Out-of-office dentistry: an alternative delivery system.

Access to care continues to be a barrier in meeting the dental needs of a growing elderly population as well as other special patient care groups. One nontraditional delivery system reported and used by some practitioners is the mobile dental clinic. A dual purpose written survey was designed to: collect descriptive information about the operation of mobile and portable dental clinics and examine the attitudes and beliefs of dentists practicing out-of-office dentistry. This survey showed out-of-office dental clinics deliver dental services to a variety of patient populations. Portable dental clinics appear to be suited for care delivery to nursing home patients. There also appears to be a significant correlation between portable clinics and the delivery of denture service (P less than .05).

The effects of subgingival irrigation with chlorhexidine and stannous fluoride. A preliminary investigation.

This pilot study compared the effectiveness of subgingival irrigation with 0.12% chlorhexidine, 1.64% stannous fluoride, and sterile saline, in addition to scaling and root planing, on levels of Bacteroides porphyromonas and the clinical parameters bleeding tendency, probing depth, and attachment level. A convenience sample of eight patients, exhibiting 32 sites with moderate periodontal disease, was randomly assigned to receive all treatments according to a four-quadrant treatment design. Subgingival irrigation was performed at 0, 1, 2, and 3 weeks following scaling and root planing. Clinical and microbial assessments were measured at baseline, 4, 8, and 12 weeks. Data were analyzed using a two-factor repeated measure analysis of variance, and the Newman-Keuls sequential range test or Friedman test and Kruskal-Wallis test revealed statistically significant (p less than .01) improvements in probing depths, attachment levels, and Bacteroides porphyromonas for all groups at 12 weeks when compared to baseline values. No statistically significant differences occurred between any of the treatment groups at any time period. Based on the findings of this investigation, it has been concluded that four weekly irrigations with 0.12% chlorhexidine, 1.64% stannous fluoride, or saline irrigation did not enhance the beneficial effects of scaling and root planing alone.