Tumor antigen presentation: changing the rules

The relationship between dental status and dental anxiety was analysed in 165 patients. To assess the dental status, D3.4 MFS-index and Bleeding-on-Probing-Index (BOP) were applied. Dental anxiety was assessed using dental anxiety rating, whereas aspects of state and trait anxiety were analysed by the State-Trait-Anxiety Inventory. The hypothesis was: higher levels of dental anxiety lead to avoiding check-ups and necessary treatment, the consequence of which is a deterioration of the dental status. No significant correlation was found between dental anxiety and dental status. A significant difference was found when comparing patients with high or low dental anxiety in respect of the D3.4 MFS-index, whereas a different trend was found on comparing these groups for BOP-index. In addition, a significant correlation was found between dental anxiety and trait anxiety. These results suggest that dental anxiety is a rather non-specific phenomenon, since it is an aspect of proneness to anxiety. In addition, in patients who display considerably high dental anxiety, this may lead to anxiety denial and abnormal behaviour (e.g. avoidance of dental hygiene or care) thus contributing to further deterioration of oral health.     

Dental knowledge, attitudes towards oral health care and utilization of dental services among male industrial workers with or without an employer-provided dental benefit scheme

In industrialized countries various dental benefit schemes have been implemented to improve the utilization of dental services, though few studies have demonstrated that effect. Prior to a comprehensive clinical study in southern Finland, a postal questionnaire survey of male industrial workers (age 38-65 yrs) was conducted to investigate knowledge and attitudes concerning oral health care and whether access to an employer-provided dental benefit scheme was associated with the utilization of dental services. The response rate was 81% (n = 325) in the subsidized group and 69% (n = 174) in the control group. In both groups, 60% of the subjects had had their last dental visit within a year but 91% of the subsidized workers compared to 79% of the controls had visited a dentist in the past two years (P < 0.001). The subjects had similar attitudes towards the importance of regular dental care and its implications for dental and general health. Subsidization explained the disparity in the current dental visiting pattern between the groups better than the possibility of using working hours for dental visits. Backward stepwise logistic regression revealed that the probability of a dental visit within the past two years was positively associated with access to an employer-provided dental benefit scheme, tooth brushing to maintain dental health, and number of teeth, and negatively associated with number of carious teeth. Our results demonstrate a positive impact of subsidization on the utilization of dental services.     

Dental health attitudes among dentate black and white adults

OBJECTIVES: Blacks and poor persons share a greater burden of oral disease and are less likely to seek dental care on a regular basis. The role of dental attitudes and knowledge of services on this circumstance is unclear. The authors quantified group differences in dental attitudes and knowledge of services and related them to regularity of dental care use. METHODS: As part of the baseline phase of The Florida Dental Care Study, a longitudinal study of oral health, 873 respondents who had at least one tooth and who were 45 years or older participated for an interview and a clinical dental examination. Dental care use, seven dental attitudinal constructs, and knowledge of dental services were queried. RESULTS: Forty-five percent of respondents reported going to a dentist only when they have a problem, and 17% of respondents had not seen a dentist in more than 5 years. Ten percent of respondents reported that they had at least one permanent tooth removed by someone other than a dentist (typically, the respondent himself). Blacks and poor persons had more negative attitudes toward dental care and dental health and were less knowledgeable of dental services. Multivariate analyses suggested that dental attitudes were important to understanding the use of dental care services for this diverse group of adults, and that race and poverty contributed independently to dental care use even with dental attitudes taken into account. CONCLUSIONS: Dental attitudes contribute to race and poverty differences in dental care use among adults. The persistence of race and poverty effects with attitudes taken into account suggests that additional explanatory factors contribute as well. These differences may contribute to more prevalent and severe oral health decrements among the same adults who also are more likely to suffer from other health decrements.     

The effects of visual surround eccentricity and size on manual and postural control

The aim of this study was to compare two different modes of behaviorally-oriented therapies for dental fear. The subjects were chosen consecutively from the waiting-list of a Dental Fears Research and Treatment Clinic. In addition, a control group was selected from patients treated under general anesthesia to compare levels of dental and general fear with the experimental groups. Twenty-two women, with a mean age of 31.8 yr, were included and randomly assigned to two groups. The median time of avoidance of dental care was 9.5 yr. One group received hypnotherapy (HT) and one group a behavioral treatment based on psychophysiological principles (PP). Both therapies included eight sessions followed by standardized conventional dental test treatments. Pre- and posttreatment measures were dental fear, general fear, mood, and patient behavior. Nine patients were not able to conclude the treatment sessions (6 HT and 3 PP); these patients did not differ significantly from the remaining patients before treatment. The PP group reported a statistically significant decrease in dental fear as well as a rise in mood during dental situations, as opposed to the HT group. General fear levels decreased but not significantly. Eleven patients completed conventional dental treatment according to a dentist's behavioral rating scale, indicating that they were relaxed, and no problems occurred during the treatments. These patients were referred to general practitioners within the community dental service. In conclusion, this small size study showed that a majority of the patients, who accomplished the behavioral therapy and the dental test treatments, became less fearful of dental care and were able to manage conventional dental care, including changing dentist.     

Prevention of deep venous thrombosis

Two studies of self-referred patients attending emergency dental clinics in Edinburgh have shown that almost half of the patients have been to the dentist in the last year and 60% had routine treatment on their last dental visit. Despite this contact with dental services, over 40% of patients with a dental emergency who attend the emergency dental clinics say that they do so because of actual or perceived difficulty in obtaining immediate care from the general dental services. Some 17% attend the clinics for reasons of convenience and 19% of patients attend the emergency clinic at the Dental Hospital because they prefer to be treated in a 'centre of excellence'. In September 1994 the School of Dentistry is to close and the Dental Hospital relocated. Changes may have to be made to the organisation of general dental practice in the Edinburgh area to accommodate patients with a dental emergency. The majority of emergency dental patients in Edinburgh are not put off attending for the relief of their problem by the cost of National Health Service treatment.     

Women's oral health awareness and care-seeking characteristics: a pilot study

The authors designed a pilot study to examine issues that affect women's oral health. They found a substantial lack of awareness regarding important oral health issues, and that 44 percent of the participants reportedly did not have regular dental care. High perceived dental need was reported concurrently with low dental care attendance. Additionally, reported lack of dental insurance and self-perception of low income and of poor dental health were important explanatory factors for the women who reportedly did not have regular dental care.     

Determination of the viremia threshold for dental cross-infection in a mouse model

An animal model of dental virus transmission was developed using the lactate dehydrogenase-elevating virus (LDV) of mice to study cross infection. Mouse-to-mouse cross-infection was carried out by scaling the teeth of LDV-infected donor mice with dental instruments, immediately prior to using the contaminated instruments on the teeth of recipient indicator mice. The level of donor viremia was found to correlate with the rate of virus cross-infection, with a viremia threshold level of 10(7.5) ID50/ml observed for dental cross-infection. The blood volume transferred during dental cross-infection was approximately 10(-4) to 10(-5) ml, demonstrating the inefficiency of virus cross-infection, since deposition of about 1000 virions on dental instruments was associated with the threshold limit. Virus transferred during dental cross-infection rapidly entered the blood circulation, showing that dental cross-infection was not dependent on an oral infection. The results from these model studies predict the general inefficiency of dental instrument virus cross-infection, and a further reduced likelihood of dental cross-infection with appropriately cleaned instruments.     

Finishing touches for beautiful smiles: orthodontist and general dentist coordinate efforts to achieve optimum esthetics. Part II

It is not uncommon for teeth to still not be attractive, even though they are straight following treatment. Several examples have been given of what can be done to improve the attractiveness of teeth when this occurs. It is the responsibility of the dental team involved in the management of a persons total dental care to advise patients of what dental services are available to them. People should have the opportunity to evaluate what dental services are needed to accomplish a pleasing result that is satisfying to them and to the dental team involved.     

An investigation of dental student values

The development of a dental student's professional values system is an important issue in dental education. The purpose of this study was to assess the relative importance of different values of dental student and instructor populations at a single dental school. Data was collected from surveys disseminated to dental students and faculty. Statistical analysis of the data indicated faculty showed a different set of values than students. Faculty placed greater value on patient care and clinical education. Students were more focused on passing licensure examinations, completing course requirements, and personal satisfaction. Junior and senior dental students placed greater value on the requirements of becoming a licensed dentist than did their younger student colleagues. Freshman and sophomore dental students placed higher values on additional academic pursuits and personal growth. This study also revealed no statistically significant difference between males and females in any of the values ranked.     

Blood-injury-injection phobia and dental phobia

The present study was carried out to explore the relation between BII phobia and dental phobia. An additional aim was to determine the fainting tendency of dental phobics and BII phobics during an invasive treatment procedure. Participants were 63 patients undergoing treatment in a dental fear clinic, and 173 patients undergoing dental surgery in a university hospital. They completed measures on fears of particular medical and dental stimuli, fainting history, general trait anxiety, dental anxiety, BII anxiety, BII avoidance, and a questionnaire aimed to define a phobia based on DSM-IV criteria. Immediately after treatment information was obtained on exposures to blood or injections, state anxiety, and feelings of faintness during treatment. The results did not indicate any significant relationship between measures of dental anxiety and BII anxiety or BII avoidance. However, 57% of the dental phobic patients could also be classified as BII phobic. The proportion of dental phobics who reported fainting episodes in their past was similar to that of the BII phobics (37%), but none of the participants fainted during treatment. It is concluded that, albeit the level of co-occurrence for both types of phobias is high, dental phobia should be considered as a specific phobia, independent for the BII subtype within DSM-IV. Further, the findings are inconsistent with the notion that individuals with BII phobia have a remarkably high tendency to faint in the presence of their phobic stimuli.     

Dental utilization by active duty Army personnel

In spring 1989, a random, Army-wide sample of 15,364 enlisted and 4,529 officer personnel was surveyed on dental utilization. Results show no difference in annual dental utilization between officer and enlisted personnel when age is controlled. Because annual dental utilization increases with age and enlisted ranks contain a disproportionately large number of younger personnel, a difference in annual dental utilization between enlisted and officer personnel emerges when age is not controlled. Check-ups are the most common reason for dental visits. Nearly all soldiers seek care exclusively in military dental clinics. Non-use is highest among 18- to 19-year-olds (12.2%).     

An overview of dental care for the young patient: 1. Introduction, priorities and disease prevention

The provision of high-quality dental care for children presents a challenge for the general dental practitioner. The aim must be to ensure that young patients reach adulthood with optimal dental health. This series of three articles takes an overview of good practice in the provision of dental care for children, with emphasis on disease prevention, early diagnosis of dental disease and deformity and appropriate treatment measures. This first paper discusses preventive measures and highlights the need to apply them, particularly for patients at high risk of dental disease or with special needs in relation to dentistry.     

What do people want from dentistry? An action research approach

Issues surrounding access to dentistry will be presented from information gathered during an action research project targeting three population groups. This project was conducted by students in the Dental Hygiene Degree Completion Program at the University of British Columbia and by the dental hygiene diploma students at Camosun College. In contrast to typical empirical dental studies which are validated by statistical presentation, action research uses an interview process and qualitative analysis to identify what people really think, believe and do. College students, independent-living seniors, and low-income families were interviewed to determine how they accessed dental care, how they liked their dental visits, and how they preferred to receive dental health information. Cost, convenience and fear of pain were significant factors which influenced whether people attended the dental office. Caring dental health providers, comfort and pleasant physical surroundings were important features of a dental office visit. Dental health practices, such as brushing and flossing, were predominantly learned from the dental profession at the dental office, through school programs, or from parents at home. This data challenged our previous assumptions about these groups. As the goal of this type of research is "action", the information gathered will lead to action plans at the community and professional level.     

Development of the computerized dental cast form analyzing system--three dimensional diagnosis of dental arch form and the investigation of measuring condition

To analyze the functional and morphological harmonies of the tooth and dental arch, a computerized system to measure a dental cast and to detect the apex of dental cusps and angle points of incisors was developed. Detailed morphology in the measured dental cast could be displayed distinctively by computer graphics (CG) with a surface model. Accuracy in determining the position of the apex of the dental cusp was examined by increasing the measuring pitch from 50 microns to 400 microns, the error increased gradually with increased measuring pitch. Taking the measuring error, the time for measurement and the memory size for analysis into account, a measuring pitch of 200 microns was determined to be reasonable. Three-dimensional data measurements from the apex of the dental cusp in molar, and the mesial and distal angles in canine and incisor were fitted to a polynomial formula. In the present measured model, the 4th order polynomial formula was used for the dental arch, and the 2nd order polynomial formula was used for the anteroposterior and lateral occlusal curves. These formulae could be simultaneously superimposed on the surface model of the dental cast, and displayed using CG.     

Variants of progressive dementias in middle-aged and elderly persons

Today, dental assistants are becoming more aware that a professional image is necessary for putting dental professionals in the best light in the changing health care society. Not only must dental assistants know how to work in the system and how to effectively care for dental patients, but attention to matters such as personal grooming, dress, and body language is necessary if dental assistants are to be a powerful and proud profession in today's society. How you look and act will make a difference in how others treat you. When you act like a professional, others will react to you as one.     

Fluoxetine in the treatment of borderline personality disorder]

The debate about mercury and dental amalgam has been one of the longest running in dentistry, and shows no signs of abating. This study aimed to investigate perceptions about mercury in dental fillings among a representative sample of the Australian public. A random sub-sample of participants in a national dental telephone interview survey completed a follow-up postal questionnaire which included four items on dental mercury. The postal survey response rate was 85.2%. Concern about mercury in dental fillings was expressed by 37.5%, while 16.2% reported having requested fillings that do not contain mercury. Avoidance of dental care because of concern about mercury in fillings was reported by 5.8%, but only 4.7% reported having had fillings replaced because they contained mercury. The data indicate that there is a substantial degree of concern about mercury and dental amalgam among the Australian public, but that the dental behavioural and treatment-pattern consequences of that concern are infrequent.     

A psychodynamic theory for dental phobia

Dentists recognise various degrees of dental anxiety in their patients. There are those who are relaxed, those who are anxious and those who are dentally phobic. The question remains why should disagreeable dental experiences result in dental anxiety in one patient, have little effect upon another and cause dental phobia in a third? The aim of this paper is to propose a psychodynamic theory for dental phobia based upon the ideas of false connections and displacement.     

Medical scheme expenditure on dental care--a smaller slice of the pie

Medical schemes play an important part in financing dental care in the private sector and provide many dental practitioners with a substantial source of income. Data on medical scheme expenditure indicates a steady decline in their proportional pay-out for dental care during the period 1985 to 1994. In 1985 more than 12 per cent of total medical scheme expenditure was spent on dental care. In 1994 this had reduced to 8.37 per cent. In the present study, the historical trend (1985-1994) of medical scheme expenditure on dental care is analysed. By using the least squares method, the annual medical scheme expenditure on dental care is computed for the next eleven years (1995-2005). If the secular trend continues, less than 4 per cent of medical scheme expenditure will be paid for dental care by the year 2005.