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PubMed1995

Acute care for unusual cases of dentinal hypersensitivity.

The case histories of two patients are presented to demonstrate use of soft mouthguard appliances as carriers for desensitizing dentifrice when restoration of the teeth or application of desensitizing agents is clinically impractical. Potassium nitrate in dentifrice form was a readily available source of potassium ions for altering pulpal nerve sensitivity. Both patients had factitious habits that exacerbated dentinal hypersensitivity and required acute care.

Acute Disease↗
PubMed1994

The "Buy-Max" mouthguard: oral, peri-oral and cerebral protection for contact sports.

Protective equipment plays an important role in the reduction of certain sports injuries. Mouthguards have been shown to reduce the number of orafacial and cerebral injuries in a variety of contact sports including rugby, hockey and boxing. The varieties of mouthguards available are discussed. The most effective, but also the most expensive, is the "Bimaxillary" mouthguard popularised by Chapman. It covers both dental arches and as the jaws are held in the position of heavy breathing, air flow is not impeded. The advantages and disadvantages of the various types of mouthguard are discussed.

Adolescent↗
PubMed1996

[Evaluation of the bite block wedged between the maxillary and mandibular molars].

The purpose of this study was to compare our original bite block (T-X Block) wedged between the maxillary and mandibular molars, with the standard gum bite block, in 200 patients whose tracheas were intubated. During emergence from isoflurane anesthesia, no trouble occurred in T-X Block group (n = 100). On the other hand, lip damage and ejection of the bite block were found in 11 and 10 cases, respectively, in gum bite block group (n = 100). As another study, an opening between the maxillary and mandibular incisor edges was measured with T-X Block placed in twenty patients under general anesthesia. The inter-incisal distances in one way of using it as a smaller wedge and in the other way as a bigger one were 21.6 +/- 2.4 and 25.2 +/- 2.6 mm, respectively. Those values were significantly larger than thickness of the gum bite block. T-X Block is very useful because its use causes no complications and makes it easier to insert a naso-gastric tube as well as to clean the oral cavity with suction by giving a larger opening of the mouth.

Adolescent↗
PubMed1996

Dental appliances in the treatment of snoring. A comparison between an activator, a soft-palate lifter, and a mouth-shield.

Different dental appliances have been recommended in the treatment of snoring. The aim of the present study was to compare three different dental appliances regarding patient tolerance and the effect of snoring. Fifteen consecutive snorers were randomly selected to treatment with either a mandibular advancement device (activator), a soft-palate lifter or a mouth-shield. The activator satisfactorily reduced snoring in four out of five patients. At four-year follow-up, two patients had discontinued the treatment, one due to craniomandibular disorder. The soft-palate lifter had insufficient effect on snoring in four out of five patients. The results suggest that the activator has a satisfactory tolerance and effect on snoring, while the soft-palate lifter and the mouth-shield are ineffective in the treatment of snoring.

Activator Appliances↗
PubMed1996

Prevention of oral injuries.

The importance of protection during various types of sports activities cannot be overemphasized. The use of mouth guards has been instrumental in preventing dental injuries. Dentists, however, must be knowledgeable in the pitfalls of these various types of protective devices.

Adolescent↗
PubMed1997

Sports-related oral injury and mouthguard use among Sheffield school children.

OBJECTIVE: The study was undertaken primarily to determine the frequency of use of mouthguards for sports among secondary school children. Information was also sought regarding the prevalence and aetiology of oral trauma; sports most frequently played; source of mouthguard; reported problems with use; and attitudes towards mouthguard. DESIGN: A total of 557 questionnaires was completed (an average response rate of 72.3 per cent). SETTING: Sheffield secondary schools (15). PARTICIPANTS: Seven hundred and seventy 14-15-year-old children. RESULTS: A tooth or lip/mouth injury was reported by 44.2 per cent and 54.4 per cent of the group respectively, and was significantly more prevalent among males. Just over 26 per cent of all reported oral trauma was attributed to sports-related accidents, but the aetiology varied significantly according to gender and social class. The subjects participated in a wide range of sporting activities with 57.4 per cent of boys frequently playing rugby and soccer. Girls most often engaged in netball (15.9 per cent) and hockey (10.3 per cent). Statistical analysis revealed only a significant effect of social class (as measured by school type and location) on the sport most frequently played by girls. Approximately 14 per cent of pupils professed to have worn a mouthguard for sports at some stage, although less than 6 per cent were currently wearing one. Gender and social group had a significant effect on the reported use of mouthguards with use significantly less among girls and those from lower socio-economic groups. Overall, nearly 70 per cent of pupils thought that mouthguards were helpful in preventing oral trauma and the majority of respondents would consider wearing one. However, girls were significantly less certain than boys about their willingness to use a mouthguard. CONCLUSIONS: In view of the evidence for the protective attributes of mouthguards there is considerable scope for promoting their wider use, especially among girls and children from a lower socio-economic background.

Adolescent↗
PubMed1996

The use of a special mouthguard in the management of oral injury self-inflicted by a 4-year-old child.

This paper describes the management of self-inflicted trauma by a 4-year-old boy who was mentally retarded as a result of encephalitis in infancy. There was severe damage to his lower lip, as well as a moderate degree of injury to the skin and nail of his right thumb. Preliminary intervention was made with a mouthguard using silicone elastomeric positioner material, which soon proved ineffective because of poor retention. The problem was overcome successfully through use of a special appliance in which a heat-cured acrylic base was combined with a superstructure made of silicone positioner material retained mechanically with retention loops of 0.7 mm orthodontic wire.

Acrylic Resins↗
PubMed1997

[Effectiveness of an anti-snoring prosthesis in obstructive sleep apnea syndrome].

Nasal CPAP is a well documented successful therapy for obstructive sleep apnoea syndrome (OSAS), but adverse effects are common and the compliance is 80 percent or less. We investigated the value of an oral device called "Snor Ex"). Eleven obese patients with severe OSAS were examined. Complete polysomnographic studies were performed while sleeping one night without therapy, with nCPAP and after an adaptation period with Snor Ex, respectively. The apopnoeahypopnoea index and the minimal SaO2 could be normalised for all patients using CPAP but only for three patients with Snor Ex. Nine patients tolerated nCPAP and Snor-Ex, respectively. We conclude that this oral device is a successful therapy for only few patients with OSAS.

Aged↗
PubMed1997

[Is SnorEx also ApneaEx? A study with a new intra-oral prosthesis as a form of therapy of obstructive sleep apnea syndrome].

UNLABELLED: In recent years different kinds of dental devices have been advocated for treating sleep apnoea. In this study we report on our results with a kind of prosthesis ("Snor-Ex", DEPITA, 29336 Nienhagen) designed to relieve upper airway obstruction in sleep in pulling forward the tongue by a truss pad positioned in the posterior area of the tongue. We performed the study to test the effectiveness of the device in reducing the number of obstructive events. PATIENTS: 23 patients with OSA (22 male, age: 53.7 +/- 8.6 years, Body mass index: 31.1 +/- 3.9 kg/m2, Apnoea index: 33.5 +/- 18.4, Respiratory disturbance index: 45.6 +/- 19.7, mean apnoea duration: 20.4 +/- 4.4 sec) were included. STUDY DESIGN: Before the study was started, polysomnography was performed and the OSA associated symptoms/claims were standardised with the help of visual analogue scales (VAS). The prosthesis were made by the dental laboratory. Between the 28th and 42nd day after beginning with the study the patients had to come to the hospital for control. The effect of the therapy was documented only by a further polysomnography in patients who could sleep for at least 2.5 hours with the prosthesis. The effects of the device on changing OSA-associated symptoms and snoring were reevaluated by the above mentioned VAS. During the control the patients were divided into non-responders (NR) and responders (R) according to the results. RESULTS: The NR prevail in the study with 75% (17/23). They are characterised by inacceptable loco-regional side effects of the prosthesis, missing improvement of the state of daytime wellbeing and constant obstructive events. Only 25% of the patients are R. They locally tolerated the prosthesis, which is the precondition for long-term therapy. The severity of OSA diminished. Snoring also diminished significantly. CONCLUSION: According to our results the insufficient acceptance and the low effectivity of the SnorEx-prosthesis preclude large-scale indication for OSA patients. The prosthesis should not be prescribed without contacting a sleep lab.

Adult↗
PubMedDate not supplied

A review of selected microstomia prevention appliances.

Perioral burns may occur due to electrical, thermal, or chemical agents. The resultant contracture of the facial tissue during healing causes limited oral access, compromised esthetics, and other related problems. This article presents various microstomia prevention appliances used by dentists and hospital burn centers. These appliances reflect different treatment concerns, ease of fabrication, age appropriateness, and cost effectiveness. An understanding of these factors and available appliances will aid the clinician in selecting or developing the best appliance for burn patients.

Age Factors↗
PubMedDate not supplied

Parental attitudes toward mouthguards.

An 11-item, one-page questionnaire was mailed to 1800 parents chosen at random in the Henrico County, VA public school system. Parents were asked questions such as "who should be responsible for mouthguard wear?" "what sports should require mouthguards?" and "has [their] child ever sustained an oral or facial injury?" The parental responses indicate that mouthguard enforcement is the responsibility of both parents and coaches. Of the total injuries reported, 19% were sustained in basketball, 17% in baseball, and 11% in soccer. Despite these high injury rates, however, there was a lack of perceived need for mouthguard use in these sports. When asked which sports should require a mouthguard rule, the sports that generated the most responses were, in decreasing order, football, boxing, ice hockey, wrestling, field hockey, and karate. Parents were more likely to require mouthguards for their sons than daughters, and more likely to require them for their children who participated in a mandatory mouthguard sport, a contact sport, or who had been previously injured. The authors conclude that because parents view themselves as equally responsible as coaches for maintaining mouthguard use, both groups should be targeted and approached as a possible source for the recommendation of mandatory mouthguard rules in basketball, baseball, and soccer.

Adolescent↗
PubMed1997

Risk factors for developing tooth sensitivity and gingival irritation associated with nightguard vital bleaching.

The purpose of this study was to determine risk factors in the development of tooth sensitivity and gingival irritation associated with the nightguard vital bleaching technique. The potential risk factors evaluated (sex, age, reported allergy, whitening solution, number of times the solution was changed daily [its usage pattern], and dental arch) were collected from the daily log form turned in by each of the 64 participants after completion of the 6-week lightening process. Also evaluated for each participant, from color slides, were tooth characteristics such as gingival recession, defective restorations, abfraction lesions, enamel-cementum abrasion, etc, and reported side effects. The generalized Mantel-Haenszel statistic was used to assess the association between the potential risk factors and the development of tooth sensitivity and/or gingival irritation. No statistical relationship existed between age, sex, allergy, tooth characteristics, or the dental arch lightened and the development of side effects. Initially, a statistically significant association existed between side effects and the whitening solution used. However, when the analysis was controlled for usage pattern, this relationship disappeared. Patients who changed the whitening solution more than once a day reported statistically significantly more side effects than did those who did not change the whitening solution during their usage time.

Acrylic Resins↗