Biomedical subjects

F van de Poel

Publications and source records attributed to F van de Poel.

10 recordsLinked to original sources

PubMed1988

Dutch dentists' decisions to take bitewing radiographs.

A postal questionnaire was sent to a 10% (n = 444) national random sample of Dutch dental practitioners. The response was 77% (n = 344). The practitioners prescribed bitewings on average for 57% of "new" 25-yr-old patients. Five significant (P less than 0.05) variables explained 24% of the variation in bitewing prescribing for these "new" patients. These were, in declining level of importance: the initial dental condition of the patient, the proportion of restorative treatment decisions based solely on radiographs, the level of urbanization of the practice location, the technical level of the practice equipment and the importance attached by dentists to the diagnostic use of dental floss for interproximal caries diagnosis. The low power of the regression model in explaining variation in the decision to take bitewings indicates an idiosyncratic use of bitewing radiographs for caries diagnosis. A weak tendency to adopt different diagnostic sets of procedures was demonstrated.

Adolescent↗

PubMed1987

Relative importance of periodontal disease for full mouth extractions in the Netherlands.

In order to determine the relative importance of periodontal disease, caries and non-disease reasons for full mouth extractions, a combined sociodental study was carried out in an urban and a rural area in the Netherlands. In the largest proportion of patients (57%) caries was the predominant disease. In only a small group (13%) was periodontal breakdown the predominant characteristic. In 16% of the patients non-disease factors possibly played a role because in this group no generalized periodontal disease or caries was found. It was concluded that in urban and rural areas and in all age groups caries and not periodontal disease was the most important reason for full mouth extractions. Non-disease factors may play a role in the decision to carry out full mouth extractions. Patients living in areas with different dentist-population ratios have a comparable caries status and periodontal condition at the time of full mouth extractions.

Adult↗

PubMed1987

Dentists' and patients' opinions of the dental condition at moment of full clearance.

Reasons for full mouth extraction in an urban and a rural area in The Netherlands (dentist-patient ratio 1:2500 and 1:5700 respectively) have been studied. Patients who participated in this combined sociodental research project were those who received full mouth extractions over a period of 1 yr. The combined patient response was 75% and the overall dentist response 90%. In the urban and the rural areas respectively 137 and 237 cases of full mouth extraction were recorded. When comparing the dentists' diagnoses with the conditions of the dentitions there appeared to be a fair degree of agreement in most of the cases, although some striking deviations were also found. In the relationship between the patient's opinion and the condition of the dentition some unexplained discrepancies were found: 37% of the dentitions in which the teeth and attachment were in a healthy condition were perceived as bad by the patients. Dentists and patients agreed in their perceptions of the dental conditions in 60% of the cases. In 27% there was a strong disagreement. In most of the discrepancies found plausible explanations could be given. In some cases this was not possible. As this involves a substantial minority of cases, dentists should be aware of reasons other than the clinical condition in the disabling treatment of full clearance.

Attitude↗

PubMed1987

Decision processes preceding full mouth extractions.

Full mouth extraction is the final step in a continuous process in which not only dental but also social processes play a role. In a research project concerning the reasons for full mouth extractions in The Netherlands, it was found that over one-third of the patients had considered full mouth extractions at least once before, and 16% considered it frequently over a period of many years. Anxiety was the most important reason for not visiting a dentist. In the patients' view in 86% of the cases they were the initiator of the decision to have all their teeth extracted. According to the dentist the patients initiated full mouth extraction in 70% of the cases. Dentists and patients agreed that irregular attenders more often took the initiative than regular attenders. Most patients (87%) had discussed the decision to have all teeth extracted with one or more persons; different contacts were reported by 14% percent of the patients. According to Freidson's lay referral theory two groups could be identified: a group with a severely truncated lay referral structure and a group characterized by a more extended lay referral structure. The first group was older (46 versus 36 yr) and had a more positive attitude towards full dentures. In order to avoid problems dentists are recommended to involve (a representative of) the patient's social network when important decisions have to be taken.

Adult↗

PubMed1987

Pathways to full mouth extraction.

The process of not attending the dentist is a vicious cycle in which anxiety plays a crucial role. A research project concerning the disease and non-disease reasons for full mouth extraction provided an opportunity to describe the dental histories in terms of dental attendance pattern and related factors which resulted in full dentures. Three profiles of dental histories could be outlined: 1) The regular attenders (19%). Because of their age (means = 47 yr), their positive attitude towards dentistry together with their positive attitude towards full dentures, it is suggested that the possibilities of keeping the natural dentition were exhausted so that full mouth extraction was an acceptable solution. 2) The symptomatic attenders (38%). Because anxiety, which was widespread in this group, was not based on negative experiences, it is suggested that anxiety is caused by social learning. Together with their positive attitude towards full dentures, the high prevalence of full dentures in their social environment and their low socioeconomic status, the conclusion is drawn that these patients lived in a culture which supports behavior that leads to total tooth loss. 3) Once regular attenders (43%). In this group anxiety leads to a negative perception of dental visits and to a negative attitude towards dentists. As a consequence dental visits are deferred, which results in deterioration of the dentition. Experiences with dentists are distorted in a negative way, which increases dental anxiety. Facilitated by a positive attitude towards full dentures, their bad dental condition finally urges them to take full dentures at early age.

Adult↗

PubMed1986

Caries status at the moment of total tooth extraction in a rural and an urban area in the Netherlands.

Edentulousness varies with the availability and accessibility of dental care. Comparing the dental status of groups of patients getting full dentures might give insight into the effect of different levels of supply of dental care on the dental condition. Therefore a research project has been started in the Netherlands in an urban and a rural area, having dentist-patient ratios of 1:2,500 and 1:5,700 respectively. In the urban and rural area an equal proportion had partial dentures prior to losing the last of their teeth. However, in the urban area 33% of the patients wearing partial dentures had full maxillary or mandibular dentures; in the rural area this figure was 73%. In the rural area a larger proportion had lost 21 or more teeth at the moment of total extraction. Therefore, it was concluded that in the urban area more effort was spent in maintaining the natural dentition. Looking at DMF-T figures and separate components of DMF-T, no differences could be established between people living in areas with a high and a low dentist-patient ratio.

Adult↗

PubMed1986

Differences in total tooth extraction between an urban and a rural area in the Netherlands.

Differences in total tooth loss between an urban and a rural area (dentist-patient ratio 1:2500 and 1:5700 respectively) have been studied. Patients who participated in this study were those who received total tooth extraction during the calendar yr 1982 (urban area) and 1983 (rural area). The overall dentist response was 90%, the combined patient response was 75%. During the year, in the urban area 137 cases of total tooth extraction were recorded; in the rural area this was 237. This frequency is equivalent to 109 and 226 total tooth extractions per 100,000 inhabitants, respectively. The age and sex distribution of the urban and rural population could not account for this difference. The rural population had a lower educational level and more people insured in a State Health Scheme, which is related to income. The frequency of symptomatic attenders was highest in the rural area among those who were insured in a State Health Scheme. It is concluded that differences in numbers of total extractions between the rural and urban areas cannot be explained entirely by differences in population characteristics.

Adult↗

PubMed1985

Caries and total extraction in a medium-sized city in the Netherlands.

In 1982 a combined sociodental research project was started in the city of Groningen in order to gain insight into the dental and social reasons for total extraction. 91% of the dentists in the city participated in this study by collecting the extracted teeth, filling out a questionnaire and asking their patients to fill out another questionnaire concerning the behavioral aspects of total tooth loss. 78% of the 134 patients returned the questionnaire. In this article the caries status in relation to the social background and dental attendance pattern has been described. The mean age at the time of extraction was 44.2 yr. The patients were a good cross-section of the Dutch population as regards education level, type of health insurance and sex. The average number of teeth was 14.2. The average DEMFT value was 22.8. Although regular attenders had less D-teeth than irregular attenders they had an average of 3.5 teeth with active caries. Regular attenders had more F-teeth but less sound teeth than irregular attenders. The contribution of the dental health care system to the dental health of the population is discussed.

Adolescent↗

PubMed1985

Periodontal status and total tooth extraction in a medium-sized city in the Netherlands.

A combined sociodental research project was started in the city of Groningen in 1982 aimed at gaining insight into the reasons for total tooth extraction. Patients showing up for total tooth extraction during 1982 participated in this study by filling out a questionnaire concerning the underlying reasons for their decision to have all their teeth extracted. The dentists in this city were asked to collect all the extracted teeth and to fill out a short questionnaire for each patient about the reason (diagnosis) for the total tooth extraction. The periodontal status of the extracted teeth was established afterwards by measuring the percentage of the loss of attachment (L.A.). It appeared that most surfaces in the molar region and the front teeth in the mandible were affected by periodontal disease. Advanced generalized periodontal disease was established in 17% of the patients, accounting for 64% of all teeth with an L.A. measurement of greater than 50%. Periodontal disease could not be identified as the main clinical condition requiring tooth extraction: even in the group of 55 yr of age and older advanced periodontal disease was found in only one third of the extracted teeth. Finally, the contribution of regular dental attendance to periodontal health is discussed.

Adult↗

PubMed1978

Amitriptyline plasma-concentration and clinical effect. A World Health Organisation Collaborative Study.

54 patients in five centres participated in a study of the relationship between steady-state plasma-levels of amitriptyline (AT) and its active metabolite nortriptyline (NT) and therapeutic response. The participants were inpatients who, after a 7-12 day period of assessment, were rated greater than or equal to 16 on the Hamilton rating scale for depression. They were given 75 mg of amitriptyline for 3 days and then 150 mg daily for an active-treatment period of 6 weeks. Clinical ratings and plasma-samples were obtained at baseline then at 2, 4, and 6 weeks after starting therapy. Contrary to the findings of three previous trials, no important correlations were found between steady-state plasma-levels and therapeutic outcome or corrected side-effects. Corrected side-effects correlated negatively with therapeutic outcome. There seems little advantage in routine monitoring of AT and NT, since variations in plasma-levels do not account for the considerable variation in therapeutic outcome.

Adult↗