Eating Disorders in the Adolescent Patient.

Eating disorders such as anorexia nervosa, female athlete triad, bulimia nervosa, obesity, and binge eating initially emerge during adolescence. These disorders are present primarily in females, but males may also present with these conditions. Dentistry has a pivotal role in the management of patients with such diet-related disorders. Because dentists examine their patients at frequent intervals and may be the health care professionals with whom patients feel more comfortable discussing eating disorders, dentists must have knowledge of the etiology, diagnostic criteria, systemic effects, and intraoral manifestations of eating disorders. In addition, the dental professional may be the first health care provider to identify the condition and refer the patient appropriately to medical colleagues for subsequent treatment. This chapter provides dentists with current and relevant information to recognize, diagnose, and integrate dental treatment for their adolescent patients who may exhibit manifestations of an eating disorder.

National Athletic Trainers' Association Position Statement: Preventing and Managing Sport-Related Dental and Oral Injuries.

OBJECTIVE: To provide athletic trainers, health care professionals, and all those responsible for the care of athletes with clinical recommendations for preventing and managing sport-related dental and oral injuries. BACKGROUND: Participation in competitive sports continues to grow at both the interscholastic and intercollegiate levels. Therefore, exposure to, and the incidence of athletic-related injury, including orofacial injury, will also likely increase. At the time of this writing, the leading governing agencies for interscholastic (National Federation of State High School Associations) and intercollegiate (National Collegiate Athletic Association) sports require only protective orofacial equipment (eg, mouthguards) for 5 and 4, respectively, of their sanctioned sports. Although orofacial injuries represent a small percentage of all sport-related injuries, the financial burden associated with these injuries (eg, tooth avulsion) can exceed $15 000 over an adult life. Therefore, effective management of sport-related dental injuries is critical to the long-term financial, physical, and emotional health of people who have experienced dental trauma. RECOMMENDATIONS: Based upon the current evidence regarding sport-related orofacial injury, we provide recommendations related to planning considerations, education, and mouthguard efficacy, material, fabrication, and care considerations. Additionally, suggested best practices for managing sport-related dental injury are also given for athletic trainers and other health care professionals.

Prevalence of oral trauma in Para-Pan American Games athletes.

The aim of this cross-sectional epidemiological survey was to assess the prevalence of oral trauma in athletes representing 25 countries competing at the most recent Para-Pan American Games (III PARAPAN) held in Rio de Janeiro, Brazil. The study was approved by the appropriate institutional review board. The examiners participated in standardization and calibration training sessions before the field phase began. Invitations were sent to >1200 participating athletes competing in eight sports and to the Medical Committee of the Para-Pan American Sports Organization before and during the III PARAPAN. A convenience sample of 120 athletes was recruited. After signing an informed consent, all athletes answered a questionnaire. Data were collected at the clinical examination and recorded in a specific trauma form. The mean age of the athletes was 32.5 years. Males comprised 79.2% of the sample; females 20.8%. The prevalence of oral trauma among the athletes was 47.5% (N = 57). However, only 15 athletes reported that these traumatic injuries were sports-related. The sport with the highest prevalence of oral trauma was judo (75%); the least was volleyball with no reported traumatic injuries. The most common traumatic injury was enamel fracture (27.4%). The teeth most affected were the maxillary permanent central incisors (N = 19), followed by the maxillary premolars (N = 8). On the basis of the results of this study of oral trauma among athletes examined at the III PARAPAN, a recommendation for enhanced educational efforts and the use of properly fitted mouthguards to prevent traumatic injuries among high-performance athletes with disabilities seems warranted.

Understanding the adolescent patient: the gateway to oral health promotion.

Although the adolescent years may be difficult emotionally and contributory to a variety of risk-taking behaviors, this period of progressive transformation of the child into an adult also offers a unique gateway for dental practitioners to promote the development of positive health behaviors as the foundational basis for the future oral and general health and well-being of our current adolescent dental patients.

Prevalence of dental trauma in Pan American games athletes.

The aim of this cross-sectional epidemiological survey was to assess the prevalence of dental trauma in athletes representing 42 countries competing at the most recent Pan American Games (XV Pan Am) held in Rio de Janeiro, Brazil in July of 2007, and to determine prior use and type of mouthguard among this group of athletes. The examiners participated in standardization and calibration training sessions before the field phase began. Invitations were sent to >5500 participating athletes competing in 41 sports and to the Medical Committee of the Pan American Sports Organization before and during the XV PAN. A convenience sample of 409 athletes was recruited. After signing an informed consent, all athletes answered a questionnaire. Data were collected at the clinical examination and recorded on a specific trauma form. The mean age of the athletes was 24.4 +/- 5.3 years. Males comprised 55% of the sample; females 45%. The prevalence of dental trauma among the athletes was 49.6% (n = 203) with no gender-based differences. Most of these injuries (63.6%) were related to activities during training or competition. Sports with the highest injury prevalence were wrestling (83.3%), boxing (73.7%), basketball (70.6%) and karate (60%). The most common injury was enamel fracture (39.8%); root fracture was the least common (0.4%). The teeth most affected were the maxillary permanent central incisors (n = 113), followed by the mandibular central incisors (n = 19). Based on the results of this study, nearly one-half of the subjects had experienced previous dental trauma; the majority related to sports activities. Furthermore, only 17% of the athletes reported prior mouthguard use; the most frequent mouthguards reported were boil-and-bite. These results suggest the importance of enhanced educational efforts and the use of properly fitted mouthguards to reduce dental trauma among athletes in international sports competition, especially in sports where mouthguards are not mandatory.

Periodontal and soft tissue prevention strategies for the adolescent dental patient.

Recent research has refocused attention on the contribution of periodontal health to the general health of patients at various ages. This article describes changes in the periodontal tissues of adolescent dental patients related to hormonal fluctuations, lack of proper oral hygiene, and risk-taking behaviors. Attention is placed on the development and prevention of acute and chronic gingival conditions in addition to gingival tissue enlargement as one side effect of certain medications.

Oral health issues for adolescent athletes.

Adolescent athletes are faced with a myriad of influences that can affect their oral health. During these formative years, the choices adolescents make regarding health could have repercussions throughout their lives. Health professionals can play an important role in educating their patients to make wise decisions. By becoming more aware of the health risks to which athletes are exposed,health professionals can learn to recognize these unhealthy behaviors and recommend appropriate prevention and cessation strategies to their patients who participate in sports.

Dental injuries in sports.

The expanding arena of sports and vigorous recreational activities is associated with an increased risk for sports-related injuries, including trauma to the teeth. Because dental professionals may not be present on site, in the best interest of athletes, it is suggested that sports medicine professionals who are present be provided with current evaluative, emergent, and referral protocols for proper management of sports-related dental injuries to address the immediate needs of the athlete and to enhance the long-term prognosis of the traumatized tooth. This article provides information related to some of the more common dental injuries encountered in sports, including crown fractures, root fractures, and traumatic tooth displacements. Use of properly fitted, custom-fabricated athletic mouth guards for the prevention of dental injuries is recommended strongly, as is the inclusion of a dentist on the sports medicine team roster.

Adaptations of mouthguards for patients with special needs.

The adaptations and applications of mouthguard appliances are many and varied, with uses ranging from protective to therapeutic. These modifications serve the individual needs of patients. This requires problem-solving based on combining form and function with the skills of the dentist.

Management of Class III crown fractures in the permanent dentition.

Management of Class III crown fractures in the permanent dentition can be both challenging and rewarding for practitioners. Several of the techniques described require further investigation to determine clinical efficacy based on scientific research. In addition to evidence-based protocols, treatment outcomes will continue to be related to the technical proficiency of the dentist, including diagnostic acumen and appropriate treatment planning decisions. A treatment planning decision paradigm, as described in this article for management of Class III fractures to permanent teeth, is summarized in Table 1.

Sports dentistry and dental traumatology.

Sports dentistry had its origins in the 1980s. More recently, the Academy for Sports Dentistry joined forces with the International Association of Dental Traumatology in cosponsoring the World Congress on Sports Dentistry and Dental Traumatology. It is the intent of the present paper to introduce readers to the arena of sports dentistry, suggest future areas for collaborative research, and stimulate authors to submit high quality, scientifically based manuscripts on sports dentistry to Dental Traumatology.

Outreach activities: focus on troubled youth.

The Department of Pediatric Dentistry at the University of Pittsburgh School of Dental Medicine has a commitment to community service. Two programs that provide care to incarcerated adolescents are described. One facility is a large second-chance detention center for males; the other is a small second-chance facility for female juvenile offenders. Not only do these programs offer dental services to these underserved adolescents, they provide a wider range of clinical experiences to predoctoral dental students. The inception of this project, its evolution, and implementation are described. Characteristics of adolescents in general and those of incarcerated adolescents are presented. Modifications in treatment considerations and behavioral characteristics are compared.

Women's oral health across the lifespan. Part Two: Developmental perspectives.

This two-part series is intended to provide dental practitioners with information related to the clinical aspects of women's health in general and women's oral health in particular. Part One in the series presented a historical perspective from the inception and evolution of women's oral health to current issues of relevance. Part Two in the series presents a developmental perspective on women's oral health across the lifespan from infancy through the post-menopausal stages. Emphasis is focused on medical and dental aspects of each developmental stage.

Women's oral health across the lifespan. Part One: Historical perspectives.

This two-part series is intended to provide dental practitioners with information related to the clinical aspects of women's health in general and women's oral health in particular. Part One in the series presents a historical perspective from the inception and evolution of women's oral health to current issues of relevance. Part Two in the series will present a developmental perspective on women's oral health across the lifespan from infancy through the post-menopausal stages. Emphasis will be focused on medical and dental aspects of each developmental stage.

Oral piercing in athletes: implications for general dentists.

General dentists need to be aware of the growing number of athletes who display various forms of body art. Intraoral piercing and tongue jewelry place athletes at greater risk for serious medical and dental consequences that are confounded when the athlete attempts to compete while wearing a mouthguard with the tongue jewelry in place. All body jewelry should be removed during sporting events. General dentists have a professional responsibility to: become more aware of the extent and implications associated with tongue piercing in athletes to discourage athletes from having the tongue pierced; be prepared to manage postpiercing intraoral and dental complications; provide proper advice for the care and use of a mouthguard in the presence of tongue jewelry; and develop educational strategies that address the medical and dental complications of intraoral piercing.

Orofacial injuries from sport: preventive measures for sports medicine.

Individuals worldwide are participating in an expanding arena of vigorous physical activities as well as competitive sports at all levels. The healthful benefits of such activities are unfortunately associated with injury risks that include orofacial soft- and hard-tissue trauma. This article describes the scope and emergency management of sports-related orofacial traumatic injuries that may be encountered by physicians in the field of sports medicine. Since most of these injuries are preventable with the use of protective equipment, specific recommendations are provided for the use of properly fitted mouthguards.

A determination of the sensitivity if the dental pulp of primary maxillary anterior teeth to electrical stimuli in children with unilateral and bilateral clefts / Determinação da sensibilidade da polpa dentária do maxilar anterior primário a estímulo elétrico em crianças com fissura unilateral e bilateral

A study was conducted to determine differences in pulpal sensitivity of the maxillary primary anterior teeth in groups of children with unilateral clefts of the lip, alveolar process and palate, bilateral clefts of the lip process, and children without clefts. Thirty-nine children between the ages of 4 and 5 years with a total of 216 maxillary primary anterior teeth were tested using a pulp tester. The results indicated that maxillary primary anterior teeth distal to the cleft site are unaffected and demonstrate pulpal responses similar to the control group, while maxillary primary anterior teeth mesial to the cleft site are affected and demonstrate signficantly less response to pulp testing compared to the control group. The results of this study are important for the clinician in establishing a proper diagnosis and treatment plan for children with clefts