(65/186) Assessment of atmospheric microbial contamination in a mobile dental unit.
INTRODUCTION: Bioaerosols are important considerations in infection control as well as in occupational health. Bioaerosols may carry potentially hazardous microbes, viruses, fungi, allergens, and other toxic substances that may harm the dental operator, patient, and the dental assistant by causing nosocomial infections. OBJECTIVE: To assess the level of atmospheric microbial contamination before, during, and after dental treatment procedures in the dental operatory of a mobile dental unit (MDU). MATERIALS AND METHODS: The study included three treatment sessions on different working days, with an interval of one month. The MDU was fumigated before the start of the study. Brain Heart Infusion Agar with 5% sheep blood was used to collect the gravitometric settling of aerosols produced before, during, and after dental treatment procedures. The agar plates were sent for aerobic and anaerobic culture. RESULTS: The results showed that atmospheric microbial contamination (CFUs/plate) was 4 times higher during working sessions as compared to the levels before the working sessions. At the end of the working day, aerosols decreased by almost 3 times that seen during work. CONCLUSION: The aerosols increased during and after work sessions. This shows the increased risk of transmission of infectious agents to the dentists who work in the MDU. Hence, all necessary preventive measures should be advised and need to be followed strictly. (+info)
(66/186) Provisional crown failures in dental school predoctoral clinics.
Following a preliminary study indicating that at least 10 percent of single-unit crown temporary restorations failed in patients who received treatment by predoctoral students, a comprehensive examination of provisional crown failure was initiated to identify strategies to reduce the failure rate. For all provisionalized, natural tooth, single-unit crown preparations in University of North Carolina School of Dentistry predoctoral clinics for one year (N=1008), we noted tooth type, type of crown, student level, faculty coverage experience, treatment clinic, temporary material and luting agent, and retreatment (failure) of the provisional restoration. For failures, we also noted the stage of crown preparation at failure and the time since initial placement of the temporary. We analyzed these data using simple cross-tabs and logistic regression on need for retreatment (alpha =0.05). The failure rate was 18.75 percent (N=189). The median time to failure was twelve days; the 25(th) and 75(th) percentiles were six and twenty-six days. Significant risk factors, in order of odds ratio estimates, were molar tooth, second- or third-year student, and inexperienced faculty. Most provisional failures occurred during the final preparation phase of treatment. Provisional restoration failure is more frequent than was initially suspected from preliminary studies. Strategies for institutional intervention to reduce provisional restoration failure include greater attention to evaluating provisional crowns placed by inexperienced students (sophomores and juniors) and placing more emphasis on the retentiveness of provisional restorations reused following the final impression. Review of provisional evaluation procedures is also indicated for faculty who do not routinely supervise these procedures. (+info)
(67/186) Is there an association between weight and dental caries among pediatric patients in an urban dental school? A correlation study.
Obesity in the young is a public health priority. The prevalence of overweight children in the United States has risen almost threefold in the last two decades. An association between weight and oral health has been suggested in adults, whereas evidence supporting this association in children is controversial at best. The aim of our study was to evaluate the association between weight and dental caries in a random prospective cohort of children at their initial visit at an urban dental school. One hundred and thirty-five children were recruited in a four-month period. The DS/ds index was used to assess caries, and BMI percentile was calculated based on age and gender-adjusted published scales. Correlation analyses, linear, and multivariate regression including age, gender, and BMI were calculated with a significance threshold of p>0.05. No correlation between dental decay in obese and non-obese children was detected (p=0.99). These findings support recent U.S. population-based literature that reports an inverse association between caries and weight in certain pediatric groups. Nevertheless, the impact of interventions to address the epidemic in the dental setting has not been investigated. As part of a health care team, dental students should be exposed to the changing demographics and sequelae of overweight in children. (+info)
(68/186) Attitudes towards replacement of teeth among patients at the Institute of Dental Sciences, Belgaum, India.
The purpose of this study was to assess the attitude towards replacement of teeth among patients who reported to the department of prosthodontics in the Institute of Dental Sciences, Belgaum, which is located in the northwestern part of the state of Karnataka in the southern region of India. A fourteen-item, closed-ended questionnaire was completed by 365 volunteer patients who were then examined by a clinician and existing and missing teeth were charted. All the patients who reported to a dental clinic in a period of two months with at least one missing tooth were included in the study. Collected data were statistically analyzed using chi-square test at a significance level of p<0.05. The age of the subjects ranged from sixteen to eighty-four years (mean age 51.06 +/-16.47 years). Among these 365 patients, 228 were in a waiting period for soft tissue healing after extraction of tooth/teeth; 19.7 percent of the patients gave financial constraints as the reason for not replacing teeth; 7.1 percent reported that they lacked the time to have teeth replaced; 6.9 percent had low felt needs; and 3.8 percent indicated they did not know that teeth could be replaced. Subjects with different levels of socioeconomic status reported different reasons for not replacing the teeth and these differences were statistically significant (chi(2)=61.16, P<0.001). Knowledge about the equivalence of artificial teeth with natural teeth (chi(2)=23.01, P<0.05) and problems with artificial teeth (chi(2)=17.25, P<0.05) were also significantly different among subjects from different socioeconomic categories. The findings indicate that awareness needs to be increased regarding the other functions of teeth like esthetics and phonetics because many subjects in this study were only aware of the function of mastication performed by teeth, especially among individuals in the lower socioeconomic group. Attitudes of patients should be taken into consideration to improve patient compliance with and acceptance of prostheses. (+info)
(69/186) Dental care for physically or mentally challenged at public dental clinics.
Recently, local administration bureaus have established a number of dental clinics and centers for the physically or mentally challenged (PMC) in collaboration with local dental associations. The aim of this study was to investigate dental treatment and general supportive care for the PMC in dental clinics in Tokyo. A dental clinic for the PMC located in northwestern Tokyo in a district with a population of about 680,000 was selected for the study. The variables studied based on dental records included total number of patients, type of disability, medical history, systemic condition, age, treatment regimen and type of general supportive care. The largest group of new patients was under 9 years of age. The highest total number of patients visiting the clinic belonged to the 60-69-year-olds group and the 70-79-year-olds group. We also investigated type of disability in patients treated under intravenous sedation at time of dental treatment. The most common condition was dementia resulting from Alzheimer's disease (42.74%), autism, cerebral palsy or mental retardation, in descending order. The percentage of patients referred from other medical institutions was 17.4%, including those from private dental clinics and Dental University Hospitals. Type of disability in patients transferred from other medical institutions included developmental disorders (28.2%), senile defects (26.9%), chronic and psychiatric diseases (44.9%). The number of patients who located and visited the clinic by themselves greatly exceeded the number transferred by request. This suggests that a permanent system should be put in place offering public specialized dental clinics where the PMC many obtain treatment. (+info)
(70/186) How to improve communication with deaf children in the dental clinic.
It may be difficult for hearing-impaired people to communicate with people who hear. In the health care area, there is often little awareness of the communication barriers faced by the deaf and, in dentistry, the attitude adopted towards the deaf is not always correct. A review is given of the basic rules and advice given for communicating with the hearing-impaired. The latter are classified in three groups - lip-readers, sign language users and those with hearing aids. The advice given varies for the different groups although the different methods of communication are often combined (e.g. sign language plus lip-reading, hearing-aids plus lip-reading). Treatment of hearing-impaired children in the dental clinic must be personalised. Each child is different, depending on the education received, the communication skills possessed, family factors (degree of parental protection, etc.), the existence of associated problems (learning difficulties), degree of loss of hearing, age, etc. (+info)
(71/186) Changes in orthodontic care patterns in a predoctoral children's dentistry clinic.
The purpose of this study was to evaluate the changes in orthodontic care patterns over a sixteen-year period in a university clinical setting. The average numbers of students, clinical procedures, and orthodontic appliances were examined from the time period 1988-2003. Appliance number and type were evaluated as a function of increased predoctoral and postdoctoral class sizes, student to faculty ratios, and decreased operating budgets for faculty recruitment. For the period 1988-98, the insertion of orthodontic appliances by dental students remained constant. A permanent increase in the predoctoral class size occurred in 1996 without an increase in faculty support, contributing to a decline in appliance insertions by students from 1999 to 2003. This time period also saw major increases in the postdoctoral class size and a reorganization of the clinical facility that then began to require the pairing of dental students to provide comprehensive care, thus decreasing their clinical exposure to the care of children. The overall clinical experience at the predoctoral level in orthodontic procedures declined, which resulted in a change in clinical requirements and new methods to ensure clinical competency. (+info)
(72/186) Evolution of dental school clinics as patient care delivery centers.
Dental school clinics, originally envisioned as closely similar to private practice, evolved instead as teaching clinics. In the former, graduate and licensed dentists perform the treatment while undergraduate dental students are assigned treatment within their capabilities. In the latter, dental students provide the treatment under faculty supervision. It is generally recognized that the care provided by the teaching clinics is inefficient. However, in the last quarter of the twentieth century, dental school clinics began to pay much more attention to how treatment is rendered. The comprehensive care movement and quality assurance systems are leading towards more efficient patient-centered care. Case studies at the University of Maryland, Columbia University, and University of Louisville describe activities to make their clinic programs more efficient and patient-friendly. This article explores whether the potential exists for faculty to take a direct patient care delivery role in dental clinics in order for those clinics to become efficient patient care delivery systems as originally envisioned in the early part of the twentieth century. (+info)