ABSTRACT
When dentists treat patients for immediate complete dentures, they assume responsibility not only for the clinical and laboratory techniques unique to immediate complete denture fabrication, but also the responsibility for informing their patients about their treatment options, instructing their patients in the care of their oral tissues and dentures, and for continuing maintenance of the immediate dentures. Immediate dentures can be a traumatic introduction to complete dentures if patients are not informed fully about the complexity of the clinical and laboratory procedures, the need for immediate denture maintenance, and the costs associated with immediate denture treatment. The importance of 8 to 12 months of continuing care for immediate denture patients must be explained to patients and the dangers of neglecting continuing care must be emphasized.
Subject(s)
Denture, Complete, Immediate , Attitude to Health , Continuity of Patient Care , Contraindications , Costs and Cost Analysis , Dental Impression Technique , Dentist-Patient Relations , Denture Design , Denture, Complete, Immediate/adverse effects , Denture, Complete, Immediate/economics , Denture, Complete, Immediate/psychology , Humans , Jaw Relation Record , Patient Care Planning , Patient Education as TopicABSTRACT
PURPOSE: Instructions for patient positioning during panoramic radiography usually describe positioning dentate patients, and errors in patient positioning are commonly identified by distortion of the dentition. The purposes of this study were to identify common errors in panoramic radiography of edentulous patients, describe the image distortions that can be expected with positioning errors in edentulous patients, and review quality assurance methods that improve the diagnostic value of panoramic films. MATERIALS AND METHODS: Panoramic films were randomly selected from the inactive files of 75 edentulous patients seen at the dental school for complete denture construction. The radiographs were numbered and reviewed by a board-certified oral and maxillofacial radiologist trained to identify errors in panoramic radiography. RESULTS: Of the 75 panoramic radiographs examined, only 6 films (8.0%) were free of errors, and 67 films (89.3%) had one or more errors in patient positioning and 33 films (44.0%) had one or more technical errors. The most common positioning errors were positioning the chin too high (32 films, 41.3%) and positioning the patient too far forward (26 films, 34.7%). CONCLUSIONS: Without modification, manufacturer's instructions for positioning dentate patients during panoramic radiography may result in positioning errors on the panoramic radiographs of edentulous patients. Proper training and appropriate attention to detail while exposing and developing panoramic films are required to ensure maximum diagnostic benefits for edentulous patients.
Subject(s)
Medical Errors , Mouth, Edentulous/diagnostic imaging , Radiography, Panoramic/methods , Chin , Head , Humans , Posture , Quality Assurance, Health Care , TongueABSTRACT
It is now generally accepted that smoking impairs wound healing. This article briefly reviews wound healing and a number of local and systemic responses to smoking which may have deleterious effects on wound healing. It is important that dentists fully understand the deleterious effects of smoking on wound healing and that they fully explain to their patients who smoke the compromised tissue response and surgical results that can be anticipated.
Subject(s)
Smoking/adverse effects , Wound Healing/physiology , Humans , Nicotine/adverse effects , Periodontal Diseases/etiology , Vasoconstrictor Agents/adverse effects , Wound Healing/drug effectsABSTRACT
A survey of recent dental school graduates regarding their preparation for and provision of dental care for cancer patients in their practices suggests several trends. Although an extensive educational effort has brought about an introduction of dental students to medically compromised patients, over 90% of the recent graduates surveyed recommended maintaining or increasing curriculum time devoted to each of twelve didactic and clinical dental oncology areas considered. The majority of dentists surveyed evaluated their dental school educational experience as weak in five (biopsy techniques, treatment modalities, maxillofacial prosthetics, nutrition for cancer patients, and patient support sources) of the twelve didactic and clinical areas considered. Not one of the twelve areas was evaluated as strong by a majority of the dentists. It is apparent that accommodation to the suggestions of practicing dentists must be made if general dentists are to provide high quality, comprehensive dental care for cancer patients.
Subject(s)
Dental Care for Chronically Ill , Education, Dental , Mouth Neoplasms , Curriculum , Education, Dental/standards , Humans , Medical Oncology/education , Mouth Neoplasms/diagnosis , Mouth Neoplasms/therapy , Program Evaluation , Surveys and QuestionnairesABSTRACT
The production and use of tobacco have been accepted parts of the American life-style for over 500 years. Tobacco use in the United States has gone through many stages over the years. The present article reviews the trends of tobacco use over the last 100 years and the public health strategies recently initiated to control tobacco use and promote public health. Finally, suggestions regarding the dentist's role in limiting tobacco use and promoting public health are presented.
Subject(s)
Mouth Diseases/etiology , Nicotiana , Plants, Toxic , Adolescent , Adult , Dentists , Female , Humans , Male , Smoking/adverse effects , Smoking/epidemiology , Smoking/trends , Smoking Cessation , Tobacco, Smokeless/adverse effects , United States/epidemiologyABSTRACT
The use of a visible light-cure dental synthetic resin offers some advantages in the clinical delivery of an ocular prosthesis and a statistically significant reduction in the processing time.
Subject(s)
Eye, Artificial , Methacrylates , Polyurethanes , HumansSubject(s)
Education, Dental, Graduate/trends , Prosthodontics/education , Aged , Humans , Middle Aged , Population Dynamics , United StatesABSTRACT
With recent concern about the cumulative effects of radiation exposure, routine radiographic examination of edentulous patients is being questioned. While the present study reports a lower incidence of positive findings than previous panoramic surveys, we still find potentially complicating conditions. Radiographic examination of new edentulous patients still appears warranted.
Subject(s)
Jaw, Edentulous/diagnostic imaging , Radiography, Panoramic/statistics & numerical data , Female , Humans , Male , Middle AgedABSTRACT
Oral conditions related to cancer therapy, which are largely preventable, continue to result in considerable morbidity, dysfunction and lost quality of life. Therefore, it is important for dentists to be knowledgeable about the problems of reimbursement for the oral health care of cancer patients and become involved in the issue of access to oral health care for cancer patients.
Subject(s)
Dental Care for Disabled/economics , Insurance Claim Reporting , Insurance, Dental , Mouth Neoplasms/economics , Diagnosis-Related Groups , Humans , Medicaid , Medicare , Reimbursement Mechanisms , United StatesABSTRACT
A survey of recent Texas dental school graduates regarding their preparedness for addressing the oral health care needs of cancer patients in their practices suggests several trends. Many graduates (26%) do not feel adequately prepared to manage and provide oral care for cancer patients. Over 95% of the dentists surveyed expressed interest in locally sponsored continuing education courses on the oral health care of cancer patients. Clearly, both predoctoral and postdoctoral dental education must recognize the need for formalized instruction on the oral cre of cancer patients if general dentists are to provide high-quality, comprehensive dental care for these patients.
Subject(s)
Dental Care for Disabled/statistics & numerical data , Dental Caries/etiology , Head and Neck Neoplasms/therapy , Dental Caries/therapy , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Humans , Mouth Diseases/etiology , Mouth Diseases/therapy , Surveys and Questionnaires , TexasABSTRACT
Timely rehabilitation of facial defects necessitates provisional prostheses during the period following surgery. The possibilities of using microwave radiation in the drying of gypsum casts, the preparation of stone molds, the curing of silicone elastomers, and the extrinsic coloring of silicone prostheses are presented. Microwave radiation has the potential for saving time, energy, and resources during the fabrication of provisional facial prostheses.
Subject(s)
Dimethylpolysiloxanes , Maxillofacial Prosthesis , Microwaves , Prosthesis Design , Biocompatible Materials/radiation effects , Calcium Sulfate/radiation effects , Chemical Phenomena , Chemistry, Physical , Desiccation , Humans , Silicone Elastomers/radiation effects , Time FactorsABSTRACT
Initial clinical studies applying the osseointegration concept for retention of facial prostheses have been encouraging. The results of these preliminary investigations indicate new treatment possibilities with facial prostheses anchored to the cranial skeleton by osseointegrated implants. Osseointegrated rehabilitation of the maxillofacial prosthetic patient presents the potential for overcoming many of the disadvantages associated with conventional retentive methods. Fabrication and support for facial prostheses by using osseointegrated implants for retention are described.
Subject(s)
Facial Bones/surgery , Maxillofacial Prosthesis/methods , Prostheses and Implants , Prosthesis Design , Humans , Magnetics , NoseABSTRACT
Topical drug therapy for ulcerative and vesiculobullous diseases of the oral mucosa has generally proved unsatisfactory because of the turbulent and changing nature of the oral cavity. The construction and use of an intraoral drug delivery system using custom carriers to deliver topical medication is described. The delivery system presented overcomes many of the obstacles associated with topical drug administration for oral lesions and provides a therapeutic alternative to systemic agents.
Subject(s)
Administration, Topical , Drug Carriers , Mouth Mucosa , Equipment Design , Humans , Mouth Diseases/drug therapy , Patient Education as TopicABSTRACT
Internal defects of the nose result from congenital abnormalities, trauma, tumor excision, and complications of cosmetic or airway enhancement procedures. Since the nose is a prominent feature of the face, and nasal deformities present complicated reconstructive problems, the rehabilitation of this structure assumes great importance. Surgical and/or prosthetic procedures using intranasal prostheses, splints, or stents have been developed to improve both form and function. Intranasal prostheses, splints, and stents during nasal rehabilitation can (1) establish and maintain airway patency, (2) maintain tissue position, (3) reduce tissue contracture after surgery, or (4) support mobile tissue in the construction and retention of facial prostheses. Although techniques for managing common problems have been presented in this article, unique clinical situations will arise. Much of the execution and ultimate success of nasal prosthetics will depend upon the ingenuity of the dentist performing the service.
Subject(s)
Nose , Prostheses and Implants , Splints , Equipment Design , Humans , Nose/surgery , Prosthesis DesignABSTRACT
The continuous assessment and updating of clinical evaluations are integral aspects of dental education. The purpose of this article was to describe the development, implementation, and assessment of an evaluation system for clinical removable prosthodontics. A system based on a three-point scale (RST) was adopted and implemented with the intent of maximizing evaluation effectiveness while minimizing stress on students and faculty members. To date, the RST system has improved both the quality of clinical evaluation and the level of clinical learning. The RST clinical evaluation system appears to be defusing students' ardent quests for grades while promoting the teaching potential within the evaluation process. The system also stimulates student self-evaluation, improves the consistency of faculty grading, facilitates student counseling, and permits an in-depth analysis of the evaluation system at regular intervals.
