Oklahoma dental Medicaid. A need for action.

Dental Medicaid in the State of Oklahoma must be made to work. But it will not work unless enough of us get involved and lead health officials, and legislators into the serious work that can turn Medicaid's promise into performance and a Medicaid card into meaningful dental care. Ironically, Medicaid's "EPSDT" (Early Periodic Screening, Diagnosis and Treatment) authorizes a high scope of dental coverage for the child. But trying to access care for the Medicaid eligible child is entirely another matter. Only a small number of Oklahoma dentists treat the quarter of a million Medicaid eligible persons in Oklahoma. Why is this so?

Acute pancreatitis: the role of diagnostic imaging.

In the U.S., acute pancreatitis is usually caused by excessive consumption of ethanol or by biliary stone disease. Major pathologic finding and complications include fluid collections within the organ or the adjacent peripancreatic tissues, pseudocysts, pancreatic necrosis, pseudoaneurysm, and abscess formation. Radiologic imaging, including endoscopic retrograde cholangiopancreatography (ERCP), sonography, and computed tomography (CT), are important in the evaluation of acute pancreatitis and its complications. CT in particular also aids in grading the severity of acute pancreatitis and in predicting complications and mortality; however, CT correlation with Ranson's clinical prognostic factors or with other classification systems is less clear. The imaging and therapeutic aspects of acute pancreatitis are discussed and illustrated and prognostic factors are correlated.

Microabrasion: effect of time, number of applications, and pressure on enamel loss.

Enamel microabrasion using hydrochloric acid and pumice is an effective method to remove superficial enamel discoloration. This procedure is used in many dental offices but little is known about how different treatment combinations of hand applicator pressure on the tooth, number of applications, and duration of application affect the amount of enamel loss. This investigation studied variables of time, number of applications, and pressure individually and in combination. Twenty-seven extracted premolars were hand rubbed with an 18% HCL-pumice mixture at time intervals of 5, 10, and 20 sec and 5, 10, and 15 applications under pressures of 10, 20, and 30 g. Fifty-four longitudinal sections were cut from the treated sections and measured for enamel loss (P < 0.05). Enamel loss significantly increased as each variable separately increased. When two variables increased at the same time, a greater amount of enamel loss occurred than when one increased. The combination of 10 ten-sec applications or 15 five-sec applications with 20 g pressure resulted in enamel loss of slightly less than 250 microns.