TMJ and the test of time.
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The influence of the Milwaukee brace treatment in a material of 56 patients, mean age 13.9 +/- 2.1 years, was studied. Thirteen of the patients wore monoblock and 46 did not, during the period of wearing the MW-brace, mean 0.9 years. Pre- and post-treatment cephalograms and study models were analysed. Small but significant detrimental changes were seen in about half of the 22 dentofacial variables analysed. Decreasing of the interincisors angle and the palatal vault height, and increasing of the ILs-SNL, ILs-MaxL and canine width were highly significant changes. Detrimental changes in the monoblock group occurred also but they were not as considerable as in the non-monoblock group. The influence of the five dentofacial characteristics which were analysed in more detail did not show any clear correlation to the magnitude of the change.
Intracavitary oral radiotherapy with moulds is indicated for superficial tumours and subclinical disease in combination with percutaneous irradiation. Large tumours do not get a satisfactory dose distribution for adequate treatment.
Expansion chambers increase effective bronchial delivery of metered dose aerosol asthma medications. A subjective comparison suggests that peak flowmeter and spirometer mouthpiece tubes function effectively as expansion chambers, though less so than a prototype commercial device. Use of mouthpieces as expansion chambers is recommended until improved devices become available.
This study compared ventilatory and metabolic responses during exercise using three breathing assemblies: mouthpiece/noseclip (BV); mouth/face mask (MM); and facemask (FM). Ten male runners completed three maximal treadmill tests with breathing assembly randomly assigned. Metabolic and ventilatory data were recorded every 15s, and heart rate (HR) and rating of perceived exertion (RPE) each min. No significant differences were found for treadmill run time, HRmax, respiratory exchange ratio (RER), and RPE, indicating similar efforts on all trials. No significant differences were found at maximal exercise for VO2 minute ventilation (VE), tidal volume (VT), and breathing frequency (f). At ventilatory threshold (TVENT), VO2, VE, and f were not significantly different. However, peak flow (PF) was significantly higher for BV than FM, and VT was significantly higher for BV than MM and FM. Results indicate alterations in ventilatory mechanics occur at TVENT, but type of breathing assembly does not significantly affect maximal values.
Dental injuries and oral soft tissue trauma are recognized risks of electroconvulsive therapy (ECT), which continue to cause concern for patients and providers. The sudden forceful closure of the jaws that precipitates trauma is not avoidable since the pterygoid, masseter, and temporalis muscles are stimulated during treatment. Therefore, the use of a biteguard and oral protection techniques is recommended. No one biteguard has been found to be effective in protecting against all of the oral conditions that exist in the adult ECT patient population. A review of the objectives of ECT oral protection and biteguard design is detailed. The characteristics of patented, commonly used, and home-made ECT oral devices are considered, and recommended techniques for oral protection are detailed.
Questionnaires addressing the attitudes of football officials toward National Collegiate Athletic Association (NCAA) mouthguard rules were developed and distributed to officials in the Big East Football Conference, the Southeastern Conference, and to head football coaches at Division 1-A colleges. Response rates, which ranged from 92.45% to 100%, showed that all groups agreed that football officials are less accountable for player compliance than are coaches, trainers and players. However, officials not only observed a lower rate of compliance with NCAA mouthguard regulations than coaches, they also expressed reluctance to enforce NCAA-sanctioned penalties for failure to comply with mouthguard regulations.
With children in this country becoming involved in organized sports at younger and younger ages, the incidence of dental and orofacial injuries is on the rise, and the practice of sports dentistry is needed more than ever. This article focuses on the costs of dental injuries and measures that can be taken to significantly reduce the risk of injury.
A survey of 246 boys aged 12-17 years (mean 13.8 years) determined the sports played, dental injury experience, knowledge and usage of and attitudes towards mouthguard wearing. Most played basketball and soccer. Twenty-one suffered 1 injury episode, 7-2 and 10-3 or more tooth injuries. Twenty-six subluxations, 19 fractures and 1 avulsion were reported. The sports with the highest prevalence of dental injury were boxing and wrestling (33%), soccer (20%), and basketball (19%). While 144 (56%) of boys knew about mouthguards, none wore one. Only 64 (25%) would wear a mouthguard if given one. Most dental injuries were minor, but four high-risk sports (> 19% injury prevalence) would justify preventive measures, including education for injury prevention and encouragement of mouthguard use.
As the country becomes more health conscious, many of our patients are becoming involved in sporting activities, from organized teams to the occasional weekend warrior. As a result, the incidence of oral trauma is increasing. Dentistry today must respond to these patient's specialized needs, providing them with the quality of care they deserve. This paper discusses the prevention, diagnosis and treatment of sports-related dental trauma for the general dentist. Injury management, smokeless tobacco, mouth guard comparisons, custom mouth guard fabrication, marketing techniques and liability are presented.
A program to produce inexpensive, custom mouth guards for high school basketball players was implemented by teams of dentists who took impressions, fabricated and then delivered the mouth guards. This community service involved three hours of donated time; the player or school was charged $7.50 for materials per mouth guard. The potential reduction of dental related injuries is immeasurable, and it is hoped that other cities will adopt a similar program.
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The cause, incidence, and prevention of trauma to teeth are highlighted from a contemporary aspect. Causative factors have become more diverse, and the incidence of trauma has become almost equal in both sexes. Newer areas identified include domestic violence, enhanced sporting activities, and an increase in adverse societal manifestations. Prevention, with a focus on education and awareness of diverse populations, is discussed.
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Data from a continuing series of surveys by the national Interview Survey confirm further increases in use of pediatric dental services through 1989. The surveys show that by 1989 almost a third of children between two and four years of age visited a dentist in the previous year. For children between two and fourteen, and between five and fourteen, 60.5 percent and 69.5 percent, respectively, had visited a dentist in the previous year. Most significant has been the decrease in the percent of children who never visited a dentist, in the past twenty-five years. In the mid 1960s, approximately a quarter of children between five and fourteen years had never visited a dentist. Twenty-five years later, the percentage was reduced to 8.6 percent. There were also decreases in the percent of very young children (less than five years and between two and four): 78 percent and 55 percent, respectively, in the 1980s. There are, however, major reasons for concern. The percentage of children living in poverty continued to increase in the 1990s. In 1990 cases of measles, mumps, rubella, and pertussis increased. Twenty-two countries had lower infant mortality rates than the U.S. Increasing rates of nursing caries and fluorosis are appearing.