ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02705.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractGiven the decline in dental caries incidence in preteens and young teenagers in the United States, a study of the incidence of dental caries in young adults (17–23 years) was conducted to provide a descriptive epidemiologic picture of this “new” natural history of dental caries in the late and post‐teenage years. A retrospective study was performed analyzing the detailed dental records of the four‐year college experience in the class of 1989, US Coast Guard Academy. Occlusal caries incidence, in the absence of associated proximal caries, was shown to be moderately common in molars (11.9%) and rare in pre‐ molars (0.8%). In contrast to previous studies' findings, demographic indicators, socioeconomic status indicators, and prior caries experience were poor predictors of occlusal caries incidence; targeting a universal sealant policy in this population therefore would be done best by tooth type rather than patient type. A preliminary costcomparison model, projected over a 40‐month period, suggests that the cost of initiating a universal molar sealant policy in this population would be 92 cents per year per student greater than the cost of restoring occlusal caries in the presence of sound proximal surfaces. This cost comparison suggests that it would be advantageous to initiate

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02706.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThis study centers on the general health of dental patients, evaluated on the basis of the physical status classification system of the American Society of Anesthesiologists (ASA). A total of 4,087 patients completed a risk‐related, patient‐administered questionnaire. On the basis of their medical data, a computerized ASA classification was determined for each patient: 63.3 percent were in ASA class I, 25.7 percent in class II, 8.9 percent in class III, and 2.1 percent in class IV. After verification and/or consultation with the physician, the dentist also determined the ASA class, and this was compared with the computerized outcome. The agreement expressed as a kappa value was 0.64; the computer result generally placed the patient in a higher category of medical risk. The computer‐determined ASA classes differed among the various dental practices (χ2= 262.9; df = 138; P<.01). It is possible to estimate the risk class of dental patients on the basis of standardized medical information only; however, the definitive ASA class can only be determined after verification of the patient's reply or, in some cases, after consultation with a phy

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02707.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractPrevious studies suggest a discrepancy between the way dentists and patients measure oral health. The purpose of this study was to determine the relationship between a dentist's rating of an older dentate person's oral health and the patient self‐rating using a single‐item indicator, and to compare the clinical (i.e., number of teeth, caries, etc.) and subjective (problems with function, pain, etc.) factors that influence the rating. The study sample consisted of 776 older dentate people. Results showed that dentists judged subjects' oral health significantly more positively than the self‐ratings. Approximately 30 percent of the elders rated their oral health identically to the dentist and half rated their oral health lower than the dentist. Bivariate comparisons showed that similar clinical and subjective variables were associated with the dentist and patient ratings. Multiple regression findings, however, highlighted differences in the factors that influenced the ratings. In addition, the proportion of variance accounted for by the clinical factors as opposed to the subjective factors was greater for the dentist rating (R2=.28 of.33) than the subject self‐rating (R2=.18

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02708.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThis article presents data regarding occurrence of hepatitis B in health care workers and children living in their households. Also reviewed are recent revisions in pediatric hepatitis B vaccine recommendations. The purpose of this discussion is twofold: to provide information to assist dental personnel in the decision‐making process regarding vaccination of infants, children, and adolescents in their households; and to increase knowledge to facilitate educational presentations. In the United States from 1979 to 1989 the prevalence of new acute hepatitis B cases increased by 37 percent. An estimated 1.25 million people with chronic hepatitis B are capable of infecting those within their immediate environment, including their families. Studies indicate that dental health care workers, through occupational exposure, may have a 10 times greater risk of becoming a chronic hepatitis B carrier than the average citizen. The World Health Organization's Expanded Programme on Immunizations recommends that children receive vaccination in populations where hepatitis B is prevalent. The three‐pronged approach for reducing pediatric transmission includes: (1) vaccination of infants bom to infected mothers, (2) routine vaccination of children born to hepatitis‐seronegative mothers, (3) identification and vaccination of specific groups of adolescents. Comprehension of these changes may increase compliance regarding vaccination of children in our household, as well as enhancing our educational presentations to patients, the community, and professional soci

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02709.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThere are few objective assays for studies of the epidemiology of periodontal diseases. The PerioScan™ is an assay capable of detecting three periodontal pathogens, namely T. denticola, P. gingivalis, and B. forsythus, which have been associated with adult periodontitis. The PerioScan™ was tested in a sample of 301 Brazilians. Clinical indices—bleeding, probing depth, gingival index, and periodontal index—were recorded from four sites in each subject. Subgingival plaque samples were collected from those sites and placed on the PerioScan™ card. Color results were scored in the field after 15 minutes. The plaque samples were screened with polyclonal antibodies for the three species by an ELISA system. The PerioScan™, when compared with the ELISA system, yields a sensitivity of 91 percent, specificity of 89 percent, and an accuracy of 90 percent. When the PerioScan™ was compared to clinical indices, there was a high sensitivity (at least 93%) and a low specificity (no less than 47%), with an accuracy of at lea

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02710.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe appropriate use of pit and fissure sealants could reduce substantially the majority of occlusal caries among US school‐aged children. The 1986–87 national oral health survey conducted by the NIDR showed that less than 8 percent of the children 5–17 years of age had sealants on their teeth. The purpose of this national study was to document the current status of community‐based sealant programs and to identify general program characteristics. Data were gathered through a mail survey to all state dental directors and site visits to four selected comprehensive community‐based programs. Twentynine states were currently conducting sealant programs. The vast majority of these programs had formal quality assurance systems and companion health education components. Eight states indicated that sealant programs had been terminated within the last two years. Medicaid reimbursement for sealants was available in 42 states, with a mean reimbursement rate of $10.71 per sealant. Reimbursement rates ranged from $3.00‐ $20.00 per sealant. State practice acts almost uniformly permitted the placement of sealants by dental hygienists (n = 48), but less frequently by dental assistants (n = 15). Approximately 43 percent of state practice acts did not require a dentist to be present physically when auxiliaries place sealants in public/community sealant programs. All respondents indicated that there was a need for additional programs in their state. No structural factors—for example, level of Medicaid reimbursement for sealants or state practice act requirements for auxiliary supervision—were found to be associated with the presence of community‐based sealant programs. Nationally, only a small percentage of children appeared to be receiving sealants in c

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02711.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe purpose of this research was to identify dentist characteristics and dental office staffing patterns related to delegation of sealant applications. Results from a 1989 ma/led survey were used to characterize Michigan general dentists (N =300) who did or did not delegate sealant applications to auxiliaries and to identify factors associated with delegation. Nearly 50 percent of respondents were applying all sealants themselves. In offices that delegated the procedure, the mean proportion of sealants being applied by dentists was 39.9 percent. Registered dental hygienists were applying 51 percent, while registered dental assistants were applying 6.5 percent. Delegating dentists were more knowledgeable about sealant procedures, held more favorable attitudes, treated more young patients, placed more sealants, and were better informed about the legality of delegation according to the state practice act. Logistic regression analysis found that employing a registered dental hygienist was the most significant factor associated with sealant delegation, followed by employing a registered dental assistant. Findings suggest that dental auxiliaries, and particularly registered dental assistants, are underutilized for applying sealants. Approaches to increasing delegation of sealants may include changing dentists' traditional hiring patterns, highlighting the skills of auxiliaries such as the registered dental hygienist (RDH) and the registered dental assistant (RDA), and increasing awareness of legally allowable procedures that RDHs and RDAs can perform.

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02712.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractMany states and localities do not have the resources to conduct oral health surveys of their whole populations, but the demands for data collection continue to increase for both program administration and for Maternal and Child Health Block Grant funding. As one response to this problem, the Oral Health Program of the Michigan Department of Public Health developed an oral health surveillance system as a low‐cost method of collecting usable data from the service populations of local health agencies providing direct patient care in Michigan. A record form, to be completed by dentists or hygienists in those agencies at initial or recall examinations, was developed and pilot‐tested for all patients of target age groups who presented over a specified four‐week period. This paper gives the results from 19 agencies that participated in the pilot test in Michigan. Results showed that 40.5 percent of 2–5‐year‐olds (n/341) had some caries experience, their d/dft was 78.2 percent, and mean dft was 4.8 (SD±3.5). Among the 6–19‐year‐olds (n/710), 61.4 percent had experienced caries, the D/DFT was 41.8 percent, and the mean DFT was 4.2 (SD±3.2). Among the adults examined, 45.1 percent of 20–64‐year‐olds (n = 820) and 38.1 percent of those 65 years or older (n = 105) had two or more teeth with untreated decay. These data suggest a high level of untreated disease among the service populations of the local dental health agencies. The method of data collection was well accepted by the staff of the agencies concerned and proved to be simple and inexpensive to conduct. While the population examined is not representative of the state population, it reflects a good cross‐section of the population seeking clinical dental services through public health agencies. The data will be used in program development and to address the Maternal and Child Health reporting requirements of the Omnibus Budget Reconciliation Act of 1989. We intend to conduct this oral health surveillance survey periodically in Michigan to demonst

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02713.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 was passed by Congress “to improve the quality and availability of care for individuals and families with HIV disease.” The act targets those individuals infected with HI V who lack financial resources to pay for care. While provision of oral health care is not mandated by the legislation, many oral health services are supported through five different programs receiving CARE Act funding. Legislative mandates, program guidance materials, grant applications, and other related materials were reviewed to analyze oral health care services supported or proposed through the CARE Act. In fiscal year 1991, an estimated $5.8 million of the total CARE Act funds ($229.6 million) were used for oral health care, and there is evidence that oral health concerns will receive increasing attention by grantees in future years. Opportunities exist for local oral health professionals to become involved in CARE Act programs and in the priority development process. It is possible that CARE Act grantees will serve as catalysts for the development of partnerships between private practitioners and public sector programs—relationships that could lead to improved access and quality of care for people with HIV infe

ISSN:0022-4006    

DOI:10.1111/j.1752-7325.1993.tb02714.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY