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[The management of chemically burned oral tissue--a case report].

Oral and perioral burns often result in post-healing microstoma, a shallow vestibule, tongue ankylosis, esthetic problems, and masticatory and speech impairments. The main cause being persistent extensive scar tissue contractions during the healing process. These disastrous sequelae can be minimized by surgical reconstruction. Use of special prosthesis may be required to provide scar tissue with the physical ability to resist contraction in post-injury and post-surgery stages. A twenty-eight-year old female was admitted to Makay Memorial Hospital in October 1986, with chemicals burn over the lower face, involving both upper and lower lips, and the entire oral mucosa. The patient had accidentally swallowed a corrosive detergent (Drano). Microstomia and tongue ankylosis developed within three months. Surgical reconstruction with the use of special oral prostheses (a commissure splint, angular retractor, and mouth protector) was conducted to counteract scar tissue contractions. Within two years of follow up, results were acceptable. The patient is presently able to open her mouth wide enough for both mastication and speech.

Adult↗

Oral health services in primary care nursing centers: opportunities for dental hygiene and nursing collaboration.

PURPOSE: The basic oral health needs of more than 100 million Americans are not being met, which places them at an increased risk for serious oral and systemic health consequences. Primary care nursing centers, a comparatively new method of health care delivery, provide health care screening, education, and referral services to person typically underserved in the traditional health care delivery system. Primary care nursing centers were surveyed to determine to what extent they provide oral health screening, education, and referral services for clients, and to identify factors that discourage and encourage the integration of these services. METHODS: Nurses from 158 primary care nursing centers in the United States made up the study population. Data were collected using a self-administered questionnaire. Data from 59 primary care nursing centers were analyzed using frequency distributions and measures of central tendency. RESULTS: Almost half of the responding nurses at primary care nursing centers "almost always" screen their clients for gum infections (49%) and oral lesions (48%). Fewer teach their clients how to perform oral cancer self-examinations (20%); or educate them regarding use of athletic mouth protectors (15%), the effects of xerostomia (19%), and the benefits of fluoride (38%). The majority do not always refer clients needing treatment for dental decay (55%), gum infections (61%), missing teeth (80%), oral lesions (67%), oral pain (64%), or oral trauma (65%). Lack of referral sources (64%) and unavailability of oral health professionals to provide on site basic oral health services (63%) were the leading factors that discourage the integration of oral health services in the centers. An appreciation for the benefits of oral health (73%) and a knowledgeable clinician to perform oral health services (68%) were the leading factors that encourage the integration of oral health services into primary care nursing centers. CONCLUSION: These data could be useful in planning, implementing, and evaluating more effective and efficient methods for channeling basic oral health services to the public. The data provide support for the collaborative efforts by dental hygienists and nurses to expand oral health services beyond the confines of the current dental care delivery system.

Community Health Centers↗

Mouthguards for edentulous patients.

There are occasions when fully edentulous patients require mouthguards. The following paper describes both the constructions of a full upper and a lower denture-mouthguard and a case report involving such a prosthesis.

Adult↗

Comparison of maxillofacial and dental injuries in four contact team sports: American football, bandy, basketball, and handball.

Maxillofacial and dental injuries were studied in registered players of American football, bandy, basketball, and handball in Finland between 1979 and 1985. In American football, where facial protection is complete and mandatory, maxillofacial and dental accidents accounted for only 1.4% of all accidents. In bandy, where facial protection was inadequate during the time of study (only the helmet and extraoral mouth protector were mandatory), the respective figure was 10.6%. The most frequent causes of injury were a blow from another player (in American football, basketball, and handball) or a blow from the stick (in bandy). In American football, the mean cost of treatment related to maxillofacial and dental injuries was only 60% of the mean total cost of all injuries. In contrast, the mean cost of treatment for maxillofacial and dental injuries in basketball and bandy was twice and three times as high, respectively, as that for all injuries. The need for adequate facial protection in contact sports is also discussed.

Adolescent↗

Traumatized anterior teeth in children: a review of the literature.

This article reviews the incidence, predisposing factors, aetiology, classification, clinical features, treatment modalities and complications of traumatic injuries to anterior teeth in children. This review is primarily based on articles selected from Medline concerning traumatic injuries to the anterior teeth of children up to August 2000. The anterior teeth are important both functionally and esthetically. Fracture of such teeth could affect the appearance of an individual and their ability to eat properly. Epidemiological studies worldwide on traumatic injuries to anterior teeth in children shows that the prevalence is relatively high with more boys affected than girls. The commonest reported aetiological factor is fall. There is need to review the various aspect of this subject and update the treatment technique. Preventive measures to minimise its occurrence such as early orthodontic treatment of procline incisors and the use of mouth protectors during contact sports were highlighted. In addition it was suggested that children be supervised when they are playing and the public be educated on first aid management of dental trauma.

Age Distribution↗

A new technique for the custom fabrication of mouthguards with photopolymerized urethane diacrylate.

The use of protective mouthguards in athletes has proven to be an effective and inexpensive means of preventing traumatic injuries to the teeth and supporting structures. Of the three general types of mouthguards available currently, the custom-fabricated type is considered superior to stock and mouth-formed protectors. A new technique is introduced for the fabrication of custom-made mouthguards with light-curing urethane diacrylate material.

Acrylic Resins↗