The state of oral and dental health of the homeless and vagrant population of Montreal.

Not much is known about the state of oral and dental health of homeless and vagrant people in Montreal. However, a study conducted during April 1993, in conjunction with dental health month, has made it possible to undertake a better evaluation of their oral health status and to identify ways of making dental treatment available to them. Once the oral health status of this population is known, the official body responsible for homeless and vagrant individuals, the "Régie régionale Montréal-Centre," can be given possible solutions for their treatment and care. Most of the homeless are welfare recipients and have access to some basic benefits from this source. One of these benefits is free access to all assured basic dental services. These services are available after a six-month waiting period, and are provided by a dentist of the homeless person's choice. At the beginning of this study, the authors hypothesized that homeless people would prefer to be treated in the hostels and shelters where they sleep, which is currently the situation in Boston. But in 65 per cent of cases, their responses to a questionnaire administered as part of this study were quite different, and indicated that they would prefer to visit a private dentist of their choice. However, there is another important group (35 per cent) who wish to receive dental treatment in the hostels they presently frequent. Any proposed solution should take into consideration both groups of homeless and vagrant persons.

The teaching of geriatric dentistry in Canada.

Very little is known about the current status of geriatric training programs at Canadian universities because of the scarcity of information published on the subject. A study of the geriatric dentistry training programs offered by Canada's 10 dental schools has been completed. Its intent was to determine what type of educational activities in geriatric dentistry have either been offered in the past, are being offered now, will be offered in the next academic year, or are planned for the next five years. The results indicate that the 10 schools are doing very little in this regard. To keep pace with the level of geriatric dentistry training currently being offered in the United States, the dental profession must convince Canadian faculty members that the teaching of geriatric dentistry is crucial to both the undergraduate student and the graduate dentist. Continuing education in geriatric dentistry could be used to meet the oral health needs of our frail and dependent senior citizens. Geriatric dentistry must be taught at all levels of the profession so that this special clientele can receive the necessary treatment either within or outside of the dental office.

Comparison of two popular methods for removal and killing of bacteria from dentures.

A study was undertaken to compare the efficacy of a soaking solution (Efferdent Extra-Strength Denture Cleanser Tablets) to mechanical cleaning with a denture paste (Advanced Formula Dentu-Creme Denture Cleaning Paste) to remove and kill plaque bacteria from removable dentures. The study was conducted in a randomized, four-way crossover fashion with 18 subjects. At each clinic visit, subjects were randomized to one of four treatment regimens: 1) no treatment; 2) brushing with denture paste; 3) soaking in Efferdent; 4) brushing followed by soaking in Efferdent. Microbiological sampling for plaque bacteria was made before and after each treatment. Aliquot samples of 10-fold serial dilutions were plated on supplemented Schaedler Agar (for total anaerobes) and on CVE agar (for fusobacteria). Analysis of covariance was performed on the log10 transformed scores at posttreatment using the pre-treatment scores as covariates. Significant treatment effects were: F(3,41) = 81.60, p less than 0.001 for anaerobes and F(3,50) = 104.38, p less than 0.001 for fusobacteria. Pairwise comparisons using Tukey hsd post hoc tests showed that for total anaerobes, treatments 1 and 2 yielded higher scores than treatments 3 and 4. For fusobacteria, treatment 1 greater than 2 greater than 3 or 4; no difference between treatments 3 and 4. The results demonstrated the superior performance of Efferdent over Dentu-Creme.

Clinical evaluation of two posterior composite resins: two-year results.

Two composite resins were evaluated for clinical acceptability as restorative materials in Class I and II cavities over a 2-year-period. In addition, dispersed phase alloy was evaluated for comparison. All restorations were assessed for anatomical form, marginal integrity and marginal leakage using modified United States Public Health Service (USPHS) criteria. At the 2-year recall, 96% of the composites and 100% of the amalgams were rated 'alpha' or 'bravo', using the parameters of assessment defined in this study. However, a significant number of shifts from the baseline, within the level of acceptability, had occurred. The two composites showed the greatest number of shifts for anatomical form and marginal leakage, while there were no differences between the composites and the amalgam for shifts in marginal integrity. Although a very high level of acceptability was determined for all of the materials, the frequency of rating change within categories for the composites was a cause of concern with regard to their long-term clinical use.