Importance Of Dental Care Research Articles

IMPACTO DA MUCOSITE ORAL EM PACIENTES TRANSPLANTADOS DE MEDULA ÓSSEA AUTÓLOGO E O PAPEL DO CIRURGIÃO DENTISTA

The Haematopoietic Stem Cell Transplantation (HSCT) is a form of treatment used for some types of hematological cancers in which the patient is both a donor and recipient. The most relevant side effect of this therapy for dentistry is oral mucositis, which in addition to causing mucosal irritation, delay and interruption of the chemotherapy cycle, can be a gateway to opportunistic infections and lead to a death outcome. As a dental surgeon increasingly active in the multidisciplinary team, the importance of dental care in the trans-HSCT phase has been widely reported in the literature. Thus, the general objective of the present work was to carry out a literature review on the impacts of oral mucositis in autologous bone marrow transplant patients, as well as the specific objective of highlighting the importance of the dental surgeon in the care of these patients. Thus, for the design of the research, the descriptors Stomatitis, Hospital Dental Team, Hematopoietic Stem Cell Transplantation, Autologous Transplantation, through DeSC; PubMed, Scielo and Lilacs databases and the Boolean operators AND, OR and NOT were used as a search strategy in the time period from 2004 to 2022. Concluding that the impacts of oral mucositis in patients undergoing auto-HSCT are pathophysiological, of morbidity, mortality and financial loss. However, the presence of the dental surgeon in the multidisciplinary team brought clinical relevance to reduce the impacts caused by oral mucositis, acting, even in a preventive way, with qualitative and quantitative reduction of the condition.

Long-term benefits for children of including dental health in education

The present quasi-experimental study evaluated the effectiveness of a dental education program implemented at the Tuntatacto Educational Unit during the last quarter of the 2022-2023 academic year. The intervention included interactive workshops, distribution of dental hygiene kits, and teaching proper brushing and flossing techniques, specifically targeting the experimental group, while the control group did not receive these activities. The results indicated significant improvements in oral hygiene knowledge and practices in the experimental group compared to the control group, demonstrating the importance of incorporating dental education into the school curriculum. Data collected through pre- and post-intervention questionnaires showed an increase in awareness about the importance of dental care, regularity of brushing, flossing, and parental supervision in dental hygiene in the group that received the education. Additionally, a reduction in anxiety toward dental visits and greater acceptance of common dental procedures was observed. This study highlights the preeminence of early, practical educational interventions in dental health promotion, which not only improves children's immediate oral health but also establishes a solid foundation for long-term healthy oral hygiene practices. The implications detected suggest that similar programs could be effectively replicated in different educational contexts to strengthen dental education and prevent dental diseases from an early age

The role of oral and prenatal healthcare providers in the promotion of oral health for pregnant women

BackgroundHormonal alterations and lowered immunity during pregnancy aggravated by poor oral hygiene increase the risk of pregnant women of developing oral diseases. We conducted this cross-sectional study to examine the role of oral and prenatal health providers in promoting dental care for pregnant women attending primary healthcare centers (PHCs) in Saudi Arabia.MethodsAn online questionnaire was sent to a random sample of women who attended PHCs in Jeddah, during 2018–2019. From a total of 1350 women who responded to our questionnaire, 515 women reported having a dental visit before pregnancy. These women comprised our study sample. Bivariate analyses and multiple logistic regression models were conducted to examine associations between oral practices of dental and prenatal health providers (exposures) and women’s utilization of dental care during pregnancy (outcome). Covariates included age, education (< 12 years of education, 12 years of education, and > 12 years of education), family income (≤ 5,000, 5,001–7,000, 7,001–10,000, and > 10,000 Saudi Riyals), health insurance (yes/no), nationality (Saudi Arabian/non-Saudi Arabian), and presence of dental problems, such as toothache, dental caries, gingival inflammation, and the need for dental extractions.ResultsOnly 30.0% of women were informed by a dentist during their dental visit before pregnancy about the importance of visiting a dentist during pregnancy. About 37.0% of women were asked about oral health, 34.4% were informed about the importance of dental care during pregnancy, and 33.2% had their mouths inspected by prenatal health providers. Women informed by dentists about the importance of dental visits during pregnancy were twice as likely (Odds ratio [OR]: 2.42, 95% confidence interval [CI]: 1.63–3.60) to visit a dentist during pregnancy. Women who were referred to dentists, had their mouth inspected, or were advised to visit a dentist during pregnancy by prenatal providers were 4.29 (95% CI: 2.67–6.88), 3.79 (95% CI: 2.47–5.82), and 3.37 (95% CI: 2.16–5.27) times as likely to visit a dentist during pregnancy.ConclusionThe partaking of oral and prenatal healthcare providers in evidence-based oral health promotion practices, antenatal-dental collaboration, and closing the referral loop increase pregnant women’s access to and utilization of preventive and treatment dental services.

Sensory-Adapted Dental Environment for the Treatment of Patients with Autism Spectrum Disorder.

Purpose: The importance of dental care and oral hygiene is often underestimated in people with autism spectrum disorder (ASD). Comorbidity with dental anxiety is greater in ASD subjects who also show unusual reactions to sensory stimuli. The aim of our study was to assess the efficacy for a sensory-adapted environment and targeted methods in reducing anxiety and positively influencing cooperation in children with ASD during a dental examination or specific treatments. Material and methods: The sample consisted of 50 Italian children with a diagnosis of ASD (36 males and 14 females; aged 9–10 years) presenting with mild intellectual disability (ID) and verbal language skills. The subjects enrolled in the study had at least two decayed teeth and all were treated in two different dental environments: regular dental environment (RDE) and sensory-adapted dental environment (SADE). Results: 20% of the sample was successfully treated in RDE, while 68% of subjects were successfully treated in SADE. Conclusions: Results suggest that a sensory-adapted environment positively affects the therapeutic dental treatment in patients with ASD and reaffirm that sensory dysregulation in children with ASD is a crucial factor influencing the successful outcome of oral care.

Assessment of Awareness of Parents on Importance of Dental Care in Pediatric Patients in Ethnic Tamil Population

Assessment of Awareness of Parents on Importance of Dental Care in Pediatric Patients in Ethnic Tamil Population

Designing a Persuasive Application for Behaviour Change with Children:

Persuasive technology is a technology that is designed deliberately to change user behaviour without coercion and deception. This study demonstrates the design of a persuasive mobile application aiming to encourage children below 12 years old to take care of their teeth and increase their awareness towards the importance of dental care. We applied a design thinking approach which comprised of five different phases: empathize, define, ideate, prototype, and test. A total of 13 children participated in this study. The findings show that children found that the application informs them how to brush their teeth properly and increases their awareness about the importance of dental care. This indicates that the design thinking approach is indeed useful for the designer to design a persuasive application aiming to change children’s behaviour.

Dental care to the oncological patient in terminality

ABSTRACT End-stage cancer patients present many oral manifestations that need the support of a dentist, who included in the multidisciplinary team, must make the necessary adjustments in order to maintain the quality of life of these patients relieving their pain and suffering. Based on a literature review, the research searched articles published between June 2000 and February 2019, in the following databases: Pubmed, Scielo, Lilacs, Wiley Online Libary. The following inclusion criteria was used: articles published in Portuguese or English which included the keywords: dental care, critical care, palliative care, terminally ill. The aim of this paper is to present the importance of dental care to patients with cancer in palliative care. In conclusion, it was possible to verify that Dentistry in the hospital environment is of paramount importance, and should be based on empathy and communication, seeking to create the necessary bonds for the development of an effective and individualized treatment plan, discussion of cases in an integrated way and demonstrating the importance of higher education institutions in the training of future professionals. This paper aims to be contributory in order to increase the discussion about palliative care in Dentistry, besides providing subsidies to future studies that will deepen in this essential and still unexplored subject.

Dental health dispositions of pregnant women: A survey from a hospital clinic in Istanbul

Dental hygienic habits should be maintained in pregnancy despite challenges. We aimed to study the dental attitudes and habits of pregnant women. The patients attending our hospital clinic were invited to fill out a structured questionnaire categorised into three major domains: (1) general oral hygiene status, (2) dental habits, and (3) dental attandence both during pregnancy and prior to pregnancy. Four hundred and seventy four women agreed to participate. Mean age of participants was 28 (18–43). While 184 (38%) women reported brushing twice a day, only 98 (20%) women claimed using floss and or mouth rinse. Fifty-nine (12.4%) women had a dental visit in their current pregnancy and 24 (5.1%) received professional treatment. Obstetric care givers should convey the importance of dental care to their patients. We suggest that dental health should be improved antenatally, and be assessed in detail by dental health care providers.Impact StatementPoor oral health conditions have shown to be associated with an increased risk of adverse pregnancy outcomes, especially in low-income countries and regions. There is escalating evidence to support the lack of awareness among pregnant women about health consequences and long term risks associated with poor oral hygiene.Our results showed that dental hygienic practices of pregnant women are disconcerting in Turkey.The need for inter-professional collaboration among obstetric healthcare providers and dental specialistis is crucial for conveying to women the importance of dental care in pregnancy and beyond.

Differences in tensile adhesion strength between HEMA and nonHEMA-based dentin bonding applied on superficial and deep dentin surfaces

Background: Improvement in dentistry shows some progresses, due to patients awareness on the importance of dental care. Cervical lesion is the most common phenomenon which oftenly found 46.36% in man and 38.13% in woman. Cervical lesions need composite restoration for treatment to stop the process of tissue damage. The process of adhesion of composite restoration material to the structure of the tooth is not easily separated and it needs optimal function in the oral cavity. Application of dentin bonding agents to attach the composite is needed. Selection of HEMA-based bonding material and Hema free-based bonding material which have a different solvent in their composition, as applied to the dentin superficial and deep dentin, affect the results of debonding test. Debonding test is done to measure the adhesion strength of a bonding material. Purpose: The purpose of this study was to analyze differences in tensile bond strength of dentine bonding HEMA-based and HEMA-free based after application in superficial and deep dentine surfaces. Method: The tooth of the bovine was as samples. A superficial dentine sample was taken from 0.5-1 mm of dentino enamel junction and a deep dentine sample was taken from 0.5 mm culmination of pulp horn. Dentine surface area was equal to p x r2 = (3.14 x 22) = 12.56 mm2. Six samples of HEMA-based bonding was applied to the dentine superficial. Six samples of HEMAfree based bonding was applied to the superficial dentine. Six samples of HEMA-based bonding was applied to the deep dentine. Six samples of HEMA-free based bonding was applied to the deep dentine. Tensile strength was measured using an Autograph AG-10TE. Result: There were differences tensile bond strength of dentine bonding HEMA-based and HEMA-free based after the application on superficial (p=0.000) and deep dentine surfaces (p=0.000). Conclusion: There were differences tensile bond strength of dentine bonding HEMA-based and HEMA-free based after the application on superficial and deep dentine surfaces. The use of dentine bonding materials HEMA-free based were better than HEMA-based after application on different dentine depths.

Dental Awareness among Parents and Oral Health of Paediatric Cancer Patients Receiving Chemotherapy.

Dental care is often overlooked by the parents of children receiving treatment for cancer including chemotherapy who are in a phase of severe immunosuppression. (i) To study dental attitudes of parents of children receiving chemotherapy towards importance of dental care. (ii) To evaluate oral hygiene status and compare it with healthy controls. A questionnaire assessing the awareness towards dental care was given to the parents of 47 paediatric patients suffering from cancer receiving chemotherapy and to parents of 47 paediatric patients reporting to outpatient Department of Pedodontics at SGT Dental College. Oral examination was also carried out for both the groups and DMFT/dmft, plaque and gingival index were noted. Parents had a varying opinion regarding dental health of their child. The caries status of children in the control group was greater than children in the study group. The mean plaque index of children in the control group (1.40) was greater than children in the study group (1.34) which was statistically significant according to Mann-Whitney U test. The gingival health of children in the study group was better than children in the control group which was also not statistically significant. This study highlights need for a periodic referral of the child cancer patients to the paediatric dental clinic in hospitals for the timely dental care.

Barriers to dental care for older minority adults.

To explore factors that motivate and/or discourage use of dental care among low-income minority older adults Participants were recruited from low-income senior housing in Hartford, CT. In-depth semistructured interviews were conducted to obtain data on demographics, oral health status, oral health knowledge, and factors that affected use of dental care. Seventeen participants completed interviews. The major perceived barriers to dental care were cost/lack of dental insurance, fear/mistrust of the dentist, and transportation problems. Other factors included having complex medical conditions, no perceived need for care, and lack of knowledge about the importance of dental care. Participants would like to have dental care provided on-site in the housing complexes. Improving communication between dentists and their older patients would help reduce fear and mistrust. Other health care providers could help educate older patients about oral health, conduct simple oral health screenings, and refer for acute and/or comprehensive care.

Xerostomia related to HIV infection /AIDS: a critical review

Introduction: The presence of oral manifestations in HIV positive individuals is quite common. Xerostomia appears as one of the most frequent problems and may lead to a reduction in the quality of life of this population. Objective: This study was a critical review of the relationship between xerostomia and HIV infection, to attract the attention of dentists on the importance of dental care to these patients. Material and method: We included articles published between 2000 and 2009, indexed in PUBMED database. The descriptors used were "HIV" and "xerostomia", the exclusion criteria adopted were: the absence of these descriptors associated, non-location of the full-text, articles based on case studies or case series and the absence of the abstract in the database. Result: Based on studies in the review, it can be said that the xerostomia is a common manifestation of HIV infection, predisposing the patient to several other oral problems. Among the risk factors for its occurrence it was reported: low counts of CD4+ T cells, high plasma viral load, the use of some medications and antiretroviral therapy. Conclusion: The HIV/AIDS can change the salivary glands, and were considered important risk factors for the occurrence of xerostomia the presence of didanosine and the drug class which corresponds to protease inhibitors in antiretroviral therapy.

Dental care utilization among older adults with cognitive impairment in the USA.

We examined the relationship between cognitive impairment and dental care utilization among older adults in the USA. A total of 329 older adults aged 70 years and older in West Virginia, USA, were included in the present analyses. We carried out multivariate ordinal regression analyses. Individuals with dementia were less likely to visit a dentist regularly, and more time had passed since their last dental visit compared with individuals with normal cognitive function. However, the pattern of dental care utilization for those with cognitive impairment, not dementia did not differ from individuals with normal cognition. A perceived greater social network and having dental insurance were associated with increased dental care utilization. Less dental care utilization might contribute to the oral health problems often observed among individuals with dementia. Efforts to increase the use of dental care should include cost-effective options for dental insurance. In addition, educating formal and informal caregivers on the importance of dental care might be beneficial, as these individuals are in the best position to facilitate dental care for individuals with dementia.

Sociodemographic disparities and behavioral factors in clinical oral health status during pregnancy

Although oral health (OH) problems are common during pregnancy, little is known about individual characteristics or behaviors relating to clinically assessed OH during pregnancy. This cross-sectional study describes the clinical OH status of a sample of pregnant women, examines relationships between sociodemographic factors and OH, behavioral factors and OH, and the influence of behavior on the relationships between sociodemographic clusters and OH. Baseline data were utilized from a pilot intervention study promoting OH during pregnancy. Participants (n=99), recruited from CenteringPregnancy(®) prenatal care groups completed questionnaires addressing race/ethnicity, income, education, dental insurance, oral hygiene practices, and dental care utilization; and clinical examinations for periodontal probing depths (PD), bleeding on probing (BOP), plaque assessment, and visual detection of untreated decay. Chi-squares and one-way anovas with Tukey's studentized range test of planned comparisons were conducted to examine bivariable relationships between both sociodemographic and behavioral characteristics to OH status. Multivariable logistic regression analyses tested whether the effects of sociodemographic variables on OH status might be mediated by behaviors, including self-reported oral hygiene and recent dental visits. Forty-five percent of the sample had untreated decay and the mean percentage of sites with BOP=18%. Bivariable analyses of sociodemographic factors indicated that compared with Whites, Hispanic women had greater % of sites with: BOP, PD ≥5mm plus BOP, and Plaque Index (PI) scores of ≥2, all P=0.05; and greater untreated decay (Chi-square 13.3, P<0.001). Lower income was related to greater untreated decay (Chi-square 7.6, P<0.01). Compared with the highest education level, the lowest level group had higher % BOP, P<0.05. Public dental insurance (versus private) was associated with greater % BOP, PD ≥5mm plus BOP, both P<0.05, and greater untreated decay (Chi-square 16.9, P<0.001). Regarding behaviors, lacking a past 6-month dental visit was related to greater: BOP, PD ≥5mm plus BOP, and PI ≥2 (F range 6.2-8.7, P<0.01-0.05); and greater untreated decay (Chi-square 12.0, P<0.001). Self-reported optimal oral hygiene was related to lower % BOP and PD ≥5mm plus BOP (F range 4.5-6.7, both P<0.05). Mediation analyses indicated that there were significant indirect effects of racial/ethnic differences on OH outcomes via having a recent dental visit (OR range 1.2-1.9). However, significant differences between the Hispanic and White groups remained. This study highlights sociodemographic disparities in clinical OH during pregnancy, the importance of dental care, and provides useful findings for tailoring interventions for expectant mothers and their infants.

Frequency and Risk Indicators of Tooth Decay among Pregnant Women in France: A Cross-Sectional Analysis

IntroductionLittle is known on the prevalence of tooth decay among pregnant women. Better knowledge of tooth decay risk indicators during pregnancy could help to develop follow-up protocols for women at risk, along with better prevention strategies. The aim of this study was to assess the frequency of tooth decay and the number of decayed teeth per woman in a large sample of pregnant women in France, and to study associated risk indicators.MethodsA secondary cross-sectional analysis of data from a French multicentre case-control study was performed. The sample was composed of 1094 at-term women of six maternity units. A dental examination was carried out within 2 to 4 days post-partum. Socio-demographic and behavioural characteristics were obtained through a standardised interview with the women. Medical characteristics were obtained from the women’s medical records. Risk indicators associated with tooth decay were identified using a negative binomial hurdle model.Results51.6% of the women had tooth decay. The mean number of decayed teeth among women having at least one was 3.1 (s.d. = 2.8). Having tooth decay was statistically associated with lower age (aOR = 1.58, 95%CI [1.03,2.45]), lower educational level (aOR = 1.53, 95%CI [1.06,2.23]) and dental plaque (aOR = 1.75, 95%CI [1.27,2.41]). The number of decayed teeth was associated with the same risk indicators and with non-French nationality and inadequate prenatal care.DiscussionThe frequency of tooth decay and the number of decayed teeth among pregnant women were high. Oral health promotion programmes must continue to inform women and care providers about the importance of dental care before, during and after pregnancy. Future research should also assess the effectiveness of public policies related to oral health in target populations of pregnant women facing challenging social or economic situations.

The political culture of healthcare: why substantial dental care in Canada is covered by government insurance only in Québec – lessons for the United States?

This opinion paper explains the unique and favourable terms of dental health insurance coverage available to residents (both permanent and temporary) of the Province of Québec, Canada. In comparison, the United States and British Canada are the poor stepchildren of government-mediated provision of dental health coverage. The differences in dental healthcare provision between these regions are a question of culture - more specifically, of differing socio-political cultures and different perspectives on the importance of dental care. Lawmakers in the United States can learn from this policy of government-administered dental insurance that appears to work well in Québec.

A new management approach for dental treatment after a cerebrovascular event: a comparative retrospective study

Current literature recommends postponing dental treatment until 6-12 months after a stroke, based on the presumed risk of recurrent stroke. The purpose of this study was to suggest that the importance of dental care during this period exceeds the risk of medical complications in this patient population. Two groups were compared: 1) a cerebrovascular (CrbV) study group: patients (n = 16) who had suffered from a CrbV event within the 12 months preceding their dental procedure; and 2) a cardiovascular (CV) control group: patients (n = 25) suffering from ischemic CV disease. Patients were monitored during and after the dental treatment. Treatment parameters and outcome were compared. Patients received various essential dental treatments with intense monitoring during their dental management. Dental procedures were invasive in 68.8% and 0% of CrbV and CV groups, respectively. Dental treatments were completed uneventfully. No clinical CrbV or CV complications were noted in either group after the dental treatment. Within the limits of this small retrospective study, it appears that dental treatment may be safely administered in patients a few weeks after the CrbV event as long as these patients are kept under optimal medical surveillance.

Childhood leukaemia: experiences of children and attitudes of parents on dental care

Parental perceptions in the importance of dental care and preferences with regard to its provision while profiling the level of dental health knowledge of parents of leukaemic children were elicited. The setting was the Paediatric Dental Care Unit located in Medical Faculty. Data were collected by means of a structured interview, employing a questionnaire. Level of knowledge on both dental facts and preventive dentistry of the participants was insufficient. Major source of dental care was the resident paediatric dentist both in prior to (78.2%) and following (100%) diagnosis. Tooth extraction (17.6%) was the only treatment provided prior to diagnosis. Following diagnosis, 60 (69%) of these children had received operative dental treatment. The source of preventive advice was inconsistent. Parents appeared to place a high level of importance on their children's dental care and the preference for this to be provided within the hospitals in which the child has been treated. There is clearly a need to establish dental care units in hospitals in which treatment of childhood malignancy is provided. The provision for the future should be the continuous education of dentists, physicians and nurses who work in hospitals and public health services.

COMPILED BY THE VACCINATION GUIDELINES GROUP (VGG) OF THE WORLD SMALL ANIMAL VETERINARY ASSOCIATION (WSAVA)

The WSAVA Vaccination Guidelines Group (VGG) was convened in order to develop guidelines for the vaccination of dogs and cats that have global application. The first version of these guidelines was published in 2007 and they were updated in 2010. The present document provides a further updated and expanded version of these international guidelines for the vaccination of small companion animals and indicates the scientific evidence base on which the recommendations are made. The VGG recognises that the keeping of pet small animals is subject to considerable variation in practice and associated economics throughout the world and that vaccination recommendations that might apply to a developed country may not be appropriate for a developing country. These guidelines are not a mandatory edict, but rather should be used by national associations and individual veterinary practices to develop vaccination schedules relevant locally. However, the VGG strongly recommends that wherever possible ALL dogs and cats receive the benefit of vaccination. This not only protects the individual animal, but provides optimum ‘herd immunity’ that minimises the likelihood of infectious disease outbreaks. With this background in mind, the VGG has defined core vaccines as those which ALL dogs and cats, regardless of circumstances or geographical location, should receive. Core vaccines protect animals from severe, life-threatening diseases that have global distribution. Core vaccines for dogs are those that protect against canine distemper virus (CDV), canine adenovirus (CAV) and the variants of canine parvovirus type 2 (CPV-2). Core vaccines for cats are those that protect against feline parvovirus (FPV), feline calicivirus (FCV) and feline herpesvirus-1 (FHV-1). In areas of the world where rabies virus infection is endemic, vaccination against this agent should be considered core for both species, even if there is no legal requirement for routine vaccination. The VGG recognizes that maternally-derived antibody (MDA) interferes with the efficacy of most current core vaccines administered to pups and kittens in early life. Because the level of MDA varies among litters, the VGG recommends administration of multiple core vaccine doses to pups and kittens, with the final dose given at 16 weeks or older and followed by a booster at 6- or 12-months of age. In cultural or financial situations where a pet animal may only be permitted the benefit of a single vaccination, that vaccination should be with core vaccines at 16 weeks of age or older. The VGG supports the use of simple in-practice tests for determination of seroconversion to the core vaccine components (CDV, CAV, CPV-2 and FPV) following vaccination, for determination of seroprotection in adult dogs and for management of infectious disease outbreaks in shelters. Vaccines should not be given needlessly. Core vaccines should not be given any more frequently than every three years after the 6- or 12-month booster injection following the puppy/kitten series, because the duration of immunity (DOI) is many years and may be up to the lifetime of the pet. The VGG has defined non-core vaccines as those that are required by only those animals whose geographical location, local environment or lifestyle places them at risk of contracting specific infections. The VGG has also classified some vaccines as not recommended (where there is insufficient scientific evidence to justify their use) and has not considered a number of minority products which have restricted geographical availability or application. The VGG strongly supports the concept of regular (usually annual) health checks which removes the emphasis from, and client expectation of, annual revaccination. The annual health check may still encompass administration of selected non-core vaccines which should be administered annually, as the DOI for these products is generally 1 year. The VGG has considered the use of vaccines in animal shelters, again recognising the particular circumstances of such establishments and the financial constraints under which they sometimes operate. The VGG minimum shelter guidelines are simple: that all dogs and cats entering such an establishment should be vaccinated before, or at the time of entry, with core vaccines. Where finances permit, repeated core vaccines should be administered as per the schedules defined in the guidelines and non-core vaccines against respiratory disease may be included. The VGG recognizes the importance of adverse reaction reporting schemes, but understands that these are variably developed in different countries. Wherever possible, veterinarians should be actively encouraged to report all possible adverse events to the manufacturer and/or regulatory authority to expand the knowledge base that drives development of improved vaccine safety. These fundamental concepts proposed by the VGG may be encapsulated in the following statement: We should aim to vaccinate every animal with core vaccines. Non-core vaccines should be given no more frequently than is deemed necessary.

Dental infection in vascular surgical patients.

Seventy patients, 18 women and 52 men of mean age 68 (range 52-81) years, with vascular disease were studied using the Community Periodontal Index of Treatment Needs (CPITN). Twenty-six were edentulous and 44 dentate; 32 dentate patients were wearing partial dentures. All had occlusive peripheral arterial disease (ankle:brachial pressure index less than 0.9) or aortic aneurysm. No significant periodontal pathology was found in edentulous patients. Of the dentate patients, 28 were in the significant pathology range (CPITN 4) and 12 were in the moderate pathology group (CPITN 3); only four had no significant pathology (CPITN 0-2). As a proportion of prosthetic vascular graft infections may be due to dental sepsis, surgeons should consider referral for dental assessment before elective bypass grafting and patients should be warned about the importance of dental care after operation.