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1.  Expanding Dental Education Partnerships Beyond the Four Walls 
Journal of dental education  2011;75(3):300-309.
The increasing complexities of health care that dental graduates must be equipped to handle require schools to develop new models of education in order to address these intricacies. To meet these challenges, it is the school’s responsibility to provide an environment that fosters discovery and scholarly activity, embraces evidence-based philosophies, encourages partnerships with other units on campus and the community, including the global community, and recognizes the richness of diversity in both our human resources and our thinking. Beyond new curriculum initiatives within our school, we recognized the need to build strong partnerships outside our four walls in order to respond to the challenges confronting us. Four such notable recent initiatives at the University of Washington School of Dentistry discussed in this article are Regional Initiatives in Dental Education, the Center for Pediatric Dentistry: Program in Early Childhood Oral Health, Northwest PRECEDENT (Practice-based REsearch Collaborative in Evidence-based DENTistry), and Alaska Native Dental Health Aide Therapist Program. These partnerships focus on new models to improve access to care and to enhance the impact of research on evidence-based practice. These are examples of the many opportunities for us to act collectively in creating new models that ensure our graduates have the knowledge, attitudes, and skills to be competent oral health care professionals.
PMCID: PMC3118285  PMID: 21368254
dental education; evidence-based dentistry; practice-based research; access to health care; partnerships; regional programs/research; dental health aide therapist; children’s oral health
2.  Nitrous oxide analgesia in humans: Acute and chronic tolerance 
Pain  2005;114(1-2):19-28.
Electrical tooth stimulation was used to investigate whether humans develop tolerance to nitrous oxide (N2O) analgesia within a single administration as well as over repeated administrations. In a double-blind cross-over experiment, 77 subjects received a 40-minute administration of 38% N2O at one session and placebo gas at the other. The sessions were separated by 1 week and the order of gas administration was counterbalanced. Acute analgesic tolerance developed for pain threshold but not for detection threshold. There was no evidence of a hyperalgesic rebound effect following cessation of the N2O administration. In a second double-blind experiment, 64 subjects received both 30-min of placebo gas and 30-min of 35% N2O, separated by a 35-min gas wash-out period, during each of 5 sessions. Sensory thresholds were assessed prior to drug or placebo administration (baseline) and between 7-12 min and 25-30 min of gas administration. A control group of 16 subjects received only placebo gas at these 5 sessions. During a sixth session, the experimental procedures were similar to the previous sessions except that the control group received N2O for the first time and the experimental group was sub-divided to test for conditioned drug effects. For both detection and pain threshold measures, acute tolerance developed during the initial N2O exposure and chronic tolerance developed over repeated administrations. Although chronic tolerance developed, a test for Pavlovian drug conditioning found no evidence of conditioned effects on sensory thresholds. In conclusion, acute and chronic tolerance develop to N2O’s analgesic effects in humans.
doi:10.1016/j.pain.2004.12.011
PMCID: PMC1416628  PMID: 15733627
Pavlovian drug conditioning; pain; individual differences; electrical tooth stimulation; rebound; pain threshold
3.  Common Fears and Their Relationship to Dental Fear and Utilization of the Dentist 
Anesthesia Progress  1989;36(6):258-264.
Common fears were studied by household telephone interviews and mail survey in Seattle, Washington, to determine their relationship to dental fear and to utilization of the dentist. Dental fear was either the first or second most common fear, with a prevalence estimated between 183 and 226 persons per 1000 population. Dental fear was associated with fears of heights, flying, and enclosures. Respondents with multiple common fears other than fear of dentistry were more likely to delay or cancel dental appointments, report a longer period since their last visit to the dentist, and report poorer oral health and less satisfaction with oral appearance. Over 22 percent of the dentally fearful group reported two or more accompanying common fears.
PMCID: PMC2163980  PMID: 2490057
4.  Effects of Lidocaine with Epinephrine on Fear Related Arousal Among Dental Phobics 
Anesthesia Progress  1986;33(5):225-229.
The effects of 2% lidocaine containing 72 μg epinephrine on fear related arousal were tested using a cross-over design on dental patients fearful of injections and other dental procedures. Heart rate and body movement in the dental operatory were monitored, and subjects' self-reported upset in the Epinephrine condition than in the No-Epinephrine condition (F = 4.8, p = .04), but the clinical significance was negligible. No interaction between initial fear levels and the drug condition could be established. Results suggest that pre-existing dental fear levels may produce greater self-report, behavioral or physiological arousal in the dental operatory than exogenous epinephrine.
PMCID: PMC2177493  PMID: 3465257

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