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Biomedical subjects

T Kaakko

Publications and source records attributed to T Kaakko.

10 recordsLinked to original sources
PubMed2004

Factors related to severe untreated tooth decay in rural adolescents: a case-control study for public health planning.

OBJECTIVES: In this case-control study of rural adolescents we identified factors to discriminate those who have high levels of tooth decay and receive treatment from those with similar levels who receive no treatment. METHODS: The sample was drawn from all 12-20-year-olds (n = 439) in a rural high school in Washington State, U.S. The criterion for being included was 5 or more decayed, missing or filled teeth. The questionnaire included structure, history, cognition and expectation variables based on a model by Grembowski, Andersen and Chen. RESULTS: No structural variable was related to the dependent variable. Two of 10 history variables were related: perceived poor own dental health and perceived poor mother's dental health. Four of eight cognition variables were also predictive: negative beliefs about the dentist, not planning to go to a dentist even if having severe problems, not being in any club or playing on a sports team and not having a best friend. No relationship was found for the expectation variable 'usual source of care'. CONCLUSIONS: These data are consistent with the hypothesis that untreated tooth decay is associated with avoidance of care and point to the importance of history and cognition variables in planning efforts to improve oral health of rural adolescents.

Adolescent↗
PubMed2001

Pharmacokinetics and clinical effects of sublingual triazolam in pediatric dental patients.

The purpose of this investigation was to describe the pharmacokinetics of sublingual triazolam in children. Nine healthy children (64-98 months old) received 0.25 or 0.375 mg of sublingual triazolam before dental treatment. Plasma triazolam concentrations were measured by gas chromatography/mass spectrometry and analyzed by noncompartmental methods. The peak concentration was 4.9 +/- 2.0 ng/mL (mean +/- SD), time to peak was 75 +/- 32 minutes, the elimination half-life was 91 +/- 32 minutes, and apparent clearance was 17.6 +/- 8.8 mL x kg(-1) x min(-1). Children were tested for gait ataxia, amnesia, and diplopia during a screening session and again after triazolam. Ninety minutes after drug administration, seven of nine children demonstrated ataxia, and three of nine demonstrated amnesia. Peak triazolam concentrations were similar in children with or without ataxia, but they were significantly higher in children with amnesia compared with those without amnesia. Six children demonstrated diplopia 30 and 120 minutes after triazolam; however, peak triazolam concentrations were similar in both groups. Sublingual administration was an acceptable alternative route of triazolam delivery in children.

Administration, Sublingual↗
PubMed2001

Recruiting phobic research subjects: effectiveness and cost.

Efficiently enrolling subjects is one of the most important and difficult aspects of a clinical trial. This prospective study evaluated strategies used in the recruitment of 144 dental injection phobics for a clinical trial evaluating the effectiveness of combining alprazolam with exposure therapy. Three types of recruitment strategies were evaluated: paid advertising, free publicity, and professional referral. Sixty-three percent of subjects were enrolled using paid advertising (the majority of them from bus advertisements [27.0%], posters on the University of Washington campus [20.1%], and newspaper advertisements [13.2%]). Free publicity (eg, television coverage, word of mouth) yielded 18.8% of enrolled subjects and professionaL referrals 14.6% of subjects. The average cost (1996 dollars) of enrolling 1 subject was $79. Bus and poster advertising attracted more initial contacts and yielded the greatest enrollment.

Adolescent↗
PubMed1999

A randomized clinical trial of triazolam in 3- to 5-year-olds.

Triazolam has shown promise as a sedative agent for use in pediatric dentistry. However, the efficacy of triazolam has not been previously examined in a placebo-controlled study. The present clinical trial used a two-group, randomized, double-blind study design to compare the efficacy of oral triazolam with that of a placebo. The primary hypothesis tested was that triazolam would reduce negative behaviors of pediatric dental patients compared with a placebo. A secondary hypothesis was that triazolam would increase the efficiency of dental treatment by reducing the need for time-consuming behavior management by the pediatric dentist. The subjects were 54 3- to 5-year-old children, randomly assigned to the drug and placebo groups. The active drug, 0.03 mg/kg triazolam (Halcion), or lactose placebo was given orally 30 min before dental treatment. Behavior management techniques commonly used in pediatric dentistry were used during dental treatment. A single pediatric dentist provided all of the dental treatment. The procedure included an inferior block anesthesia and careful attention to anesthesia effectiveness. All sessions were video-taped and the tapes coded for child and dentist behaviors by an independent observer. There were no statistically significant differences between the groups with respect to completion of dental treatment. There were no significant differences found in either the total time or the percent of time that the subjects exhibited disruptive movements, verbal or non-verbal distress. The total use of time in the dental chair was slightly higher in the placebo than in the drug group due to more time spent preparing the child. Contrary to preliminary reports in the literature, this investigation found little or no improvement in child behavior when triazolam was used as a sedative compared with a placebo. However, triazolam did shorten the length of dental treatment, primarily by reducing dentist time in preparing the child for the dental procedure (e.g., establishing rapport and shaping behavior).

Administration, Oral↗
PubMed1999

Factors predictive of anxiety before oral surgery: efficacy of various subject screening measures.

Recruiting anxious people for analgesic and anxiolytic studies allows greater opportunities to study the positive effects of anxiolytic medication. The purpose of this study is to describe a population recruited for a study of anxiolytic medication using the third molar model and to evaluate the relative efficacy of different measures of dental anxiety as recruitment tools. A concerted effort was made to recruit anxious subjects. The following measures were tested: Corah's Dental Anxiety Scale (DAS), Kleinknecht's Dental Fear Survey (DFS), Litt's Oral Surgery Confidence Questionnaire (OSCQ), and Spielberger's State-Trait Anxiety Inventory. The influence of prior experience with tooth extractions on anxiety was also assessed. Subjects who had previously experienced tooth extraction reported higher anxiety before oral surgery than did subjects without such experience. DAS, DFS and state anxiety scores correlated with anxiety reported before oral surgery. However, OSCQ scores and trait anxiety were not related to anxiety reported before surgery. Linear regression indicated that the DFS predicted anxiety before oral surgery best of all measures that were used. Kleinknecht's DFS is thus recommended for use as a tool for recruiting anxious patients.

Adolescent↗
PubMed1998

Dental fear among university students: implications for pharmacological research.

University students are often subjects in randomized clinical trials involving anxiolytic and analgesic medications used during clinical dental and medical procedures. The purpose of this study was to describe a typical university student population available for research by using data from a mail survey. Subjects were 350 students chosen randomly from all enrolled, full-time, traditional students on the main campus at the University of Washington in Seattle, WA. The aim was to determine the extent and nature of dental anxiety in this population. In addition, the relationships between subject willingness to receive dental injections and general and mental health and medical avoidance and medical fears were examined. The Dental Anxiety Scale (DAS) was used to measure dental anxiety. Dental anxiety was prevalent in this population; 19% of students reported high rates of dental fear. Thirteen percent of students had never had a dental injection. Students with no experience with dental injections were more reluctant than those with experience to receive an injection if one were needed. DAS scores were correlated with injection reluctance. Students who were reluctant to go ahead with a dental injection also reported poorer general and mental health than those who were less reluctant. These students also reported higher medical avoidance and medical anxiety scores. University students provide a rich source of potential subjects for clinical research. The student population, like the community at large, contains people with high levels of dental and medical fear.

Anesthesia, Dental↗
PubMed1998

Dental fear among university employees: implications for dental education.

We surveyed 350 University of Washington permanent employees chosen randomly from among both faculty and staff. The aim was to determine the extent and nature of dental anxiety in the university population potentially available for teaching clinics. In addition, the relationship of fears to self-reported dental health, utilization of dental care, and other general and mental health issues was examined. Dental anxiety was prevalent in this population; 13 percent of subjects reported high dental fear. In contrast to respondents with lower dental fear, subjects with clinically significant fear reported poorer perceived dental health, a longer interval since their last dental appointment, a higher frequency of past fear behaviors, more physical symptoms during last dental injection, and higher percentage of symptoms of anxiety and depression. Dental anxiety was not associated with poorer perceived general health or a longer interval since the last dental injection. University employees are a rich source of potential teaching patients for achieving curricular requirements for managing anxious patients. Student clinicians need guidance to be able to recognize fearful patients; they also need instruction about psychiatric conditions like anxiety and depression in order to be able to better manage and prevent dropouts in their patient roster.

Adult↗
PubMedDate not supplied

Psychiatric diagnoses among self-referred dental injection phobics.

In order to determine the psychiatric characteristics of people with dental injection phobia. 118 dental injection phobics were systematically assessed using a structured clinical interview and a written questionnaire. Fifty-four percent of subjects had a current Axis I diagnosis other than dental injection phobia, mainly anxiety, mood or adjustment disorder, and 68.6% of subjects had an additional lifetime Axis I diagnosis. Subjects with additional current Axis I diagnoses reported higher dental anxiety, greater severity of injection fear cognitions, and poorer relationships with dental professionals, than did subjects without any or with past Axis I diagnoses. Further investigation is needed to explore the treatment possibilities for patients with and without additional current diagnoses.

Adolescent↗
PubMedDate not supplied

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↗