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Biomedical subjects

P Domoto

Publications and source records attributed to P Domoto.

18 recordsLinked to original sources

Pharmacokinetics of oral triazolam in children.

The purpose of this study was to determine the pharmacokinetic behavior of triazolam in children. Nine healthy children, aged 6 to 9 years, received oral triazolam (0.025 mg/kg suspended in Kool-Aid, Kraft General Foods, Chicago, IL) before dental treatment. Plasma triazolam concentrations were measured by gas chromatography/mass spectrophotometry at approximately 5, 15, 30, 45, 60, 90, 120, 180, and 240 minutes. A one-compartment model with first-order absorption and varying parameters was used, and estimated concentration curves were obtained for each subject. The observed peak plasma concentration was 8.5 +/- 3.0 ng/mL (mean +/- SD). The observed time to peak plasma concentration was 74 +/- 25 minutes. Elimination half-life was 213 +/- 144 minutes. Substantial recovery from signs and symptoms of clinical sedation required 180 to 240 minutes. The long duration of effect and relatively slow elimination should be noted by clinicians concerned with patient safety.

Biological Availability↗

The estimation of caries prevalence in small areas.

National surveys have been effective for the estimation of caries prevalence in broad regions of the US. However, it is unclear if data from such surveys can be used to estimate prevalences in small areas such as states or counties because of small sample sizes within individual areas. In this study, we applied specialized statistical methods to the estimation of small-area caries measures using data from an oral health survey conducted in the State of Washington. Dental exams to assess caries and the presence of sealants and fluorosis were performed on 2921 third-grade students in 84 public schools selected by a stratified random sample from all 39 counties in the state. Statistical methods for small-area estimation were used to estimate disease and sealant utilization measures for each of the counties. Adjustment was made for covariates measured at the school level, including ethnicity and the proportion of children in the Federally sponsored school lunch program. Substantial variability in disease and sealant utilization between counties was found. The estimated number of decayed and filled surfaces per child was 4.7 (inter-county range, 2.4 to 7.4). The estimated number of surfaces of untreated decay was 1.2 per child overall (range, 0.5 to 3.1). Thirty percent of the children had restorative treatment needs (range, 15 to 54%). The prevalence of sealants on one or more permanent molars was estimated to be 34% (range, 19 to 46%). Overall, only 8% of children showed evidence of fluorosis. The results demonstrate the usefulness of small-area estimation methods for oral health surveys.

Child↗

Dental fear in Japan: Okayama Prefecture school study of adolescents and adults.

A total of 3,041 students and staff in middle school in Okayama Prefecture, Japan, were surveyed regarding dental fear. Over 88% reported fear, with 42.1% classified as having high fear. Almost 70% reported acquiring dental fear prior to junior high school. A majority reported being hurt at the last appointment. Delay of dental work was also reported for over 50% of the sample. Coping, pattern of physiological upset, nondental fears, and sex and age differences were also reported. Results suggest intervention is needed to address the major dental public health problems associated with dental fear.

Adolescent↗

Taking bitewing radiographs in preschoolers using behavior management techniques.

Radiographs are essential diagnostic tools to enable dentists to make adequate decisions and treatment plans. Treatment plans for young children, however, are quite often based on no or less than ideal radiographs. Getting successful bitewing radiographs from young children demands both behavior management techniques and adequate equipment. This report reviews the literature, and presents a modified technique of taking radiographs in young children. The technique was successfully used with 156 three-to-five-year-old children from Yakima County, Washington. Behavioral management of the children employed several techniques: building rapport, tell-show-do, modeling, positive reinforcement and increasing the child's sense of control. The equipment and placement technique were designed to be as atraumatic as possible. Positive experiences in the dental office often enhance a child's future cooperation. The techniques presented are simple to learn and use in treating very young children.

Behavior Therapy↗

Dental fear of Japanese residents in the United States.

The purpose of this study was to investigate dental fear in a sample of Japanese adults and to make preliminary comparisons with a previously described US sample. The survey instrument was translated into Japanese and then translated back into English and was sent to 839 Japanese residing in the Seattle area. A total of 419 (49.9%) usable questionnaires were returned. Results indicate a level of fear higher than the US population (only 17.9% were not at all afraid). Fear level did not vary by age; most respondents (73.3%) acquired their fear in early childhood. While reported utilization was lower than the American sample, the percentage of Japanese respondents who reported being hurt at the last appointment was high (68.0%). Japanese respondents indicated that 35% of dentists appeared to be in a hurry, hurry being associated with being hurt. Japanese coping practices appeared to differ from the American sample. For example, 14.7% of the Japanese whereas 28.2% of the US sample requested the dentist to stop treatment.

Adolescent↗

Results of a promising open trial to prevent baby bottle tooth decay: a fluoride varnish study.

One hundred thirty-three farm worker children with an average age of 17 months participated in a study of a fluoride varnish in WIC programs in the Yakima Valley of Central Washington. After parents were interviewed, the child was examined and a fluoride varnish applied to the maxillary incisors. At the six-month recall 62 children and their parents returned. Results indicated a significant decrease in decalcification from 35 percent to 21 percent and an increase in decay from 3 percent to 16 percent. The rate of decay was lower than the 30 percent found in this age-group in this population. Of 130 sound teeth at baseline, 13 percent were decayed or decalcified in six months; of 73 decalcified teeth at baseline, 51 percent were found to be sound in six months. Additional experimentation with fluoride varnish is warranted.

Bottle Feeding↗

White spots caries in Mexican-American toddlers and parental preference for various strategies.

One hundred and thirty Mexican-American children ages nine to thirty-four months (Mean = 17.1 months), and their parents/caretakers were studied at a farmworkers clinic in rural Washington. Parents/caretakers participated in a bilingual interview; then each child received a dental examination, and a cotton swab was used to collect plaque for a caries activity test (Cariostat). Results showed that 7 percent had at least one maxillary incisor decayed and 30.4 percent had at least one incisor with a white spot lesion. The Cariostat was related to dental age, but not to disease. Forty percent of the parents/caretakers whose children had disease were aware of the problem. Immediate substitution of cup for bottle and the elimination of extra nighttime feedings were the least likely interventions endorsed by the subjects. Other interventions, including periodic visits for fluoride applications were much more likely.

Age Determination by Teeth↗

Teaching parents at WIC clinics to examine their high caries-risk babies.

Seventy-seven parents/caretakers of children, averaging 24.4 months from four WIC clinics in King County, Washington, observed a five-minute video-tape. These parents/caretakers were then asked to examine their own children, using a mirror and a brochure with illustrations of the progression of disease. Following completion of a questionnaire, a trained dental student or dentist examined the child and completed the same questionnaire. Over 80 percent of parents/caretakers responded the same as dentists. Dentists identified disease in 35.1 percent of the sample. Kappa = 59, Z = 4.4, and p < .001. Results support the training of nondental personnel to screen early childhood caries.

Bottle Feeding↗

Pain management in school-aged children by private and public clinic practice dentists.

A mail survey of 198 Seattle dentists who treat children assessed their beliefs about pain control in school-aged children and examined the relationship of those beliefs to pain management behaviors. The survey population of general dentists and pediatric dentists in clinics and private practice had a response rate of 89.6%. Two of three dentists always use local anesthetic when doing restorations or extractions and also provide more anesthetic at the child's request. One in three dentists never provides postoperative medication following tooth extractions. Ten percent regularly deny child pain and many do not believe child pain reports are valid. Dentists who work in private practice are more likely to provide local anesthetic than are dentists who work in clinics. Dentists who desire more control over a child are less likely to provide local anesthetic. Dentists who question children about comfort are more likely to provide additional anesthetic based on a child's report of discomfort and to provide postoperative medication if the dentist perceives a dental procedure to be painful.

Adolescent↗

Early childhood caries and risk factors in rural Puerto Rican children.

A sample of 167 Puerto Rican children whose ages ranged from six months to forty-seven months (mean = 23 months) were studied. Children were examined for Early Childhood Caries with light and mirror and a structured interview was administered to parents and caretakers to identify risk factors. Results indicated that only 37.4 percent of the children were free of decalcification lesions or frank decay. While 53.9 percent of the children had lesions on maxillary incisors, 40.0 percent had molars affected by decalcification lesions and caries. Analysis of risk factors indicate that giving the baby a bottle when crying at night, number of adults and children in the family, use of fluoridated dentifrice, and age of the child were associated with the caries process in these children. Bottle and breast feeding, per se, were not risk factors. Disease patterns suggest other dietary risk factors, such as frequent snacking on food/drinks with sugar.

Adult↗