treatment needs of chronically hospitalized patients with psychiatric disease in Israel. A random sample of 301 patients hospitalized for more than 1 year in 14 of 18 psychiatric institutions in Israel was drawn from the National Psychiatric Hospitalization Registry, and 84.4% of them were examined. Their dental status was evaluated using decayed, missing, filled teeth (DMF-T) index and demographic and medical data were retrieved from the patients' files. Of the 254 patients examined, 4 (1.6%) were caries-free, 176 (69%) patients had only a partial natural dentition, while 66 (26%) were edentulous. The average DMF-T score was 23.8. The caries component accounted for 2.7 of the DMF-T, the missing teeth component was 20, and the restored teeth componen...

The self-reported oral health status and behaviors of adults who are deaf and blind

Special Care in Dentistry — Mon, 07 Dec 2009 00:00:00 +0100

This qualitative study explored perceived oral health, felt need, oral health knowledge and behaviors, and utilization of dental services among a community of deaf and blind adults in Toronto, Canada. Seven adults participated in in depth interviews facilitated by intervenors skilled in communication with people who are deaf and blind. Subjects reported that their oral health was good, however oral health knowledge was poor and daily oral hygiene practices were minimal. Few subjects had ever received dental health education and were largely unaware of how to prevent dental disease. A subsidized dental program enabled subjects to have regular dental visits, though they were concerned about the costs of more complex dental treatment not covered by the program. They also worried about finding...

Complications associated with anesthesia administration for dental treatment in a special needs clinic

Special Care in Dentistry — Mon, 07 Dec 2009 00:00:00 +0100

The goal of this study was to identify and quantify complications occurring with the administration of anesthesia for the dental treatment of patients with special needs. Anesthesia providers completed a standardized evaluation form, delineating possible complications for 202 consecutive ambulatory patients receiving anesthesia in a special needs clinic. Statistical analysis of four types of administered anesthesia showed that the overall complication rate was 23.8%. Evaluation of the data showed complications that were considered either mild (95.8%), or moderate (4.2%), while no reports of severe complications occurred. Airway obstruction and nausea/vomiting were the most frequently encountered complications. Variables found to affect the incidence of anesthetic complications included ASA...

Hurler syndrome: a case report of a 5-year follow-up of dental findings after bone marrow transplantation

Special Care in Dentistry — Mon, 07 Dec 2009 00:00:00 +0100

Hurler syndrome is a rare autosomal recessive disorder of mucopolysaccharide metabolism. It results from a deficiency in lysosomal enzymes responsible for the breakdown of glycosaminoglycans. Affected individuals may show progressive physical and mental deterioration as glycosaminoglycans are deposited in the organs of the body. Bone marrow transplantation (BMT) is effective in improving some of the clinical manifestations of Hurler syndrome. Death is caused by cardiorespiratory failure and usually occurs before the second decade of life. In this case report, the course of dental development was followed over 5 years, from the primary dentition into the permanent dentition, of a child who was successfully treated with a bone marrow transplant in infancy. The timing of bone marrow therapy h...

Occurrence of ameloblastoma in a patient with nasopharyngeal carcinoma after treatment by irradiation

Special Care in Dentistry — Mon, 07 Dec 2009 00:00:00 +0100

We present the case history of a 46-year-old male patient who had a nasopharyngeal carcinoma (NPC) treated by irradiation, which was complicated by the occurrence of an ameloblastoma. Following a review of the English language literature, this case history was identified as being the first report, to our knowledge, of the occurrence of ameloblastoma in a patient who had been irradiated for an NPC. This case report highlights the importance of regular dental care for a patient who had an NPC and was treated with radiation therapy. (Source: Special Care in Dentistry)

Recessive dystrophic epidermolysis bullosa—oral rehabilitation using stereolithography and immediate endosseous implants

Special Care in Dentistry — Mon, 07 Dec 2009 00:00:00 +0100

Dental management of patients with epi-dermolysis bullosa (EB) is challenging because of the severe soft tissue lesions associated with this disease. A case history is presented where two immediate endosseous implants were placed in the mandible of a patient with recessive dystrophic EB using computer-aided technology to plan the surgery and prosthetic rehabilitation. After a 24-month follow-up, the prosthesis was stable with healthy asymptomatic soft tissue around the implants. The stereolithographic model provides a precise and noninvasive copy of the mandibular and maxillary arches of patients with EB for rehabilitation of the dentition with immediate endosseous implants and a prosthesis. (Source: Special Care in Dentistry)

Reviewers index

Special Care in Dentistry — Thu, 29 Oct 2009 00:00:00 +0100

(Source: Special Care in Dentistry)

Dental aesthetics assessed against orthodontic treatment complexity and need in Nigerian patients with sickle-cell anemia

Special Care in Dentistry — Thu, 29 Oct 2009 00:00:00 +0100

This study investigates the relationship between dental aesthetics and orthodontic treatment complexity and need in a group of patients with sickle-cell anemia (SCA) in Nigeria. The study sample consisted of 176 individuals [mdash] 77 (43.8%) male and 99 (56.3%) female subjects with SCA (aged 10 to 35 years) who were coming for routine medical care to two outpatient clinics. Dental aesthetics were assessed using the Standardized Continuum of Aesthetic Need component of the Index of Orthodontic Treatment Need. Treatment complexity and need were assessed according to the Index of Complexity, Outcome and Need and Dental Aesthetic Index. Both parametric and nonparametric statistics were employed in the data analysis. Significant positive relationships were found between dental aesthetics and o...

Continuing education program

Special Care in Dentistry — Wed, 14 Oct 2009 23:00:00 +0100

(Source: Special Care in Dentistry)

Dental team management for a patient with Klippel–Feil syndrome: Case report

Special Care in Dentistry — Tue, 13 Oct 2009 23:00:00 +0100

The objective of this case report was to describe the planning and execution of dental treatment for a 10-year-old male patient with KFS. (Source: Special Care in Dentistry)

Self-inflicted oral injury in an infant with transverse myelitis

Special Care in Dentistry — Tue, 13 Oct 2009 23:00:00 +0100

We report on a child who had ATM and respiratory distress requiring ventilatory assistance who presented with severe self-mutilation involving his lips. Other findings included bruxism that had caused mobility of the primary teeth. Comprehensive dental care was carried out under sedation. The management of the lip trauma was achieved by the use of a soft, plastic mouth guard, and corticosteroid ointment. (Source: Special Care in Dentistry)

Advanced General Dentistry program directors' attitudes on physician involvement in pediatric oral health care

Special Care in Dentistry — Tue, 13 Oct 2009 23:00:00 +0100

Childhood oral disease is a significant health problem, particularly for vulnerable populations. Since a major focus of General Dentistry Program directors is the management of vulnerable populations, we wanted to assess their attitudes regarding the inclusion of physicians in the prevention, assessment, and treatment of childhood oral disease. A survey was mailed to all General Practice Residency and Advanced Education in General Dentistry program directors (accessed through the ADA website) to gather data. Spearman's rho was used to determine correlation among variables due to nonnormal distributions. Overall, Advanced General Dentistry directors were supportive of physicians' involvement in basic aspects of oral health care for children, with the exception of applying fluoride varnish. ...

Oral cancer screening: Practices, knowledge, and opinions of dentists working in Ohio nursing homes

Special Care in Dentistry — Tue, 13 Oct 2009 23:00:00 +0100

The state of oral health of nursing homes residents is less than satisfactory. The oral health care in nursing homes is also deficient, therefore it is likely that oral cancer (OC) screening of residents will be inadequate. The purpose of this cross-sectional study was to determine OC screening practices, knowledge, and opinions of dentists working in nursing homes throughout Ohio. A 28-item pretested questionnaire was mailed to 75 dentists who were serving 606 nursing homes. The response rate was 49%. The main outcome measures of interest included: OC screening practices of the Ohio dentists, their knowledge of OC detection, and their opinions regarding OC screening competency. Age was found to be a significant factor, with younger dentists being more likely to have higher knowledge score...

Oral findings and dental treatment in a child with West syndrome

Special Care in Dentistry — Tue, 13 Oct 2009 23:00:00 +0100

This article reports the case history of a 7-year-old child diagnosed with WS. The major clinical features were generalized tooth wear and gingival enlargement, altered chronology and sequence of dental eruption, primary canine cusp-to-cusp relationship, ectopic dental eruption, and mildly arched palate. Multiple white spot lesions were also observed, possibly associated with poor oral hygiene, due to a fermentable carbohydrate-rich diet, and continuous use of sugar-containing medications. Dental care management of patients with special needs is discussed and the dental treatment for this child with WS is described. (Source: Special Care in Dentistry)

Introduction

Special Care in Dentistry — Tue, 13 Oct 2009 23:00:00 +0100

(Source: Special Care in Dentistry)

Presence of staphylococci in mouth and presence of streptococci in late infections of knee and hip joint prostheses: antibiotic prophylaxis, a conundrum

Special Care in Dentistry — Tue, 13 Oct 2009 23:00:00 +0100

(Source: Special Care in Dentistry)

The new American academy of orthopedic surgeons' recommendations regarding antibiotic prophylaxis: where's the evidence?

Special Care in Dentistry — Tue, 13 Oct 2009 23:00:00 +0100

(Source: Special Care in Dentistry)

Abstracts from the Special Care Dentistry 21st Annual Meeting can be accessed in the electronic version of this issue at interscience.wiley.com

Special Care in Dentistry — Wed, 02 Sep 2009 23:00:00 +0100

This study's purpose was to note trends in the prevalence of oral manifestations of HIV and assess variations in the dental care of adults with HIV given the current use of antiretroviral therapy in both the industrialized world and developing nations. A comprehensive review of the English literature was completed on the incidence and prevalence of oral diseases and the types of dental services that provided comprehensive oral care to patients who have been HIV positive since 1980. The study concluded that significant and similar disparities exist in the use of dental health services for both patients with HIV and the general population. With the use of HAART, the incidence of oral mucosal lesions is also being reduced. In this presentation, attendees will learn what effect the existing me...

Continuing education program

Special Care in Dentistry — Tue, 25 Aug 2009 23:00:00 +0100

(Source: Special Care in Dentistry)

Oral health outcomes in an adult dental population: the impact of payment systems

Special Care in Dentistry — Mon, 24 Aug 2009 23:00:00 +0100

This study compared the effect of payment systems on recall visits and oral health outcomes for four patient payer groups. The authors reviewed recall audit data obtained over a 4-year period. Dental payer groups in the study population differed with respect to dental outcomes. Patients who had recall visits at 1 year or longer had worse outcomes than patients seen more frequently. A Medicaid subgroup with the greatest number of risk factors displayed improved oral health outcomes when seen on a more frequent recall schedule. Study findings suggest that, given the increased risks to maintaining oral health, patients being supported by public-funded programs would benefit from more frequent recalls. Such an emphasis would appear to provide the opportunity to improve outcomes in disadvantage...

Beers' criteria—is it relevant to dentistry?

Special Care in Dentistry — Mon, 24 Aug 2009 23:00:00 +0100

(Source: Special Care in Dentistry)

Fluoxetine-induced sleep bruxism in an adolescent treated with buspirone: a case report

Special Care in Dentistry — Mon, 24 Aug 2009 23:00:00 +0100

This article reports on a case history of an adolescent with fluoxetine-induced bruxism that was successfully treated with buspirone. As SSRI use is on the rise for treating childhood psychiatric disorders, this case report highlights the importance of recognizing SSRI-induced bruxism and the possible related adverse dental side effects. Furthermore, this report supports the efficacy of a treatment strategy in adolescents, which has previously been reported only for adult patients. (Source: Special Care in Dentistry)

Caries experience in individuals with cerebral palsy in relation to oromotor dysfunction and dietary consistency

Special Care in Dentistry — Mon, 24 Aug 2009 23:00:00 +0100

The aim of this study was to investigate caries experience in individuals with cerebral palsy (CP) who have oromotor dysfunction and relate it to age and dietary consistency. Noninstitutionalized individuals with CP (n = 108) aged 4[ndash]19 years (mean: 10 years, 1 month ± SD 4 years, 5 months) were recruited for this study. Subjects who were severely impaired (35.2%) had orofacial motor dysfunction most frequently, followed by those who were slightly affected (27.7%), moderately affected (20.4%), and very slightly affected (16.7%). Age was a statistically significant factor for oromotor dysfunction (p= 0.007), with the youngest individuals having the most severe oromotor problems. Dietary consistency and oromotor function were statistically significant influence on the DMF index (p= 0.0...

Masticatory dysfunction in patients with myotonic dystrophy (type 1): a 5-year follow-up

Special Care in Dentistry — Mon, 24 Aug 2009 23:00:00 +0100

Eight patients with myotonic dystrophy type 1, DM1 (age range 45[ndash]63 years) were followed for a period of 5 years. Two sets of data analyzing masticatory function and activities of daily living (ADL) were obtained at baseline and at 5 years. The results from both time points were compared. The number of food items considered easy to chew, maximum bite force, occlusal contact area, number of teeth, and ADLs were significantly reduced (p < 0.05) at the second assessment when compared to the first. During the intervening 5 years, six of the eight patients adopted a soft diet. These results suggest deterioration in ADLs and masticatory function of patients with DM1. Continuous evaluation of the feeding ability and the type of diet are necessary for patients with DM1. (Source: Special Care...

Oral home telecare for adults with tetraplegia: a feasibility study

Special Care in Dentistry — Mon, 24 Aug 2009 23:00:00 +0100

This pilot study investigated the feasibility of delivering an individualized program of oral home telecare training using PC-based, real-time interactive videoconferencing via the Internet to meet the unique challenges of dental care for people with tetraplegia. A home-based videoconferencing method was tested with two adults with tetraplegia and an occupational therapist (rehabilitation specialist). As part of the proposed rehabilitation training to improve independence in performing oral hygiene, adaptive devices (a rechargeable oscillating-rotating power toothbrush and a cordless oral irrigator) were introduced to facilitate oral care performance with interactive, Web-based instruction. Training was conducted once a week for 4 weeks. The oral home telecare experience was evaluated usin...

Improving oral healthcare: improving the quality of life for patients after a stroke

Special Care in Dentistry — Mon, 24 Aug 2009 23:00:00 +0100

With the increase in the elderly population, the prevalence of systemic diseases such as strokes and heart attacks will also increase. Persons who have had a stroke will be more susceptible to mistreatment, neglect, abuse, and aspiration pneumonia. The expansion of the elderly population will make the training of professional healthcare workers and other auxiliaries extremely important. Quality of life can be maintained if poor oral health is reduced through better daily oral hygiene practices. Informing others about the known association between oral health and systemic diseases will increase the awareness of the need for good oral hygiene in order to reduce the risk of systemic diseases. Healthcare professionals must also be able to recognize, document, and report to Adult Protective Ser...

Continuing education program

Special Care in Dentistry — Wed, 24 Jun 2009 23:00:00 +0100

(Source: Special Care in Dentistry)

Effects of human aging on periodontal tissues

Special Care in Dentistry — Sun, 21 Jun 2009 23:00:00 +0100

Loss of teeth is frequently associated with periodontal disease in older adults. The aim of this review was to present the effects of aging on the periodontal tissues. Aging alone does not lead to critical loss of periodontal attachment in healthy elderly persons. The effects of aging on periodontal tissues are based on molecular changes in the periodontal cells, which intensify bone loss in elderly patients with periodontitis. These effects may be associated with (1) alterations in differentiation and proliferation of osteoblasts and osteoclasts; (2) an increase in periodontal cell response to the oral microbiota and mechanical stress leading to the secretion of cytokines involved in osseous resorption; and (3) systemic endocrine alterations in the elderly people. (Source: Special Care in...

Failure of tooth eruption in two patients with cerebral palsy and bruxism—a 10-year follow-up: a case report

Special Care in Dentistry — Sun, 21 Jun 2009 23:00:00 +0100

The aim of this paper was to analyze delayed tooth eruption in two children with cerebral palsy who had severe bruxism and to determine whether treatment could influence tooth eruption and alignment. Extraction of primary teeth was carried out and orthodontic treatment was considered due to severe tooth wear of primary teeth, lack of space, and development of a class III malocclusion. Analysis was based on clinical examination, photographs, radiographs, and dental casts. In both patients, early mixed dentition was delayed for more than 5 years. Calcification and root development of posterior permanent teeth corresponded with the chronological age. Root resorption of the severely abraded primary teeth and eruption of their successors were delayed or failed. Eruption of permanent teeth occur...

Effect of an oral health assessment education program on nurses' knowledge and patient care practices in skilled nursing facilities

Special Care in Dentistry — Sun, 21 Jun 2009 23:00:00 +0100

This pilot intervention study measured the impact of an oral health education intervention on nurses' knowledge and patient care practices in regard to oral assessments of institutionalized elders. Two 1-hour education sessions were completed over a 3-week period; a pretest and a posttest were administered immediately preceding the first session and immediately following the second session. Medical records were reviewed prior to and after the intervention to assess practices including completeness of oral health assessment and congruency with the Minimum Data Set 2.0 (MDS). Nine nurses attended the education intervention. Retrospectively, 176 records were reviewed preintervention and 80 postintervention. There was no significant change in knowledge from the pre- to posttest (p= .262). Comp...

Drooling of saliva in children with cerebral palsy—etiology, prevalence, and relationship to salivary flow rate in an Indian population

Special Care in Dentistry — Sun, 21 Jun 2009 23:00:00 +0100

In this study, there were 74 males and 39 females with an age range of 6[ndash]18 years who were attending a special school in Chennai, India. The severity of drooling was assessed by visual examination; demographics and data regarding severity and control of drooling were collected via a questionnaire. Data regarding the type of CP and drugs taken by the children were obtained from the medical records maintained by the school. The unstimulated salivary flow rate of these children was determined through a passive method. The overall incidence of drooling was 48.7%, with 17.7% having severe drooling. Individuals with athetosis had the least severe amount of drooling. There was a significant relationship between ability to close the mouth and the severity of drooling. The severity of droolin...

Parental perception of oral health status of children in mainstream and special education classrooms

Special Care in Dentistry — Sun, 21 Jun 2009 23:00:00 +0100

The aim of this study was to compare parental perceptions of oral health status and access to dental services by children in 34 special education and 16 mainstream public elementary school classes in San Mateo County, California. A self-administered parental survey was utilized and included questions about demographics, oral health, and dental utilization. The overall response rate was 58.8%. After adjusting for age and gender of the child, compared to mainstream, parents of students in special education classes were significantly more likely to report their children to have worse oral health (OR = 2.4, 95% CI 1.54, 3.67), be lacking a past year dental visit (OR = 1.96, 95% CI 1.01, 3.84), and have missed school days due to dental reasons (OR = 2.5, 95% CI 1.55, 4.17). Both groups rated th...

Knowledge and practices of dentists in preventing infective endocarditis in children

Special Care in Dentistry — Sun, 21 Jun 2009 23:00:00 +0100

This preliminary study assessed the knowledge and practices of dentists in the prevention of infective endocarditis (IE). The study included 21 dentists working at two public hospitals in Brazil who cared for children with special needs who also have cardiac conditions. The data from a semistructured interview were processed for qualitative and quantitative analysis. All subjects defined IE correctly. Most subjects (81%) said they had treated patients with a previous history of IE and 7 (33%) stated that many guardians seemed to be afraid to mention that their child had a previous history of IE. The main risk of infectivity was the oral cavity according to 16 subjects (76%). Nine subjects (43%) considered a dental procedure involving any amount of bleeding as being a risk, and periodontal/...

Karnofsky performance status scale

Special Care in Dentistry — Sun, 21 Jun 2009 23:00:00 +0100

(Source: Special Care in Dentistry)

Latex allergy: How real is the problem?

Special Care in Dentistry — Tue, 05 May 2009 04:00:00 +0100

(Source: Special Care in Dentistry)

Dental professionals' knowledge about treatment of patients with spinal cord injury

Special Care in Dentistry — Fri, 01 May 2009 04:00:00 +0100

This study investigated the knowledge and training of dental professionals to competently serve persons with spinal cord injuries (SCI). Fifty dental clinics were approached to complete a survey containing questions regarding their special needs training. From the 35 completed surveys, descriptive quantitative data were analyzed. The majority of professionals reported minimal exposure to special needs dentistry during their academic training. Further analysis revealed a lack of expertise in wheelchair transfers or knowledge of possible medical complications. This study suggests that additional training is needed if dental professionals are to comfortably and safely care for patients with SCI. (Source: Special Care in Dentistry)

Continuing education program

Special Care in Dentistry — Wed, 15 Apr 2009 04:00:00 +0100

(Source: Special Care in Dentistry)