Priorities in planning and evaluating oral health programs.
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Biomedical subjects
Publications and source records attributed to A M Horowitz.
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The response of the rat isolated testicular capsule to norepinephrine (NE), acetylcholine (ACh) and prostaglandins (PG) was found to be age-dependent. The testicular capsular contractions attributable to smooth muscle cells located within the tunica albuginea may be involved in the transport of non-motile spermatozoa from the testis and into the epididymis. With an increase in age of the age of the rat there was a concomitant increase in mass of the testis, thickness of the capsule and the amount of smooth muscle fibers present in the tunica albuginea. The response to the addition of equimolar concentrations of NE and PGA2 became progressively greater as the age of the animal increased. However, the response of the testicular capsule to ACh remained constant throughout adulthood, while PGF2 alpha became progressively less stimulatory as the age of the animal increased. These findings suggest that neurohumoral agents may have an important role in the maintenance of testicular capsular contractions with regard to ageing.
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Spontaneous contractions of the adult rabbit isolated testicular capsule were found to be influenced by moderate hyperthermic and hypothermic temperature changes. The decrease in testicular capsular spontaneous contractions resulting from an exposure to 32, 40 and 42 degrees C have been shown to be influenced by the addition of NE, ACh and PGF2 alpha. Of the three neurohumoral agents studied, NE was found to cause the greatest increase and re-initiation of testicular capsular tone during both hypothermia and hyperthermia. These data indicate that endogenous levels of neurohumoral agents may play an important role in the maintenance of testicular capsular tone during exposure to hyperthermic or hypothermic conditions.
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The contractile response of the isolated testicular capsule to acetylcholine, norepinephrine and prostaglandins (A-2, E-1 and F-2alpha) was related to the age of the rat. Norepinephrine and PGA-2 caused an increased capsular response between 45 and 60 days of age, the time at which spermiogenesis begins. It is suggested that the activity of the testicular capsule is involved in the transport of non-motile spermatozoa from the testis and into the epididymis.
After two school years of a supervised daily plaque-removal program in school, children in the treatment group showed a significant reduction in plaque and gingival inflammation scores compared with children in the control group. However, differences between groups in terms of plaque and gingivitis scores virtually disappeared during the summer vacation. The increment of dental caries was lower in the treatment group than in the control group, but the reduction, which averaged about 20 percent, was not statistically significant either for teeth or for surfaces. Although the 24-month findings of the present study indicate some degree of success in reducing plaque and gingivitis and a marginal effect in reducing the incidence of dental caries among children who engaged in daily, supervised plaque-removal in school, obvious drawbacks limit the value of this regimen.
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In September 1973, a three-year school-based study was initiated in East Hampton, Connecticut, a rural nonfluoridated community. The purpose of the study is to determine the effect on dental decay, gingival inflammation and oral hygiene of removing dental plaque through supervised daily toothbrushing and flossing in school during a three-year period. To establish baseline data, three indexes were used: the DHC Index to evaluate gingivitis; the DMF Surface Index to quantify dental caries and the PHP Index to measure dental plaque. The examinations for dental caries, including radiographs, are scheduled annually in September, whereas the plaque and gingival examinations are done biannually, in September and June. After the baseline examinations the 481 children were blocked according to grade and sex and then were randomly assigned to either a treatment group or to a control group. In November, the treatment group was provided 10 sessions of instruction in plaque removal. For the remainder of the year (six months) they practiced daily plaque removal, supervised by a dental hygienist and a nurse. The control group was not instructed in oral hygiene procedures. In the treatment group, mean plaque and gingival scores at the June (first follow-up) examination were 14 percent and 29 percent lower, respectively, than at baseline. No change was seen in the control group. At the second follow-up examination in September (after summer vacation), the same indexes were nearly at baseline levels in the treatment group. There was no treatment effect on dental caries increments after one year of study. Considering the nature of the treatment regimen and the few treatments during the first year of the study, it is not surprising that there were no caries-preventive benefits demonstrated among children in the treatment group after one year. The total number of the plaque removal sessions will be greater during the second year of the study. Therefore, the possibility of detecting a caries preventive effect at the twenty-four month examinations, should one exist, will be enhanced.
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Poor oral health can have a significant impact on overall health and quality of life. Yet few studies have established the oral health needs of outpatient veterans. The purpose of this study was to assess the oral health knowledge and practices, the dental status, and the periodontal treatment needs of outpatient veterans seeking primary care services at a statewide healthcare system. Veterans were interviewed and received an oral examination by a trained examiner using NIDCR criteria for dental caries detection and the Community Periodontal Index of Treatment Needs (CPITN). The mean age of the study participants' (n = 135) was 57.7 (SD = 14.1) years. Ninety-five percent of the sample was male and 44% African-American. Untreated coronal and root caries was present in 57% and 36% of veterans, respectively. Sixty-nine participants received the periodontal examination, with 29% of them in Category III. An interpretation of these findings shows a high need for preventive and restorative oral health care among outpatient veterans receiving primary services in an integrated and comprehensive VA health care system.
PURPOSE: The purpose of this investigation was to describe and assess the disparities, if any, in parental perceived cost barriers to oral health care among developmentally disabled children using a national data set. METHODS: Data from the 1997 National Health Interview Survey (NHIS) were analyzed using a SUDAAN statistical package. RESULTS: After adjusting for age and sex, parental perception of unmet need was significantly associated with developmentally disabled children 2-17 years in lower socioeconomic groups. CONCLUSIONS: Though most children from lower socioeconomic groups are eligible for Medicaid coverage, parents of these children perceive cost barriers to dental care. Children with developmental disabilities face even more perceived barriers to care based on family income.
Lack of reimbursement for pit and fissure sealants by third-party payers is frequently cited as a major barrier to increased use by dental practitioners. An increase in insurance coverage for sealants since January, 1984 may facilitate practitioners' use of the procedure, ultimately improving the public's oral health.
Dietary fluoride supplements are not now being prescribed appropriately by health care providers, an example of the slow rate of acceptance of an effective caries preventive regimen available for nearly a quarter-century. Industry, the American Dental Association Council of Dental Therapeutics, the American Academy of Pediatric Dentistry, the American Association for Dental Research, the National Foundation of Dentistry for the Handicapped, the W.K. Kellogg Foundation, and the National Institute of Dental Research have all initiated or supported a variety of activities to educate health care providers on the use of fluoride supplements and developing educational materials for providers to use in educating the public. Barriers to appropriate use include the following factors: complexity of the dosage schedule; priority of preventive regimens in educational institutions; economic factors; and lack of public knowledge--clearly a barrier to their acceptance, appropriate use, and compliance. Dental school faculty have a responsibility, to both their students and the general public, to provide appropriate information about dietary fluoride supplements and their use. Emphasis should be placed on educating dental students on the best ways of achieving compliance in their patients. Federal agencies might join the ranks as well, along with the individual dentist, in educating all relevant groups and promoting health through disease prevention.
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