Attitudes, behaviour and infection control among Zambian dental personnel concerning HIV and BHV infections.
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Biomedical subjects
Publications and source records attributed to F Scheutz.
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The aim of the study was to evaluate whether general anxiety and dental anxiety were more common in a group of parenteral drug addicts. 41 drug addicts (mean = 27.4 yr) attending a dental clinic in Aarhus in Denmark participated. A randomly sampled reference group comprising 350 individuals living in Aarhus and with similar age distribution was selected from the Central Person Register. Questionnaires with social and educational data and three self-report rating scales, namely Corah's dental anxiety scale (CDAS) and Spielberger's State-Trait anxiety inventory's two scales (STAI-State and STAI-Trait) were completed by the participants. Response rates were 95.6% and 89.3% for drug addicts and controls, respectively. Median CDAS, STAI-State, and STAI-Trait were 10, 46 and 44 in the addicts which was statistically significantly higher than in the general population. These differences were still present when the addicts were compared to a subsample from the reference group with a better matching of educational and social background factors. Spearman's correlation coefficient between CDAS and STAI-State, CDAS and STAI-Trait, and STAI-State and STAI-Trait were 0.57, 0.49 and 0.50, respectively, which were significant and moderately high correlations. Finally, anxiety levels were similar irrespective of caries experience.
The present study was undertaken in order to evaluate whether electrodermal activity was a useful tool with which to measure dental anxiety in a group of drug addicts. Electrodermal activity was compared to the subjects' self-reported feelings during ordinary dental treatment sessions. In the first part of the study the level of electrodermal activity during treatment sessions was videotaped and recorded on paper by means of a polygraph. The patients were interviewed using a semi-structured questionnaire dealing with the addicts' dental anxiety and fear. In connection with the interviews the addicts completed Corah's Dental Anxiety Scale (CDAS). There was no recognizable pattern in electrodermal activity when this was compared with the patients' feelings during the treatments. Median CDAS was 9.5. In the second part of the study, electrodermal activity was recorded on the polygraph only. This group also completed a CDAS questionnaire. No correlation between the patients' self-reported highest level of anxiety and level of electrodermal activity, number of fluctuations or amplitude in relation to specific dental stimuli was found; agreement was found in two, three and none of 10 cases respectively. Median CDAS was 10.0. It could be concluded that, although the study revealed apprehension and situational anxiety among the addicts, no correlation to electrodermal activity was found. This discrepancy between the physiological and cognitive data probably reflects the uncertainty of these measures under the given circumstances.
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The aim of the study was to investigate the prevalence of previous clinical hepatitis B virus (HBV) infection and the prevalence of HBV markers in Danish oral surgeons, to estimate the annual HBV infection rate, and to assess whether the use of hepatitis B vaccine is to be recommended for this group. The total study population comprised 40 individuals occupied with oral surgery. A questionnaire and a request for a blood sample were sent to all dentists employed at the Danish hospitals and the departments of oral surgery at the 2 dental colleges. 36 (90%) answered a questionnaire, whereas only 27 (67.5%) had a blood sample taken for analysis of hepatitis surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis core antigen (anti-HBcAg), antibody to hepatitis A virus (anti-HAV), and serumtransaminases. One had been clinically ill from HBV infection and was positive for anti-HBs. The prevalence rate was thus 3.7% (95% confidence limits: 0.1%-19.0%) and the annual attack rate was 0.3%. The prevalence was not higher than among Danish dentists in general, and they are not considered a high-risk group in Denmark. Even with due statistical consideration to the present small sample, Danish oral surgeons do not seem to belong to a high-risk group like other surgeons in different medical specialities. It is concluded that the use of a hepatitis B vaccine is not recommended at present for this group of dentists.
The aim of the present study was to obtain information about a group of young drug addicts' dental habits, knowledge, and attitudes. Semistructured interviews with open-ended questions based on well-defined hypotheses were obtained with 20 intravenous drug addicts attending a Danish addiction clinic. All the interviews were taped and typed out verbatim. The analysis of the interviews was primarily carried out qualitatively. Almost all the addicts had been enrolled in the Public Child Dental Care system and the majority vividly remembered this as an unpleasant experience. None of the addicts attended a dentist regularly after having finished school, when the drug abuse usually started. Only a need for acute relief could generally motivate the addicts to visit a dentist, and in the few instances they were questioned about any drug abuse or viral hepatitis infection they usually concealed this. They evidenced very limited knowledge concerning the causes and prevention of dental decay and periodontal disease, and the high prevalence of dental caries was often believed to be caused solely or partly by the ascorbic acid or citric acid that is mixed and injected together with the drugs. A distinct behaviour with a neglected oral hygiene and an excessive intake of candy, soft drinks, and other food with a high sugar content was common. The dietary habits were related to the injection of the drugs in a ritual manner. The drug addicts only realized how deplorable their dental health had become during periods of abstinence, and then they were often embarrassed or ashamed of their esthetic appearance, although this was not perceived to have a negative influence on attempts at resocialization.(ABSTRACT TRUNCATED AT 250 WORDS)
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The present study was undertaken to investigate the dental health of a group of parenteral drug addicts. The study population comprised 134 persons with a mean age of 25 yr (min. 18, max. 37) examined in 1977-81. Mean DMFT was 18.3 and mean DMFS was 50.2, approximately twice as much as found in comparable age groups in Denmark. Even free smooth surfaces were often involved. The oral hygiene was measured by the use of the Visible Plaque Index (VPI) and the Bleeding Index (BI). Both indices were high, mean VPI = 77.4 and mean BI = 71.3. 12-40% of the teeth selected had a loss of periodontal attachment of more than 4 mm. It is suggested that not only drug abuse, but also factors like low social status, low education and different barriers towards receiving dental treatment should be considered in a multifactorial cause-effect relationship. The effect of offering a free dental care system for this high-risk group will be dealt with in another paper.