A growing body of literature describes the performance of dental fear questionnaires in various countries. We describe the psychometric properties of Greek versions of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Survey (DFS) in adult Greek patients.
Greek versions of the MDAS and DFS were administered to two samples of adult dental patients. In the first sample, 195 patients attending one of three private practice dental offices in a large city in Greece completed the questionnaires in the waiting room before dental treatment. After treatment, their dentists (who did not know how the patients had answered the questionnaire) rated their anxiety during dental treatment. In the second sample, 41 patients attending a Greek university dental school clinic completed the questionnaire twice at two separate visits, in order to provide test-retest data. Cronbach's alpha was used to compute the internal consistencies, while Spearman's rho was used to compute the test-retest reliabilities. Construct validity was assessed by correlating the responses to the MDAS and DFS by Spearman's rho. Spearman's rho was also used to examine the criterion validities, by comparing the questionnaire responses with the dentists' ratings of anxiety.
The internal consistencies for the MDAS were 0.90 and 0.92 in the two samples; for the DFS, the internal consistencies were 0.96 in both samples. The test-retest reliabilities were 0.94 for the MDAS and 0.95 for the DFS. The correlation between the two questionnaires was 0.89. The patients' responses to both questionnaires were significantly related to the dentists' ratings of their anxiety during dental treatment (both p values <0.001).
The results indicate that the Greek versions of the MDAS and DFS have good internal consistencies and test-retest reliabilities, as well as good construct and criterion validities. The psychometric properties of the Greek versions of these questionnaires appear to be similar to those previously reported in other countries.
A basic list of 133 book and journal titles in dentistry is presented. The list is intended as a bibliographic selection tool for those libraries and health institutions that support clinical dentistry programs and services in the nondental school environment in the United States and Canada. The book and journal titles were selected by the membership of the Dental Section of the Medical Library Association (MLA). The Dental Section membership represents dental and other health sciences libraries and dental research institutions from the United States and Canada, as well as from other countries. The list was compiled and edited by the Ad Hoc Publications Committee of the Dental Section of MLA. The final list was reviewed and subsequently was approved for publication and distribution by the Dental Section of MLA during the section's 1996 annual meeting in Kansas City, Missouri.
To evaluate self-reported oral health attitudes and behavior among a group of dental students in Bangalore, India and to compare the oral health attitudes of students of different years of dental school.
A self-administered questionnaire based on a modified version of the Hiroshima University Dental Behavior Inventory (HU-DBI) was administered to 250 dental students.
Significant differences (P<.05) were observed among students of different years in the degree of worrying about the color of the teeth, not having been to the dentist before and brushing each tooth carefully. Strongly significant differences (P<.001) were observed among students of different years in brushing the teeth twice daily, being satisfied with the appearance of the teeth, cleaning the teeth well without toothpaste, visiting dentist only when having a toothache, taking too much time to brush their teeth, worrying about having bad breath and using mouth rinse on a regular basis.
Among dental students, the overall knowledge of oral health was good, even though there were deficits in knowledge in a few areas. The oral health attitudes and behavior of dental students improved with increasing levels of education.
Oral health; Dental students; Questions; Oral attitudes; Oral health behavior
For dental outpatients undergoing conscious sedation, recovery from sedation must be sufficient to allow safe discharge home, and many researchers have defined "recovery time" as the time until the patient was permitted to return home after the end of dental treatment. But it is frequently observed that patients remain in the clinic after receiving permission to go home. The present study investigated "clinical recovery time," which is defined as the time until discharge from the clinic after a dental procedure. We analyzed data from 61 outpatients who had received dental treatment under conscious sedation at the Hiroshima University Dental Hospital between January 1998 and December 2000 (nitrous oxide-oxygen inhalation sedation [n = 35], intravenous sedation with midazolam [n = 10], intravenous sedation with propofol [n = 16]). We found that the median clinical recovery time was 40 minutes after nitrous oxide-oxygen sedation, 80 minutes after midazolam sedation, and 52 minutes after propofol sedation. The clinical recovery time was about twice as long as the recovery time described in previous studies. In a comparison of the sedation methods, clinical recovery time differed (P = .0008), being longer in the midazolam sedation group than in the nitrous oxide-oxygen sedation group (P = .018). These results suggest the need for changes in treatment planning for dental outpatients undergoing conscious sedation.
The purpose of this study is to assess the impact of knowledge acquired in preventive aspects of dental education on dental students’ own health attitudes, oral hygiene and gingival status in the United Arab Emirates.
To compare the self-reported oral health behavior of first year dental students in the University of Sharjah with their actual oral hygiene and gingival conditions, 93 volunteers who participated in the study completed the Hiroshima University-Dental Behavioral Inventory (HU-DBI) questionnaire. Subsequently a clinical examination for their Plaque Scores (Modified Quigley Hein Plaque Index) and Gingival Bleeding Index was performed by a calibrated dentist.
29% of the participants reported bleeding gums; 83% were concerned by the color of their gums while 63% reported that it was impossible to prevent gum disease with brushing alone; and only 10% noticed some sticky white deposits on their teeth. However, approximately 92% were not in agreement that they would have false teeth when they grew older. 56% mentioned that they used dental floss regularly and 86% brushed twice daily or more. Male students had higher bleeding and plaque scores than female students. There appeared to be a significant relationship between plaque scores and HU-DBI responses; in addition to the significant relationship noted between recorded bleeding percentages and HU-DBI responses.
Female students have shown better dental care behavior than male students. The dental students with better self-reported oral health attitudes were expected to have lower plaque scores but instead had moderate plaque and gingival bleeding scores. This indicates the need for more emphasis on preventive measures in oral health education.
Oral hygiene; gingival status; dental students
The aim of this study was to compare the differences in self-reported oral health attitudes and behaviour between preclinical and clinical dental students in Turkey using Hiroshima University Dental Behavioural Inventory (HU-DBI).
A Turkish version HU-DBI questionnaire with additional 7 questions, totally 27 items, was distributed among 1022 dental students.
The response rate was 75% (486 preclinical and 278 clinical students). Significantly higher (P=0.000) percentage of the preclinical students, compared to clinical students, worry about colour of their teeth, are bothered by the colour of their gums, put off going to the dentist until they have a toothache; think that their teeth are getting worse despite their daily brushing, it is impossible to prevent gum disease with tooth brushing alone, and they cannot help having false teeth when they are old. Moreover, the preclinical students more frequently agree on that their gums tend to bleed when they brush their teeth, they use a toothbrush which has hard bristles, and they don’t feel they’ve brushed well unless with strong strokes (P=0.000). However, a higher proportion of clinical students compared to preclinical students brush each of their teeth carefully, think that they can clean their teeth without using toothpaste, have had their dentist tell them that they brush very well (P=0.000). The HU-DBI score of clinical students (7.47±1.86) was significantly (P=0.000) higher than preclinical students (6.00±1.86).
Dental students should have a comprehensive program, including their self-care regimes, starting from their first year of education.
Dental students; Oral health attitudes and behavior; HU-DBI; Turkey
This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit.
Subjects and methods
Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh.
Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P < 0.0001), while the most encouraging factor was the availability of friendly staff (P < 0.0001). The high cost of dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P < 0.0001), while the high quality of dental care was the most encouraging factor (P < 0.009). Students who made their visits because of pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P < 0.002), while they considered the high cost of dental care as discouraging factor for using dental services (P < 0.038). Students who visited the dentist for routine treatment gave the quality of dental care as encouraging for the use of dental clinics (P < 0.0001). Satisfaction with dental care was found to be significantly associated with high quality of dental care, convenient appointment, friendly staff, modern dental clinics and clinics recommended by friends.
Quality of dental care, reasonable fees for dental services and close location of dental clinics to students’ homes are encouraging factors for utilization of dental services.
Dental health services; Utilization factors; Patient satisfaction
In Sweden, the National Board of Health and Welfare forecasts a decrease in dentists with 26% and an increase in dental hygienists with 47% until the year of 2023. This, together with changes in both epidemiology, especially of dental caries, and political priorities, calls for an effective and well-developed cooperation between dentists and dental hygienists in future dentistry. Hence, the aim of this project was to investigate whether highlighting teamwork during the undergraduate studies of dental students and dental hygiene students could improve the students’ holistic view on patients as well as their knowledge of and insight into each other’s future professions. Thirty-four dental students and 24 dental hygiene students participated in the study. At the beginning of their final year in undergraduate education, a questionnaire testing the level of knowledge of the dental hygienists’ clinical competences was completed by both groups of students. In addition, activities intending to improve teamwork quality included the following: (i) a seminar with a dentist representing the Public Dental Health Services in Sweden, (ii) dental students as supervisors for dental hygiene students, (iii) planning and treatment for shared patients and (iv) students’ presentations of the treatments and their outcomes at a final seminar. The project was ended by the students answering the above-mentioned questionnaire for the second time, followed by an evaluation of the different activities included in the study. The knowledge of dental hygienists’ competences showed higher scores in almost all questions. Both groups of students considered the following aspects important: seminars with external participants, dental students acting as supervisors and planning and treating shared patients. By initiating and encouraging teamwork between dental students and dental hygiene students, it is possible to increase knowledge on dental hygienists’ competence and also to develop and strengthen a holistic view on patients and dental work, thereby preparing both groups of students for their professional life.
teamwork; undergraduate dental education; intervention
The authorization of departments of community dentistry and public health in the nation's dental schools is a relatively recent innovation in dental education. Such a department was established at the University of Southern California School of Dentistry in 1966, as part of the School of Medicine's effort to share responsibility in providing both access and availability of health services in inner-city Los Angeles, California. Dentistry was included in the protocol submitted to the US Office of Economic Opportunity to build a neighborhood health center in Watts, operated under the joint jurisdiction of the medical and dental schools. The dental division of the health center was designated a satellite of the community dentistry department. The department envisioned future changes during the revolutionary 1960s when all aspects of the nation were experiencing upheaval as traditional concepts were challenged by new attitudes. The nation's leaders in government and education as well as in the health professions were stimulated by scientific and technologic discoveries. Dentistry had come of age, having gained the respect of other health-care disciplines. It was a time of expanded exploration of means toward a healthier populace and a more sensitive ethical provider of health care. In one decade, the USC community dentistry department accomplished a major shift in attitude about the specialty from one of pervasive opposition and antipathy to that of acceptance and even enthusiasm. The department became competitive with similar units nationwide in educating dental students and practitioners to fulfill their responsibilities at the highest level of proficiency and to be true to the trust bestowed on them by the public. In pursuit of these goals, the department reflected credit on dentistry and the University of Southern California.
This cross-sectional study was performed in the Dental School of Prince of Songkla University to ascertain noise exposure of dentists, dental assistants, and laboratory technicians. A noise spectral analysis was taken to illustrate the spectra of dental devices.
A noise evaluation was performed to measure the noise level at dental clinics and one dental laboratory from May to December 2010. Noise spectral data of dental devices were taken during dental practices at the dental services clinic and at the dental laboratory. A noise dosimeter was set following the Occupational Safety and Health Administration criteria and then attached to the subjects' collar to record personal noise dose exposure during working periods.
The peaks of the noise spectrum of dental instruments were at 1,000, 4,000, and 8,000 Hz which depended on the type of instrument. The differences in working areas and job positions had an influence on the level of noise exposure (p < 0.01). Noise measurement in the personal hearing zone found that the laboratory technicians were exposed to the highest impulsive noise levels (137.1 dBC). The dentists and dental assistants who worked at a pedodontic clinic had the highest percent noise dose (4.60 ± 3.59%). In the working areas, the 8-hour time-weighted average of noise levels ranged between 49.7-58.1 dBA while the noisiest working area was the dental laboratory.
Dental personnel are exposed to noise intensities lower than occupational exposure limits. Therefore, these dental personnel may not experience a noise-induced hearing loss.
Noise-induced hearing loss; Noise; Dental practice; Dental school; Dental instruments
to (1) identify and quantify the types of treatment that dentists in general dental practice use to manage defective dental restorations; and (2) identify characteristics that are associated with these dentists’ decisions to replace existing restorations. The Dental Practice-Based Research Network (DPBRN) comprises dentists in outpatient practices from five regions: AL/MS: Alabama/Mississippi, FL/GA: Florida/Georgia, MN: dentists employed by HealthPartners and private practitioners in Minnesota, PDA: Permanente Dental Associates in cooperation with Kaiser Permanente’s Center for Health Research, and SK: Denmark, Norway, and Sweden.
A questionnaire was sent to all DPBRN practitioner-investigators who reported doing at least some restorative dentistry (n=901). Questions included clinical case scenarios that used text and clinical photographs of defective restorations. Dentists were asked what type of treatment, if any, they would do in each scenario. Treatment options ranged from no treatment to full replacement of the restoration, with or without different preventive treatment options. We used logistic regression to analyze associations between the decision to intervene surgically (repair or replace) and specific dentist, practice, and patient characteristics.
512 (57%) DPBRN practitioner-investigators completed the survey. A total of 65% of dentists would replace a composite restoration when the defective margin is located on dentin; 49% would repair it when the defective margin is located on enamel. Most (52%) would not intervene surgically when the restoration in the scenario was amalgam. Dentists participating in solo or small private practice (SPP) chose surgical intervention more often than dentists who participate in large group practices (LGP) or in public health practices (PHP) (p<.0001). Dentists who do not routinely assess caries risk during treatment planning were more likely to intervene surgically and less likely to choose prevention treatment (p<.05). Dentists from the SK region chose the “no treatment” option more often than dentists in the other regions.
Dentists were more likely to intervene surgically when the restoration was an existing composite, compared to an amalgam restoration. Treatment options chosen by dentists varied significantly by specific clinical case scenario, whether the dentist routinely does caries risk assessment, type of practice, and DPBRN region.
In Tanzania, oral health services are mostly in the form of dental extractions aimed at alleviating acute dental pain. Conservative methods of alleviating acute dental pain are virtually non-existent. Therefore, it was the aim of this study to determine treatment success of emergency pulpotomy in relieving acute dental pain.
Setting: School of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Study design: Longitudinal study.
Participants: 180 patients who presented with dental pain due to acute irreversible pulpitis during the study period between July and August 2001.
Treatment and evaluation: Patients were treated by emergency pulpotomy on permanent posterior teeth and were evaluated for pain after one, three and six week's post-treatment. Pain, if present, was categorised as either mild or acute.
Of the patients with treated premolars, 25 (13.9%) patients did not experience pain at all while 19 (10.6%) experienced mild pain. None of the patients with treated premolars experienced acute pain. Among 136 patients with treated molars 56 (31%) did not experience any pain, 76 (42.2%) experienced mild pain and the other 4 (2.2%) suffered acute pain.
The short term treatment success of emergency pulpotomy was high being 100% for premolars and 97.1% for molars, suggesting that it can be recommended as a measure to alleviate acute dental pain while other conservative treatment options are being considered.
The purpose of this study was to evaluate self-reported oral health attitude and behavior among a group of Turkish dental students and to compare differences in oral health attitudes between years of study and gender.
This study included 267 (153 female, 114 male) dental students. A modified English version of Hiroshima University Dental-Behavioral Inventory (HU-DBI) which consists of twenty-eight dichotomous responses (yes-no) was used.
Totally 141 preclinical (1, 2 and 3rd years of study) and 126 clinical students (4 and 5th years of study) who were mean age of 21.16 participated in the study. Statistically significant differences were found between years of study for brushing each of teeth carefully, cleaning the teeth well without using toothpaste, using a toothbrush which has hard bristles and for having had their dentist tell that they brush very well. There were statistically significant differences between females and males for using a toothbrush which has hard bristles and using tooth floss regularly. Statistically significant differences were found for brushing each of the teeth carefully and using mouth wash on regular basis between smokers and non-smokers.
This study confirmed that oral and dental health behavior and attitudes and also their knowledge about oral and dental health care of dental students improved with increasing level of education while oral and dental health care of female students were better than males and oral and dental health care of non-smokers were better than smokers.
Oral health behavior; Dental attitudes; Dental students; Turkey
The objective of this study was to assess whether the concern about halitosis influence oral health attitude and practices among young literate adults in Nigeria.
Materials and Methods:
This cross-sectional survey of 400 randomly selected temporary camp resident adults in Anambra state, South Eastern Nigeria was conducted using a modified version of the Hiroshima University-Dental Behavioral Inventory questionnaire.
Out of the 400 questionnaires distributed, only 294 were filled and returned giving an overall response rate of 73.5%. Half (50.0%) of the participants in this study expressed concern about halitosis. The participants that expressed concern about halitosis were mostly in the 25- to 27-year-old age group, females, known smoker, regular dental floss, and mouth wash users, had incorrect tooth brushing knowledge, brushed teeth more frequently and more forcefully, had no previous dental treatment, prefer symptomatic dental visit, experienced gingival bleeding, expressed worry about the color of their gingiva and teeth but were satisfied with the dental appearance.
Data from this study showed that concerns about halitosis-triggered behavioral reaction in oral self-care practices namely tooth brushing frequency, tooth brushing force, mouth wash, and dental floss use. Also revealed were poorer oral health and lower preventive dental visit practices among participants concerned about halitosis. There is need for improved public knowledge and awareness about halitosis by the dentist in Nigeria.
Concern; halitosis; oral hygiene practices
The roles of physicians in oral healthcare delivery are very important due to the unequal distribution of the low oral health manpower as well as the lack of awareness of patients concerning the treatment of oral health problems by dentists in Nigeria.
To assess the Nigerian clinical level medical students’ knowledge of dental problems and conditions in relation to the dental specialty that treat them.
Subjects and Methods:
This questionnaire-based cross-sectional study of clinical level medical students of University of Benin, Benin City, Nigeria, was conducted between May and June, 2010. The knowledge of the students was graded as good (16-20), fair (8-15), and poor (<8).
Out of the 350 questionnaires distributed, 279 were filled and returned giving an overall response rate of 79.7% (279/350). Of these, 47.0% (131/279), 50.2% (140/279), and 2.8% (8/279) of respondents showed poor, fair and good knowledge respectively. The trend showed a statistically significant increase in the mean level of knowledge of dental specialty with an ascent in the clinical level (P = 0.01).
The level of knowledge of dental specialty in this survey was suboptimal and varied with different specialties which may have adverse implication in future patient care. The variation in the level of knowledge with different clinical level suggested gain in knowledge about dental specialty mainly through nonformal means among medical students.
Clinical level; Dental specialty; Knowledge; Medical students
The aim of the present study was to compare self-reported dental fear among dental students and patients at a School of Dentistry in Belo Horizonte, Brazil. Eighty students ranging in age from 20 to 29 years and 80 patients ranging in age from 18 to 65 years participated in the study. A self-administered pre-tested questionnaire consisting of 13 items was used for data acquisition. The city of Belo Horizonte Social Vulnerability Index (SVI) was employed for socioeconomic classification. The chi-square test and binary and multinomial logistic regression were employed in the statistical analysis, with the significance level set at 0.05. The majority of dental students (76.5%) sought the dentist for the first time for a routine exam, while patients (77.3%) mostly sought a dentist for the treatment of dental pain. Dental fear was more prevalent among the patients (72.5%) than the students (27.5%). A total of 47.1% of the students and 52.9% of the patients reported having had negative dental experiences in childhood. The logistic model revealed an association between dental fear and a pain-related experience (OR: 1.8; 95%CI: 1.3–2.6). Patients were more prone to dental fear (OR: 2.2; 95%CI: 1.0–5.0). Although at different percentages, both students and patients experienced dental fear. Current patient with previous experience of dental pain had more dental fear.
behavior; fear; pain; undergraduate student; dentistry; epidemiology; health; patients
Johrei has been credited with healing thousands from radiation wounds after the Hiroshima and Nagasaki bombs in 1945. This alternative medical therapy is becoming increasingly popular in the United States, as are other Energy Medicine modalities that purport to influence a universal healing energy. Human brain cells were cultured and exposed to increasing doses of ionizing radiation. Experienced Johrei practitioners directed healing intentionality toward the cells for 30 min from a distance of 20 cm and the fate of the cells was observed by computerized time-lapse microscopy. Cell death and cell divisions were tallied every 30 min before, during and after Johrei treatment for a total of 22.5 h. An equal number of control experiments were conducted in which cells were irradiated but did not receive Johrei treatment. Samples were assigned to treatment conditions randomly and data analysis was conducted in a blinded fashion. Radiation exposure decreased the rate of cell division (cell cycle arrest) in a dose-dependent manner. Division rates were estimated for each 30 min and averaged over 8 independent experiments (4 control and 4 with Johrei treatment) for each of 4 doses of X-rays (0, 2, 4 and 8 Gy). Because few cell deaths were observed, pooled data from the entire observation period were used to estimate death rates. Analysis of variance did not reveal any significant differences on division rate or death rate between treatment groups. Only radiation dose was statistically significant. We found no indication that the radiation response of cultured cells is affected by Johrei treatment.
biofield therapy; cell culture; energy medicine; spiritual healing; time-lapse microscopy
In patients with stage IV gastric cancer, systemic chemotherapy is the key treatment. Combination chemotherapy (cis-diamminedichloride platinum plus S-1 and docetaxel plus S-1) results in long-term survival in clinical practice. In selected cases, additional (adjuvant) surgery may result in further long-term survival. This study aimed to evaluate the efficacy of adjuvant surgery following the response to chemotherapy for advanced gastric cancer. Based on response to chemotherapy, the indications for adjuvant surgery (surgery after the response to chemotherapy) are that resection is expected to be curative rather than palliative, provided that no other distant metastases occur. The study included 20 advanced gastric cancer patients who had undergone gastrectomies after the response to the combination chemotherapy of docetaxel and S-1, between September 2003 and December 2008 at Hiroshima University Hospital. At a median follow-up of 980 days, the median overall survival was 855 days. A 2- and 3-year survival was observed in 80 and 54.9% of patients, respectively, following macroscopic curative surgery. In the palliative group, the median overall survival was 510 days, but a 3-year survival was not observed. In the partial response group, the median overall survival was 865 days and a 3-year survival was observed in 37% of patients. One-year survival was not observed in the stable disease group. The patient survival in the partial response group was statistically more prolonged than in the stable disease group. The median overall survival in patients with liver metastasis was 865 days, while that in patients with peritoneal dissemination was 510 days. In conclusion, adjuvant surgery may be effective in gastric cancer patients diagnosed as stage IV by means of liver or distant lymph node metastasis, except in cases of peritoneal dissemination.
gastric cancer; adjuvant surgery; S-1; docetaxel
Dental trauma generally requires multidisciplinary planning and treatment for good prognosis. When immature teeth are traumatized to a degree where pulp necrosis ensues, the objective of root canal treatment should be apexogenesis and root maturation. Apexification of the root is the conventional choice, which involves cleaning the canal and filling it with a temporary medication that stimulates the formation of a calcific apical barrier. Dental Trauma Service of Piracicaba Dental School, State University of Campinas (UNICAMP), Brazil employs a dressing for apexification treatments with calcium hydroxide, chlorhexidine gel 2% and zinc oxide. This paper reports the case of a dental trauma of the maxillary central incisors and subluxation on teeth 11, 12 and 21 that were treated with multidisciplinary collaboration (Endodontics, Periodontology and Operative Dentistry) to improve prognosis. After five-years there were no pathological conditions and the teeth showed every evidences of success.
Apexification; Endodontics; Calcium Hydroxide; Periodontics; Tooth Injuries
Evaluation of self perceived and actual need for orthodontic treatment helps in planning orthodontic services and estimating the required resources and man power. In the present study, the perceptive need as evaluated by patients and the actual need to orthodontic treatment, as assessed by orthodontists, were evaluated at two types of dental practices in the city of Jeddah using the Index of Orthodontic Treatment Need (IOTN).
A consecutive sample of 743 adults seeking orthodontic treatment at two different types of dental practices in Jeddah; King Abdulaziz University, Faculty of Dentistry (KAAU) (Free treatment) and two private dental polyclinics (PDP) (Paid treatment), was examined for orthodontic treatment need using the dental health component (DHC) of the IOTN. The self-perceived need for orthodontic treatment was also determined using the aesthetic component (AC) of the IOTN. The IOTN score and the incidence of each variable were calculated statistically. AC and DHC categories were compared using the Chi-Square and a correlation between them was assessed using Spearman's correlation test. AC and DHC were also compared between the two types of dental practices using the Chi-Square.
The results revealed that among the 743 patients studied, 60.6% expressed no or slight need for treatment, 23.3% expressed moderate to borderline need and only16.1% thought they needed orthodontic treatment. Comparing these estimates to professional judgments, only 15.2% conformed to little or no need for treatment, 13.2% were assessed as in borderline need and 71.6% were assessed as in need for treatment (p < 0.001). Spearman's correlation test proved no correlation (r = -.045) between the two components. Comparing the AC and the DHC between the KAAU group and PDP group showed significant differences between the two groups (p < 0.001).
Patient's perception to orthodontic treatment does not always correlate with professional assessment. The IOTN is a valid screening tool that should be used in orthodontic clinics for better services especially, in health centers that provide free treatment.
Teachable moments in the dental clinic are rare and are not adequately exploited. Students often ask simple procedural questions, such as “What should I do next?” A preferred approach is one in which the clinic preceptor helps the dental student collect data about the patient’s condition, analyze the data, and consider scientific evidence and the patient’s profile in the formulation of diagnoses and treatment plans. The School of Dentistry at Oregon Health & Science University modified the one-minute preceptor method that was developed to instruct medical students in clinical office settings, using the acronym iCARE, which is an abbreviation for microskills that the dental preceptor and student follow when interacting in a dental clinic setting. From the preceptor’s perspective, iCARE stands for Inquire, Cultivate, Advise, Reinforce, and Empower; from the student’s perspective, iCARE is Initiate, Contribute, Apply, Reflect, and Execute. iCARE enhances the value achieved in preceptor and student interactions, promotes the student’s critical thinking, and encourages the student’s use of scientific evidence in formulating and supporting patient care decisions in the clinic.
preceptor; dental student; pedagogy; evidence-based dentistry; clinic instruction; one-minute preceptor; critical thinking
During a survey for hemoglobinopathies in over 9000 residents of Hiroshima Prefecture, Japan, a fast moving hemoglobin was identified in eight members of three generations in a Japanese family. The abnormal hemoglobin, named Hb Hiroshima, constitutes about 50% of the total hemoglobin in hemolysates from the carriers who have a mild erythremia but are otherwise apparently clinically unaffected. All preparations of Hb Hiroshima have increased affinity for oxygen, by either tonometric or oxygen electrode determinations. At pH 7.0, the oxygen pressure, P50 required to half saturate an unfractionated hemolysate from a carrier was one-half that of Hb A, and the P50 of a purified sample containing no Hb A was one-fourth that of Hb A. The pH dependence of the oxygen equilibrium (Bohr effect) is below normal, as shown by the absolute value of the Bohr effect factor which is about half that of Hb A, in the pH range between 7.0 and 7.4. The Hill constant, n, for Hb Hiroshima between pH 7.0 and 7.4 is 2-2.4, compared to 2.8-3 for Hb A under the same conditions, indicating reduction of, but not complete abolition of heme-heme interaction. Urea dissociation and canine hybridization tests located the biochemical lesion in the beta chain. Fingerprints (Ingram), carboxypeptidase digestion, and amino acid analysis demonstrated that the substitution was at residue 143 in the beta chain, where histidine was replaced by aspartic acid.
In contrast to other recently described high oxygen affinity mutants that show intact Bohr effects, all three of the major characteristics of the reversible combination of hemoglobin with oxygen (oxygen equilibrium, heme-heme interaction, and pH dependence) are affected in Hb Hiroshima. A tentative interpretation of these effects, relating structure to function, is offered in terms of recently developed models of normal hemoglobin.
The importance of systemic management to prevent accidents is increasing in dentistry because co-morbid illnesses in an aging society and invasive surgical procedures are increasing. In this prefecture, a new medical system called the remote online hemodynamic monitoring system (ROHMs) was started in 2001. Eight private dental offices participated in this trial. When dental practitioners feel the risk of a dental procedure, they can contact via ROHMs to this hospital. Then, the hemodynamic data (blood pressure, heart rate, ECG, SpO2, and RPP) of the patient in the clinic can be transmitted here via the internet, and the images and the voice can be transmitted as well. The availability of this system was assessed in 66 patients (98 cases). The most frequent complications were hypertension, heart disease, and diabetes mellitus. Systemic management included monitoring during the dental procedure (71.4%), checking vital signs after an interview (15.3%), and monitoring under sedation (13.3%). There were 35.7% of all cases where an unscheduled procedure was necessary for the systemic management. Based on a questionnaire, the majority of the patients felt relieved and safe. This system creates a situation where a specialist is almost present during the procedure. This system will provide significant assistance for future medical cooperation for risk management.
online; high-risk patient; dental treatment; medical cooperation; medical accident; risk management
Dental trauma is such a situation wherein the patient is affected both socially and psychologically. During their first dental visit, these patients with trauma are in pain and need emergency treatment. Such patients are quite apprehensive because of impaired functions, esthetics, and phonetics. The prime objective while handling such cases is successful pain management with immediate restoration of function, esthetics, and phonetics. The advances in adhesive dentistry have allowed dentists to use the patient's own fragment to restore the fractured tooth. Reattachment is such an ultraconservative technique which provides safe, fast, and esthetically pleasing results. This paper discusses fragment reattachment technique and presents a clinical case of complicated crown fracture.
To investigate the present status of nutrition education for dentists and physicians in Canada, we conducted a survey of the nutrition education programs in 10 Canadian dental and 16 medical schools in the academic year 1982-83. Seven of the dental schools and seven of the medical schools had a separate course in nutrition. The average duration of these courses was 22 hours for the dental schools and 26 hours for the medical schools. Nutrition education was integrated with another discipline in 4 of the dental schools and 11 of the medical schools. The average duration of this type of instruction was 14 hours for the dental schools and 18 hours for the medical schools. Six of the dental schools and eight of the medical schools employed a nutritionist/dietitian to provide instruction in nutrition. We recommend that courses in basic and applied clinical nutrition be incorporated throughout the curricula of Canadian dental and medical schools, and that personnel trained in clinical nutrition be employed to provide instruction in this area.