Dental services market in Poland and its impact on the health decisions of patients and doctors.

AIM: The aim of the paper is to verify the impact of the current dental services market in Poland on the society decisions regarding dental treatment as well as to assess the differences in the valuation of commercial and public dental services. METHODS: Study Design: In the first step 1,444 subjects including children, adults and elderly were subjected to a questionnaire survey to characterise them in terms of sex, age, place of residence and level of education, type of dental treatment used including services privately funded and reimbursed by the National Health Fund and the reasons of his/her decisions. In the second step we compared the results of the survey to the average price of commercial and reimbursed procedures to verified a possible correlations between them. The research tool was a questionnaire survey by the author. The questionnaires were distributed among randomly selected kindergartens, schools, workplaces, senior clubs, social care homes and random passers-by in the streets. Average prices of dental procedures were based on price lists of 12 commercial offices and National Health Fund's contract conditions for the reimbursed services. CONCLUSION: Regardless of the age, Poles are far more likely to use private dental care. The level of education affects the form of financing of the dental treatment of children. There is a large disproportion between the revenues of private and public dental offices providing the same dental services.

Moebius syndrome: The challenge of dental management.

AIM: Moebius syndrome (MBS) is a rare disorder which involves unilateral or bilateral paralysis or lack of the VI and VII cranial nerves. This is accompanied by abnormalities affecting the head, mouth, upper and lower limbs, and chest. A distinguishing feature of this syndrome is the so-called mask-like face. A small number of publications relating to occlusal and dental bnormalities and documenting the progress of orthodontic treatment has led the authors to present the case of a patient with Moebius syndrome. CASE REPORT: A patient with Moebius syndrome was initially treated by means of removable appliances and later by means of a fixed appliance after permanent tooth extractions. As a result of the treatment, there was an improvement in the ratio of the posterior facial height to the anterior facial height: Sgo/NGn increased from 55.8% to 59.1%, which is closer to the Caucasian population norm. CONCLUSION: The aesthetic result was satisfactory both for the patient and for her parents.

The possibility of modification and improvement of dental services in Poland for children and adolescents with special emphasis on orthodontic service.

AIM: World Dental Federation reveals that dental caries is one of the most common diseases in the world, and as much as 90% of the population is facing oral cavity problems. About 28% of teenagers aged 10 and 15 absolutely needs orthodontic treatment and about another third of this age group represents very serious cases. The aim of this study is to verify the authorial model which modifies and facilitates the system of dental services in Poland with a special emphasis on orthodontic service. MATERIAL AND METHODS: The research was carried out with the method of diagnostic survey through a survey questionnaire. For this study, 1159 people were questioned for the research. In order to check the reliance between the variables Pearson chi-square test and the test of the Highest Reliability were used. Average market prices and the "prices expected" by the Greater Poland Voivodship Department of National Healthcare System were used to price dental services. RESULTS: The research revealed that the highest percentage of people who used only private dental services is between 19 and 64 years of age and the lowest percentage is represented by the elderly, i.e. subjects over 65 years of age. As for the dental services offered by the National Health Fund, the highest percentage of patients are children and adolescents under 18 and the lowest percentage of patients is represented by people in the working age. The tendency towards private healthcare is in direct proportion to parents' increase in the level of education. The main reason why parents take their children to a private dentist is the long waiting time for the visit offered by the National Health Fund as well as better materials and equipment offered by private dentists. The costs connected with extending the basket of guaranteed services for children and youngsters are combined with the increase in National Health Fund expenditure reaching EUR 7,014,151. The lack of refunding dental services for patients aged 19-64 will generate savings reaching about EUR 34,756,765. CONCLUSION: The reduction of public funds allocated for dental treatment of patients aged 19-64 will generate savings which will satisfy the needs connected with the increase in the range of refunded orthodontic treatment with the use of orthodontic permanent braces for patients under 18 years of age. The solution suggested will only slightly affect people in the working age as they reveal a strong tendency for treatment financed with their private funds.

Executive function in pediatric patients with cystic fibrosis, inflammatory bowel disease and in healthy controls.

OBJECTIVE: The main aim of this study was to analyze and compare executive function performance in pediatric patients with cystic fibrosis (CF), inflammatory bowel disease (IBD) and in healthy controls. PATIENTS AND METHODS: 28 patients with CF, 30 patients with IBD and 30 healthy participants took part in the study (all in the age range of 7-17). All participants were in the intellectual norm. The Wisconsin Card Sorting Test (WCST) was applied to assess executive functions. RESULTS: The CF group received significantly (p < 0.05) poorer scores than the control and IBD groups in the following WCST indicators: Number of trials administered, Total number of errors, Perseverative errors, Non-perseverative errors, Percent of conceptual level responses, Trials to complete the first category. The IBD group was not significantly different from the control group in any of the WCST indicators. CONCLUSIONS: To our best knowledge, results of this study are the first report of the presence of executive function deficits among pediatric patients with CF. It is also the first study that describes the performance of the executive function in IBD pediatric patients, and the first that compares cognitive functioning between CF and IBD patients.

In favour or against euthanasia--dentistry students' opinion.

Euthanasia and a doctor-assisted suicide are not only practiced worldwide, but also legalized in some countries. In Poland they are broadly discussed. The purpose of this paper was to define dentistry students attitude towards human right to ask for death and euthanasia. In the research 148 students of both sexes were questioned. Generally students were against euthanasia in the world as well as in Poland, although men were in majority for euthanasia. Believers were against it due to ethically-religious reasons, while non-believers were for euthanasia motivating it by rational reasons.

[Ultrastructural pattern of enamel in initial caries]. / Ultrastrukturalny obraz szkliwa w próchnicy poczatkowej.

In beginning caries of particular interest are destructive changes in the enamel layers just below the surface. The studied material comprised about twenty enamel blocks obtained from 10 teeth with carietic spots removed for orthodontic reasons in children aged 12-14 years. The aim of the study was assessment of the initial enamel damage under electron microscope. In all electronograms of the enamel involved by the carietic spot various grades of demineralization of the enamel below its surface were seen. The changes in initial caries seemed well delineated from the remaining healthy enamel, although within the carietic focus demineralization was observed from very slight widening of the area around the prisms to massive destruction of prism structure. The changes in the carietic spot under electron microscope showed a wide variety of patterns of destruction of enamel prisms, although clinically the surface of the enamel involved by beginning caries was small and not damaged.

[Trials of remineralization of artificially produced enamel lesions]. / Próby remineralizacji sztucznie wywolanych uszkodzen szkliwa.

The purpose of the study was checking in vitro whether after application of calcifying preparations remineralization occurs of artificially damaged enamel prisms. The study was carried out on 32 enamel samples obtained from 8 human teeth. For remineralization saturated solutions were used of phosphate-calcium compounds in the form of fluid or gel. The degree of demineralization and remineralization of enamel was assessed on the basis of images of enamel breaks in JSM-50A scanning microscope. Partial remineralization of artificially damaged enamel was found. Detailed evaluation of the remineralization progress requires extension of investigation methods.

[Comparative investigations on toothpastes]. / Badania porównawcze past do oczyszczania zebów.

A comparative study was carried out of the clinical usefulness and properties of two types (differing in the type of chalk used) of the following toothpastes: Nivea, Herbena, Salodent and four various Fluorodent toothpastes (differing in the type of calcium carbonate and thickener). The study was carried out on 100 students of the first classes of the Economics College in Poznan. The obtained results of clinical investigations justify the replacement (in part at least) in the production of toothpastes of the imported chalk Socal with Polish chalk from Janikowo.

[Study of the initial enamel injuries in vitro]. / Badania poczatkowych uszkodzen szkliwa in vitro.

The purpose of the study was production under laboratory conditions of enamel changes corresponding to early caries. The study was carried out on 20 healthy human teeth in vitro, in two phases differing in the conditions of the experiment. Carietic changes were produced with lactate buffer (in concentrations from 0.025 to 1.0 M) as fluid without added inhibitor of the solubility of the superficial layer. The assessment of the degree of enamel demineralization was based on images obtained in JSM 50A scanning microscope. In the first stage of the experiment a minimal demineralization of the subsuperficial layer of the enamel was obtained. In the second stage besides damage to the subsuperficial layer enamel erosion was noted. In this connection further studies are necessary for determining of the proper conditions for obtaining initial enamel damage.

[Demineralization and remineralization of enamel in the light of the most recent literature reports]. / Demineralizacja i remineralizacja szkliwa w swietle najnowszego pismiennictwa.

In the light of a review of the most recent literature reports the present views on demineralization and remineralization of enamel in vivo and in vitro are presented. Modes and conditions of the development of artificial enamel damage of the character of incipient caries are discussed. The possibility in stressed of cure of initial enamel damage after application of calcification-inducing solutions and human saliva.