Special Care in Dentistry via MedWorm.com

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

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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

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Continuing education program

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

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Book Review: Handbook of Essential Information for Hospital Dental Leaders

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

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Special care dentistry on a global scale

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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Latex allergy: How real is the problem?

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

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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

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Periodontal management of a patient with severe aplastic anemia: a case report

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

This article describes the periodontal management of a patient with severe aplastic anemia. A 51-year-old female patient was hospitalized with aplastic anemia and was referred for the management of her cyclosporine-induced gingival enlargement and bleeding from her gums. She also complained of pain in the palatal area and the mandibular anterior region. The patient was managed successfully with supra- and subgingival instrumentation, local drug delivery (LDD), electrosurgery, repeated oral hygiene instruction, and constant supervision. The treatment resulted in dramatic improvement in the patient's oral health and quality of life. This report highlights the importance of nonsurgical therapy followed by electrosurgery for the management of residual gingival enlargement. (Source: Special Car...

Marcus Gunn (jaw-winking) phenomenon: a case report

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

While Marcus Gunn phenomenon (MGP) is well documented in the medical literature, little data exist within the dental literature. This is a case report of an adolescent with MGP who presented for orthodontic treatment and required bite-opening in order to treat her malocclusion. No operative complications were experienced and orthodontic treatment has been uneventful. Although MGP may be uncommon in a dental context, dentists and other oral health professionals can play a significant part in its detection and diagnosis. (Source: Special Care in Dentistry)

Laser as a therapy for dry mouth symptoms in a patient with Sjögren's syndrome: a case report

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

This clinical case study reports on dry mouth symptoms in a patient with Sjögren's syndrome (SS) who was treated with laser phototherapy (LPT). A 60-year-old woman diagnosed with SS was referred to the laboratory for lasers in dentistry to treat her severe xerostomia. A diode laser (780 nm, 3.8 J/cm2, 15 mW) was used to irradiate the parotid, submandibular, and sublingual glands, three times per week, for a period of 8 months. The salivary flow rate and xerostomia symptoms were measured before, during, and after LPT. Dry mouth symptoms improved during LPT. After LPT, the parotid salivary gland pain and swelling were no longer present. Treatment with LPT was an effective method to improve the quality of life of this patient with SS. (Source: Special Care in Dentistry)

Effectiveness of oral self-care among adult Gullah-speaking African Americans with diabetes

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

We investigated the efficacy of plaque removal after an oral self-care demonstration among adult Gullah-speaking African Americans with diabetes. Fifty-four adults with diabetes completed an observed, uninstructed oral self-care demonstration with their normal mode of oral self-care. Before and after the oral self-care demonstration, the plaque levels of six test teeth were assessed using the Plaque Index. The mean percentage of plaque removal after the oral self-care demonstration was 27.4%. The mandibular teeth and the lingual surface had less plaque removal compared with the maxillary teeth and buccal surfaces. Only approximately 10% of participants achieved 50% or more plaque removal after the oral self-care demonstration. Thus, the majority of the participants did not achieve an accep...

Dental health of patients with Parkinson's disease in Iceland

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

The oral and dental health of patients with Parkinson's disease (PD) has not been well documented and the findings are conflicting. Patients with PD were invited to take part in a clinical and radiographic examination together with a comparison control group of persons who were a spouse or family member. Subjects (n = 67) and controls (n = 55) were examined and compared. Subjects with PD had more missing teeth, caries, dental plaque, and poorer periodontal health. Counts of cariogenic bacteria in saliva were significantly higher for subjects with PD. They did not consume more sweets or sugar, did not brush less frequently, used dental floss more than controls, and visited the dentist at least as often. Salivary flow levels were comparable between subjects with PD and controls. The lack of ...

Oral health conditions in Italian Special Olympics athletes.

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Dellavia C, Allievi C, Pallavera A, Rosati R, Sforza C During three Italian Special Olympics National Games, 365 athletes were screened. Dental and medical conditions and demographic data were recorded. The athletes were divided into two groups: those with Down syndrome (DS) and those without DS but who had intellectual disabilities (non-DS). Most of the subjects were in good systemic health. Total DMFt was 10.3 (SD 5.8; D = 1.3; M = 6.1; F = 2.8). Decayed and filled teeth were significantly more frequent in athletes who did not have DS compared to those with DS. No significant differences were found between the two groups in the number of subjects with filled, sealed, or traumatized teeth. Athletes with DS and without DS who participated in the Italian Special Olympics had a ...

Radiation-associated carotid artery atherosclerosis: case report and review of contemporaneous literature.

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Friedlander AH, Federico M, Yueh R, Norman KM, Chin EE Radiation therapy (RT) is a component of the treatment of patients with head and neck malignancies. This therapy may damage the nearby carotid arteries, thereby initiating or accelerating the atherosclerotic process (atheroma formation). Dentists treating patients who have been irradiated should examine the patient's panoramic radiograph for evidence of atheroma-like calcifications, which appear 1.5 to 2.5 cm posterior and inferior to the angle of the mandible. Patients with evidence of such lesions should be referred to their primary care physician with the suggestion that an ultrasound examination of the carotid arteries is indicated. PMID: 19284506 [PubMed - in process] (Source: Special Care in Dentistry)

Antigen-presenting cells in human immunosuppressive drug-induced gingival enlargement.

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Cury PR, Arsati F, de Magalhães MH, de Araújo VC, de Araújo NS, Barbuto JA An immunoperoxidase technique was used to compare the number of CD1a+ and factor XIIIa+ dendritic cells (DCs), and CD68+ Macrophages (M) in 30 gingival samples from subjects with clinically healthy periodontitium (HP) and 10 samples from subjects with drug-induced gingival enlargement (DIGE). Fewer CD1a+ and factor XIIIa+ DCs were found in areas with inflammatory infiltration (II) of the lamina propria (LP) in the group with immunosuppressed DIGE (IDIGE) compared to the group with HP. In the sulcular and junctional/pocket epithelia, the number of CD1a+ DCs was decreased in the group with IDIGE (p < 0.05). There was a tendency toward a reduced number of CD1a+ DCs and CD68+ M in areas wi...

Toothache pain: Behavioral impact and self-care strategies.

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Cohen LA, Bonito AJ, Akin DR, Manski RJ, Macek MD, Edwards RR, Cornelius LJ A computer-assisted telephone interview in Maryland of adults who had low income and were Hispanic, Black, and White and who had experienced a toothache during the previous 12 months was conducted. Respondents reported a high prevalence of toothaches, with 44.3% having experienced more than five toothaches during the preceding 10 years. Pain intensity associated with the most recent toothache was high with 45.1% of the respondents reporting the highest pain possible. Pain interfered with many aspects of normal functioning. Self-care strategies generally took precedence over professional health services. Pain sufferers used a combination of self-care and formal care strategies. Initial strategies most o...

Correlation between mothers' perceptions/expectations and the behavior of children with HIV during dental treatment.

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Abdelnur JP, Drugowick RM, Guimarães LF, de Moura NG, Maia LC, de Souza IP The aim of this study was to evaluate the mothers' perceptions and expectations of the behavior of their children who were HIV positive, during dental treatment. The sample was composed of 40 mother and child pairs. The mothers answered seven questions during two different appointments (M1, the child's initial appointment, and M2, the child's treatment appointment) in order to identify their perceptions and expectations about their children's behavior during dental treatment. In addition, child's behavior during the appointments was evaluated. The results of the mothers' interviews were then correlated with their children's behavior using Spearman's correlation test (p < 0.05). There was no sign...

Oral findings in adults with osteogenesis imperfecta.

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Sæves R, Wekre LL, Ambjørnsen E, Axelsson S, Nordgarden H, Storhaug K This paper describes oral findings in an adult population with osteogenesis imperfecta (OI) in Norway (n = 94). All participants underwent a structured interview and an oral examination. Panoramic radiographs were analyzed. The findings were compared with data from other Nordic epidemiological studies. Seventeen individuals (19%) had clinical signs of dentinogenesis imperfecta (DI). Persons with OI had twice as many missing teeth as the general population, and the number of endodontically treated teeth was higher than in the general population. All persons in the study had an acceptable state of tooth tissue loss. Almost all (97%) of the participants in the study group visited a dentist or a dental...

Jane Margaret Chalmers: a remembrance (1965-2008).

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: Ettinger RL PMID: 19284511 [PubMed - in process] (Source: Special Care in Dentistry)

Continuing education program.

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: PMID: 19284512 [PubMed - in process] (Source: Special Care in Dentistry)

Erratum.

Special Care in Dentistry — Sun, 01 Mar 2009 05:00:00 +0100

Authors: PMID: 19284513 [PubMed - in process] (Source: Special Care in Dentistry)

Consent, restraint, and people with special needs: a review.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Authors: Romer M Dentists providing treatment to individuals with developmental disabilities are often faced with unique medical/legal issues. Obtaining informed consent when a patient does not have capacity can be an involved process. Issues regarding therapeutic aides used for immobilization (i.e., restraint) during treatment may further complicate the situation. This area is controversial and has even resulted in legal difficulties for some dentists. Several topics related to the use of restraint are addressed in this article. A review of the literature and applicable laws pertaining to consent issues for people with special needs is presented and appropriate use of medical immobilization is discussed. Existing guidelines are reviewed. Informed consent and the use of restraint shoul...

Statement on sedation,anesthesia,and alternative techniques for people with special needs.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Authors: Glassman P PMID: 19152560 [PubMed - in process] (Source: Special Care in Dentistry)

Special Care Dentistry Association consensus statement on sedation, anesthesia, and alternative techniques for people with special needs.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Authors: Glassman P, Caputo A, Dougherty N, Lyons R, Messieha Z, Miller C, Peltier B, Romer M Many people with special needs (PSN) have difficulty having good oral health or accessing oral health services because of a disability or medical condition. The number of people with these conditions living in community settings and needing oral health services is increasing dramatically due to advances in medical care, deinstitutionalization, and changing societal values. Many of these individuals require additional supports beyond local anesthesia in order to receive dental treatment services. The purpose of this consensus statement is to focus on the decision-making process for choosing a method of treatment or a combination of methods for facilitating dental treatment for these individuals...

A review of guidelines for sedation, anesthesia,and alternative interventions for people with special needs.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Authors: Glassman P There are significant numbers of people in our society with disabilities or other special needs. Their number and percentage are growing, in some cases, dramatically. Many of these individuals need special support in order to receive dental treatment. Modalities that can be used to provide dental treatment include pharmacological approaches to produce various levels of sedation or anesthesia. In addition to the use of medications, there are also techniques that employ behavioral or psychological interventions. In some circumstances, physical support or protective stabilization is used. There are also social supports and prevention strategies that can impact the individual's preparation for and need for dental treatment. This review of the numerous guidelines, which ...

The dental patient with special needs: a review of indications for treatment under general anesthesia.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

This article presents a review of the literature discussing indications for the utilization of GA in the treatment of dental patients with special needs. PMID: 19152563 [PubMed - in process] (Source: Special Care in Dentistry)

Risks of general anesthesia for the special needs dental patient.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Authors: Messieha Z The risk of dental rehabilitation under general anesthesia has multiple contributing factors. The literature has addressed the general anesthetic risk of dental general anesthesia and sedation in the operating room and the office settings, but more studies are needed to address the special needs population in particular. There is still a great need for more studies to assess the risk versus benefit for special need population as well as to stratify such risk in order to assist care providers in decision making as well as in sharing such risk concerns with patients, caretakers, and guardians. One recommended approach is to conduct a national retrospective study of patients treated under general anesthesia in the past 10 years in all the various settings and assess th...

Providing deep sedation and general anesthesia for patients with special needs in the dental office-based setting.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

This article discusses the issues of morbidity and mortality associated with deep sedation and general anesthesia specifically in the dental office-based setting for patients with special needs (PSN). A focused review of a particular environment and patient population was challenging as it was difficult to identify articles that discuss the unique scope of this subject. During the review of the literature, no article was identified that discussed this exact topic. There were articles that discussed the delivery of general anesthesia for PSN in an outpatient setting and associated issues of morbidity and mortality. There were also articles and sources of information that discussed the delivery of general anesthesia for other patient populations in the office-based setting. In an effort to s...

Social supports and prevention strategies as adjuncts and alternatives to sedation and anesthesia for people with special needs.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Authors: Glassman P, Miller C People with special needs are assuming a more prominent place in our society. The number of people living in communities with medical, physical, and psychological conditions is increasing dramatically. In spite of the advances that people with special needs have made in recognition of their right to live in society and access services open to other people, their oral health is still significantly poorer than that of other groups. There are a number of modalities that can complement or replace pharmacological interventions and allow individuals to have dental treatment in a dental office or clinic. These include behavioral or psychological interventions and social support and prevention strategies. Social supports include care management and integration of ...

Understanding basic behavioral support techniques as an alternative to sedation and anesthesia.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Authors: Lyons RA Patients with special needs often present a challenge for the dental care team. The exacting and surgical nature of dental procedures requires significant patient cooperation to ensure the safe delivery of care. Some individuals who have special care needs have difficulty cooperating during treatment, thus creating a potentially harmful situation. Modern dentistry, particularly pediatric dentistry, provides the dental team with a variety of strategies designed to enable the team to safely provide comprehensive care in the least restrictive manner. These techniques range from tell-show-do, to medical stabilization, to general anesthesia. The effective use of noninvasive, nonpharmacologic behavioral guidance/support techniques cannot only avoid the need for sedation or ...

Psychological treatment of fearful and phobic special needs patients.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

This article reviews current research and literature related to methods used to alleviate dental fear and concludes that while some important psychological methods are available, much work is left to be done in this area. It is clear that there is an important role for psychological and behavioral input to the dentist-patient interaction. While dental phobia represents a class of special needs itself, patients with other important disabilities (e.g., physical or cognitive impairments) are sometimes comorbidly phobic, a condition often missed or misdiagnosed by treating practitioners. Office-based techniques that focus on relaxation, breathing, imagery, hypnosis, and effective use of operatory language are described. The methods advocated here can be used with patients having mild or modera...

Consent,restraint,and people with special needs:a review.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Continuing education program.

Special Care in Dentistry — Thu, 01 Jan 2009 05:00:00 +0100

Authors: PMID: 19152570 [PubMed - in process] (Source: Special Care in Dentistry)

Could Clostridium difficile delay dental treatment for geriatric patients?

Special Care in Dentistry — Sat, 01 Nov 2008 04:00:00 +0100

Authors: Saunders RH PMID: 19068062 [PubMed - in process] (Source: Special Care in Dentistry)

Oral health, general health, and quality of life in older people.

Special Care in Dentistry — Sat, 01 Nov 2008 04:00:00 +0100

Authors: Kandelman D, Petersen PE, Ueda H The purpose of this report is to review the interrelationship between poor oral health conditions of older people and general health. The impact of poor oral health on quality of life (QOL) is analyzed, and the implications for public health intervention and oral health care are discussed. Findings from the current research may lead to the following conclusions: The available scientific evidence is particularly strong for a direct relationship between diabetes and periodontal disease; the direct relationship between periodontal disease and cardiovascular disease is less convincing. General and associated oral health conditions have a direct influence on elder people's QOL and lifestyle. The growing number of elderly people challenges health aut...

The oral health of homeless adolescents and young adults and determinants of oral health: preliminary findings.

Special Care in Dentistry — Sat, 01 Nov 2008 04:00:00 +0100

Authors: Chi D, Milgrom P A survey was administered to 55 homeless adolescents and young adults aged 14 to 28 years who presented for care at a community health center in Seattle, Washington in 2005. Forty-five valid surveys were analyzed. The aim of the study was to identify factors associated with self-reported oral health. The most common self-reported dental problem was sensitive teeth (52.6%), followed by discolored teeth (48.6%), toothache (38.5%), or a broken tooth (37.8%). Dental problems were associated with lower self-reported oral health, while non-high school graduates, mixed race youths, and methamphetamine users had significantly higher self-reported oral health. Among homeless youths, addressing dental problems with direct dental care may improve self-perceived oral heal...

Oral health considerations in muscular dystrophies.

Special Care in Dentistry — Sat, 01 Nov 2008 04:00:00 +0100

This article briefly reviews the more common types of MD, namely, Duchenne MD, Becker MD, Emery-Dreifuss MD, facioscapulo-humeral MD, limb-girdle MD, oculopharyngeal MD, and myotonic dystrophy. Aspects of their epidemiology, pathophysiology, clinical presentation, diagnosis, and medical management as well as oral health considerations are discussed. PMID: 19068065 [PubMed - in process] (Source: Special Care in Dentistry)

Tooth pigmentation caused by bilirubin: a case report and histological evaluation.

Special Care in Dentistry — Sat, 01 Nov 2008 04:00:00 +0100

Authors: Amaral TH, Guerra Cde S, Bombonato-Prado KF, Garcia de Paula E Silva FW, de Queiroz AM Systemic disorders in pediatric patients, such as congenital biliary atresia, acute liver failure, and biliary hypoplasia, may be the indications for a need of liver transplantation. One of the manifestations of these disorders is the elevated serum levels of bilirubin (hyperbiliru-binemia), a product of hemoglobin degradation, which is deposited in different tissues, including mineralized and soft tissues. When hyperbilirubinemia occurs during the period of dental development, these teeth can develop a green coloration, which remains permanently, because, after maturation, these tissues loose their metabolic activity. This case report describes a 9-year-old girl who required a liver transpl...

Oral hygiene status in relation to sociodemographic factors of children and adults who are hearing impaired, attending a special school.

Special Care in Dentistry — Sat, 01 Nov 2008 04:00:00 +0100

This study examined the oral hygiene levels and periodontal status in a group of children and adults with hearing impairment attending a special school in Udaipur, India. Oral hygiene status was assessed by the Simplified Oral Hygiene Index (OHI-S) of Greene and Vermillion and periodontal status by the Community Periodontal Index. An analysis using a bivariate analysis revealed that all the oral hygiene variables varied significantly with age, economic status, and education of the parents. A multiple regression analysis showed that the education of the mother was the single best predictor for oral hygiene status and explained 92% of the variance. These findings show that children with hearing impairment have poor oral hygiene and high levels of periodontal disease. This may be due to a lac...

Survey of the level of anti-HBs antibody titer in vaccinated Iranian general dentists.

Special Care in Dentistry — Sat, 01 Nov 2008 04:00:00 +0100

Authors: Alavian SM, Izadi M, Zare AA, Lankarani MM, Assari S, Vardi MM Hepatitis B is an infectious disease to which dentists are susceptible. The main aim of this study was to determine the level of antibody titer and immunity in vaccinated Iranian general dentists. A total of 861 general dentists were invited to participate in this study; 598 persons who could recall their history of vaccination and consented to have blood samples taken were recruited. Demographic and work-related data were recorded, and anti-Hepatitis B surface antigen (anti-HBs-Ag) evaluations were measured using the enzyme-linked immunosorbent assay (ELISA). Of the 598 participants, 35 (5.9%) were nonimmune (anti-HBs <10 IU/l), 101 (16.9%) were relatively immune (anti-HBs = 10-99 IU/l), and 462 (77.3%) were co...

Behavioral and physiological changes in children with Down syndrome using mechanical and chemomechanical (Carisolv) caries removal methods.

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

This study compared behavioral and physiological changes during caries removal in children with Down syndrome when using a chemomechanical caries removal technique (Carisolv) and a conventional method of caries removal. Twenty children (ASA class 1) between 5 and 12 years of age participated in the study; 10 subjects had Down syndrome and 10 were healthy controls. The behavioral and physiological assessments were carried out during five stages of dental treatment: (1) 5 minutes before local anesthesia; (2) during local anesthesia; (3) during caries removal; (4) immediately after restoration; and (5) 5 minutes after the end of the treatment. The caries removal step resulted in the greatest behavioral and physiological changes. Except for oxygen saturation, statistically significant differen...

HPV, oral sex, and the risk of oral cancer: food for thought.

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Brondani M PMID: 18782193 [PubMed - in process] (Source: Special Care in Dentistry)

Dental utilization for medicaid-enrolled adults with developmental disabilities in Iowa residential care facilities.

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Brister TM, Damiano PC, Momany ET, Chalmers J, Kanellis M The goal of this study was to evaluate the dental utilization of Medicaid-enrolled adults in Iowa residential care facilities (n = 1423). Medicaid enrollment and claims files for 2003 were used, as well as information from the Iowa Department of Inspections and Appeals. Dental utilization was defined as having any dental visit during 2003. Of the residents, 74.1% utilized at least one dental service in 2003. Residents in facilities that were part of smaller organizations, and younger residents, were more likely to have had a dental visit. Of those with a visit, over 80% received a preventive service but this declined with age. Despite additional barriers, dental utilization was generally good for Medicaid-enrolled resid...

Manifestation of acute monocytic leukemia in the oral cavity: a case report.

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Fatahzadeh M, Krakow AM This case history describes a 26-year-old male with gingival bleeding who presented for care and was treated accordingly. Within a week he developed signs and symptoms of systemic disease and upon further investigation, he was diagnosed with acute monocytic leukemia to which he succumbed within 72 hours. The implications of gingival bleeding are discussed, and the necessity to consider systemic disease in the differential diagnosis is emphasized. PMID: 18782195 [PubMed - in process] (Source: Special Care in Dentistry)

Behavioral and physiological changes in children with Down syndrome using mechanical and chemomechanical (Carisolvtrade mark) caries removal methods.

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

This study compared behavioral and physiological changes during caries removal in children with Down syndrome when using a chemomechanical caries removal technique (Carisolvtrade mark) and a conventional method of caries removal. Twenty children (ASA class 1) between 5 and 12 years of age participated in the study; 10 subjects had Down syndrome and 10 were healthy controls. The behavioral and physiological assessments were carried out during five stages of dental treatment: (1) 5 minutes before local anesthesia; (2) during local anesthesia; (3) during caries removal; (4) immediately after restoration; and (5) 5 minutes after the end of the treatment. The caries removal step resulted in the greatest behavioral and physiological changes. Except for oxygen saturation, statistically significan...

Tuberous sclerosis complex: a case report.

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Wong A, Subar P, Itaya L Tuberous Sclerosis Complex (TSC) was first described in the late 1800s as a relative of neurofibromatosis, but it has since been identified as a discrete disorder. Patients with TSC typically present with facial adenomas, seizure disorder, and a developmental disability. The syndrome is caused by mutations in either chromosomes 9 or 16, both of which code for cell development and maturation. This case report describes the unique findings of TSC, and suggests areas for future study. By understanding the dental and medical implications of TSC, early intervention may vastly improve a patient's overall quality of life. PMID: 18782197 [PubMed - in process] (Source: Special Care in Dentistry)

Virtual patient instruction for dental students: can it improve dental care access for persons with special needs?

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

This study demonstrated that an interactive, multi-media (CD-ROM), virtual patient learning module for dental students could be an effective tool in providing students needed clinical exposure to patients with developmental disabilities. PMID: 18782198 [PubMed - in process] (Source: Special Care in Dentistry)

Factors affecting the use of protective stabilization in dental patients with cognitive disabilities.

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Karibe H, Umezu Y, Hasegawa Y, Ogihara E, Masuda R, Ogata K, Shirase T, Kawakami T, Warita S The goal of this study was to investigate the effects of various factors on the use of protective stabilization (PS) in patients with cognitive disabilities during dental treatment. An observational, case-control design was used with a case (protective stabilization group or PS group) and a control (usual management group or UM group) to assess a sample of subjects. Forty-eight dental patients were selected from the two groups. Various factors were compared between the groups. The prevalence of patients with profound cognitive disabilities was higher in the PS group (68.7%) than in the UM group (6.2%) (p < 0.0001). The odds ratio of using protective stabilization was 6.18 (95% confi...

Continuing education program questions.

Special Care in Dentistry — Mon, 01 Sep 2008 04:00:00 +0100

Authors: PMID: 18782200 [PubMed - in process] (Source: Special Care in Dentistry)

The legacy of jonathan a. Ship.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

Authors: Ghezzi EM PMID: 18647370 [PubMed - in process] (Source: Special Care in Dentistry)

Meta-analysis: an introduction into a research process.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

This article will discuss these aspects of meta-analysis, including the history of its development and usage in the scientific community, basic terminology, and a relevant literature review. PMID: 18647371 [PubMed - in process] (Source: Special Care in Dentistry)

Comprehensive dental treatment of a patient with Huntington's disease: literature review and case report.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

Authors: Rada RE Huntington's disease is an inherited neurodegenerative disorder for which there is no cure. Because of the physical impairment and medication side effects, these patients can experience extensive oral disease. A patient presented to the dental clinic with complaints of oral pain and an inability to chew due to extensive caries and periodontal disease. General anesthesia was required to treat his oral problem due to the patient's disease-associated uncontrolled movements, psychological status, and extensive oral disease. As varying anesthesia techniques have been recommended for patients with Huntington's disease, medical consultation was important to restore this individual's oral health. PMID: 18647372 [PubMed - in process] (Source: Special Care in Dentistry)

Orthodontic treatment of a patient with recessive dystrophic epidermolysis bullosa: a case report.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

Authors: Pacheco W, Marques de Sousa Araugio R Epidermolysis bullosa (EB) represents a heterogeneous group of hereditary, chronic, non-inflammatory skin pathologies. Recessive dystrophic epidermolysis bullosa (RDEB) is characterized by sub-lamina dura separation, due to blistering below the lamina densa of the basement membrane zone, and is associated with the absence of Type VII collagen fibers. The mouth, pharyngeal, and esophageal mucosa are compromised by scarring and tissue contraction. The purpose of this article was to present a case report on an orthodontic patient with RDEB. PMID: 18647373 [PubMed - in process] (Source: Special Care in Dentistry)

Dental Discomfort Questionnaire: its use with children with a learning disability.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

This study investigated whether the behaviors from the Dental Discomfort Questionnaire (DDQ) could help identify toothaches in children with a learning disability, who have a limited capacity to self-report. The objectives were to examine whether the behaviors from the DDQ occur more often in children with a learning disability who have caries and a toothache than in children who do not have caries and a toothache; and secondly, to examine whether two additional items increase the specificity and sensitivity of the DDQ to recognize a toothache, in this particular population of children with a learning disability. The DDQ was completed by a convenience sample of 58 parents on behalf of their children: 31% girls, aged between 6 and 13 years (mean = 7.5, SD = 2.7). Of the total group, 26% (n ...

Development of a screening tool to assess the suitability of people with a disability for oral care under sedation or general anesthesia.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

The objectives were to investigate retrospectively the uptake of general anesthetic (GA) services and use this information to develop a composite tool. One hundred cases referred for GA were reviewed to generate data for a Delphi Panel. Patients with disabilities were the subject of a tool, devised by the Delphi Panel, to appropriately allocate patients to the most suitable care, including the patients' medical, behavioral, and social status as well as planned dental treatment complexity. A total of 124 patients, between the ages of 4 and 75 years, in seven centers were treated under sedation or GA, according to the tool. Agreement on behavior assessment between dentists and anesthesiologists was poor. The tool has the potential to identify which people with disabilities can be effectively...

Risk factors for oral postoperative infection in patients with diabetes.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

Authors: Barasch A, Safford MM, Litaker MS, Gilbert GH The prevalence of diabetes mellitus in the general population has been increasing sharply. Currently, much is feared but little is known about postoperative complications of oral surgery among persons with diabetes. Existing dental education and practice guidelines cite excess infectious risk among patients with diabetes; however, empiric evidence to support such concerns is lacking. In fact, dentists commonly prescribe antibiotics when dental surgical procedures involve bone. This practice may contribute to the rising problem of microbial resistance and may increase overall healthcare costs. The growing number of dental patients with diabetes warrants strengthening the evidence base to guide their dental care and prevent possible ...

Poster descriptions from the 20th Annual Meeting on Special Care Dentistry, held March 14-16, 2008 in San Antonio, TX.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

Authors: PMID: 18647377 [PubMed - in process] (Source: Special Care in Dentistry)

Abstracts/session descriptions from the 20th Annual Meeting on Special Care Dentistry, held March 14-16, 2008 in San Antonio, TX.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

Authors: PMID: 18647378 [PubMed - in process] (Source: Special Care in Dentistry)

Oral paper descriptions.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

Authors: PMID: 18647379 [PubMed - in process] (Source: Special Care in Dentistry)

Continuing education program questions.

Special Care in Dentistry — Tue, 01 Jul 2008 04:00:00 +0100

Authors: PMID: 18647380 [PubMed - in process] (Source: Special Care in Dentistry)

Another perspective on individuals with disabilities: An editorial.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

Authors: Waldman HB, Perlman SP In 2005, there were nearly 40 million individuals (14.9% of the population), 5 years of age and older, with one or more disabilities (not including individuals living in institutions).(1) There is a great variation at the state level: the proportion of the population with disabilities ranges as high as 10.4% in Maine for youngsters between 5 and 20 years, to 52.1% for individuals 65 years and older in Mississippi. By contrast, the lowest proportion of youngsters 5 to 20 years of age with disabilities was in Connecticut (4.5%) and the lowest proportion for individuals 65 years or older with disabilities was in Nevada (33.3%). Political and social factors may be affecting the number of services available and many people with disabilities are not receiving ...

A paired analysis of correlates of dental restorative care in siblings with and without Down syndrome.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

This study examined the hypothesis that age-matched siblings with and without Down syndrome (DS) have the same risk of ever having had a tooth restored. A sibling-matched, population-based, cross-sectional survey design was used with the help of the Canadian Down Syndrome Society whose members were the sample source. The relationship between DS status and restorative status was evaluated using conditional multiple logistic regression with matching by sibling status and adjustment to control for sociodemographic and clinical variable. Data from 793 sibling pairs were used for the analyses. DS status was strongly related to dental restoration in that subjects with DS had reduced odds for ever having had a tooth restored (OR: 0.28; 95% CI: 0.18-0.43). An analysis of the results suggested that...

Dental treatment in a patient with epidermolysis bullosa.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

Authors: Siqueira MA, de Souza Silva J, Silva FW, Díaz-Serrano KV, Freitas AC, Queiroz AM Epidermolysis bullosa (EB) is a rare inherited group of genodermatoses characterized by mucocutaneous fragility and blister formation, either spontaneously or as a result of minimal mechanical trauma. The repetition of these episodes in the oral cavity leads to atrophy of the mucosa, causing microstomia, ankyloglossia, tongue denudation, and vestibule obliteration, characteristics that make dental treatment difficult. Patients with EB are at high risk for caries due to the presence of dental anomalies; they also tend to have a soft diet and difficulties with mechanical removal of the dental biofilm. This case report presents a patient diagnosed with EB and describes the difficulties faced by ...

A review and dental management of persons with craniosynostosis anomalies.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

This article discusses craniosynostosis and its oral problems. Dental treatment protocols based on general, facial, oral, and psychological aspects are offered. PMID: 18489656 [PubMed - in process] (Source: Special Care in Dentistry)

Skeletal age of individuals with Down syndrome.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

Authors: de Moraes ME, Tanaka JL, de Moraes LC, Filho EM, de Melo Castilho JC The aim of this study was to assess the skeletal age of Brazilian individuals with Down syndrome (DS) using the method of Greulich and Pyle. Forty subjects with DS between the ages of 6 and 16 years were studied and compared to a control sample of children without DS. The statistical analysis showed that at the age of 7 years the skeletal age (SA) of the individuals with DS was delayed in relation to their chronological age (CA) (SA < CA). On the other hand, at the age of 15 years, their SA was advanced in relation to their CA (SA > CA). An evaluation of the results suggests that the period of adolescent development for individuals with DS was shorter. These individuals reach the completion of bone matu...

Oral characteristics of children with attention-deficit hyperactivity disorder.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

Authors: Bimstein E, Wilson J, Guelmann M, Primosch R The purpose of this study was to compare the oral and demographic characteristics of children with attention-deficit hyperactivity disorder (ADHD) to those of a control group of children. A sample of 25 dental records of children medicated for ADHD was compared to 127 records of healthy children not receiving any medication. The children with ADHD had a statistically higher prevalence of toothache, bruxism, bleeding gums, and oral trauma histories than the control group (chi square, p < 0.05). The differences in other recorded oral characteristics and habits, such as plaque accumulation, gingival inflammation, calculus, oral hygiene compliance, dental caries experience, and unmet dental needs, were not statistically significant. ...

Oral health status, treatment needs, and obstacles to dental care among noninstitutionalized children with severe mental disabilities in The Netherlands.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

In conclusion, Dutch noninstitu-tionalized children with severe disabilities still receive a relatively low degree of quality dental care. This is particularly true for children from ethnic minority groups. PMID: 18489659 [PubMed - in process] (Source: Special Care in Dentistry)

Enamel microabrasion in an individual with Cohen syndrome.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

Authors: de Macedo AF, Tomazela-Herndl S, Corrêa MS, Duarte DA, Santos MT This case report describes the esthetic dental treatment of a patient with Cohen syndrome where microabrasion was used to treat dental fluorosis. The patient's teeth had white and light yellow spots, which were diagnosed as moderate dental fluorosis. These spots were treated with microabrasion using pumice paste and 37% phosphoric acid. The paste was applied with a rubber cup on a low-speed handpiece and manually using a wooden stick. It took four appointments to treat all of the patient's teeth. Topical neutral fluoride was applied after each appointment to decrease any dental sensitivity. The esthetic result was satisfactory. Esthetic dental treatment may result in positive emotional and behavioral changes...

Continuing education program questions.

Special Care in Dentistry — Thu, 01 May 2008 04:00:00 +0100

Authors: PMID: 18489661 [PubMed - in process] (Source: Special Care in Dentistry)

Research and special needs dentistry.

Special Care in Dentistry — Sat, 01 Mar 2008 05:00:00 +0100

Authors: Thomson WM PMID: 18402615 [PubMed - in process] (Source: Special Care in Dentistry)

Interdisciplinary approach to oral health for persons with developmental disabilities.

Special Care in Dentistry — Sat, 01 Mar 2008 05:00:00 +0100

This study evaluated the subjects' oral health, access to care, oral health behaviors, and adherence to referrals. The study recruited 102 subjects (74% were African American or Hispanic). Among them, 24% reported brushing their teeth less than once a day, and 68% had dental insurance. The prevalence of leukoplakia was 4% and the prevalence of temporomandibular joint (TMJ) clicking and pain were 11% and 9%, respectively. Their decayed, missing, filled (DMF) equaled 14 points with 7 missing teeth. The subjects' DMF index was poorer compared to the general population. The routine referral process was not effective in improving the subjects' access to dental care. More sophisticated referral systems need to be developed for this population. PMID: 18402616 [PubMed - in process] (Source: Sp...

Dental findings in Kabuki make-up syndrome: a case report.

Special Care in Dentistry — Sat, 01 Mar 2008 05:00:00 +0100

This article documents the case history of a 9-year-old Brazilian child diagnosed with Kabuki make-up syndrome (KMS). The clinical features are described, with emphasis on the craniofacial and orodental manifestations. The patient had the distinctive KMS craniofacial features consisting of long palpebral fissure, hypertelorism, high-arched eyebrows with sparse hair in the lateral one-third, eyes with eversion of the lateral one-third of the lower eyelids, long and curved eyelashes, palpebral ptosis, large anteverted prominent ears in a lower position, broad, depressed nasal root with a flat nasal tip, and mild neuropsychomotor developmental deficits. The intraoral examination revealed an anterior open bite, overretention of primary teeth, and a high-arched palate. Two findings in this chil...

Death, dying and bereavement: a survey of dental practitioners.

Special Care in Dentistry — Sat, 01 Mar 2008 05:00:00 +0100

This study determined the prevalence of death within a dental practice. It also investigated methods by which dentists supported grieving survivors, and how frequently dentists received formal bereavement education in dental school. A perceived need for training in death and dying was also investigated. A survey was mailed to 200 randomly selected general dental practitioners in Ontario, Canada. It was found that (1) the vast majority of respondents (86%) had experienced the death of a patient within the past 12 months; (2) support methods included sending sympathy cards (79.3%), sending flowers (34.5%), attending the funeral or wake (23%), or visiting/calling survivors (11.5%); (3) only 4% of respondents reported receiving formal bereavement education during dental school; and (4) 61% bel...

Prevalence of dental trauma in patients with cerebral palsy.

Special Care in Dentistry — Sat, 01 Mar 2008 05:00:00 +0100

This study presents the findings of a record review that evaluated the prevalence of dental trauma in patients with cerebral palsy and evaluated its possible relationship with age, type of palsy, and epilepsy. The dental records of 2,200 patients with special needs admitted to the special care clinic of the School of Dentistry of Araçatuba/UNESP, Brazil, between 1998 and 2003 were reviewed. Of the records that were analyzed, 500 patients who had cerebral palsy were selected for this study. Information regarding age, gender, type of palsy and dental trauma was collected and statistically analyzed. It was observed that 10.6% of the subjects (n = 53) had sustained dental trauma. The number of traumatized teeth was 84. Enamel or enamel/dentin fractures were the most frequent types of trau...

Oral health, dental treatment, and cardiac valve surgery outcomes.

Special Care in Dentistry — Sat, 01 Mar 2008 05:00:00 +0100

Authors: Wu GH, Manzon S, Badovinac R, Woo SB The aim of this study was to determine whether not treating chronic dental infection during the admission for cardiac valve surgery would increase the morbidity and mortality of patients. Patients were divided into three groups: dentally unhealthy and untreated (Group A), dentally healthy not requiring treatment (Group B), and dentally unhealthy and treated (Group C). Hospital computer records and phone interviews were used to assess morbidity and mortality as assessed through the Social Security Death Index. Ninety-eight patient charts were reviewed. Patients in Group A (n = 47)were not at a significantly greater risk for developing infective endocarditis (IE) within 6 months of cardiac surgery compared to patients in Groups B (n = 17) and...

Doxepin rinse for management of mucositis pain in patients with cancer: one week follow-up of topical therapy.

Special Care in Dentistry — Sat, 01 Mar 2008 05:00:00 +0100

This study assessed the effectiveness of oral doxepin rinse for mucositis-related pain management in patients following 1 week of repeated dosing. Patients with oral mucositis due to head and neck radiation therapy or hematopoietic stem cell transplant (HSCT) were recruited to participate in a 1-week follow-up study. Subjects who gave informed consent rinsed with doxepin (5 ml) during the initial visit and were then told to use doxepin rinse over the next week as needed, three to six times per day, and return for a follow-up visit. At each visit, mucositis was scored using the Oral Mucositis Assessment Scale and oral pain was assessed using a visual analogue scale before and after rinsing. The use of a systemic analgesic was recorded, and side effects were documented. At the follow-up visi...

Continuing education program.

Special Care in Dentistry — Sat, 01 Mar 2008 05:00:00 +0100

Authors: PMID: 18402622 [PubMed - in process] (Source: Special Care in Dentistry)

The oral health of older people: general dental practitioners' beliefs and treatment experience.

Special Care in Dentistry — Tue, 01 Jan 2008 05:00:00 +0100

Authors: Antoun JS, Adsett LA, Goldsmith SM, Thomson WM The purpose of this study was to examine New Zealand general dentists' beliefs about older people's oral health and to identify the important barriers that prevent dentists from treating institutionalized older adults. A postal survey was distributed nationwide to a representative sample of 700 dentists (response rate 64.5%). Dentists' beliefs were mostly consistent with current epidemiological knowledge, although most (81.5%) mistakenly believed that the root surface caries increment was greater than that for coronal caries. One in four had visited a long-term care (LTC) facility during the previous 2 years. Over three-quarters cited the inconvenience of leaving their practices as a barrier, and the lack of a financial incentive ...

Dental treatment of children with Angelman syndrome: a case report.

Special Care in Dentistry — Tue, 01 Jan 2008 05:00:00 +0100

Authors: Murakami C, Nahás Pires Corrêa MS, Nahás Pires Corrêa F, Nahás Pires Corrêa JP Angelman syndrome (AS) is a rare genetic neurological disorder. The main clinical characteristics of this syndrome are delayed neuropsychological development, intellectual disability, speech impairment, movement or balance disorder, and a behavioural uniqueness. The syndrome has oral manifestations such as diastemas, tongue thrusting, sucking/swallowing disorder, mandibular prognathism, a wide mouth, frequent drooling, and excessive chewing behaviour. The dental literature on the syndrome is scarce. The purpose of paper is to describe the interesting aspects of the dental treatment of a child with AS. PMID: 18271768 [PubMed - indexed for MEDLINE] (Source: Special Ca...

Attitudes and practices of nurses on a pediatric cancer and stem cell transplant ward: adaptation of an oral care protocol.

Special Care in Dentistry — Tue, 01 Jan 2008 05:00:00 +0100

This study evaluated nurses' current practices and understanding of oral health for hematology and oncology patients. A written questionnaire administered to 33 nurses on the pediatric cancer and blood disorders unit of Children's Medical Center of Dallas included questions on oral evaluation, oral hygiene, and case-based questions. Information gathered was used to develop an oral care protocol. The study found that nurses were proficient in diagnosing obvious conditions including mucositis and pseudomembranous candidiasis, but they were less than proficient when diagnosing less easily recognizable conditions such as xerostomia. The nurses were found to have inadequate knowledge of the treatment and oral hygiene protocols for conditions that they could and could not diagnose. The protocol ...

A review of malocclusion among individuals with mental and physical disabilities.

Special Care in Dentistry — Tue, 01 Jan 2008 05:00:00 +0100

Authors: Winter K, Baccaglini L, Tomar S Oral health disparities between individuals with disabilities and the general population are widely reported in the literature, and malocclusion is no exception. As the number of people living with disabilities grows, so does the need to explore their oral health status. This review examines the reported prevalence of malocclusion in individuals with Down syndrome (DS), cerebral palsy (CP), cleft disorders, mental disabilities, and physical disabilities from 1976 to 2004. Malocclusion was assessed according to Angle's classifications, the Dental Aesthetic Index (DAI), and selected occlusion characteristics. The prevalence of malocclusion was higher in individuals with disabilities than in controls without disabilities. Malocclusion was more freq...

Topical minocycline for managing symptoms of recurrent aphthous stomatitis.

Special Care in Dentistry — Tue, 01 Jan 2008 05:00:00 +0100

In this study, minocycline oral rinses were compared to a placebo in patients suffering from frequent episodes of RAS. Thirty-three patients with RAS were randomly allocated to topical therapy with 0.2% minocycline or a placebo aqueous solution mouthwash. Seven patients also participated in a blind crossover study. The intensity of pain was recorded daily using a visual analogue scale. Minocycline mouthwashes resulted in significant reduction in the severity and duration of pain due to RAS. The findings in the subgroup that participated in the crossover were consistent with outcomes in the randomized study. The findings of this study show that minocycline oral rinses reduce pain in patients with RAS and may have implications for the use of minocycline in other non-infectious inflammatory u...

Tooth surface protection for individuals who are mentally disabled.

Special Care in Dentistry — Tue, 01 Jan 2008 05:00:00 +0100

Authors: Yeganegi KS, Tandon S For individuals with mental disabilities, oral hygiene care is often neglected, especially in the posterior teeth. One hundred children and young adults, aged 7 to 25 years, who had mental disabilities were chosen to participate in this study. Fuji VII glass ionomer cement (GIC) was applied to the cervical third of posterior teeth using a split-mouth design. The plaque accumulation on test and control side teeth were compared on follow-up examinations and the retention of the GIC was evaluated on each surface. Plaque scores increased over time in both the test and the control sides, although the scores were significantly less on the test side when compared to the control side. The GIC was best retained on the maxillary buccal surface, and least on the man...

"To treat or not to treat--that is an important question".

Special Care in Dentistry — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Ettinger RL PMID: 17990474 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

Health benefits and reductions in bacteria from enhanced oral care.

Special Care in Dentistry — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Ferozali F, Johnson G, Cavagnaro A This investigation assessed the oral cavity and microbiological status of 36 non-verbal persons with developmental disabilities. The authors examined oral hygiene interventions aimed at reducing risk factors linked to bacterial colonization and aspiration pneumonia. The findings indicated a statistically significant decrease of potentially pathogenic bacteria and a reduction in total bacteria counts for people receiving oral care via intermittent suction. PMID: 17990475 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

Receipt of dental care, dental status and workforce in U.S. nursing homes: 1997 National Nursing Home Survey.

Special Care in Dentistry — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Dye BA, Fisher MA, Yellowitz JA, Fryar CD, Vargas CM The goal of this paper was to report the prevalence of dental care--a Healthy People 2010 objective--for nursing home residents 65 years and older, and to assess the association between receipt of dental care with other oral status and workforce measures. Data from 7,363 residents aged 65 years and older with information in the 1997 National Nursing Home Survey (NNHS) were used. Overall, 18.2% of elderly nursing home residents had received dental care in the last month. Multivariable modeling found residents were more likely to receive dental care in the past month if they lived in the Northeast (OR=3.32, 95% CI 2.51-4.39); were dentate (OR=1.46, 95% CI 1.26-1.69); had a length of stay 12 months or longer (OR= 1.37, 95% CI 1...

Fitting complete dentures after multiple tooth extraction in a patient with severe dementia.

Special Care in Dentistry — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Fujisawa T, Yokoyama A, Muramatsu M, Kimura Y, Kurozumi A, Kobayashi I, Sano H, Totsuka Y, Fukushima K Complete dentures were constructed after tooth extraction for a 71-year-old uncommunicative patient with Alzheimer's disease. Although she had never previously used them, her husband requested the fitting of complete maxillary and mandibular dentures. Thirteen teeth were extracted under local anesthesia and intravenous sedation (IVS), followed by impression-making under IVS. Denture fabrication and adjustment were carried out under mild physical restraint. A tissue conditioner was applied to the fitting surface of the denture base followed by regular denture adjustments. The time required for the patient to eat a meal decreased from 90 minutes without dentures to 30 minutes w...

Oral conditions of 1,049 patients referred to a university-based oral medicine and orofacial pain center.

Special Care in Dentistry — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Suarez P, Clark G At the USC Orofacial Pain/Oral Medicine Center, 1,049 new patients seen from September 2003 to September 2005 were sorted according to their primary diagnosis. Two-thirds were female and 19.7% were over 64 years of age. The most prevalent diseases were categorized and compared with a similar study published 15 years ago. The seven categories included osseous disease (3.3%), mucogingival disease (17.8%), salivary/lymphatic disease (3.3%), TMD (46.3%); neuropathic pain/headache disorders (13.1%), motor/sleep disorders (9.1%), and miscellaneous (not included in above categories) (7.1%). The 35 most frequent diagnoses were sorted by the mean age of our patients and the male-female ratio was also determined. The oldest patients had burning mouth syndrome (68.1 +/-...

Why is periodontal disease more prevalent and more severe in people with Down syndrome?

Special Care in Dentistry — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Morgan J Periodontal disease has been found to be significantly more prevalent and more severe in people with Down syndrome. A series of studies have reported a prevalence of between 58% and 96% for persons younger than 35 years of age. This phenomenon cannot simply be attributed to poor oral hygiene. The etiology of periodontal disease in persons with Down syndrome is complex. In recent years, much focus has been placed on the altered immune response resulting from the underlying genetic disorder. This paper presents an overview of contemporary knowledge on periodontal disease in patients with Down syndrome. PMID: 17990479 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

Salivary parameters in infants aged 12 to 60 months with Down syndrome.

Special Care in Dentistry — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Siqueira WL, Siqueira MF, Mustacchi Z, de Oliveira E, Nicolau J The purpose of this study was to measure certain components in whole saliva from children with Down syndrome aged 12 months to 60 months. Twenty children with Down syndrome were compared with 18 children without Down syndrome. Whole saliva was collected under slight suction and the salivary pH was measured with a portable pH meter soon after collection. Electrolyte concentrations were determined by inductively coupled argon plasma with atomic emission spectrometry. Sialic acid was determined by thiobarbituric acid assay. Amylase was assayed measuring the maltose produced by the breakdown of starch and peroxidase with ortho-dianisidine. No statistically significant differences were observed in sialic acid, calcium,...

Oral health needs and barriers to dental care in hospitalized children.

Special Care in Dentistry — Sat, 01 Sep 2007 04:00:00 +0100

Authors: Nicopoulos M, Brennan MT, Kent ML, Brickhouse TH, Rogers MK, Fox PC, Lockhart PB The goal of this study was to examine the oral health status and utilization of dental care reported by hospitalized children. A bedside oral examination was performed on hospitalized children. Past dental treatment and current oral health needs were assessed. The mean age (+/- SD) of 120 enrolled patients was 6.7 (+/- 2.9) years (range 3 to 12); 60% were males. The age of the patients' first dental office visit was 3.5 +/- 1.8 years, with 28% having never seen a dentist. Unmet oral health needs (e.g., untreated dental caries) were noted in 42% of children, and soft tissue (mucosal) abnormalities in 59% of children. Children with chronic medical conditions reported barriers to receiving dental car...

Custom-made mouth guards for Special Olympics athletes.

Special Care in Dentistry — Sun, 01 Jul 2007 04:00:00 +0100

Authors: Suzuki H, Kawara M, Tanaka Y, Mega J, Takahashi H PMID: 17972441 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

Helicobacter pylori infection in people who are intellectually and developmentally disabled: a review.

Special Care in Dentistry — Sun, 01 Jul 2007 04:00:00 +0100

Authors: Kitchens DH, Binkley CJ, Wallace DL, Darling D The Helicobacter pylori (H. pylori) bacterium has been classified by the World Health Organization as a type 1 carcinogen with associations to the development of peptic and gastric ulcers, gastric carcinoma and primary B-cell lymphoma. Individuals who have intellectual disabilities and developmental disabilities (IDDD) exhibit H. pylori gastric infection at approximately twice the rate of the general population and have recurrences after triple drug treatment at a rate nearly seven times that of the general population. Gastrointestinal malignancy is reported to account for almost 50% of all cancer deaths in this population. Oral-oral and fecal-oral routes are theorized to be the primary modes of transmission for the ingestion of t...

Oral health status of adults with Down syndrome in Hong Kong.

Special Care in Dentistry — Sun, 01 Jul 2007 04:00:00 +0100

In conclusion, while having fewer caries, Hong Kong Chinese adults with DS had poorer periodontal health than age- and gender-matched control subjects. PMID: 17972443 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

The impact of providing dental services to frail older adults: perceptions of elders in adult day health centers.

Special Care in Dentistry — Sun, 01 Jul 2007 04:00:00 +0100

Authors: Walker RJ, Kiyak HA Very little is known about the oral health of, and access to, dental services among frail elders who live in the community and use an adult day health center (ADHC) for respite care. This pilot study evaluated the perceived oral health quality of life (OHQOL) of elders who used a mobile dental program in urban, suburban, and rural ADHC settings. Pre- and post-treatment interviews were conducted to evaluate OHQOL using the Geriatric Oral Health Assessment Index (GOHAI). ADHC records were used to obtain demographic, medical history and medication data. Following initial dental examinations and consent, dental treatment was provided at each ADHC. Of the 138 elders screened at three ADHCs, pre- and post-treatment data were obtained on 76 subjects following thei...

Effectiveness of a triclosan/copolymer dentifrice on dental plaque and gingivitis in Brazilian individuals with cerebral palsy.

Special Care in Dentistry — Sun, 01 Jul 2007 04:00:00 +0100

Authors: Feng HS, Pinheiro IC, Grande SR, Pannuti CM, Barros FJ, Lotufo RF This randomized clinical trial investigated the effect of a dentifrice containing triclosan on the reduction of dental plaque and gingivitis in institutionalized individuals with cerebral palsy. Fifty-seven residents were randomly allocated to a test group (n=28, dentifrice with triclosan) and a control group (n=29, conventional dentifrice). A single calibrated investigator performed examinations at baseline and after three months. The amount of dental plaque was assessed, and gingivitis was measured. The caretakers performed brushing with dentifrice. After three months, there was a significant reduction in the plaque index in both groups, but there was no difference between the two groups. There was a significa...

Denture-handling ability of elderly persons with dementia: examination of time spent inserting and removing dentures.

Special Care in Dentistry — Sun, 01 Jul 2007 04:00:00 +0100

Authors: Kubo KY, Iinuma M, Shibutani T, Ito M, Iwaku F To evaluate the effects of dementia on denture-handling ability, we measured the amount of time that elderly subjects spent inserting and removing dentures. Elderly subjects with dementia tended to take more time inserting and removing dentures than those who were not demented. Only elderly patients who were severely demented needed significantly more time removing partial dentures than they did removing complete dentures. There was no significant difference between the time spent inserting dentures and removing dentures. The greater amount of time required to insert or remove dentures for subjects with dementia was due to disorientation. The results indicate that elderly people with mild to moderate dementia are able to insert an...

Severe tongue injury in an adolescent with epilepsy: a case report.

Special Care in Dentistry — Sun, 01 Jul 2007 04:00:00 +0100

This report presents a case history of an adolescent with a severe tongue injury related to epileptic seizures and outlines the proposed treatment, which included use of a maxillary silicone bite guard that allowed healing of the tongue injury within a few months. PMID: 17972447 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

The use of chloral hydrate for pediatric dental sedation.

Special Care in Dentistry — Tue, 01 May 2007 04:00:00 +0100

Authors: de Rezende GP, da Costa LR, da Costa PS PMID: 17658181 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

Self-awareness of premalignant oral lesions among veterans attending six U.S. Veterans Affairs Medical Centers.

Special Care in Dentistry — Tue, 01 May 2007 04:00:00 +0100

This study identified factors associated with self-awareness among patients newly diagnosed with a premalignant oral lesion. Data describing sociodemographics, medical/dental histories, tobacco/alcohol use and oral health were obtained by questionnaire and clinical examination of 73 veterans at six U.S. Veterans Affairs Medical Centers. Lesion types included homogenous and non-homogenous leukoplakia, smokeless tobacco lesion (STL), papilloma, lichen planus and erythroplakia. Prior to diagnosis, 29 subjects (39.7%) were unaware of their lesion. In bivariate analyses, lesion self-awareness was associated with anatomic location, multifocal/generalized appearance, pain, oral sores, and cigar use (p<0.05). Awareness varied with lesion diagnosis and was more likely with STL and less likely wi...

Aggressive periodontitis associated with Papillon-Lefèvre syndrome: report of a 14-year follow-up.

Special Care in Dentistry — Tue, 01 May 2007 04:00:00 +0100

Aggressive periodontitis associated with Papillon-Lefèvre syndrome: report of a 14-year follow-up. Spec Care Dentist. 2007 May-Jun;27(3):95-100 Authors: de Freitas AC, Assed S, da Silva LA, Silva RA This case report describes the periodontal management, therapeutic approach, and 14-year follow-up of a patient diagnosed with Papillon-Lefevre syndrome (PLS). A female child, diagnosed with PLS-associated periodontitis at the age of 9 years and 11 months, presented with hyperkeratosis of the palms and soles, as well as generalized aggressive periodontitis. The dental treatment comprised standard periodontal debridement, scaling and root planing, instructions on oral hygiene, restorations, extraction of hopelessly affected teeth and a therapeutic use of antibiotics. The concomi...

Oral management in a patient with fibrodysplasia ossificans progressiva.

Special Care in Dentistry — Tue, 01 May 2007 04:00:00 +0100

Authors: Young JM, Diecidue RJ, Nussbaum BL Fibrodysplasia ossificans progressiva (FOP) is an autosomal dominant disorder of connective tissue. FOP results in debilitating heterotopic ossification of the axial and appendicular skeleton. Permanent ankylosis of the temporomandibular joint (TMJ) is a common late finding, but is usually preceded by specific inciting trauma. Extreme care must be exercised when carrying out routine dental care to prevent soft tissue trauma. Oral health care for patients with FOP is usually complex. There are additional considerations when oral surgical procedures, such as extractions, are needed. Maintaining a balance between oral health and disease progression in these patients is challenging, as they frequently present with advanced oral disease. Fiber opt...

Solitary median maxillary central incisor in association with Goldenhar's syndrome: a case report.

Special Care in Dentistry — Tue, 01 May 2007 04:00:00 +0100

Authors: Garcia de Paula e Silva FW, de Carvalho FK, Diaz-Serrano KV, de Freitas AC, Borsatto MC, de Queiroz AM Goldenhar's syndrome is a rare disorder characterized by several anomalies that include dermal epibulbar cysts, auricular appendices and malformations and vertebral anomalies. In this article, the authors report a case of Goldenhar's syndrome in a 10-year-old child who presented with the classical signs of this condition and a solitary median maxillary central incisor (SMMCI). PMID: 17658185 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

Oculocerebrorenal Lowe syndrome: a literature review and two case reports.

Special Care in Dentistry — Tue, 01 May 2007 04:00:00 +0100

Authors: Rodrigues Santos MT, Watanabe MM, Manzano FS, Lopes CH, Masiero D The present paper reviews the dental findings in oculocerebrorenal Lowe syndrome and presents two case histories. Reports of different patients are useful in order to enhance knowledge about the syndrome, because there are so many different oral manifestations. PMID: 17658186 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

Transitional implants in a patient with Williams-Beuren syndrome: a four-year follow-up.

Special Care in Dentistry — Tue, 01 May 2007 04:00:00 +0100

Authors: Mass E, Oelgiesser D, Tal H Williams-Beuren syndrome (WBS) is characterized by several diagnostic features, including oligodontia. Restoration of congenitally missing teeth in patients with WBS is a challenge, both emotionally and clinically. In the atrophied alveolar bone process of a juvenile patient with WBS, the maxillary lateral incisors were replaced with two Immediate Provisional Implants (IPI). Early implant loading was used with temporary acrylic resin crowns that were replaced by semi-permanent restorations; the case has been followed for four years. Restoration of the missing maxillary lateral incisors with IPIs and temporary crowns proved to be a convenient, long-lasting and psychologically acceptable solution to the patient and her family. PMID: 17658187 [PubM...

I teach special needs dentistry...

Special Care in Dentistry — Thu, 01 Mar 2007 05:00:00 +0100

Authors: Shetty K PMID: 17539218 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)

Reduction in caries rate among patients with xerostomia using a power toothbrush.

Special Care in Dentistry — Thu, 01 Mar 2007 05:00:00 +0100

Authors: Papas AS, Singh M, Harrington D, Ortblad K, de Jager M, Nunn M The purpose of this study was to evaluate whether the use of a Sonicare toothbrush could be beneficial in reducing coronal and/or root caries among patients with medication-induced xerostomia. Eighty subjects with drug-induced xerostomia using either a Sonicare toothbrush (SC) or a manual toothbrush (MTB) were included in the study. Control subjects using a MTB were frequency-matched to 40 subjects using a SC, based on age, gender, number of teeth at baseline, and salivary flow rates. Subjects were individually matched according to the type of xerostomic medication they were taking. Caries were assessed at baseline, and subjects were instructed to have carious teeth restored. Summary statistics were assessed and co...

Prevalence of oral diseases in Shwachman-Diamond syndrome.

Special Care in Dentistry — Thu, 01 Mar 2007 05:00:00 +0100

In conclusion, based on self-completed subject and dentist questionnaires, diseases of oral hard and soft tissues were more prevalent and severe in persons with SDS when compared with healthy controls. PMID: 17539220 [PubMed - indexed for MEDLINE] (Source: Special Care in Dentistry)