Treatment of oral and nonoral sources of halitosis in elderly patients.

The increasing number of older patients being seen in medical and dental offices in the industrialised world emphasises the need for a thorough understanding of the normal aging process. Additionally, close attention must be paid to the disease processes that affect this special needs population. Although there are many positive psychosocial issues associated with the aging patient, many diseases and disabilities associated with the aging process place an increased burden on the elderly patient. The relationship between general and oral health must be understood by the practitioner if therapies are to be effective. Although it is not the objective of this article to provide a comprehensive review of oral healthcare, an attempt will be made to provide general information on the diagnosis and treatment planning for oral malodours often associated with poor oral and/or systemic health. Every healthcare provider treating the elderly patient for oral malodours must recognise that there is potentially a direct relationship between the oral and systemic health of the patient. While most oral malodours have a simple cause, no single therapy is always effective. For best results, a team approach to diagnosing and treating oral malodours involves the dentist, physician, dietician and pharmacist. This multidisciplinary approach should be arranged before the onset of any complex therapy. When indicated, supportive, responsible family members should be additionally involved to assure patient compliance. The mouth and teeth can be a source of great pride and pleasure. A beautiful smile is one of the most pleasant greetings a human can offer. Enjoying a meal of fine food and drink is truly gratifying.(ABSTRACT TRUNCATED AT 250 WORDS)

Managing periorbital space abscess. Secondary to dentoalveolar abscess.

Although orbital space infections are a relatively rare sequela of dentoalveolar infections, such cases have been reported. This case report describes the management of an abscess involving the left eye that originated as a dental abscess.

Birth prevalence of cleft lip and palate in Colorado by sex distribution, seasonality, race/ethnicity, and geographic variation.

An epidemiologic study was designed to describe the association of potential risk factors with the occurrence of cleft lip and palate (CL/P) births in Colorado for the years 1982-1988. There were 307 children out of 381,175 live births identified, through birth certificate data, with a diagnosis of cleft palate or cleft lip with or without cleft palate. For this period, the birth prevalence was 0.81/1000. Male gender [odds ratio (OR) = 1.62, 95% confidence interval (CI) = 1.28, 2.04], white race (OR = 2.87, 95% CI = 1.52, 5.44), and non-metropolitan residence (OR = 1.59, 95% CI = 1.23, 2.05) were each associated with an excess risk of having a cleft abnormality of any type at birth. No differences in the occurrence of cleft lip and palate were observed by month of birth, altitude of county of residence, or in Hispanic compared with non-Hispanic newborns. Using information from the 1989 Colorado Registry for Children with Special Needs, there was little evidence of ascertainment bias on major factors of interest for the birth certificate data. Further studies are required to define the factors associated with excess risk of CL/P in non-metropolitan areas.

Recognizing and reporting dental violence: a survey of dental practitioners.

A survey was sent to 1,000 Colorado dentists to evaluate their recognition and reporting of child, elder, and spouse abuse. Approximately 40% of the dentists returned the survey. In answering questions about suspected and reported cases of child abuse, 29% of the respondents indicated that they had suspected at least one of their patients to be a victim of child abuse, while 14% of the respondents had actually reported at least one case. Only 7% of the responding dentists had ever suspected a case of elder abuse, while just over 1% indicated that they had reported at least one suspected elder abuse case to authorities. When asked about their recognition and reporting of spouse abuse, 30% of the responding practitioners had suspected at least one case, while only 3% had ever actually reported a case to authorities. The overwhelming majority of responding dentists indicated that they needed to know more about child, elder, and spouse abuse.

Tomography.

Conventional tomography is used in dentistry to demonstrate objects lying in a plane of interest distinct from their surrounding anatomic structures. Through technique parameters, which generate the controlled blurring of structures above and below the plane of interest, anatomic structures are visualized without the superimposition noted on other types of plain radiographs. In this article, the basic principles of tomography have been reviewed and the clinical applications for conventional tomography in dentistry have been described.

Diagnosing and treating halitosis.

Halitosis (bad breath) has been defined as offensive odors emitted from the mouth. Although bad breath is a common complaint, identifying the cause and developing an appropriate treatment plan can be difficult. A thorough examination must be performed to rule out an oral source.

Recognizing and reporting victims of domestic violence.

Domestic violence can be defined as any violent behavior directed against an individual within the home or family. It occurs in all segments of society and is not limited to a single ethnic or socioeconomic group. Since most intentional injuries occur in the head and neck area, the dentist might be the first to treat the domestic violence victim.

Absorbed dose determination for tomographic implant site assessment techniques.

A set of data to compare the absorbed dose delivered by tomographic implant site assessment techniques was generated. Absorbed doses were measured in fourteen anatomic sites from (1) computed tomography scans and (2) a series of tomographic cuts performed on a linear tomography unit. The doses to the thyroid gland, the active bone marrow, the brain, the salivary glands, and the eyes were determined with the use of a tissue-equivalent phantom with lithium fluoride thermoluminescent dosimeters at the appropriate locations.

Facial growth during adolescence in early, average and late maturers.

The relative stage of maturity of a child may be determined by comparing the child's hand-wrist radiograph to known standards of skeletal development. Hand-wrist radiographs of 70 adolescents were used to categorize the individuals by skeletal maturation into early, average and late maturation groups using the Fishman SMA method of assessment. The rates of mandibular and maxillary growth relative to the last stages of the pubertal growth spurt were measured. Statistical evaluation of the data was performed using an analysis of variance. The magnitude of change in growth increments of the mandible was greater in the late maturers than in the early or average maturers. Incremental differences in growth between the maxilla and mandible during the last stages of puberty were noted, with the mandible growing significantly more than the maxilla.

Localization of anatomic structures before endodontic surgery with tomograms. Report of a case.

Tomograms taken before endodontic surgery can demonstrate the location of root apices relative to adjacent anatomic structures. This buccolingual perspective is not depicted on conventional periapical or panoramic radiographs. Accurate length determination from the root apex to the inferior alveolar canal is simplified, and the relationship of root surfaces to the buccal and lingual plates is well visualized on the tomographic images.

Cross-sectional radiography for implant site assessment.

An accurate tomographic technique is described for acquisition of optimal cross-sectional images of implant sites before implant surgery. The described technique is applicable to tomographic systems equipped with a cephalometric head positioner. This cross-sectional tomographic technique was performed on a series of patients and the images of the first 20 patients subsequently evaluated. The cross-sectional images allowed for the characterization of the alveolar crest and visualization of anatomic structures in a buccolingual dimension while providing an accurate estimation of available vertical space from the crest.

Cross-sectional radiography for implant site assessment.

An accurate tomographic technique is described for acquisition of optimal cross-sectional images of implant sites before implant surgery. The described technique is applicable to tomographic systems equipped with a cephalometric head positioner. This cross-sectional tomographic technique was performed on a series of patients and the images of the first 20 patients subsequently evaluated. The cross-sectional images allowed for the characterization of the alveolar crest and visualization of anatomic structures in a buccolingual dimension while providing an accurate estimation of available vertical space from the crest.

Spatial resolution requirements for digitizing dental radiographs.

A study was performed to determine the appropriate spatial resolution for digitizing and transmitting dental radiographs with the KODAK EKTASCAN, a computer-based digital enhancement and transmission system. Periapical, bitewing, and panoramic radiographs were digitized in three formats representing varying spatial resolution parameters. Eight viewers used a 5-point rating scale to evaluate the detectability of periapical pathosis on the periapical images, of proximal surface caries on the bitewing images, and of various bony abnormalities on the panoramic images. Receiver operating characteristic curves were generated, and the results of the periapical, bitewing and panoramic experiments were presented as trapezoidal and maximum likelihood receiver operating characteristic curve areas. The results of this study indicate that digital images of dental radiographs provide adequate diagnostic accuracy for evaluating the presence of periapical pathosis, proximal surface caries, and specified bony abnormalities. The digitization parameters established for the KODAK EKTASCAN provide a guide for digitizing dental radiographs on other commercially available digital image-processing systems.