Implications of the changing medical profile of a dental school patient population

Article Abstract:

The results of recent studies indicate that more patients with significant compromising medical conditions are seeking dental care at dental schools. Based on this finding, it was hypothesized that the overall number of dental clinic patients with medical conditions has increased. A 10-year study from 1976 to 1986 of the patient population at a dental school reveals that the makeup of this group has substantially changed. Routine techniques used to examine the patients did not change during this period, but the number of patients with underlying medical conditions did increase. The number of dental patients with medical conditions is on the rise and the types of conditions that are observed are also changing. Diseases such as cancer, diabetes, AIDS, and hepatitis were more frequently seen in the patient population in 1986 than in 1976. In particular, the number of dental patients with cardiovascular disease has risen from about 45 percent in 1976 to 59 percent in 1986. Also, at least in this country, the population as a whole is aging, and individuals over the age of 65 years currently represent a larger proportion of the dental patient population. Issues of liability may more frequently surface for the dentist in years to come. In general, a more comprehensive approach to dental care is needed, including more complete physical examinations and closer attention to medical conditions of the patient. Dental schools and continuing dental education programs should emphasis the importance of medical evaluations and recognition of symptoms. There are significant implications for dental care and treatment, and medical considerations will most likely influence the development of new curriculum for dental schools. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Surveys, Study and teaching, Dentistry, Dental care, Oral hygiene, Dental clinics, Dental education

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Effect of toothbrushing with 0.4 percent stannous fluoride and 0.22 percent sodium fluoride gel on gingivitis for 18 months

Article Abstract:

Fluoride agents are effective in reducing tooth decay and have been assessed recently for their value in treating periodontal disease, which affects the structures supporting the teeth, such as the gums. Sodium fluoride (NaF) was shown to reduce bacterial growth in plaque, which is a gummy mass of microorganisms growing on the surface of teeth. However, several studies suggest that stannous fluoride (SnF2) may be more effective than NaF in reducing the bacteria in plaque. The effects of brushing with 0.4 percent SnF2 or 0.22 percent NaF on gingivitis, the inflammation of the gums, was evaluated in 281 subjects with the gum disease. The subjects, who were divided into three groups, were instructed to brush with a fluoride-containing toothpaste accepted by the American Dental Association, to rinse with water, and subsequently to brush with either 0.4 percent SnF2, 0.22 percent NaF, or a fluoride-free placebo gel, a substance with no known therapeutic effect. The subjects who brushed with SnF2 had more tooth staining than subjects in the other two groups. There were no differences among the three groups in gingivitis, bleeding, or amounts of various microorganisms when subjects were examined at 6, 12 and 18 months. The findings suggest that NaF and SnF2 have no ability to reduce gingivitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Fluorides, Gingivitis, Dental plaque, Gum diseases

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Supplemental corticosteroids for dental patients with adrenal insufficiency: reconsideration of the problem

Article Abstract:

Most patients with adrenal insufficiency will not need corticosteroids during dental surgery. A review of the dental and medical literature from 1966 to 2000 identified only four reports of an adrenal crisis during dental surgery.

Oral surgery, Corticosteroids, Adrenocortical hormones, Addison's disease

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