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Ownership and maintenance of dental records.

The maintenance of good dental records is essential for the defense of a professional liability claim. If a dentist must give records and radiographs to a patient, insurance carrier, or succeeding practitioner, he should always give copies and maintain the originals. As a professional liability claim can often be filed long after treatment ceases, the dentist should retain his records permanently. The right of a patient to gain access to his medical or dental records has been granted by recent court decisions as well as by laws and regulations enacted in some states. The court decisions granting a patient access to his records are law in the jurisdictions in which the cases were decided. However, those decisions would present persuasive authority in a stage having no case law or statute regarding access by the patient to medical or dental records. The dentist should consult his attorney to determine the local law before allowing a patient access to his records and radiographs.

Dental Records

Practical recording of dental caries increment.

Records obtained from regular dental patients at initial examination are transferred to punch cards. Subsequent data entered on punch cards. Provision is made for transferring basic and amended information to new cards when required. Analysis of incremental data can be used to evaluate changes in practice and assess work load.

Adolescent

Caries experience of Danish children evaluated by the child dental health recording system.

The purpose of this report is to describe certain features of the child dental health care in Denmark. The caries picture and the caries distribution pattern in Danish children aged 2--15 years are demonstrated and some regional variations are analyzed. The study is based on epidemiologic data collected in the school year 1977--78 from about 500 000 children being treated in accordance with the Child Dental Care Act. The data collection is being effectuated annually under a child dental health recording system, and the aim and function of this system is discussed. The mean defs- and DMFS-indices are illustrated for individual age groups reflecting the natural history of dental caries. Certain trends in relation to different geographical distributions of caries and in relation to different cohorts of children from 1972 to 1977 are discussed. The analysis of the caries picture is extended by means of the distribution pattern according to caries severity zones. Finally, the use of caries epidemiologic data for planning and resource allocation purposes is illustrated and some policy implications for the development of the child dental health services in Denmark are discussed.

Adolescent

Caries frequency in children with controlled diabetes.

The frequency of caries was assessed in 33 diabetic children in whom the diabetes required insulin and dietary restriction and had been diagnosed before eruption of the permanent teeth. The frequency of caries and the number of erupted teeth were obtained from the dental records of the school dental service. Age- and sex-matched non-diabetic classmates served as controls. The mean number of DFS at the last dental examination of the diabetic children was 13.4, compared with 20.5 in the controls. The difference was largest in 12- to 14-year-old children, particularly in the premolar region, where the mean number of carious and filled surfaces in the diabetics was 2.6 compared with 5.9 in the controls. In all age groups, proximal carious lesions were less common in the diabetics than in the controls. No notable difference was found between the mean number of erupted teeth in the diabetics and that of the controls, except among the 12- to 14-year-old children. In that age group the diabetics had, on the average, 6.0 erupted premolars compared with 7.3 in the controls and 2.7 erupted permanent second molars compared with 3.5 in the controls. The results indicate that the dietary restriction observed by the diabetics had a favorable effect in promoting a lower caries frequency on all groups of teeth and on most tooth surfaces.

Adolescent

Forensic identification of burn victims.

An explosion and fire that caused $25 million in damage caused the deaths of seven men, four of whom could not be identified through ordinary methods. Three of these four victims were positively identified through forensic dentistry techniques. Dental records, particularly radiographs, of all patients should be retained should the dentist be called on to aid in the task of identification.

Burns

There are no two cases alike.

A number of routine cases are reviewed: 1. A skull with a canine porcelain crown nicely glued in line was considered a study object, not a case of actual forensic interest (Fig. 1). 2. A murder victim was identified as a certain young girl; records including radiographs and plaster models showed no inconsistencies, but at least 28 concordant traits, among them characteristics in a root-filled central incisor (Fig. 2). 3. The body of a young suicide could be identified by means of one intraoral radiograph taken prior to one extraction, the only treatment listed in his dental record (Fig. 3). 4. After a fire, an unmarked rubber denture was found among debris; it showed burning along the distal palatal edge, so could not have been in the mouth of the owner during the fire. Being so completely deformed, it had to be discarded as evidence. 5. Another denture, removed from the mouth of a victim of the same fire, showed typical burning of the frontal parts, but also a stripe of burning along the midline (Fig. 4); accordingly, this victim must have inhaled flames before he died. 6. An old woman disappeared; in her home, police found an unmarked full lower denture left behind on her bed. When recovered dead several months later, this woman carried a full upper denture but no lower. Dental experts were not involved in this case but later saw both dentures; they had been made at different times and occluded badly. Did this woman have two sets? Or did the lower denture maybe originate from her murderer? The author urges that the FDI design an international system of denture marking. 7. A man was found murdered with an axe; police experts had reason to believe that he might have been executed somewhere else, but tooth 12 (Fig. 6)---found lying loose under the head---showed marks which proved that it had been exarticulated by one of the axe blows (Fig. 5). Consequently, the recovery site was also the execution site.

Adolescent

Eruption of permanent teeth in West African (Gambian) children in relation to age, sex and physique.

Dental records of 635 West African (Gambian) children within the age range of 4.5-14 yr yielded 2108 examinations for boys and 1863 for girls. There was no difference between eruption ages of homologous permanent teeth on the left and the right side of the same jaw. Except for PM1 and PM2, teeth in the lower jaw erupted earlier. There was a clear sex difference in eruption age, which was earlier in females. Calendar age can be estimated from the state of permanent dentition, though the error of the estimate increases with the number of teeth, being about 0.5 years for 1 or 2 teeth and increasing to slightly over 1 year for 12 teeth or more. There was an association between the number of teeth erupted at a given age and height and weight of the children. Also children with fewer teeth at a given age contain a greater proportion of children below standard weight or height for that age. This effect disappeared when children were classified in terms of weight for height.

Adolescent

[Comparison between the findings of the AOK health insurance company (position 01) and clinical diagnosis in Berlin patients].

The dental records of 9986 patients between the ages of 12 and 50 (position 01) of the AOK (Public Health Insurance) Berlin were studied concerning missing and carious teeth. The number of teeth and actual frequency of caries were established. It was shown that it was possible and practicable to obtain information on number and loss of teeth on the basis of sick notes. On the other hand the actual frequency of caries was found to be significantly higher on clinical examination than could be derived from AOK statistics: 12 to 15 year-olds showed on average 4,7 acute carious teeth on clinical examination as against 2,3 on AOK records.

Adolescent