Health-related quality of life of children on treatment for acute lymphoblastic leukemia: A systematic review.

Children with acute lymphoblastic leukemia (ALL) undergo intense anticancer treatment. We systematically reviewed 22 studies evaluating 2,073 ALL patients' health-related quality of life (HRQL) and its clinical/demographic correlates during treatment. Overall HRQL was significantly reduced on treatment. Despite HRQL improvements over time, longitudinal studies reported a proportion of children continued to experience reduced HRQL after treatment completion. We found inconsistent associations between clinical/demographic factors and HRQL outcomes. Tentative evidence emerged for worse HRQL being associated with intensive phases of chemotherapy, corticosteroid therapy, experiencing greater toxicity, older age, and female sex. Longitudinal studies are needed to identify children at-risk of reduced HRQL.

Pain and anxiety reduction using a manual stimulation distraction device when administering local analgesia oro-dental injections: a multi-center clinical investigation.

OBJECTIVE: This study was designed to assess the effects of a manual stimulating distraction device (Isoflex referred to as Manual Stimulation Distraction Device or MSDD) for reducing pain and anxiety experienced with standard dental local anesthetic injections. Additionally, the memory recall effects on injection pain and anxiety were also explored. METHODOLOGY: Patients from different dental clinics were identified by their practitioners as requiring dental procedures under local anesthesia, in the same area on both sides of the mouth. A local anesthetic solution was injected on either the left or right side at different times by random selection; one side using MSDD, while the opposite side used a solution without MSDD. Each patient acted as his or her own symmetrical split-mouth control. The same dentist administered both injections, using identical technique and equipment for each side. Forty-six patients used the MSDD first with the injection, while 54 used MSDD second when they received the injection. Using 10-point visual analogue nominal and ordinal scales, pain and stress were recorded by the patient each time after receiving the injection. The results were pooled and subjected to statistical analysis. Student's paired t-test was employed to test for significant differences in pain and anxiety (stress) when injections were administered with and without MSDD. RESULTS: Results showed significant reductions in perceived pain and stress from local analgesia injections (p < 0.001) when MSDD was used. There was no correlation of pain reduction with age, gender, upper or lower jaw, with or without MSDD. There was a trend for pain and stress to be scored higher for those subjects who had a lower period since the first injection (POFI) scores. This was attributed to recent memory of pain, as POFI scores over one week were significantly lower (p < 0.05). Stress reduction for POFI scores greater than one week proved to be non-significant (p = 0.099). CONCLUSION: In this study, MSDD was effective at reducing pain and stress experienced with local regional analgesic injections.

Anticariogenic effects of black tea (Camellia sinensis) in caries prone-rats.

OBJECTIVE: Black tea (Camellia sinensis) may have anticariogenic properties. The present study was designed to determine whether consumption of black tea influences cariogenesis in young, caries-prone rats. METHOD AND MATERIALS: Eighteen-day-old Sprague-Dawley rats (n = 24; eight per group) fed a cariogenic diet (MIT 200) were randomly assigned to three groups to receive deionized, distilled fluoride-free water, tea, or fluoridated water (25 ppm), ad libitum, for 14 days. In addition, an initial control group of rats was studied at 20 days of age. Teeth were stained with silver nitrate to detect caries and cut mesiodistally. First and second molars were assessed for caries. RESULTS: The initial control group had negligible caries. Caries-prone rats consuming fluoride-free water had significantly more caries lesions (6.75) than did the tea (3.12) and the fluoridated water (0.85) groups. CONCLUSION: Consumption of black tea for 2 weeks attenuated development and progression of caries in caries-prone young rats.

Hypersensitive dentinal pain attenuation with potassium nitrate.

Dentinal hypersensitivity occurs when gingival recession exposes dentin at the cervical margins of teeth. Twenty-four periodontal patients, with postoperative hypersensitive dentin were treated by burnishing saturated potassium nitrate (KNO3) to relieve pain. Using a visual analogue scale with participants acting as their own control, a subjective assessment of pain was measured and compared before and after KNO3 application. Thirty-six regions involving 98 teeth were assessed. A significant reduction of sensitivity and pain was achieved by using a saturated KNO3 solution (p < .0001 Student-t).

Cosmetic or esthetic dentistry?

This article, through presentation of case studies, defines differences and suggests separate definitions for the terms cosmetic dentistry and esthetic dentistry. Dentistry strives to emulate harmonious form and function for therapy, and modification of appearance is an integral part of dental treatment. Cosmetic dentistry suggests a certain accommodation and is a compromise of current technology. Cosmetic dentistry is commonly selected as an interim procedure that does not necessarily function ideally and does not always emulate the pristine state of a natural dentition. Esthetic dentistry requires less accommodation, incorporates acceptable biologic technology for long-term survival, functions suitably, and mimics the pristine state of the natural dentition. Cosmetic and esthetic dentistry are different in definition, concept, and execution.

The influence of postoperative telephone calls on pain perception: a study of 118 periodontal surgical procedures.

This age-matched and sex-matched study examined the influence of postoperative telephone calls on pain perception and on the number of analgesics used for pain relief. Adult periodontitis subjects (n = 118) received periodontal surgery after examination and sanative therapy (scaling, root planing, and removal of local irritants). All subjects received similar care, postoperative instructions, and medication, except 59 subjects were phoned 24 hours postoperative (PC group), and 59 were not (NC group). Callers covered 10 points and were reassuring and positive about surgical outcomes. One week postoperative, subjects completed a questionnaire that rated pain intensity on a visual analogue scale and indicated the number of pills used and whether they had been called. Pain and analgesics used were significantly decreased in the PC group (P < 0.001) compared to the NC group. A significant positive correlation was found between pain and pills used in the groups combined (r = 0.79, P < 0.001 PC + NC), and in the groups separately (r = 0.50, P < 0.001 PC; r = 0.41, P < 0.01 NC). Postoperative communication between healthcare providers and patients significantly reduces pain perception and number of analgesics used for relief.

Oral scurvy and periodontal disease.

Although gingival bleeding is a manifestation of both scurvy and inflammatory periodontal disease, the two conditions are distinctly separate entities. The defective collagen synthesis associated with scurvy also manifests many of the same symptoms as deficient vitamin C physiology, but neither condition is associated with periodontal disease. Unlike scurvy, the various periodontal diseases are caused by oral plaque microorganisms. The body's reaction to these microorganisms is strongly influenced by the compromised functioning of leucocytes and monocytes. Although certain infections and systemic diseases cause gingival bleeding, avitaminosis-C does not cause commonly encountered periodontitis. Vitamin C should not be used for the prophylaxis or cure of periodontal disease in otherwise healthy, well-nourished individuals. A patient with bleeding gingivae warrants referral to a periodontist, oral medicine specialist, or appropriately qualified dentist for examination and treatment.

Antibiotic prophylaxis in periodontal surgery. A retrospective study.

Antibiotics are frequently used in periodontal and minor oral surgery to prevent complications. The potential disadvantages of antibiotic prophylaxis are well documented. This study compares the incidence of complications for procedures performed with and without antibiotic prophylaxis. The clinical records of 1499 patients who received treatment at a university teaching hospital were reviewed. 1078 surgical procedures were done on 596 patients. 895 surgical procedures were done without prophylactic antibiotics, with 17 complications (1.9 per cent). 183 procedures were done using antibiotic prophylaxis, with 1 complication (0.55 per cent). The difference between the incidences of complications in the two groups was not statistically significant (P < 0.001). In view of the questionable benefits and potential disadvantages of using antibiotics, their routine use during or following periodontal surgery must be questioned.

Candidal infection of the tongue together with candidal infection of the palate in patients with the human immunodeficiency virus.

The most common oral opportunistic infection affecting persons with acquired immunodeficiency is candidiasis. This article reports on candidal infection of the tongue together with candidal infection of the palate in patients who have the human immunodeficiency virus. A retrospective analysis of 336 patients with acquired immunodeficiency syndrome revealed a prevalence of 8% with candidal infection of both the tongue and palate. Patients in this group were significantly older (39.2 years versus 34.5 years) and had significantly lower CD4-CD8 ratios than did the rest of the cohort.

The acidity (pH) and buffering capacity of Canadian fruit juice and dental implications.

Excessive consumption of acidic fruit juices is associated with dental morbidity. The pH and buffering capacities of fruit juices packaged and consumed in Canada were measured, and the implications on dental pathology of consuming juices of these qualities are discussed. Canadian fruit juices have a pH below the critical dissolving pH of enamel, and have buffering capacities similar to juices produced and consumed elsewhere in the world. Citrus, apple, and grape juice, or blends of these juices, are all potentially hazardous to teeth. Erosion, attrition, decay and dentinal hypersensitivity may all result from abusive juice drinking.

Oral malodor--a review.

Oral malodor has many etiologies. The use of accurate descriptor terms to describe this condition facilitates its clinical diagnosis and treatment by health care professionals. Oral malodor, a generic descriptor term for foul smells emanating from the mouth, encompasses ozostomia, stromatodysodia, halitosis (both pathological halitosis and physiological halitosis) and fetor oris or fetor ex ore. These latter terms, in turn, denote different sources of oral malodor. The terms ozaena, fetor narium, dysosmia, hyperosmia, cacogeusia, and dysgeusia are also related to oral malodor, and assist in accurately describing a clinical presentation. Systemic pathological states, such as diabetes mellitus, uremia and hepatic diseases, induce metabolic products that are detectable as oral smells. Local oral conditions produce volatile sulphur compounds and other breakdown products that intensify oral malodors. The clinical labelling and interpretation of different oral malodors both contribute to the diagnosis and treatment of underlying disease. This article stresses the relationship between smell and taste, emphasizes specific meanings for related oral malodor terms, reviews smell comprehension and indicates some of those commonly-encountered associated clinical conditions.

A successful method for quantifying viable oral anaerobic spirochetes.

Spirochetes are markedly prevalent in periodontal disease but are not included as predominant cultivable organisms because of the inability to quantify them by viable count. A successful method was developed for enumerating viable oral spirochetes as colony-forming units (CFU) in an agarose-based medium. Treponema denticola, Treponema vincentii and Treponema socranskii in log-phase growth in new oral spirochete (NOS) broth were used for evaluation of the method. Critical components of the method include enzyme-free low temperature-gelling (37 degrees C) agarose in NOS medium in small tissue-culture flasks into which the spirochetes were seeded and diluted. The flasks were anaerobically incubated in a glove-box. Reliable, consistent and reproducible viable counts of pure spirochete cultures were obtained. The injurious effects of spirochete temperature-sensitivity were averted by using molten agarose at 37 degrees C. Distinctive colony morphologies of spirochete species could be compared from pure cultures. Addition of rifampin into the medium showed no decrease in spirochete CFU count. The method as described allows for selection of mutants and detection of biochemical activity and is potentially useful for enumeration of spirochetes from periodontal pockets as members of the predominant cultivable flora.