Long-term periodontal status after orthodontic treatment.

This study evaluated the clinical periodontal status of persons who had completed orthodontic therapy at least 10 years previously (study) and compared the findings to those of adults with untreated malocclusions (control). Subjects in the study (n = 112; 63 female subjects, 49 male subjects; mean age 29.3 +/- 4.2 [SD] years) and control (n = 111; 62 female subjects, 49 male subjects; mean age 32.9 +/- 6.5 years) populations underwent a comprehensive periodontal examination that consisted of measurements taken at six points around the circumference of each tooth: (1) plaque, (2) visual inflammation, (3) bleeding after probing, (4) pocket depth, (5) gingival recession, and (6) loss of connective tissue attachment. Data from the individual measuring points were organized into 14 different combinations of either tooth types or surface locations; each was subjected to a four-way ANOVA partitioned on group (study vs. control), sex, socioeconomic status, and malocclusion type. The results showed that differences in age distribution within the groups were affecting the comparisons between the groups. Consequently, the groups were balanced for age and analyses were done to investigate group differences by means of multiple regression techniques. The comparisons showed no significant differences between the groups for any of the periodontal variables. It was concluded that orthodontic treatment during adolescence had no discernible effect upon later periodontal health.

Use and quality of bitewing films in private dental offices.

Patient records (387) were obtained from twenty-five dentists in private practice in Rochester, New York. The number and types of radiographs taken at each recall examination in the most recent 10-year period were recorded. Bitewing radiographs were taken at 50.5% of the recalls with size 2 film used most frequently (83.7%). The average recall interval was 8.4 months overall and 18.0 months for bitewing recalls. Of all proximal surfaces available on the bitewing films, 68.2% were judged adequately separated for diagnostic purposes. For individual surfaces, the highest percentages were recorded for the mesial surface of the maxillary second premolar (89.9%) in the permanent dentition and for the distal surface of the mandibular second molar (83.7%) in the deciduous dentition. Taking four bitewing films instead of two improved the percentage of adequately separated proximal surfaces at a given recall by 2% to 25%. The percentage of unreadable proximal surfaces caused by overlapping or distortion on the bitewing radiographs, when excluding the canines, ranged from 6.3% to 39.5% in the permanent dentition and from 12.5% to 24.9% in the deciduous dentition.

Bitewing radiographs and dentists' treatment decisions.

A study involving twenty-one general dentists in private practice in Rochester, New York, was performed to assess the relationship between radiographic evidence of caries and restorative intervention in permanent teeth. Seven thousand three hundred thirty-eight bitewing radiographs taken of 387 patients over the most recent 10-year period were obtained and independently examined by six Eastman Dental Center faculty members as to presence of restorations and caries status of nonrestored proximal surfaces. Patients 20 years of age and younger had significantly lower mean maximum caries penetration scores before restorative treatment when compared to older patients. For all age groups, the mean maximum caries penetration scores indicated that, on the average, restorative treatment was initiated before there were radiographic changes in dentin. There were no differences among the dentists in the study regarding the mean elapsed time between radiographic caries diagnosis and restorative treatment. The random distribution and low number of apparent caries reversals, and the subsequent restoration of 25% of these teeth, suggested that the dentists in this study did not employ systematic remineralization strategies for their patients.

Genetic counseling of asymptomatic carriers in a primary care setting. The effectiveness of screening and counseling for beta-thalassemia trait.

In a prospective, controlled, stratified, experimental effectiveness study of screening and counseling, 25 000 consecutive adults were screened for thalassemia trait. Eight hundred forty-three adults had a mean corpuscular volume less than 77 fL; 192 (22% of those with microcytosis) had hemoglobin A2 greater than 3.5%, proving beta-thalassemia trait. Video-program, neutral-educational, and patient-centered counseling methods produced equal levels of learning, retention, psychologic impact, and effects on life adjustment immediately and at 2 and 10 months after counseling. Ninety-nine percent of the patients told other persons about the counseling, and 43% had 106 others screened. Factors related to having someone else screened included plans to have children (p less than 0.002), being younger (p less than 0.0025), better education (p less than 0.05), and having high knowledge of thalassemia (p = 0.05). For maximum effectiveness, screening and counseling programs should focus on patients for whom a positive result has high significance.

Adolescent coitus and infant birthweight.

Seventy-nine percent of a group of adolescent mothers reported coitus during pregnancy. There was a significant difference between the mean birthweight and gestational age of infants born to mothers who reported coitus within 90 days of delivery compared to the mean birthweight and gestational age of infants of mothers who reported no gestational age of infants of mothers who reported no coitus within 90 days of delivery. Thirty-nine percent of the variance in birthweight was explained by maternal factors alone, but only 1.0% of the variance in birthweight was accounted for by the interval between last coitus and delivery. Prepregnancy weight (r = 0.380) and weight gain during pregnancy (r = 0.327) contributed 19.1% and 7.4% of the variance in birthweight, respectively.

PIP: The subjects for this study are 99 (consecutive) adolescents who received prenatal care in the Rochester Adolescent Maternity Project (RAMP) between August 1980 and December 1981 and their infants. Data was collected from semi-structured interviews about the adolsecents' coital activitiy during pregnancy and the interval between last coitus and delivery. Demographic, obstetric and medical data were collected from each subject's chart. Neonatal data included birthweight and gestational age. T-tests, chi-square and multivariate analyses were performed. Results indicate that 79% of the study population reported coitus during pregnancy. 71% of these respondents stated that coitus occurred within 90 days of delivery. There was a significant difference between the mean birthweight and the mean gestational age of infants of mothers who reported coitus within 90 days of delivery compared to the infants of mothers who reported no coitus within 90 days of delivery. On multivariate analysis, prepregnancy weight (r=.380) and weight gain during pregnancy (r=.327) were both significantly correlated with birthweight. 39% of the variance in birthweight was explained by maternal factors alone, but only 1.0% of the variance in birthweight was accounted for by the interval between last coitus and delivery. As found by others, prepregnancy weight, weight gain during pregnancy, smoking frequency, and race were the major maternal factors accounting for the variance in birthweight. It is concluded that coitus alone during pregnancy in adolescents does not account for a significant amount of the variance in infant birthweight.

The influence of weight loss on the dexamethasone suppression test.

To evaluate the influence of weight loss on the dexamethasone suppression test (DST), we studied 61 patients with major depressive disorder as defined by the Research Diagnostic Criteria, 59 healthy normal volunteers, and 16 volunteers who lost weight by dieting. Nonsuppression on the DST was not correlated to weight loss in the depressed patients. Of the healthy volunteers, 12.5% converted to nonsuppression status. This conversion rate is not significantly different from nonsuppression rates in the normal population. Implications of these findings are discussed.

Adolescent mothers and their infants.

It is unclear why children of adolescent mothers experience more developmental problems than children of adult mothers. There has been minimal systematic investigation of whether there is a relationship between the young age of the mother and her mothering behaviors. Our data fail to demonstrate any relationship between adolescent maternal age and the counts of maternal behaviors three days following birth. Seventy-five normal primiparous mothers less than 20 years old were videotaped with their normal infants for ten minutes in a standardized laboratory setting during the three days following birth. The frequency of maternal behaviors was counted from the videotapes by trained observers. Future studies of primiparous adolescent mothers should consider the effects of maternal race/culture and socioeconomic status on their mothering behaviors. The relationship between adolescent maternal age and the vocalizations expressed by the mother to her infant should also be explored further.

Plasma ACTH levels in depression before and after recovery: relationship to the dexamethasone suppression test.

Sixteen patients with major depressive disorder who were nonsuppressors on the dexamethasone suppression test (DST) on hospital admission were studied for plasma levels of adrenocorticotropic hormone (ACTH). Eight patients reverted to normal suppression with clinical recovery, while eight remained nonsuppressors. There was a significant reduction of ACTH levels in those who normalized on their DST, while ACTH levels remained high in the group that continued to be nonsuppressors. The results favored the hypothesis that dexamethasone nonsuppression in depression is mediated by high ACTH levels.

Associations between crestal lamina dura and periodontal status.

The purpose of the present study was to investigate associations between radiographic crestal lamina dura and the clinical periodontal status of the corresponding interdental area. The population consisted of 90 individuals (53 females and 37 males), ages 21 to 45 years (mean 31 years), who underwent a comprehensive periodontal examination. Buccal and lingual to the contact point at each interdental area four different clinical criteria were scored as being present or absent: (i) visual inflammation, (ii) bleeding after probing with 25 gm force, (iii) pocket depth greater than 3 mm after probing with 50 gm force, (iv) loss of connective tissue attachment. Bite-wing and full-mouth periapical radiographs were taken and processed using standardized techniques. Each interdental crestal area on the radiographs was examined and scored for presence or absence of an intact lamina dura. Statistical analyses were undertaken using correlated means to compare the presence or absence of lamina dura with the individual and simultaneous clinical criteria. No significant differences were obtained between any of the comparisons and, in addition, there was no correlation between lamina dura images on periapical and bite-wing radiographs. The results indicated that crestal lamina dura on radiographs did not appear to be related to the presence or absence of clinical inflammation, bleeding upon probing, periodontal pockets or loss of attachment.

Discrimination of the age of adolescent females on the basis of facial cues.

In an ongoing study of adolescent maternal-infant interaction, we investigated the accuracy with which judges could assign the age of two groups of females, based on videotaped facial cues alone. The two groups were eight "adolescents," whose ages were less than or equal to 17 years, and 20 "adults," whose ages were greater than 20 years. Twenty-seven judges, whose average age was 28.7 years with a range from 27 through 44 years of age, were asked to judge the ages of the subjects in the two groups. Overall, the judges were successful in identifying adolescents 41.8% of the time. There was no relationship between the ages of the judges and the accuracy of their judgments. On the basis of facial cues alone, our results clearly suggest that the process of assigning an individual to an adolescent or adult group is essentially random, approaching a 50/50 breakdown. This study supports the concept that observed differences between adolescents and adults interacting with their infants is due to actual differences in behavior and not the cultural bias of the judge.

Emotional complications of adolescent grand mal epilepsy.

Adolescents who have grand mal epilepsy and their parents were interviewed, and the adolescents were evaluated neurologically. Better seizure control and less neurologic disability were unexpectedly associated with less open communication between the adolescents and their families and friends, and with a poorer self-image and poorer expectations for the future. These findings were unrelated to IQ or school performance. This outcome is consistent with other studies of invisible defects and stigmatization, and suggests that youngsters who have relatively mild defects involving social disability may be more troubled than those with more apparent defects, for which denial may be operative. An incidental finding in the study was that a question more predictive of overall family, social, and academic function than the neurologic findings was simply whether or not the youngster was attending the appropriate grade in school for his or her age.

A computerized system for the evaluation of community dental programs.

This paper reports on a relatively uncomplicated and inexpensive computerized system for prospective evaluation of clinical dental programs from the point of view of effectiveness and efficiency. Availability of this system does away with some high start-up costs. Three forms of input data, new case information, examination findings and operative procedure information, are regularly collected on data sheets and specially designed Port-a-punch IBM cards. Easily interpreted output tables are generated monthly on such variables as completed cases according to treatment series and clinician, number of various procedures performed by clinicians, etc. Productivity is measured, in part, by application of monetary constants to procedure data. This paper describes the computer programs used, the cost of setting up and operating the system (which is within the budgetary constraints of most small, publicly funded programs) and the benefits that can be derived from the use of such a system. The system provides prompt feedback of relevant administrative data, thus allowing for relatively quick response to problems. Use of the system reduces clerical needs to a minimum and the program can easily be implemented on any except the very smallest digital computer.