Dental anxiety in a sample of West Indian adults.

AIM: The aim of this study was to investigate the level of dental anxiety and its possible causes among people in Trinidad and Tobago. METHOD: This is a cross-sectional survey of parents and guardians accompanying children who were attending a paediatric dental clinic. Participants completed a questionnaire while in the waiting room, which included the Modified Dental Anxiety Scale (MDAS), age, gender and occupation. An additional item was included which asked participants to rate the anxiety felt on having a tooth extracted. RESULTS: There were 100 participants (81% female). Overall, 40% of participants reported moderate to severe anxiety. Twenty-three per cent of participants had moderate anxiety (MDAS 15-18) and 17% had severe anxiety/phobia (MDAS 19-20). Level of anxiety was related to gender (multiple linear regression, p < 0.05). Proportions of participants were very/extremely anxious of having a tooth drilled (48%), local anaesthetic injection (53%) and extraction (52%). Thirty-six per cent of participants had avoided dental treatment in the past because they were too anxious. CONCLUSION: High levels of dental anxiety were found in this sample of Trinidadian adults. The MDAS was able to detect significant elements of that anxiety. The addition of a question on extraction revealed that this procedure may contribute substantially in anxiety toward dental treatment in the Caribbean.

Medical problems among dental patients at the school of dentistry, the university of the West Indies.

This study ascertained demographic information and prevalence rates of medical problems among 571 new and consecutive dental patients attending the emergency clinic of the School of Dentistry, The University of the West Indies. Patients were interviewed by specially trained and calibrated dental students and interns. Various medical problems of patients were recorded in individual open-ended case sheets, maintaining their privacy and confidentiality. This information was then transcribed into a specially designed and pretested form. The data were entered into a Microsoft Excel spreadsheet and analyzed using the SPSS statistical package to obtain the prevalence rates of medical conditions, which were then cross-tabulated with gender, age, ethnicity, and other variables. Significance of differences, if any, was evaluated by chi-square test. In all, 303 medical conditions were encountered in 239 individuals, giving a prevalence rate of 42 percent. Hypertension (12.6 percent), diabetes (6.1 percent), asthma (5.8 percent), arthritis (4.7 percent), and various allergies (8.3 percent) constituted an important segment of the problems. Gender, ethnic, and age differences were also evident for some diseases. In this study-which was the first of this kind in the West Indies-vital information on medical problems among dental patients was obtained by interviews conducted by dental students and interns, forming an important part of their dental education.

Oral and dental conditions presenting to medical practitioners in Trinidad and Tobago.

OBJECTIVES: To describe the type and frequency of oral and dental conditions presenting to medical practitioners in Trinidad and Tobago, type of management, and interest in continuing education in oral diseases. METHOD: Cross sectional survey of registered medical practitioners in Trinidad. 20-item self-reported questionnaire. RESULTS: 103 medical practitioners participated in the study (response rate 69%). Mean age 33 years. Mean years since qualifying was 8 years and 72% worked mainly in hospital service or private practice (19%); 67% had seen patients with a dental problems, with 69% of those at least as frequently as once a month. Most frequently seen problems were dental abscess (72.5%) and toothache (59.4%). In the case of dental abscess and oral mucosal infection 31.9% and 63.8% respectively, diagnosed and treated before referring. 84% cent expressed interest in receiving continuing education in oral diseases. CONCLUSIONS: In the context of access to oral care in Trinidad and Tobago, medical practitioners appear to be important providers and may benefit from further training in the diagnosis and management of oral diseases.

Parents' views on factors influencing the dental health of Trinidadian pre-school children.

OBJECTIVE: To describe parents' views on the dental health of pre-school children in Trinidad. BASIC RESEARCH DESIGN: Self-administered 22 item questionnaire by 138 parents and guardians of pre-school children. CLINICAL SETTING: University paediatric dentistry clinic. PARTICIPANTS: Consecutive parents or guardians of pre-school children attending a university paediatric dentistry clinic. MAIN OUTCOME MEASURES: Views on dental health and dental care of pre-school children, perceptions of own oral health and demographic information. RESULTS: Most participants (80%) were educated up to secondary school level and 59% were from homes where the head of the household was either in manual work or unemployed. One-half of the participants (50.7%) felt that teeth of young children should be brushed three times a day, with (75.4%) choosing a small brush. Most participants (65%) considered the position of supervised brushing of childrens' teeth from 'in front' to be the most effective method while 4.5% choose 'from behind'. Twenty seven percent did not know if their child's toothpaste contained fluoride and 82.6% did not know how much fluoride it should contain. Thirty three percent of the respondents had given their child a sweetened baby bottle or comforter at night. Fifty four percent felt a child's first dental visit should be when all baby teeth were present. Forty two percent would want a decayed baby tooth filled, 31.9% would want it extracted and 22.4% were unsure. CONCLUSION: The generally inaccurate factual knowledge and low awareness of preventive care among parents suggest the need for accurate information about factors influencing the dental health of pre-school children. These findings have significant implications for the delivery of effective health promotion strategies and the accuracy of health education messages in Trinidad and Tobago.

Parents' views on factors influencing the dental health of Trinidadian pre-school children.

OBJECTIVE: To describe parents' views on the dental health of pre-school children in Trinidad. BASIC RESEARCH DESIGN: Self-administered 22 item questionnaire by 138 parents and guardians of pre-school children. CLINICAL SETTING: University paediatric dentistry clinic. PARTICIPANTS: Consecutive parents or guardians of pre-school children attending a university paediatric dentistry clinic. MAIN OUTCOME MEASURES: Views on dental health and dental care of pre-school children, perceptions of own oral health and demographic information. RESULTS: Most participants (80 per cent) were educated up to secondary school level and 59 per cent were from homes where the head of the household was either in manual work or unemployed. One-half of the participants (50.7 per cent) felt that teeth of young children should be brushed three times a day, with (75.4 per cent) choosing a small brush. Most participants (65 per cent) considered the position of supervised brushing of childrens' teeth from 'in front' to be the most effective method while 4.5 per cent choose 'from behind'. Twenty seven percent did not know if their child's toothpaste contained fluoride and 82.6 per cent did not know how much fluoride it should contain. Thirty three percent of the respondents had given their child a sweetened baby bottle or comforter at night. Fifty four percent felt a child's first dental visit should be when all baby teeth were present. Forty two percent would want a decayed baby tooth filled, 31.9 per cent would want it extracted and 22.4 per cent were unsure. CONCLUSION: The generally inaccurate factual knowledge and low awareness of preventive care among parents suggest the need for accurate information about factors influencing the dental health of pre-school children. These findings have significant implications for the delivery of effective health promotion strategies and the accuracy of health education messages in Trinidad and Tobago.

Urinary fluoride levels in children in a single school in Trinidad and Tobago: a preliminary investigation

OBJECTIVE: To determine urinary fluoride levels in school children in a non-fluoridated area in Trinidad and Tobago. METHOD: Morning urine samples were requested from 750 children aged 5 to 14 years, attending a primary school in the area of St Joseph, north west Trinidad. Urine was collected at home and brought to school in labelled plastic bottles. Urinary fluoride concentration (ppm) was measured using an ion-specific electrode. RESULTS: Urine samples were available for 500 children (67). Mean age was 8.5 years. Overall mean fluoride concentration was 0.5 ppm +/- standard deviation (SD) 0.27; males (n = 263) were 0.58 ppm +/- 0.28 and females (n = 237) 0.55 ppm +/- 0.27. Children in the 5 to 7-year age group had the highest levels (0.64 ppm +/- 0.33). CONCLUSION: Mean urinary fluoride levels in this sample of school children were low indicating a fluoride intake below the optimum level for caries prevention. Fluoridation programmes may need to be implemented to increase fluoride intake among school children in the study area.

Urinary fluoride levels in children in a single school in Trinidad and Tobago: a preliminary investigation.

OBJECTIVE: To determine urinary fluoride levels in school children in a non-fluoridated area in Trinidad and Tobago. METHOD: Morning urine samples were requested from 750 children aged 5 to 14 years, attending a primary school in the area of St Joseph, north west Trinidad. Urine was collected at home and brought to school in labelled plastic bottles. Urinary fluoride concentration (ppm) was measured using an ion-specific electrode. RESULTS: Urine samples were available for 500 children (67%). Mean age was 8.5 years. Overall mean fluoride concentration was 0.5 ppm +/- standard deviation (SD) 0.27; males (n = 263) were 0.58 ppm +/- 0.28 and females (n = 237) 0.55 ppm +/- 0.27. Children in the 5 to 7-year age group had the highest levels (0.64 ppm +/- 0.33). CONCLUSION: Mean urinary fluoride levels in this sample of school children were low indicating a fluoride intake below the optimum level for caries prevention. Fluoridation programmes may need to be implemented to increase fluoride intake among school children in the study area.

Dental emergencies presenting to a university-based paediatric dentistry clinic in the West Indies

OBJECTIVES: The aims of the present study were to investigate the type and prevalence of dental emergencies presenting at a teaching hospital paediatric emergency clinic in Trinidad, and to describe the socio-demographic factors related to the use of the service. DESIGN AND METHODS: The authors used a prospective study of consecutive dental patients presenting to a paediatric emergency clinic. Data recorded included type of presenting emergency and socio-demographic variables. RESULTS: Data were available for 309 participants; 47 percent were male and 53 percent female. The average age of the participants was 8.66 years (SD = 3.75 years; range = 1-16 years). Seventy-three percent of the participants' parents were involved in manual work or unemployed, and 21 percent were in nonmanual/professional employment; the occupation was not known in 6 percent of cases. Caries-related problems accounted for 74 percent of emergencies. Dental trauma mostly affected the upper permanent incisor teeth, with concussion, subluxation and intrusion being the most commom injuries. CONCLUSION: Dental emergencies presenting to this university-based clinic were predominantly related to caries and trauma. The service was more frequently utilized by children in the mixed dentition stage, children from lower socioeconomic groups and those living in the local area. The frequency of caries-related problems indicates the need for more community-based preventive strategies, including encouraging greater attendance for routine dental care and dental health education. Strategies for oral health promotion should be developed to prevent dental trauma (AU)

Dental emergencies presenting to a university-based paediatric dentistry clinic in the West Indies.

OBJECTIVES: The aims of the present study were to investigate the type and prevalence of dental emergencies presenting at a teaching hospital paediatric emergency clinic in Trinidad, and to describe the socio-demographic factors related to the use of the service. DESIGN AND METHODS: The authors used a prospective study of consecutive dental patients presenting to a paediatric emergency clinic. Data recorded included type of presenting emergency and socio-demographic variables. RESULTS: Data were available for 309 participants; 47% were male and 53% female. The average age of the participants was 8.66 years (SD = 3.75 years; range = 1-16 years). Seventy-three per cent of the participants' parents were involved in manual work or unemployed, and 21% were in nonmanual/professional employment; the occupation was not known in 6% of cases. Caries-related problems accounted for 74% of emergencies. Dental trauma mostly affected the upper permanent incisor teeth, with concussion, subluxation and intrusion being the most common injuries. CONCLUSION: Dental emergencies presenting to this university-based clinic were predominantly related to caries and trauma. The service was more frequently utilized by children in the mixed dentition stage, children from lower socioeconomic groups and those living in the local area. The frequency of caries-related problems indicates the need for more community-based preventive strategies, including encouraging greater attendance for routine dental care and dental health education. Strategies for oral health promotion should also be developed to prevent dental trauma.

Perceptions and use of dental quacks (unqualified dental practitioners) and self rated oral health in Trinidad.

OBJECTIVE: To investigate reasons for use of dental quacks, treatment received, satisfaction with treatment, perceived differences to qualified dentists, and relationships to sociodemographic factors and self rated oral health. METHOD: A 14-item questionnaire including closed and open questions, was administered by interview to adult patients attending government health centres in Trinidad. RESULTS: Data were collected between November 2001 and March 2002. Two hundred and two people from 273 invited to participate, were interviewed (response rate 74%). Sixty seven per cent reported visiting a dental quack. People who had used a quack were older, from lower socioeconomic groups and more likely to be living in an area where there were fewer government dental clinics. The most common reason for visiting a quack was toothache (74%) and extraction was the most common treatment received (61%). Forty three per cent of respondents were dissatisfied with the treatment received from a quack and 83% felt that treatment provided by a qualified dentist was different. Main reasons for using a quack were cost (53%) and availability (20%). People who had used a quack were less likely to rate their oral health as 'Very good' or 'Excellent'. CONCLUSION: Those using the services of dental quacks in Trinidad were more likely to have lower, self rated oral health. Affordability and availability of dental treatment were identified as barriers to care from qualified dentists.

The working practices and job satisfaction of dental nurses in Trinidad and Tobago: findings of a national survey.

OBJECTIVE: To describe the working practices and level of job satisfaction of dental nurses in Trinidad and Tobago. DESIGN: Postal survey. PARTICIPANTS: Fifty enrolled and practising dental nurses in Trinidad and Tobago were surveyed, 38 replied (76%). OUTCOMES MEASURES: Current working practice, career breaks, continuing education, job satisfaction. RESULTS: All dental nurses were employed by the Ministry of Health or Regional Health Authorities. Most performed a wide range of clinical and administrative duties along with delivering dental health education. Forty five per cent of respondents had taken a career break since qualifying with maternity and child rearing being the most common reason (94%). Sixty six per cent had attended a continuing education course in the previous year, with this most frequently being a dental refresher course. Satisfaction with pre-qualification training was high but current job satisfaction was low. Concerns with working conditions and career paths were identified. CONCLUSION: Dental nurses in Trinidad and Tobago expressed confidence in their ability to perform their current duties and showed interest in continuing education. Job satisfaction was low.

Sources of stress and psychological disturbance among dental students in the West Indies

The aim of this study was to investigate sources of stress and psychological disturbance in dental students across the five years of undergraduate study at a dental school in Trinidad. Eighty-three percent of students completed a modified version of the Dental Environment Stress questionnaire (DES) and the Brief Symptom Inventory (BSI). On a scale ranging from 0 (not stressful) to 5 (highly stressful), overall mean DES scores for each of the five years of study were 1.58, 1.83, 2.65, 2.39, and 2.61 respectively, suggesting that levels of stress increase over the five years with a noticeable spike at the transition between the preclinical and clinical phases. Significant differences were found between specific stressors across the five years of study. Seven specific stressors and the stressor domains of Academic work and Clinical factors were more stressful for female students (t-test p < 0.05). The Global Severity Index of the BSI indicated that 54.8 percent of males and 44.2 percent of females were in the clinical range indicating significant psychological disturbance. Psychological disturbance was significantly associated with stress levels for male students (Spearmans rank correlation r = 0.56; p < 0.001), but not generally for female students. Further development is needed of dental educational programs that enhance students' psychosocial well-being.

Malignant teratoid medulloepithelioma: a case report.

A case report "Malignant Teratoid Medulloepithelioma" is herewith presented for its rarity. Medulloepitheliomas are embryonic tumors occurring infancy and are probably congenital. Occasionally they show glial tissue and cartilage.

2-Hydroxy-1-naphthaldoxime as an analytical reagent for titanium(IV).

2-Hydroxy-1-naphthaldoxime is proposed as a new selective and sensitive reagent for titanium. The oxime complex can be dried to constant weight at 105-110 degrees and the conversion factor is 0.1793. The method is sensitive and gives reproducible results. Quantitative separation of titanium(IV) from iron(III) and other metals by this method gives good results. The method has been applied to the gravimetric determination of titanium(IV) in ilmenite and the results are in good agreement with those obtained by the cupferron method. The dried complex has definite composition [TiO(OH)(C(11)H(8)O(2)N)](2) and is a non-electrolyte. The dimeric structure proposed for the complex is based on evidence from elemental analysis, molecular weight determination, magnetic susceptibility and infrared spectral data.