ABSTRACT
BACKGROUND: There is evidence that children with cardiac conditions have high levels of untreated dental disease. One possible explanation is that they are more dentally anxious as a result of increased exposure to medical interventions. Therefore, the primary aim of this study was to compare the level of dental anxiety between paediatric cardiology patients and healthy children. METHODS: The study group comprised 54 children (mean age 12.2 years) who attended the outpatient paediatric cardiology clinic in tertiary care. The control group (n = 53, mean age 12.38 years) was recruited from consultant-led new-patient orthodontic clinics. Child dental anxiety was measured using the Modified Child Dental Anxiety Scale (faces version). The parents completed the Modified Dental Anxiety Scale along with a questionnaire regarding their child's medical and dental histories. RESULTS: The mean level of dental anxiety was significantly higher in the study group (P < 0.05). Analysis of covariance indicated that overnight hospital admission history may have influenced the strength of this relationship. CONCLUSIONS: Paediatric cardiology patients had significantly increased levels of dental anxiety. It is likely that aspects of their medical history, notably overnight hospital admissions, are contributory factors.
Subject(s)
Dental Anxiety/epidemiology , Heart Diseases/psychology , Adolescent , Child , Child Behavior , Dental Care , Female , Humans , Male , Surveys and QuestionnairesABSTRACT
BACKGROUND. Hypophosphatasia (HP) is characterized by defective mineralization of bone and teeth because of deficient alkaline phosphatase activity. There are generally six recognized clinical forms, of which the most severe is often lethal prenatally or early in life. In milder forms, such as odontohypophosphatasia (OHP), premature exfoliation of primary teeth may be the only clinical manifestation. CASE REPORT. A 20-month-old girl was referred to the Specialist Paediatric Salaried Dental Service within the Harrogate and District NHS Foundation Trust with mobility of tooth numbers 71 and 81. Clinical examination revealed grade III mobile 71 and 81, with minimal gingival inflammation and plaque deposits. There were no other dental findings and no significant medical history. Tooth numbers 71 and 81 exfoliated prematurely with no evidence of root resorption, shortly after presentation. Haematological and urinary investigations showed no abnormalities. Histological examination showed a complete absence of cementum. A diagnosis of OHP was made. After 10 months of dental follow-up, no further teeth have increased mobility. CONCLUSION. Odontohypophosphatasia should be included as a differential diagnosis in children presenting with early loss of primary teeth. The dentist may be the first health care professional to whom the patient presents.
Subject(s)
Hypophosphatasia/diagnosis , Incisor/abnormalities , Tooth Demineralization/congenital , Tooth, Deciduous/abnormalities , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Hypophosphatasia/physiopathology , Infant , Tooth Demineralization/diagnosis , Tooth Demineralization/physiopathology , Tooth Exfoliation/physiopathology , Tooth Mobility/physiopathologyABSTRACT
In this paper, a Markov chain model is developed to model the work flow in a computed tomography (CT) imaging department at University of Wisconsin Medical Foundation. Using this model, we estimate the patient length of stay and investigate different configurations of radiology specialists for potential efficiency improvement to reduce flow time and cost. What-if analysis is carried out to investigate the impact of various staffing levels and sensitivity study is used to identify the bottleneck operation, i.e., the most impeding one whose improvement can lead to the highest productivity increase.
