ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00433.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00434.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This study Investigated salivary levels of Streptococcus mutans, lactobacilli, and caries experience in a random sample of 448 black and 362 white older dentate adults living in North Carolina. Significant proportions of the participants had stimulated salivary flow rates less than 1.0 mL/min, salivary buffering capacity less than 4.0, S. mutans levels of 105cfu/mL or more in stimulated whole saliva, or lactobacilli levels of 105cfu/mL or more. Each of these factor levels could be considered, on a clinical basis, to increase caries risk. in general, people with higher levels of S. mutans or lactobacilli had more untreated coronal and root caries, but not greater total caries experience.

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00435.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Aspiration of oropharyngeal flora is the most common route of acquiring Gram‐negative pneumonia, a major nosocomial infection. Epidemiologic studies indicate that the elderly are at increased risk for developing these life‐threatening pneumonias. The primary objective of this study was to determine the effects of salivary oral defenses against Gram‐negative colonization. The study population consisted of 41 male outpatients, age 70 and older, seen at the Denver VAMC. The group included subjects with both diminished and normal salivary flow. Each subject answered a questionnaire regarding overall health, medication use, and symptoms of salivary dysfunction. We then collected whole saliva, unstimulated and stimulated parotid saliva, and performed a throat swab on each patient. For each throat culture, analysis was done to identify Gram‐negative bacteria. Flow rates between colonized (n = 6) and noncolonized subjects (n = 34) were compared. While there were no significant differences in the flow rates between the two groups, a trend was noticed in that flow rates were lower for all three flow measures in the colonized group (whole, 22% decrease; unstimulated, 22% decrease; and stimulated, 28% decrease). These preliminary findings suggest that subjects with diminished salivary flow may possibly be at Increased risk for oropharyngeal Gram‐negative colonization. Research on the role that saliva plays in oropharyngeal bacterial colonization is

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00436.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Formal and structured training in medical risk assessment (MRA) has been a requirement in general practice residency (GPR) programs since their Inception in 1972. Institutions offering GPR programs frequently differ in the levels and types of available resources necessary to implement this training. Program directors have expressed significant concerns that this training is difficult to provide, especially in the area of physical examination. The literature has not yet established how or if programs have organized their curricula to conform to accreditation standards in MRA established by the American Dental Association's Commission on Dental Accreditation. The purpose of this study was to conduct a nationwide survey of all GPR programs to Identify program characteristics and resources, didactic and clinical educational methods, and perceived achievement of ADA Standard Fourteen for MRA training. Recommendations for further research are also given. Results will be reported in this paper, the paper following in this issue, and an additional paper to be published in a forthcoming issue.

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00437.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This is the second part of a three‐part series reporting a national survey of general practice residency directors and their evaluation of the medical risk assessment (MRA) instruction curriculum in their programs. The purpose of Part II is to evaluate the degree of success of the Implementation of the ADA Commission on Accreditation's standard for MRA programs. Acceptable levels of achievement were attained in most areas of basic and intermediate‐level skills. However, approximately one‐third to one‐half of general practice residency directors report that they are not achieving the standard for some intermediate or advanced assessment skills. When various instructor categories were compared, physicians scored significantly higher than oral and maxillofacial surgeons or other dentists in their ability to achieve acceptable outcomes in MRA instruction. The results of this survey, coupled with available literature concerning medical risk assessment instruction, support that changes in the undergraduate curriculum, a mandatory additional year of training, or modification of defined goals and outcomes should be con

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00438.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Metastatic tumors to the oral cavity are uncommon. Most of these cases involve the mandible or the maxilla. Rarely, metastasis occurs to the oral soft tissues from a distant primary tumor. The lung and breast are the most common primary sites. It is extremely rare to have an oral soft‐tissue metastasis from a carcinoma of the colon. A case of primary adenocarcinoma of the colon with metastasis to the soft tissues of the mouth is described. Three similar case reports are reviewed. A metastatic lesion to the oral cavity could be the first indication of the presence of a primary tumo

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00439.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This article describes a new removable appliance that has been used successfully to treat lip‐chewing in a severely disabled, mentally retarded patien

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00440.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In this pilot study, dietary habits, microbial factors, and salivary factors in 20 older adults who had active decay on root surfaces were compared with those of 20 adults who had inactive or no root caries. In this case‐control study, the groups were matched by sex and were of similar age. Subjects using medications known to induce dry mouth were excluded. Subjects completed a nutrition interview and a four‐day food diary. Stimulated whole saliva flow rate, buffering capacity, levels of salivary lactobacilli with use of the Dentocult method, and S. mutans cultured on MSB agar were determined. The root caries group had a greater mean number of eating occasions per day (6.1 vs. 4.6), more frequent exposures to fermentable carbohydrates (5.8 vs. 4.2), and higher average daily sugars intake (133 g/day vs. 105 g/day) than the control group. Root caries subjects had significantly higher lactobacilli counts and less salivary buffering capacity. Within the root caries group, significant correlations were found with Root Caries Index and lactobacilli (r = 0.56) and S. mutans counts (rS= 0.50). These results show that frequent intake of simple sugars, high lactobacilli counts, and low saliva buffering capacity may be risk factors associated with root caries in older adu

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00441.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0275-1879    

DOI:10.1111/j.1754-4505.1992.tb00442.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY