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Biomedical subjects

R L Ettinger

Publications and source records attributed to R L Ettinger.

At least 19 recordsLinked to original sources
PubMed1992

Selected issues on care and management of the ageing patient: 1. Utilization and decision making.

The elderly are a vulnerable and expanding group of patients who are retaining their teeth longer. Even simple dental care in these people can become invasive and require the use of a local anaesthetic. Part 1 assesses the factors which may influence the ability of the patient to receive treatment and establishes treatment priorities. It also describes the particular problems that may arise when dealing with the elderly and indicates the adjustments of a practice which would help in the care of these patients. Part 2 will discuss prevention and treatment.

Aged↗
PubMed1992

Effect of fluoride concentrations on overdenture abutments.

This study evaluated the preventive effect of four concentrations of fluoride. Twenty-five extracted caries-free anterior teeth from patients aged 50-70 were prepared as overdenture abutments. The teeth were sectioned mesiodistally into two halves. The teeth were covered with a protective varnish, leaving a window on the root surface and one on the cut dentin of the occlusal. The root halves were randomly divided into 5 groups of 10 specimens and each group received a different 5-minute topical treatment prior to being placed in the demineralizing solution. The treatments were: Group 1: distilled H2O only; Group 2: 100 ppm F-, Group 3: 250 ppm F-, Group 4: 500 ppm F-; and Group 5: 1000 ppm F-. The teeth were cycled for 6 hours in a demineralizing solution and for 17 hours in a fluoride-free remineralizing solution. The cycling was maintained for 10 days. The root halves were sectioned and prepared for histologic examination. The depth of the lesions were measured from standardized photo-micrographs by means of a sonic digitizer. The conclusions were: (1) the lesions on the root surface were too small to be measurable, (2) the lesions on dentin were all of similar depth, and (3) the lesions had bands within them and the width of these bands showed a dose response to the fluoride concentration of the topical application.

Aged↗
PubMed1992

Oral care for the homebound and institutionalized.

Most patients who are homebound or in LTC facilities have multiple health problems that require the cooperation of many different types of providers. Dentists have a specific role in this process because they can improve the quality of life for the elderly by keeping them free of oral infection, restoring their dentition so they can enjoy eating, and restoring facial esthetics. It should be apparent that dental care for these patients is a complicated process. There are many considerations in prescribing the type of treatment needed by each patient. These include the patient's life span, medical history, drug history, mental status, mobility status, neuromuscular coordination, dental status, previous dental experience, dental expectations, and economic status. This information must be gathered by the dentist from the patient, the family, the nursing staff, and the patient's physician. Furthermore, the dentist also must assess the facilities and equipment available to carry out oral health care. Only after such considerations can a dental treatment plan evolve that is appropriate for the individual concerned. Dental care for one patient may be no treatment whatsoever, whereas a different patient in the same institution may require the most technologically sophisticated care that dentistry has to offer. Finally, the following circumstances should suggest that a homebound or institutionalized patient needs an urgent oral/dental evaluation: General Signs and Symptoms; Orofacial pain, Visible oral infection, Difficulty chewing food, Halitosis/dry burning mouth, Visible oral soft tissue lesions (white, red, or ulcerated). Tooth-related signs and symptoms; Visible dental decay, Loose or mobile teeth, Bleeding or sore gums. Denture-related Signs and Symptoms; Loose, ill-fitting, or worn dentures, Missing denture teeth, Home repairs attempted.

Aged↗
PubMed1992

Attitudes and values concerning oral health and utilisation of services among the elderly.

Thus, attitudes to oral health and dental utilisation patterns of older adults show great variation and it seems the level of oral health care an individual will seek and accept will depend on their individual: age and their personal experience with dentists, past and present socio-demographic environment, number of remaining teeth, level of education achieved, expectations of family and/or significant others, level of discomfort experienced either with the dental condition or with past dental care, economic ability to pay for care, level of health or functional dependency, level of cognitive impairment, ability to reach dental services which includes distribution of dentists and geographic isolation, the philosophy of the dentists available to care for the individual.

Age Factors↗
PubMed1990

Restoring the ageing dentition: repair or replacement?

An old tooth does not exist on its own; therefore, any decision about a tooth demands knowledge about the elderly patient to whom the tooth belongs. If it is available, one can then evaluate the oral cavity in which the tooth resides. When all this information has been gathered, decisions about the individual tooth can be made. This paper discusses three specific issues: when does one 'patch' an amalgam restoration; when should one crown this restored tooth; and when does one 'patch' the crown, and when does one replace it? A review of the literature indicated that reliable and generally applicable data on these issues do not exist, so that these decisions are still made by clinical judgement based upon experience. In view of the known changes in caries rates, fluoridation of water supplies, and patient attitudes, dentists' judgements of appropriate restorative treatment for older adults based upon past experience may be inappropriate. Longitudinal clinical research is required to develop clinically usable guidelines, especially for the elderly.

Aged↗
PubMed1990

Effect of a geriatric educational experience on graduates activities and attitudes.

Clinical geriatric dentistry has not been an important part of most dental curricula. However, changes in demographic and patient expectations signify that geriatric oral health care can no longer be equated with supplying dentures for an aging population, but must be understood as treatment of the complex needs of a dentate population. The 1975 to 1985 graduates of the University of Iowa College of Dentistry were surveyed to evaluate the influence on dental practice of a comprehensive geriatric dental curriculum introduced in 1980. The post-1980 graduates were more likely to be practicing in larger population centers and less likely to be treating patients over 75 years of age. The dentists who graduated before 1980 were more likely to be consultants in nursing homes and carrying out examination, emergency care, and/or denture care, whereas the group of dentists who graduated after 1980 and had geriatric clinical experience with frail and functionally dependent older adults were more likely to be carrying out comprehensive care. When given a list of 18 geriatric dental and gerontological topics, few differences were found between cohort groups in terms of knowledge and confidence in carrying out procedures.

Cohort Studies↗
PubMed1979

Eliminating office architectural barriers to dental care of the elderly and handicapped.

Methods by which the most common architectural barriers to dental care for the elderly and handicapped can be overcome are described. Some physiological and medical conditions that necessitate special provisions in location and design of the office management of patients have been described. The consequences of accessibility have been discussed and suggestions for management of elderly and handicapped patients are presented.

Aged↗
PubMed1978

An unusual triad: microdontia, taurodontia, and dens invaginatus.

A 12 1/2-year-old white boy was examined and found to have permanent teeth that were smaller than those of the average adult. The microdontia was accompanied by taurodontia of the mandibular molars and several teeth with dens invaginatus. The patient was normal in appearance and had no other illness. The pedigree was compatible with X-linked recessive inheritance.

Child↗
PubMed1977

Removal time: a factor in the accuracy of irreversible hydrocolloid impressions.

Controversy exists regarding the correct time of removal of an alginate impression from the mouth. To investigate the effect of time of removal on accuracy, a series of alginate impressions were made of the lower left quadrant of a subject having a cast gold crown with four reference marks on tooth no. 19. The impressions were removed from the mouth at 1-5, 2, 3, 4-5 and 7 min after the insertion of the tray. Accuracy of the impressions was assessed by comparing the distances between the reference marks in stone casts with standard measurements taken from the gold crown prior to cementation. Impressions removed at 1-5 and 7 min produced the greatest distortions buccolingually. For the mesio-distal lengths all time intervals produced casts which were larger than the standard. The reasons for these findings are discussed and possible explanations are presented.

Alginates↗
PubMed1977

Dental care for the homebound--assessment and hygiene.

A general categorization of homebound patients is presented to aid the dentist in assessing their treatment needs and requirements. The importance of oral hygiene is shown, and modifications of oral hygiene appliances are presented. The role of the general dentist in the care of these patients is stressed.

Dental Care↗
PubMed1977

Use of teeth with a poor prognosis in cleft palate prosthodontics.

Patients who have unoperated or incomplete closure of their clefts and who have only a few teeth of poor prognosis remaining are a challenge to the prosthodontist. Two cases have been presented to illustrate treatment techniques that can be used for such patients.

Adult↗
PubMed1977

The acrylic removable partial denture.

Some aspects of acrylic partial dentures have been reviewed. The spoon denture, the Every design, and the Lam design have been discussed and suggestions made for their construction and use for patients with specific problems.

Acrylic Resins↗