Family Dentist Research Articles

Trends in the referral and treatment of new patients at a free emergency dental clinic since 1989.

To investigate the changes in the pattern of new patient referral and treatment at a dental hospital emergency clinic since the introduction of the new dental contract in 1989. A prospective survey and review of clinical records. The examination and emergency clinic at Cardiff Dental Hospital. 500 consecutive new patients attending the clinic in May/June in 1989, 1993, 1994 and 1995. Numbers of referrals; source of referral; geographical distribution of patients; registration with general dental practitioners; type of dental disease; treatment received. New patient attendances increased by 56% since 1989. Referrals from family doctors and dentists decreased while self-referrals increased. Self-referral by patients not registered with family dentists increased by 56%. Extraction of teeth was the commonest form of treatment in all years and increased by 72%. Numbers of patients attending for dental treatment at this setting increased substantially after 1989. Increasing numbers of these patients were inappropriately self-referred for treatment. Patients increasingly selected extraction of teeth as the primary treatment rather than restorative procedures. These changes appeared to be unrelated both to the severity of dental disease at presentation and to socio-economic status.

The Moral Foundations of Scientific Ethics and Responsibility

Any significant involvement of AADR/IADR in ensuring responsible research among their members must be grounded in a widely accepted consensus that there are good moral reasons for such involvement. One important source of such reasons is AADR/IADR's identity as a scientific research, a professional, and a dental association. These identities and the commitments to society and to clients implicit in them generate several mutually reinforcing reasons for taking responsibility for the reliability of members' research. With regard to scientific research, these reasons arise from what it means to do such research, and from the various ways the larger society supports that activity. With regard to the professional dimension, the reasons arise from what it means to be a profession in this society and can be best seen in relation to the four major characteristics of professions. With regard to AADR/IADR's being a dental profession, such reasons arise from dental researchers' specific role in the dental family of professions' goal of delivering optimal care to the clients of practitioners. The clients' perspective, specifically the need to be able to trust that one will receive the best care possible, is a final source for such reasons. Two current issues, the sharing of findings and commercial/industrial support for research, give new urgency to this question of the Association's role in ensuring responsible research.

The views and expectations regarding dental care of the parents of children with special dental needs: a survey in the County of Cheshire, England

A postal questionnaire of multiple-choice design was sent to 122 parents of children with special dental needs in the county of Cheshire, England, with the aim of determining parents' views and expectations of dental care. Replies were received from 85 (70%). Eighty respondents (94%) were in favour of preventive dental advice being given to their children and 83 (98%) felt that an explanation should be given of the risk to general health posed by dental disease or its treatment. A high proportion of parents felt that simple dietary and oral hygiene advice was necessary, that the benefits of fluoride supplementation should be explained and that free fluoride supplements should be issued. The 'family dentist' was most favoured as the source of advice, closely followed by a community dental officer. Likewise the dental surgery was the most popular location for receiving advice, and doctors' surgeries were the least favoured. Parental support for regular school dental screening examinations of all children was extremely high and parents thought that special-needs children should be examined more frequently.

Understanding Change: Five-Year Follow-up of Brief Hypnotic Treatment of Chronic Bruxism

In this paper I describe the treatment of a 63-year-old woman with a 60-year history of nocturnal bruxism. Treatment included assessment, two psychotherapy sessions, including a paradoxical behavior prescription to reduce daytime worrying, hypnotic suggestions for control of nocturnal grinding, and reinforcement of the patient's expectations for success. This case demonstrates how enduring change may occur rapidly in spite of the chronicity of a patient's complaint. Follow-up assessments at 2, 3, and 5 years revealed that she continued to be symptom-free with her self-reports corroborated by her spouse and family dentist. I discuss implications for understanding the role of hypnosis in therapeutic change.

Marketing and Utilization of the Active Duty Dependent's Dental Insurance Plan

Based on a random, representative sample of 2,733 officer and 7,938 enlisted Army enrollees in the Active Duty Dependent's Dental Insurance Plan (ADDDIP), we found that soldiers turned to many sources to learn about the plan and that oral sources were consulted more commonly than written sources. More than 40% of Army enrollees have never used the plan. Officer dependents have used the ADDDIP to a fuller extent than enlisted dependents. Over half of Army enrollees felt that program enrollment should be renewed automatically. The best-liked features of the ADDDIP included good cost value, known services covered, and access to a single family dentist.

What kind of people want to become dentists? General Dental Council Recruitment Working Party survey of first year undergraduate dental students.

Above all, the survey has provided a clear, if complex, description of the population of first year dental students: who they are and where they have come from; why they are doing the course and what they want to achieve from it. A number of specific conclusions about recruitment gaps can be drawn from the information received from the survey, namely: i) Girls at mixed-sex schools are apparently less likely to enter dentistry than their counterparts at all-girls' schools. This, however, is part of a much wider issue which encompasses the question of science versus arts choices amongst male and female pupils. ii) Some dental schools have a very high concentration of students whose home is the local region. Wider national publicity for these schools could be attempted. iii) In East Anglia, the East Midlands, Yorkshire and Humberside and the West Midlands, the number of qualified school leavers who become dental students is below average. iv) Family dentists and orthodontists are in a very strong position to encourage interested patients to enter the profession beginning at an early age, and with guidance could encourage these children towards additional sources of information and advice, such as the General Dental Council, which at the moment appear to be under-used. v) The information on dentistry provided by most careers advisers could be improved. In particular, careers teachers and form teachers/tutors are a widely contacted source of guidance but the information they were able to provide was not rated highly. University open days and residential courses are successful and might be used further.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood pressure measurements during dental checkups representative of 26-hour registration

The effect of dental checkups on blood pressure was investigated. In 27 normotensive patients (13 men and 14 women) aged 22 to 64 years (mean 39.75 ± 10.5 years), a 26-hour continuous, noninvasive blood pressure registration was carried out. Of each patient at least 175 blood pressure measurements were registered during these 26 hours, giving a total amount of 4725 blood pressure measurements. A dental checkup appointment with the family dentist was included. Blood pressure values displayed the well-known diurnal variation, but the visit to the dental surgeon was not accompanied by a rise in blood pressure. There was no significant difference between the blood pressure values during the 26-hour period and those during the checkup period. During a rest period after the dental checkup, neither the systolic nor the diastolic pressure fell to any degree in relation to the 26-hour values or the visit to the surgeon.

An American Board of Orthodontics case report

The I-year-.oId male patient had severe inflammation around the maxillary central incisors, which were slightly extruded and quite mobile. He complained of an intense, throbbing pain and general malaise. Two weeks before the initial visit, his family dentist had placed rubber bands around the maxillary central incisors to close an existing diastema. The rubber bandls were later found to have migrated apically and had essentially destroyed all the bone and periodontal attachments contiguous to these teeth. The osseous defect was extensive and of a through-and-through nature in that part of the anterior maxilla. Although he had previously been in excellent health, the patient now had a temperature of 102” F. All the untoward symptoms had developed after the placement of the rubber bands. Because of the acute local problem and the general symptoms, only a panoral radiograph was taken at this time. However, visual examination demonstrated no abnormal oral habits and although pharyngeal patency was normal, the anterior tonsillar pillars and soft palate were &ythematous.

Orthognathic surgery: a significant contribution to facial and dental esthetics

Esthetic dentistry was once a specialty of the family dentist and the orthodontist. Today it is a field for the prosthodontist, periodontist, oral and maxillofacial surgeon, and others. When jawbones are malpositioned, unesthetic facial contours can result, and dental compensations occur that can be additionally unattractive. Orthodontic attempts to correct malocclusion or other disharmonies of the dentition in affected individuals without surgical intervention can cause tooth instability and result in less than satisfactory cosmetic results. The treatment of orthognathic surgeons is especially well suited for full-face esthetic appearance--the picture the patient views each day in the mirror.

An American Board of Orthodontics case report

The I-year-.oId male patient had severe inflammation around the maxillary central incisors, which were slightly extruded and quite mobile. He complained of an intense, throbbing pain and general malaise. Two weeks before the initial visit, his family dentist had placed rubber bands around the maxillary central incisors to close an existing diastema. The rubber bandls were later found to have migrated apically and had essentially destroyed all the bone and periodontal attachments contiguous to these teeth. The osseous defect was extensive and of a through-and-through nature in that part of the anterior maxilla. Although he had previously been in excellent health, the patient now had a temperature of 102” F. All the untoward symptoms had developed after the placement of the rubber bands. Because of the acute local problem and the general symptoms, only a panoral radiograph was taken at this time. However, visual examination demonstrated no abnormal oral habits and although pharyngeal patency was normal, the anterior tonsillar pillars and soft palate were &ythematous.

The beauty of the face: an orthodontic perspective

In esthetic dentistry, the practitioner needs to consider more than just tooth shade and contour. All too often, attention is directed toward reconstructing the dentition for function and esthetic appearance without regard for an existing malocclusion and facial imbalance. When an individual accepts esthetic dental reconstruction, it can be assumed that he or she is attempting to improve a self-image. Dentofacial balance must be considered to truly enhance a patient's potential to achieve the optimal dentofacial esthetic appearance and enhance self-image. Optimal care in the area of esthetics, therefore, requires that esthetic dentistry be considered a multidisciplined service encouraging cooperation among the patient's family dentist, orthodontist, oral and maxillofacial surgeon, prosthodontist, plastic surgeon, periodontist, and possibly others.

Surgical repositioning of impacted mandibular second molar teeth

Impacted second molars refractory to orthodontic treatment are frequent problems. The family dentist and the orthodontist should be on the alert for them. A philosophy for their management and the authors' experience over the past 13 years are presented. The proper time for definitive treatment of these impactions is during early adolescence, generally in the 11- to 14-year range. Impaction of the second molar is usually a problem of arch length deficiency. There may be an associated problem with a third molar impaction. The alternatives for impacted second molar treatments are (1) surgical repositioning with or without adjacent third molar removal, (2) removal of the second molar allowing the third molar to erupt, and (3) transplantation of the third molar to the second molar socket. In the authors' experience, surgical repositioning has provided the most promising results of the three choices. Technical aspects of surgical repositioning are discussed along with case selection criteria. Six cases are presented to demonstrate typical problems and their management. With proper timing and intervention, the prognosis is excellent for repositioning second molar impactions.

Nonsurgical retreatment of a postsurgical endodontic failure

A 45-yr-old Caucasian woman was referred by her family dentist because of pain and periapical pathology associated with both her maxillary central incisors. The teeth had been endodontically treated and retrofill amalgams had been placed. Both teeth were diagnosed as postsurgical endodontic failures. The teeth were retreated nonsurgically. An 18-month recall examination showed normal soft tissue anatomy and an apparent decrease in the size of the periapical radiolucencies. Nonsurgical retreatment of postsurgical endodontic failures is an alternative to reoperation or extraction.

A Pediatrician's Program for the Prevention of Dental Caries in the First Years of Life

To the Editor.— Inasmuch as infants and children usually do not visit a pedodontist or a dentist in the first few years of life, I have recently undertaken a dental prophylactic program. The program consists of three approaches: (1) Fluoride supplementation is started in the first 2 weeks of life whenever the infant is ready to use formulas, or when well water with inadequate fluoride content is used. This consists of 0.25 mg of fluoride with the usual vitamin drops and later vitamin tablets with fluoride until the infant is seen by the family dentist.

Demographic predictors of infant car seat use.

Demographic family data obtained from mothers exposed to an inpatient postpartum child restraint device (CRD) education program were correlated with the results of direct observations of how the infant was restrained at a two-week posthospital physical examination visit. Those correctly restraining their infants in an approved CRD were found to be from a higher socioeconomic group than those who did not use CRDs or used them incorrectly. Additionally, the group correctly using the CRD demonstrated a heightened interest in other aspects of preventive medicine and stated that they had a family dentist. This demographic profile enables prediction of which family is most likely to respond to traditional education programs and may be a first step in designing new or alternate approaches for reaching parents not influenced by currently employed instructional methods.

The Patient With Cancer

Patients with cancer require competent oral health care, provided by a sympathetic and conscientious clinician. Often the ambulatory patient will be best managed by the generalist-family dentist. An understanding of the nature of oral disease in these compromised patients and a readiness to discuss dental treatment modifications with the attending physician should help prepare the dentist to prevent and to treat oral disease in the patient with cancer.

Prevention and precautions for the individual traveller overseas

SynopsisThe intending traveller should plan a detailed itinerary well in advance of his departure from the United Kingdom if he is to take full advantage of the health precautions and advice that are available. The present mechanism of delivering health care advice is inefficient and many travellers remain ignorant of how they should protect themselves against illness acquired overseas. Passport offices, travel agents, shipping and airline authorities and health insurance firms are in a unique position to share the responsibility with the community health services and general practitioners of ensuring that intending travellers are appropriately briefed and visit their family doctor and dentist in plenty of time. Chemoprophylaxis against malaria and inoculation against many tropical diseases are available and sensible advice can be given about how to keep healthy abroad. Adults and children should also be immune to infections such as poliomyelitis, diphtheria, tetanus and, if visiting the developing world, tuberculosis as well. Sensible clothing, equipment and adequate supplies of any regular medicaments must be taken. Some form of health insurance and, in addition for E.E.C. countries, a certificate of entitlement to free health care are wise additional precautions to take.

口底に発現した類表皮嚢胞の一症例

Dermoid cyst is a developmental anomaly that may be encountered infrequently in the soft tissues of the oral cavity. Intraoral dermoid cyst occurs most commonly in the midline of the floor of the mouth. Our purpose is to present a case, review the literature, and discuss this lesion's relationship to epidermoid cyst. A patient, a 9-year-old boy, was refferred to our clinic by his family dentist in January, 1980. Under general anesthesia, the cyst was extirpated through an intraoral incision. Sections of the specimen were embedded in paraffin and stained with hematoxylin and eosin. It was finally diagnosed as a sublingual epidermoid cyst by histologic examination.

Distance decay and dental decay: A study of dental health among primary school children in Newcastle upon Tyne

Bradliy J. E., Kirby A. M. and Taylor P. J. (1978) Distance decay and dental decay: a study of dental health among primary school children in Newcastle upon Tyne, Reg. Studies 12, 529–540. The purpose of this study is to try and explain variations in dental health among primary school children at a local scale within Newcastle upon Tyne. Data for 61 schools are correlated against social class variables describing their catchment areas and measures of accessibility to dental services within the city. It is found that access to family dentist has the highest correlation with dental health although class variables are also significant. This finding is related to previous studies and both methodological and policy implications are described.

The syndrome of oral complaints: Etiology and therapy

Many patients who were examined at the oral medicine clinic have had almost no findings, despite their severe complaints, and we propose to diagnose their condition as SOC (syndrome of oral complaints). It is more frequent in middle-aged postmenopausal women who thereby tend to express all three determinants of illness—the biologic, the psychological, and the social. Such a triple assessment of the determinants, together with a thorough physical examination, brings the SOC into the diagnostic category of hypochondria. Therefore, it should be treated by the family dentist or by the general internist, with reassurance, local measures, and minor tranquilizers.