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PubMed1989

Dental aspects of anorexia and bulimia nervosa.

Anorexia nervosa and bulimia nervosa are both psychosocial pathological eating disorders. An intense preoccupation with food, weight and a distorted body image coupled with a morbid fear of becoming obese are common elements in both syndromes. Self-starvation with extreme weight loss is associated with anorexia nervosa. Bulimia nervosa is characterized by unrestrained eating sprees followed by purging, fasting or vomiting. Approximately 50% of anorexia nervosa patients also practice bulimia. The impact of eating disorders on the oral soft and hard tissues depends upon the diet as well as the duration and frequency of binge-purge behavior. Erosion of the teeth due to frequent regurgitation of highly acidic stomach contents is a common finding. Dental caries development is less predictable and appears to be diet- and oral hygiene-dependent. Painless enlargement of the parotid salivary glands is a common sequela of chronic vomiting but the pathophysiological cause has not been firmly established. The dehydration of the oral soft tissues due to salivary gland impairment in addition to dietary deficiencies and poor oral hygiene can adversely impact the health of the periodontal tissues and oral mucosa. Initial dental care is focused on discouraging behavior that is destructive to the oral tissues. Improved oral hygiene, the use of gastric acid-neutralizing antacid rinses and the daily application of topical fluorides can be useful in reducing enamel erosion. Extensive restorative oral rehabilitation should be postponed until the underlying psychiatric components of the disorder are stabilized.

Adolescent↗
PubMedDate not supplied

The Head Start dental component: evaluation of an urban program.

To evaluate the dental portion of a Head Start Program, the investigators determined the degree of compliance in providing children aged 3-5 years with annual examinations, topical fluoride, followup care, and a dental curriculum for their classroom. The study included an audit of the children's health records, a clinical assessment of care needs, oral cleanliness, and restoration quality, and an evaluation in the last month of the school year. The evaluation procedures were standardized, and dual examiners were used for all assessments. Differences of opinion between examiners were settled immediately, and the consensus was noted in the evaluation record for the study. A review was conducted of the health records for the 564 children enrolled in eight Head Start centers in Dallas, TX. According to those records, 74 percent of the children had been examined. Nearly 24 percent had required dental care because of caries--the range among centers was 11 to 43 percent. Of the group requiring care, 85 percent had received all the care needed. With the use of World Health Organization criteria, a mean score of 2.47 for oral cleanliness was determined for a random sample of 178 children. This sample also exhibited 1.45 decayed and 1.18 filled deciduous teeth per child. Restoration quality was rated; 94 percent were judged to be acceptable by Ryge's criteria. At all the centers, the dental health curriculum met the program standards set for Head Start by the Public Health Service, Region VI. This investigation showed that the centers did not uniformly comply with the clinical care standards devised for Head Start by the Public Health Service, but they did provide dental services that otherwise might not be available to children enrolled at the eight centers.

Child, Preschool↗
PubMed1986

Oral health of individuals aged 3-80 years in Jönköping, Sweden in 1973 and 1983. I. A review of findings on dental care habits and knowledge of oral health.

The aim of the present study was to present data from dental care habits and knowledge of oral health in two cross-sectional studies carried out in 1973 and 1983. A random sample of approximately 1000 individuals evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60 and 70 years was studied for each of these two years. In the 1983-year examination 80 individuals 80 years of age were also included. All subjects were inhabitants of the community of Jönköping, Sweden. A questionnaire about dental care habits and knowledge was used in combination with a clinical and radiographical examination. The participants answered 23-101 questions. The same questions were raised in 1973 and 1983. For most age groups more then 80 per cent visited a dentist yearly in 1983. This yearly attendance was higher than that for 1973. In the 20-year-old group 14 per cent of the individuals received dental care in the PDS in 1973 compared to 63 per cent in 1983. The main reason to visit a dentist in 1973 was by the patient's own initiative while in 1983 the appointments were based on the dentist's initiative. The number of subjects that felt discomfort in connection with a visit to the dentist had decreased between 1973 and 1983. Knowledge about the etiology of caries had increased between 1973 and 1983 was not the case for gingivitis and periodontitis. An increase had occurred in toothbrushing frequency and the use of toothpicks and disclosing tablets but this between 1973 and 1983. In 1983, 98 to 93 per cent of the subjects in the age groups 10-30 years had been exposed to topical fluorides. The corresponding figure for 30-year-olds in 1973 was 1 per cent. It is obvious that during the period 1973 to 1983 there has been an increase in dental attendance, knowledge of dental diseases, oral health and the use of preventive measures.

Adolescent↗
PubMed1979

[Relations between some measures of the human body and menarcheal age (author's transl)].

It is considered which relations may exist between certain measures of the body (KM) and the moment of menarche (MZ). Statistical evaluations are based on the results of interrogations and anthropometry of Karl-Marx-Stadt school-girls, registered in 1974 under the main-topic "Fluoridation of drinking-water (TWF) and its possible effects on the physical process of growth and puberty of children and teen-agers". Considered measurements (height, weight, width of shoulders and pelvis, neck circumference as well as the Rohrer-index show higher means in menstruated individuals (M) than at non-menstruated ones (NM). The same comes true to girls of the same age and - concerning the width of shoulders and pelvis and neck circumference - also to girls of the same height. Advantage in development of M against NM individuals is 1-3 years, depending respectively on the considered dimensions of the body. Girls with an early MZ have also higher measurements of the body in their later physical development.

Adolescent↗
PubMed1994

AANA journal course: update for nurse anesthetists--treatment of avulsed teeth in the operating room.

Teeth that are avulsed in the operating room either during intubation, extubation, or other orally related procedures must be treated immediately in order to provide the best opportunity for success following replantation. New treatment methods have been developed that can significantly increase the success of replanted avulsed teeth. These methods utilize special pH balanced reconstituting fluids, cushioning devices, topical fluorides, and antibiotics that permit the storage of avulsed teeth for up to 96 hours with good success following replantation. This Journal course reviews the biologic background for these procedures and makes specific treatment recommendations.

Education, Nursing, Continuing↗
PubMed1994

Quality and adequacy of training of expanded function dental auxiliaries in the U.S. Army.

This study explores the quality and adequacy of training U.S. Army expanded function dental auxiliaries (X2s). Data were collected in the spring of 1989 using self-administered questionnaires from dental commanders, clinic chiefs, X2 graduates, dentists working with X2s, and potential X2 students. Nearly all (94.2%) dental activities personnel responded. Results show overall performance of X2s was rated excellent or very good by 76% of commanders, 70% of clinic chiefs, and 42% of dentists. Of 23 job-specific tasks assessed, X2s received lowest performance ratings for placement of complex composite restorations and highest ratings for individual topical fluoride application. Of X2 graduates, 82% rated the overall quality of X2 training as very good or excellent. X2 graduates and their supervisors recommend retaining each job-specific skill in the X2 training program while lengthening the program from 16 to 28-30 weeks. Training of U.S. Army X2s may offer a model to other dental care systems with limited resources.

Dental Auxiliaries↗
PubMed1995

Case planning and management according to caries risk assessment.

Ultimately, the dentist's role is to guide children through their growth and development free of disease. The dentist must recognize each child's unique susceptibility to caries and each parent's interest, competency, and accomplishment in controlling this disease. With this recognition, it is possible to tailor the frequency and content of dental visits necessary to maintain a child caries-free. Similarly, the frequency of examinations, office topical fluoride treatments, radiographs, and other diagnostic or preventive interventions depends upon the dentist's assessment of how intense professional efforts need to be to help parents maintain their children in health. Goldman and Burket summarized the relationship between science and practice and detailed the responsibilities of clinicians with the following words: "The practice of dentistry is an art in which the teachings of dental science are put to their practical application. A patient visits the dentist for consultation on the state of health of the dentition, with the expectation that everything possible will be done not only to repair or help heal by therapeutic correction any disease present but also to prevent disease from occurring, if possible." Treating caries at the level of the disease process to prevent its expression, progression, and ultimate dental destruction is the highest calling and deepest challenge facing dentists who care for young children. Techniques including risk assessment, triage, tailored care, and thoughtful treatment grounded in dental and behavioral science have put that goal within reach of dentists and parents to the great benefit of children.

Case Management↗