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Biomedical subjects

D J Stiefel

Publications and source records attributed to D J Stiefel.

At least 19 recordsLinked to original sources
PubMed1985

A postgraduate dental training program for treatment of persons with disabilities.

Educational aspects of a five-year project of postgraduate training in dentistry for patients with severe disabilities are described. Courses consisted of two weeks of didactic and up to six weeks of clinical instruction. Participating dentists, dental hygienists, and assistants demonstrated significant post-course gains in cognitive knowledge and confidence. Follow-up evaluations indicated that more than 75 percent actively apply their training, particularly those in academic dentistry. The nationwide response to the program indicates a demand for advanced training of this type.

Clinical Competence↗
PubMed1979

A survey of preceived oral health needs of homebound patients.

1. While almost 60 percent of all patients reported dental needs, it is assumed that actual needs were in fact considerably higher. Problems relating to dentures were the most freqeuntly expressed complaint. 2. A strong relation existed between the ability of homebound patients to get to a dentist and the time elapsed since last dental visit. Number of teeth was a significant determinant in frequency of seeking care. Persons with teeth or dentures sought treatment more often than those who were edentulous. Pain was the only variable for which a difference was noted between the two groups in the effect on time of last dental visit. 3. The study revealed an inaccessibility of dental care for the majority of patients confined to their homes. Ability to get to the dentist was identified as a major barrier to care for the homebound. The delivery of dental services to such patients in their immediate surroundings, by specially trained dental professionals using mobile units, must therefore be seriously considered as a means for improving access to care for this population.

Aged↗
PubMed1979

Inclusion of a program of instruction in care of the disabled in a dental school curriculum.

Lack of practitioner training is considered a major reason for dental neglect of disabled persons. The feasibility of instruction in the care of the disabled for dental and dental hygiene students at the undergraduate level was demonstrated in a prototype program encompassing a continuum of didactic courses, clinical experiences in extramural and intramural settings, inservice training and continuing education, interdisciplinary activities, and evaluative research. Successful implementation of such a program required developing and using appropriate support systems, such as instructional materials, social services, public relations, and monitoring of care delivery. A format combining specific courses with inclusion of disability subject matter in existing courses appeared to be advantageous in intergrating the program into the dental curriculum. Evaluation data indicated the value of undergraduate training in improving access to dental care for the disabled patient.

Attitude↗
PubMed1979

Assessment of student attitude and confidence in a program of dental education in care of the disabled.

An analysis is presented of the effect of a four-year dental school program in care of the disabled on expressed student attitude and confidence towards treating the handicapped patient. The longitudinal study, involving 503 students in six dental classes, revealed a willingness by the majority of students (greater than or equal to 60 percent) to treat pateints with whom they feel capable. This attitude remained essentially unaffected by the program. In contrast, levels of students' perceived confidence in treating handicapped persons increased significantly as the result of specific instruction in disability management; heightened confidence levels were sustained for one academic year. Expressed ability to treat the disabled appeared to increase for successive classes. The result support the premise that dental graduates who have received instruction in disability care will fell more confident and hence will be more likely to treat patients with special needs.

Attitude↗
PubMed1975

Comparison of human pancreatic and parotid amylase activities on different substrates.

The specific activities of highly purified preparations of human parotid and pancreatic amylase on several different soluble and insoluble starches were compared. The ratio of parotid to pancreatic activity varied with the physical nature of the substrate. With all soluble starches, irrespective of source, parotid amylase exhibited a higher specific activity than did pancreatic amylase; the reverse was true for an insoluble chromogenic starch (Amylose Azure). The variation in enzyme-substrate interaction supports previous indications of configurational differences between the two amylases. The observed organ-specific characteristics according to organ of origin may have value in determining relative parotid and pancreatic amylase activities in body fluids under normal and pathological conditions, thereby helping to clarify their functional and clinical significance.

Amylases↗
PubMedDate not supplied

A comparison of the oral health of persons with and without chronic mental illness in community settings.

Severe dental disease has been reported for patients receiving psychiatric treatment. This study compared the oral status of noninstitutionalized adults with chronic mental illness with a similar group without such history, and evaluated relative risk factors, for example, xerostomia, diet, hygiene, and poverty. A sample of 37 subjects with chronic mental illness (CMI) and 29 control subjects without mental illness were assessed for dental, medical and social history; head, neck, and oral soft tissue pathology; salivary flow; DMFS, gingivitis, loss of periodontal attachment, plaque, and calculus. The groups were equivalent in socio-economic level, education, dental history, and home care. All subjects with CMI received psychotropic medications (mean of 3.8 drugs for 10.3 years). The CMI group had significantly higher incidence in the following variables: self-reported dry mouth; consumption of carbonated beverages (P less than .001); mucosal, lip, and tongue lesions (P less than .01); coronal smooth surface caries (P less than .001); severity of plaque (P less than .001) and calculus (P less than .01); and salivary flow (P less than .05). No significant differences were evident in the M and F components of DMFS, in gingivitis or loss of attachment. The results indicate significant increases in risk factors and increased oral pathosis in persons with mental illness who live in community settings compared with a control group that showed dental neglect.

Adolescent↗
PubMedDate not supplied

Efficacy of chlorhexidine swabbing in oral health care for people with severe disabilities.

Chlorhexidine is effective when used as an oral rinse, but many disabled people cannot use such a protocol. A double-blind cross-over study tested the efficacy of applying chlorhexidine with a sponge-swab, in a sample of 76 severely disabled adults, drawn from diverse rehabilitation settings. Two randomly assigned groups applied 10 mL 0.12% chlorhexidine gluconate (Peridex, Procter & Gamble) or 10 mL placebo, using a "Toothette" (Halbrand) once daily, 5 times per week for 10 weeks. All subjects received 10 mL 0.05% NaF, applied similarly but separately from the test/placebo agent. Pre- and post-trial measures included perceived level of function and oral status, that is, DMFS, plaque, calculus, pocket depth, and tooth stain. The protocol received high levels of compliance and acceptance. Compared with placebo, swabbing with chlorhexidine resulted in consistent, and, in part, significant improvements in plaque, gingivitis, and periodontal pocket depth. Side effects of chlorhexidine, that is, tooth stain and calculus, were relatively minor. Perceived improvements in dental health were associated with improved physical health, appearance, and mouth odor. The results indicate that chlorhexidine swabbing is a useful oral disease preventive protocol for persons with disability.

Adult↗
PubMedDate not supplied

A comparison of oral health in spinal cord injury and other disability groups.

A controlled pilot study determined oral health in persons with quadriplegia due to spinal cord injury, and compared dental disease rates in spinal cord injury and other disability groups. Seventeen adults with spinal cord injury and 17 controls were assessed for dental/medical/social history; manual function; head, neck, and oral lesions; salivary flow; DMFS; and gingivitis, periodontal pockets, plaque, and calculus. Findings were compared with those from prior studies according to the same protocol, for groups of similar age with mental retardation, cerebral palsy, traumatic brain injury, and chronic mental illness. No significant differences between spinal cord injury and control subjects were noted, except that fewer spinal cord injury subjects brushed daily or flossed (p < 0.05); dependent subjects tended to have more plaque and gingivitis than those brushing independently. Subjects with spinal cord injury and mental illness had less gingivitis than those with mental retardation and cerebral palsy (p < 0.001); on calculus, subjects with spinal cord injury ranked lower than subjects with mental illness (p < 0.05). On DFS, mentally ill subjects and those with traumatic brain injury ranked higher than mentally retarded and cerebral palsy groups, with spinal cord injury subjects intermediate. Mentally retarded and traumatic-brain-injured subjects had fewer teeth than other groups (p < 0.05). The findings suggest differences in oral health status and oral care for various disabled populations.

Adult↗