Outpatient Dental Clinic Research Articles

Dental Local Anesthetic Techniques for Minor Operations at Outpatient Clinic

The most widely used method of pain control in dental practice is to block the pathway of painful impulses by local anesthesia. For a maximum effect of pain control at outpatient minor operation, regional anesthesia including nerve block must be performed. This issue includes various dental local anesthetic techniques on mandible, maxilla and considerations for selection of dental local anesthetics according to patient's age, duration of operation. Additionally, current conscious sedation technique combined with local anesthesia will be introduced for control of patient's anxiousness. Based on patient's general condition, severity of operation, local anesthesia sometimes must be changed into general anesthesia to avoid failure of dental practice. The exact choice of anesthetic techniques for minor operations at dental outpatient clinic must not be underestimated for complete success of pain control.

Dental Treatment Need Among First-Visit Patients Of Dental Outpatient Clinic At IIUM Kuantan For The Year 2016

Introduction: This cross-sectional study aimed to determine association of age and gender with dental treatment need among first-visit patients at Dental Outpatient Clinic, IIUM Kuantan in 2016. Materials and Methods: Ethical approval (IREC 762) was obtained from IIUM Human Ethics Committee. List of first-visit patients who attended clinic from 1st January to 31st December 2016 was retrieved to assess patient's age and gender. Dental treatment need was determined according to the normative need which was professionally defined by dental-officer-in-charge. All first-visit patients were included, except those attended Orthodontic department or with old Malaysian identification card or foreign passport. Included patients were classified into six age groups (≤14, 15-19, 20-34, 35-44, 45-64 and ≥ 65). Pearson's chi square test was used for statistical analysis using SPSS Version 20 software. Results: From a total number of 2,713 patients (age range of 2 to 87), 1,210 (44.6%) were males and 1,503 (55.4%) were females. Age (p<0.001) and gender (p<0.001) were significantly associated with dental treatment need. Paediatric patients (≤14) majorly received paedodontic care (97.5%). Young-age patients (15-19, 20-34 and 35-44) mostly required conservative care (39.5%, 31.2% & 30.6%, respectively) while elder-age patients (45-64 and ≥ 65) have major need for prosthodontics (30.0% & 40.2%, respectively). Females outnumbered males in all age groups, except for the age group of ≥ 65 whereby the situation was the opposite. Females also outnumbered males in all types of treatment need, except for periodontics which was predominated by males. Conclusion(s): Age and gender have significant associations with treatment need for dental care.

A comparison of effectiveness between oral rapid testing and routine serum-based testing for HIV in an outpatient dental clinic in Yuxi Prefecture, China: a case–control study

ObjectiveTo compare the outcomes of routine provider-initiated HIV testing and counselling (PITC) and oral rapid HIV testing for dental clinic outpatients in a hospital.DesignWe employed a case–control study design and...

The effectiveness of SMS Reminders and the impact of patient characteristics on missed appointments in a public dental outpatient clinic

This paper reports on the Failure To Attend (FTA) rate of appointments as well as patients following the implementation of SMS reminders in a public dental outpatient service. Given the ineffectiveness of the intervention and a highly representative patient’s profile, this paper identifies the demographic characteristics of patients who miss all of their appointments. Data on appointment attendance, patient demographics and dental service type was collected over a time period of 46 consecutive months. Using descriptive and inferential statistics (chi-square, two sample tests and Marascuilo procedure) we found the SMS intervention was ineffective in reducing the FTA rates. Further, patients associated with high rates of non-attendance exhibited one or more of the following characteristics: male; age 26 – 44; non-concession card holders; a person of Indigenous, local, Asian or African descent, and of refugee status, persons living in low socio-economic areas; and appointments in General Care and Student Clinics. Whilst the literature overwhelmingly attributes SMS reminders to improving the attendance rate of patients in outpatient clinics, our contradictory findings suggest a more targeted approach in settings whose patients exhibit strong characteristics associated with non-attendance.

Prevalence of Dental Developmental Anomalies in Patients Attending a Faculty of Dentistry in Ajman, United Arab Emirates

Objective: To determine the prevalence of dental developmental anomalies among patients visiting the dental clinics at Ajman University, United Arab Emirates. Material and Methods: This retrospective study consisted of 425 digital panoramic radiographs. The study sample included people in the United Arab Emirates who have visited the outpatient dental clinics at the Faculty of Dentistry, at Ajman University. These OPGs have been evaluated for the presence of dental anomalies such as: Macrodontia, Microdontia, Talon cusp, Taurodontism, Dilaceration, Ectopic Eruption, Supernumerary teeth or roots, Fusion, Gemination, and Concrescense. Results: 80.7% had at least 1 anomaly, with the maximum of 5 anomalies presented in 1.2% of the sample. Dilacerations were the most commonly identified anomaly (61.4%), followed by missing third molars (22.8%), and Ectopic Eruption (15.5%) where (12.9%) of this anomaly has affected the maxillary canines. Hypercementosis (10.2%) followed by Microdontia (4.6%), which was mostly seen in the Upper laterals. Taurodontism accounted for (4.1%), Macrodontia (2.3%) and Talon cusp (2.3%). Gemination, Dens Invaginatus, and Concrescence were separately present in 1.1%, each one, of the cases observed. Conclusion: Variations in data and results among different studies suggest the impact of racial, genetic and environmental factors. The high frequency of dental anomalies emphasize the need of early detection and diagnosis which can be achieved through radiographic imaging, this would aid in further awareness to minimize any means of complexity in dental problems.

A Retrospective Analysis of Radiographic Jaw Findings in Young Women; Prevalence and Predictors.

Aims and Objectives:To determine the prevalence and types of jaw pathologic findings as detected in panoramic radiographs of a sample of young women attending a teaching hospital in Al Madinah Al Munawarah, Saudi Arabia, and to determine the most important factors that predict the occurrence of jaw pathologic findings.Materials and Methods:The electronic clinical files of a representative sample of female patients who attended the outpatient dental clinics were retrieved. Patients were aged 18 to 25 years. Types of pathologic radiographic jaw findings and their prevalence were determined through screening of panoramic radiographs. Data were analyzed using the statistical analysis software [SPSS version 21 (IBM Corp.)]. Multiple linear regression was used to explore the significance of some types of dental lesions as predictor variables for the occurrence of jaw pathologic findings.Results:A total of 190 patients (mean age, 22.4 ± 2.46 years) were included in the study. Periapical lesions, retained roots, and alveolar bone loss were detected in 53.6%, 24.8%, and 17.4% of the participants, respectively. Other odontogenic abnormalities such as supernumerary and impacted teeth (6.4% and 33.7%, respectively) were also detected. Patients' age was found to be a good predictor for alveolar bone loss and number of periapical lesions (P ≤ 0.05).Conclusions:A high prevalence of periapical lesions, retained roots, and alveolar bone loss was found among a sample of young female dental attendees, as shown by their panoramic radiographs. Further studies are needed to explore potential risk factors for such a noticeable trend of poor oral health, and the needed strategies to counteract this trend.

Glossopharyngeal neuralgia of tumor origin diagnosed in dental care. Case report

ABSTRACT BACKGROUND AND OBJECTIVES: The glossopharyngeal neuralgia is a neuropathy considered rare that manifests itself in the IX cranial nerve distribution characterized by an electric shock-like pain, often associated with hyperalgesia and allodynia. The etiology may be related to vascular changes, brain tumor, or even idiopathic. The aim of this study was to report a case of glossopharyngeal neuralgia secondary to a brain tumor diagnosed in a dental clinic, highlighting its clinical manifestations and discussing its nosological limit with other orofacial pain. CASE REPORT: Female patient, 63 years old, sought care at a dental outpatient clinic of Orofacial Pain complaining about an intense electric shock and jumping pain of sudden onset on the lower right edge region and right tongue base. She reported that the events were triggered and exacerbated when chewing, opening the mouth, laughing and talking. The diagnostic hypothesis of glossopharyngeal neuralgia was tested by momentary depletion to the application of benzocaine 20% and pain remission with the administration of carbamazepine (400mg/day) for 20 days. The patient was referred to the Neurology service of the hospital, where the magnetic resonance imaging presented an expansive, solid, extra-axial lesion in the right prepontine cistern, suggesting meningioma. CONCLUSION: The professional should be aware of the differential diagnosis of orofacial pains, especially in episodic neuropathies, to rule out the tumor etiology. In these cases, the quick referral to tertiary centers is fundamental for the good prognosis.

Music before Dental Surgery Suppresses Sympathetic Activity Derived from Preoperative Anxiety: A Randomized Controlled Trial.

The aim of this study was to estimate the relieving effect of music intervention on preoperative anxiety by using heart rate variability (HRV) analysis. In this randomized controlled trial, 86 adult patients were scheduled to undergo impacted tooth extraction under intravenous sedation and local anesthesia and were classified as either fearful or nonfearful based on a questionnaire. Thereafter, the patients were subdivided into 2 groups: those who listened to music from the time that they arrived at the outpatient clinic until immediately before entering the operating room and those who did not listen to music. The effect of music intervention was evaluated by assessing 1) the low-frequency/high-frequency ratio of HRV, in which positive changes indicate increased sympathetic nervous activity, and 2) the coefficient of component variance for high frequency, in which positive changes indicate increased parasympathetic nervous activity, assessed by means of HRV analysis. Subjective preoperative anxiety was evaluated on a visual analog scale. For fearful patients, the mean magnitude of low-frequency/high frequency changes from baseline among those who listened to music was significantly lower as compared with those who did not listen to music (in the private room: -1.45 ± 1.88 vs. 1.05 ± 1.88, P = 0.0096, 95% confidence interval of effect size = -4.52 to -0.48, Cohen's d = -0.75; in the operating waiting room: -2.18 ± 2.39 vs. -0.10 ± 3.37, P = 0.011, 95% confidence interval of effect size = -3.94 to -0.22, Cohen's d = -0.71, respectively). Visual analog scale scores were also significantly different. Coefficient of component variance for high frequency and heart rate did not differ significantly between the 2 groups. From the perspective of autonomic nervous activity, music intervention is useful for relieving anxiety in patients with dental fear before they enter a dental outpatient operating room. Music intervention may relieve anxiety by reducing sympathetic nervous activity, while parasympathetic nervous activity is not involved (UMIN000016882). Knowledge Transfer Statement: The results of this study revealed that music intervention is useful for clinicians when planning preoperative anxiety management of patients with dental fear who undergo impacted tooth extraction under intravenous sedation and local anesthesia. As a bridging intervention, music intervention enables stress management to continue uninterrupted from the patient's arrival at the dental outpatient clinic to intravenous sedation until completion of the dental surgery. With consideration of cost-effectiveness, absence of adverse physical effects, immediate effect, safety in terms of not using drugs, and lack of concerns about recovery, this information could lead to more appropriate decisions regarding anxiety management in dentistry.

Oral submucous fibrosis: A demographic study

Introduction: Oral submucous fibrosis (OSF) has the highest malignant potential disorder than any other oral premalignant lesions. It is found in the Asian subcontinent, mostly India, Pakistan, Sri Lanka and Bangladesh. The understanding of the exact role of alkaloids and other etiological agents with respect to pathogenesis will help in the management and treatment modalities. Materials and Methods: A total of 1006 patients of OSF attending the dental outpatient clinic of the Department of Oral Medicine and Radiology over a period of 24 months were selected for the study. A detailed case history and clinical examination was done in visible light. The diagnosis of OSF was difficulty in opening the mouth and associated blanched oral mucosa, with palpable fibrous bands. Other diagnostic features included burning sensation, salivation, tongue protrusion, habits and associated malignant changes. Study was done on the basis of age group, habit duration, frequency of habit, and type of habit. Statistical Analysis Used: Simple correlation analysis was performed. Results: Of the 1006 cases of OSF studied, 422 (41.94%) cases were stage II. Two hundred and twenty six (22.29%) were stage IV, 184 (18.29%) stage III, and 174 (17.29%) stage I. Among the groups divided based on age, Group II (20-30 years age) showed more prevalence than the others. Areca nut (gutkha) was a powerful etiological factor (60.43%) among other etiological factors. Conclusion: In the present study it was concluded that although the prevalence based on duration and frequency of habit was variable, it was found that most of the subjects were having stage II OSF and the severity was more in subjects who were chewing for longer duration and swallowing.

Individual oral symptoms in burning mouth syndrome may be associated differentially with depression and anxiety

Background Burning mouth syndrome (BMS) is an idiopathic disease characterized by the feeling of burning in the oral cavity. Ten per cent of patients presenting to oral medicine clinics have BMS. Anxiety and depression are common co-morbidities in BMS, but it is not known if they are associated with specific BMS symptoms. Objective In an exploratory analysis, this study examined the association of generalized anxiety and depression with individual BMS symptoms. Methods Forty-one patients were recruited from a dental outpatient clinic (30 with BMS and 11 with other oral conditions), evaluating specific BMS symptoms and their intensity. Anxiety and depression symptoms were assessed using a standardized measure (Clinical Interview Schedule–Revised). Results Taste change (p = 0.007), fear of serious illness (p = 0.011), metallic taste (p = 0.018) and sensation of a film on the gums (p = 0.047) were associated with an excess of psychiatric symptoms. More specifically, metallic taste (coefficient = 0.497, 95% CI = 0.149–0.845; p = 0.006) and sensation of film on gums (coefficient = 0.625, 95% CI = 0.148–1.103; p = 0.012) were associated significantly with higher scores for depressive symptoms; taste change (coefficient = 0.269, 95% CI = 0.077–0.461; p = 0.007), bad breath (coefficient = 0.273, 95% CI = 0.065–0.482; p = 0.012) and fear of serious illness (coefficient = 0.242, 95% CI = 0.036–0.448; p = 0.023) were associated with higher anxiety scores. Conclusion Specific BMS symptoms are associated differentially with generalized anxiety and depression. Dental practitioners should ascertain which BMS symptoms are predominant and be mindful of the association of certain symptoms with anxiety or depression and, where necessary, consider medical consultation.

Cone-beam computed tomography in pediatric dentistry, a retrospective observational study.

The aim of this study was to find the reasons for referral and their correlation with age, gender, field of view, and resolution for all patients under the age of 18 who underwent a cone-beam computed tomography (CBCT) scan between 1 May 2010 and 1 May 2012 in the dental out-patient clinic of the University Hospital Ghent. From the local CBCT database, 79 pediatric patients gave their consent. Subsequently age, gender, reason for referral, external or internal referral, field of view(FOV), and resolution data were collected. Descriptive and comparative statistical analysis was performed. There seemed to be a correlation between orthodontic referrals and female patients. The majority of patients referred for trauma follow-up were 12years and older. Fourteen percent of referrals were for dento-alveolar trauma, 18% for other dento-alveolar reasons, 4% for developing dentition-generalized, 36% for developing dentition-localized, 10% for endodontics, 1% for periodontics, 16% for surgical applications, and 1% was for the visualization of the TMJ. Eighty percent of the CBCTs were taken at a FOV 50 × 55mm. Larger FOV was used for surgical planning or follow-up reasons. The majority of the CBCTs was taken at a resolution of 200μm, while a resolution of 150μm was used for endodontic issues. From these results, a classification system for referral was developed. From the present study, it can be concluded that a referral pattern could be detected which was correlated with gender, age group, FOV, and resolution. These results can help practitioners make the decision to refer for CBCT when extra three dimensional imaging is expected to have a benefit in therapeutic value for a pediatric or adolescent patient. This study can guide dental professionals referring pediatric and adolescent patients for CBCT.

Screening of Transforming Growth Factor Beta 3 and Jagged2 Genes in the Malay Population With Nonsyndromic Cleft Lip With or Without Cleft Palate.

To determine the prevalence of mutations in transforming growth factor beta 3 (TGFβ3) and Jagged2 genes and their association with nonsyndromic cleft lip with or without cleft palate (CL±P) patients. Cross-sectional study on nonsyndromic CL±P and noncleft patients. Reconstructive clinic and outpatient dental clinic, Hospital Universiti Sains Malaysia. Blood samples of 96 nonsyndromic CL±P and 96 noncleft subjects. Prevalence and association of mutations in TGFβ3 and Jagged2 genes with nonsyndromic CL±P. Most of the nonsyndromic CL±P patients (53.1%) had left unilateral CLP. There were slightly more females (56.6%) compared with males. The prevalence of the mutations in the TGFβ3 gene was 17.7% (95% confidence interval [CI]: 9.5, 24.5) and in the Jagged2 gene was 12.5% (95% CI: 5.5, 18.5), which was higher compared with the noncleft group. For the TGFβ3 gene, there was no mutation in the coding region in either of the groups. All variants were single nucleotide polymorphisms located within the intronic flanking region. Two variants were identified (g.15812T>G and g.15966A>G) in both nonsyndromic CL±P and noncleft patients. However, the association was not significant (P > .05). Three variants (g.19779C>T, g.19547G>A, and g.19712C>T) were identified in the Jagged2 gene among nonsyndromic CL±P and noncleft patients. Only g.19712C>T showed a significant association with nonsyndromic CL±P patients (P = .039). g.19712C>T might play a crucial role in the development of cleft lip and palate. To the best of our knowledge, this is the first report of the mutation found within intron 13 of the Jagged2 gene among nonsyndromic CL±P Malay patients.

Assessment of pain among a group of Nigerian dental patients.

BackgroundPain is considered a key symptom associated with possible impairment of oral-health-related quality of life and its assessment is important for the planning and evaluation of preventive and treatment effort. The tools for assessing pain must therefore be valid and consistent. The objective of this study was to assess dental patients’ level of pain based on the clinical diagnosis of their dental condition and the correlation between two pain assessment scales, Visual analogue scale (VAS) and the Full Cup Test (FCT), for the assessment of pain among dental patients.MethodsA total of 185 patients presenting at the University of Benin Teaching Hospital dental outpatient clinics with various forms of orofacial pain were included in this study. The mean VAS scores and mean FCT scores for the different dental conditions were compared. Agreement between VAS and FCT was evaluated using the Intra-class correlation (ICC) coefficients and Cronbach alpha coefficient was also calculated to assess consistency of the two pain scales.ResultsMajority i.e. 95.1, 96.2 and 100% who presented with acute pulpitis, acute apical periodontitis and pericoronitis respectively, presented with moderate to severe pain levels (p < 0.05). Only 25.9 and 4% who presented with chronic marginal gingivitis and chronic pulpitis respectively presented with no pain (p < 0.05). A large proportion (75%) of patients with no pain had single diagnosis while more than half (52.1%) of those who presented with severe pain had multiple diagnoses (p = 0.025). The mean VAS and FCT scores for acute pain were 6.1 ± 2.1 and 5.9 ± 2.4 respectively and for chronic pain 3.9 ± 2.7 and 3.7 ± 2.7 respectively (P = 0.001). The interclass correlation coefficient revealed that the mean VAS and FCT scores were statistically correlated and reliable with a Cronbach alpha coefficient of 0.85.ConclusionIt can be concluded that patients who presented with either acute or chronic dental conditions may experience moderate to severe level of pain, with patients with multiple diagnoses experiencing more severe pain, and there is a correlation between the VAS and FCT for pain assessment among dental patients.

Prevalence of developmental dental anomalies among adult population of Jazan, Saudi Arabia

This study was intended to determine the prevalence of developmental dental anomalies (DDA) among adults attending the outpatient dental clinics of college of dentistry, Jazan University, Kingdom of Saudi Arabia. The data obtained are expected to increase the understanding of their etiology and also aid for better management and prevention. The materials were retrieved from the files of patients reporting to the dental clinics of college of dentistry, Jazan University over a period of four months from December 2013 to March 2014. Panoramic radiographs of 1000 patients (500 males and 500 females) with an age range of 18–40 years were examined for anomalies in teeth number, shape, size and position. Descriptive statistics was performed using SPSS 20 and the value of significance obtained using Chi square and Fisher exact test. The level of significance was set at 95% confidence level. The prevalence of DDA was 37.8% and distributed equally in both the sexes. The most common anomaly was rotation (20.2%) followed by ectopic eruption (7.6%). Microdontia (0.9%), supernumerary roots (0.7%), macrodontia (0.6%) and transposition (0.3%) were less common. The prevalence of rotation is statistically significant (p < 0.05). A significant number of patients had DDA. The prevalence of rotation was high and associated with other common dental diseases. Comparison of our data with other studies showed variation in their prevalence suggesting the influence of genetic and environmental factors. The high prevalence of DDA suggests the need for proper diagnosis, intervention and treatment. Further research into etiological factors for dental anomaly presentation in adults in Saudi Arabia could create awareness and guide preventive strategies to assist in minimizing the associated dental problems.

Risk factors for tooth wear lesions among patients attending the dental clinic of a Nigerian Teaching Hospital, Benin City: A pilot study

Aims: This study was to evaluate the risk factors associated with tooth wear lesions in patients attending a dental clinic. Context: Tooth wear lesions entail the loss of dental hard tissues in the absence of caries or trauma. They include abrasion, attrition, and erosion. The etiology is often related to habits leading to insidious symptoms with similar presentations in both community and hospital patients. Materials and Methods: This cross-sectional study involved patients attending the outpatient dental clinic of a Nigerian Teaching Hospital over a 3-month period. A semi-structured questionnaire was used to elicit information from the respondents. Results: A total of 152 respondents aged 17–80 years and above, comprising 86 males (56.6%), and 66 females (43.3%) constituted the study population. The Binis were the most represented 34.2%, followed by the Esans 21.1%, while the least represented were the Yorubas (6.6%). The occupations represented in this study include civil servants (30.3%), unskilled workers (23.7%), and non-medical professionals (7.9%). Tooth wear lesions were present in 55.3% of the respondents. Attrition accounted for 29.6%, Abrasion (11.8%), combination of attrition and abrasion (4.6%), and abfraction (2.0%). There was a statistically significant association between tooth wear lesions and age, occupation, sensitivity or pain, tooth cleaning aids, toothbrush texture brushing technique, intake of carbonated beverages, and method of intake. Conclusion: Tooth wear lesions such as attrition and abrasion were prevalent among the respondents in this hospital setting and, therefore, represent an important group of dental problems among this population. It is, therefore, important to direct the appropriate oral health awareness program for the prevention, early detection, and management of these conditions.

Screening of Transforming Growth Factor Beta 3 and Jagged2 Genes in the Malay Population With Nonsyndromic Cleft Lip With or Without Cleft Palate.

To determine the prevalence of mutations in transforming growth factor beta 3 (TGFβ3) and Jagged2 genes and their association with nonsyndromic cleft lip with or without cleft palate (CL±P) patients. Cross-sectional study on nonsyndromic CL±P and noncleft patients. Reconstructive clinic and outpatient dental clinic, Hospital Universiti Sains, Malaysia. Blood samples of 96 nonsyndromic CL±P and 96 noncleft subjects. Prevalence and association of mutations in TGFβ3 and Jagged2 genes with nonsyndromic CL±P. Most of the nonsyndromic CL±P patients (53.1%) had left unilateral CLP. There were slightly more females (56.6%) compared with males. The prevalence of the mutations in the TGFβ3 gene was 17.7 (95% confidence interval [CI]: 9.5, 24.5) and in the Jagged2 gene was 12.5% (95% CI: 5.5, 18.5), which was higher compared with the noncleft group. For the TGFβ3 gene, there was no mutation in the coding region in either of the groups. All variants were single nucleotide polymorphisms located within the intronic flanking region. Two variants were identified (g.15812T>G and g.15966A>G) in both nonsyndromic CL±P and noncleft patients. However, the association was not significant (P > .05). Three variants (g.19779C>T, g.19547G>A, and g.19712C>T) were identified in the Jagged2 gene among nonsyndromic CL±P and noncleft patients. Only g.19712C>T showed a significant association with nonsyndromic CL±P patients (P = .039). g.19712C>T might play a crucial role in the development of cleft lip and palate. To the best of our knowledge, this is the first report of the mutation found within intron 13 of the Jagged2 gene among nonsyndromic CL±P Malay patients.

Medical waste monitoring in a dental outpatient clinic

Aim. To estimate the amounts and weight of medical waste in the dental outpatient clinic. Methods. Amounts and weight of types A and B medical waste, as well as the number of patients treated in the branch №1 of OAO «City Dentistry», Kazan, Russia from June 2012 to May 2013 were analyzed using the methods of public health statistics. Results. Total amount of type A medical waste was 7516 pieces, with the average amount of 300.6±9.21 per month. Total weight was 8995.3 kg, with the average of 359.8±11.03 kg per month. Total amount of type B medical waste was 6804 per year, with the average of 272.2±5.19 per month, and their total weight was 12090.6 kg, with the average of 483.6±13.39 kg per month. Despite the trend of increasing the absolute amounts and weight of type A and B waste, if calculated per patient treated, these values had a trend for reduction. Medical waste amounts differed between the departments of the outpatient clinics, even between departments providing same medical care. In general, types A and B waste weight was increasing, while amount of waste decreased. Conclusion. Types A and B waste weight depended mainly on the number of treated patients compared to waste amount. Waste weight and amount, if calculated per patient treated, had different trends and were different not only between the departments of surgery, orthopedics and conservative dentistry, but also between different departments of conservative dentistry.

Validation of the Malay version of the Modified Dental Anxiety Scale and the prevalence of dental anxiety in a Malaysian population.

The aims of the present study were to evaluate the reliability and validity of the Malay version of the Modified Dental Anxiety Scale (MDAS), and to determine the prevalence of dental anxiety and associated factors in a Malaysian population. A Malay-language questionnaire with questions to elicit demographic and dental care-related information, and the Malay version of the MDAS, were administered to 455 patients at the dental outpatient clinics of the Hospital Universiti Sains Malaysia. Factor analysis and internal consistency statistics were generated. A test-retest of the questionnaire was performed with 30 participants. Cronbach's alpha was 0.854, indicating good internal consistency. Factor analysis yielded results showing good validity. Approximately 3.5% of the participants expressed the highest levels of anxiety. Dental anxiety was significantly higher among females than males. Age correlated inversely with dental anxiety. Individuals seeking dental care only if a problem appeared had significantly more anxiety than regular attendees. Patients who postponed treatment because of fear had significantly higher anxiety levels than those who delayed treatment for other reasons. Past adverse dental experience exacerbated dental anxiety. The Malay version of the MDAS had good reliability and validity. Anxiety levels found in the Malaysians studied were comparable to participants from other countries.

Dental Caries in the Primary Dentition of German Children with Cleft Lip, Alveolus, and Palate

Objective : The purpose of this cross-sectional study was to assess the prevalence of dental caries in children with cleft lip, alveolus, and/or cleft palate living in central Germany between 1996 and 2010. Participants : A total of 295 children 1 to 6 years of age from three birth cohorts (BC) with clefts from central Germany were included in the study. They were compared with 548 1- to 6-year-old cleft-free children from the same region. Setting : Children with clefts underwent a dental examination in an outpatient dental clinic at the University of Leipzig. The first BC was examined between 1996 and 1998, the second between 2002 and 2004, and the third between 2008 and 2010. Controls were examined at day-care centers in Leipzig during the same periods. Main Outcome Measure : The standard dental caries index for the primary dentition (dmf/t3-4) was used for clinical assessment. Results : Over the entire study period, the mean prevalence of dental caries in deciduous teeth was significantly higher (1.32 dmf/t3-4) in children with clefts compared with cleft-free children. However, a decline in caries (approximately 1 dmf/t3-4) and an increase in the proportion of children with healthy primary dentition were observed in both groups. These results represent a caries decline of 61% in children with clefts. Conclusions : Caries rates for children 1 to 6 years of age with clefts from central Germany showed a considerable decline over the last years. The caries rates for clefts patients in the third BC (2008 to 2010) was similar to that of cleft-free children in the first BC (1996 to 1998).

Evaluation of Oral Status and Tobacco Use in a Rural Population and Testing a Scale Developed to Rate Oral Status: A Pilot Study

The objectives of this investigation were to evaluate the oral status and tobacco use of subjects residing in rural areas to provide epidemiological data for planning oral health programs and to test a scale developed to rate oral status. A cross-sectional investigation was conducted among first-visit subjects visiting the out-patient dental clinics of two rural hospitals during a sixmonth period. Data were collected by interviews and clinical examinations. Criteria evaluated in the proposed scale were based on the status of the oral tissues in disease and health. Differences in proportions were compared using the Chi squared test and a p-value of < 0.05 was considered statistically significant. The study population comprised 614 patients (43.6% male, 56.4% female) aged between four and 80. Only 1.6% subjects had an intact dentition while 17.9% presented with a healthy periodontium. Two hundred forty-five subjects had undergone prosthetic rehabilitation. Tobacco use was reported by 13.3% subjects and they accounted for 88% of the oro-mucosal lesions observed. Once daily tooth cleansing was reported by 68.2% subjects while 2.3% did not practice any oral hygiene measures. The scale used mirrored the subjects’ oral status accurately. To conclude, the poor oral status of this population was compounded by lack of awareness about the presence of oral disease. A renewed stress on implementation of oral health promotion strategies for rural populations seems critical in the present context and the proposed scale needs to be validated by studies on larger population groups.