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Biomedical subjects

A de Jongh

Publications and source records attributed to A de Jongh.

At least 19 recordsLinked to original sources
PubMed2006

[Popularity of aesthetic dental treatments. Results of a national study in the Netherlands].

There are indications of a growing public interest in aesthetic dental treatments. For want of reliable data, a group of 907 randomly selected Dutch individuals was questioned in order to give this apparent tendency a foundation in figures. The results of this study show that about 25% of the respondents received aesthetic dental treatment at some time, about 8% was treated during the past year, and almost 8% intended to undergo aesthetic dental treatment in the coming year. In this respect, tooth whitening was found to be the most popular treatment. The results of this study suggest that there is a positive attitude towards aesthetic dentistry and that women take a greater interest in it than men. Whether this interest will lead to a rise in the number of actual aesthetic dental treatments is still unclear.

Esthetics, Dental↗
PubMed2005

[Guidelines for the treatment of highly anxious dental patients].

Treatment of extreme or pathological forms of dental anxiety requires specific skills. This paper is an attempt to formulate a number of treatment strategies, based on the available literature and effectiveness studies. It is suggested that based upon the assessment information three types of problem areas can be identified, namely, 1. a phobia of specific dental procedures or situations; 2. long overdue requiring acute dental treatment; and 3. intrusive or interfering psychiatric symptoms. In this article these problem situations are reviewed and several appropriate treatment options are discussed.

Anxiety Disorders↗
PubMed2004

[Treatment strategies for anxious adults in general dental practice: guidelines for mild forms of anxiety].

In this article an attempt is made to formulate a number of general clinical guidelines, based on the currently available knowledge and clinical experience within the area of dental anxiety. It is concluded that, in case of mild forms of anxiety, a careful treatment approach of the dental practitioner--which is focused on a style of establishing trust, specific pharmacological support and the teaching of coping strategies--can reduce patients' anxiety level, thereby preventing avoidance behaviour and deterioration of the oral health.

Anxiety Disorders↗
PubMed2004

[Dental anxiety].

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Dental Anxiety↗
PubMed2003

The influence of brain tumor treatment on pathological delta activity in MEG.

The goal of the MEG study was to investigate the influence of tumor treatment on pathological delta activity (1-4 Hz). The treatment consisted of neurosurgery, and in some of the patients, additional radiotherapy. MEG and MR recordings were made both before and after the treatment in 17 patients. The signal power in the delta frequency band was determined for each recording. The malignant tumors were associated with large tumor volumes. Furthermore, both malignant tumors and tumor volume were associated with high signal powers in the delta band, indicating a correlation of delta power with the severity of the lesions. In all patients with high grade tumors, the delta power was lower after the treatment. The sources underlying the delta signals were estimated with an automatic single dipole analysis method. Estimated sources were projected onto MR scans. Preoperatively 14 clusters of equivalent sources describing focal activity were found in 12 out of 17 patients. Thirteen of these clusters were located near the tumor, and one cluster near an edema border. The locations near tumors are plausible and suggest that in general the source estimation was reliable. After the operation, 13 such clusters were found in 12 patients. Eleven clusters were located near the lesion border and one cluster near the edema border. Furthermore a cluster contralateral to the lesion in the other hemisphere indicated that brain lesions can affect the functioning of more distant brain areas than just the peritumoral brain tissue. Of the 12 patients who had preoperatively peritumoral clusters, 11 patients had postoperatively perilesional sources. In these cases the shift in source locations was in general considerably smaller than the dimension of the preoperative tumors. This finding indicates that similar areas generate the pre- and postoperative delta activity. Furthermore, focal delta sources were found in a case without tumor recurrence, and also in cases that most tumor tissue was removed. These findings suggest that the pathology underlying the slow waves is not the presence of the tumor bulk but the structural damage done by the tumors on the surrounding white/gray matter.

Adult↗
PubMed2003

Localization of fast MEG waves in patients with brain tumors and epilepsy.

It was investigated if single dipole analysis of spontaneous fast waves (>8 Hz) can be used to determine the location of the epileptic focus. Automatic dipole analysis was applied to MEG data of 25 patients with intracranial tumors and epilepsy. The frequency range of 8-50 Hz was divided into standard EEG bands. MEG results were overlaid on the MRI scans of the patients. Dipoles describing fast wave fields were located in the parietal/occipital cortex, and not at tumor border zones. In the cases that the dipoles were lateralized there was no clear preference to be located ipsi or contralateral to the tumor. However the generators of epileptic activity in these patients are thought to be located in the border areas of the tumors. Therefore it seems unlikely that the dipole locations describing fast waves are related to the epileptic zones in patients with brain tumors and epilepsy. A remarkable finding is that lateralized dipoles tend to be located in the right hemisphere and not in the left hemisphere. This appears to reflect an asymmetry of possibly normal background activity.

Adult↗
PubMed2003

Trauma-related phenomena in anxious dental patients.

OBJECTIVES: The main purpose of this descriptive study was to investigate whether dental anxiety is associated with the occurrence of trauma-related symptoms (i.e. recurrent memories and a tendency to avoid these memories) associated with earlier traumatic dental experiences. METHODS: A sample of 37 consecutive anxious patients attending a dental fear clinic was assessed prior to dental treatment. The results were compared with those of a sample of 32 consecutive patients of a general dental practice, who served as a reference group. RESULTS: The proportion of patients who indicated they had had a horrific dental experience at least once in their life did not significantly differ between the anxious group and the reference group. Conversely, significantly more patients (76%) in the anxious group reported suffering from memories of these events. They also showed a higher level of trauma-related symptomatology as indexed by the Impact of Event Scale (IES). About half of the anxious patients suffered from symptoms typically reported by patients with posttraumatic stress disorder (PTSD). Severity of dental anxiety showed a high correlation with both frequency of intrusions (r = 0.64, P < 0.001) and avoidance of the memories (r = 0.62, P < 0.001). CONCLUSIONS: The results suggest that in anticipation of treatment dentally anxious individuals suffer from a high level of intrusive recollections of earlier dental experiences.

Adolescent↗
PubMed2001

Referrals to a secondary care dental clinic for anxious adult patients: implications for treatment.

OBJECTIVES: This study aimed to determine the methods suggested by general dental practitioners for management of patients with dental anxiety whom they refer to a dental hospital setting, the treatment modalities eventually used with such patients and the relationship between patients previous sedation experience and the current referral. METHODS: Consecutive referral letters (n = 125) for management of patients with dental anxiety over a 16 month period were analysed for content, including reason for referral and suggested treatment modalities. Patient records were also examined for previous sedation experience. RESULTS: From 115 referrals eligible for analysis, the dentists requested management of anxiety using pharmacological methods in 113 referrals with only two referrals mentioning psychologically-based treatments. In secondary care, 29% of the adult referrals opted for dental treatment using psychological techniques alone. CONCLUSIONS: In spite of the efficacy of psychological treatments for dental anxiety, primary and secondary care dentists appear not to be suggesting or promoting their use for patients with dental anxiety. Further research into the availablility of, and barriers to accessing the full range of services for those with dental anxiety, including patient perspectives, needs to be undertaken.

Adolescent↗
PubMed2001

The localization of spontaneous brain activity: first results in patients with cerebral tumors.

OBJECTIVE: From EEG studies, it is known that structural brain lesions are accompanied by abnormal rhythmic electric activity. With the better spatial resolution of MEG, MEG dipole analysis can extend the knowledge based on EEG power spectra. This study presents the first results of a completely automatic analysis method applied to spontaneous MEG. METHODS: Spontaneous MEG data of 5 patients with cerebral brain tumors and 4 controls were collected using a whole-head MEG system. Signals were bandpass-filtered with cut-off frequencies according to standard EEG bands. A moving dipole model was fitted to samples with at least twice the average sample power. Dipoles explaining 90% or more of the magnetic variance were projected onto a matched MR scan. RESULTS: In controls, dipole distributions are symmetrical with respect to the mid-sagittal plane whereas distributions in patients often are asymmetrical to it. Dipoles describing gamma activity were located contralateral, and dipoles describing delta and theta activity were located ipsilateral to lesions. CONCLUSIONS: The automatic method gives plausible 3-dimensional information about generator foci of abnormal slow waves and other rhythms with respect to lesion foci and thereby adds physiological knowledge to that derived from EEG power spectra.

Adult↗
PubMed2001

[Dental--mental].

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Dental Anxiety↗
PubMed2001

[Evaluation of patient's level of functioning in the dental practice].

In order to improve the reliability of diagnostic judgements of complex or persisting dental complaints it is important to be aware of the role of emotional problems regarding the origin and the maintenance of dental complaints. In this paper the focus is on the collection of information about patients' history through an anamnesis, and the observation of patients behaviour and mood.

Child↗
PubMed2001

[Patients with mental problems].

Epidemiological studies show that one out of four Dutch individuals suffers from a mental disorder. Consequently, dentists are confronted with noticeable deviant or problematic behaviour. In this paper an overview is presented of several of psychological problems and their relevance to dental treatment. This is illustrated by a case description. For a proper diagnosis and adequate treatment planning it is important that dentists have some general knowledge of psychological functioning of patients, and the possible psychological determinants of illness and well-being. This would prevent unnecessary damage of dental tissues and needless suffering but also frustration, both for the patient and the dentist.

Adult↗
PubMed2001

[Dental complaints are found always between the ears. Somatization in the dental practice].

The aim of the present study was to investigate the occurrence of somatization-specific behaviour in the dental setting and its relationship with patients' report of both dental and psychological complaints. Somatization-specific behaviour was operationalized as an unexplained dental complaint, high dental attendance, a high treatment consumption or an unreasonable demand with regard to treatment. Of the 309 patients 8.7% fulfilled the criteria for somatization-specific behaviour, which was mainly expressed as a high frequency of attendance (6.8%). Women showed significantly more often (73%) somatization-specific behaviour than men (27%). Further, a relation between depression and somatization-specific behaviour was found. Particularly patients with a relatively high level of long-lasting dental complaints demonstrated somatization-specific behaviour.

Adolescent↗
PubMed2001

[Crying for attention: patients who mimic manifestations of disease].

This article focuses on the different forms of factitious diseases. Patients may mimic or produce the manifestations of a disease in order to attract attention of doctors. Sometimes patients inflict such serious injuries on their own bodies that they need to undergo long-term treatment in a hospital such as in the case of Munchausen syndrome. Recognition of alarm signals associated with this type of condition may help to avoid a long lasting process of illness, screening and unnecessary treatments.

Adult↗
PubMed2001

[Extremely anxious patients: does treatment achieve the desired effect?].

The aim of the present study was to determine the outcome of treatment of several treatment modalities utilized at the Centre for Special Dental Care in Amsterdam, the Netherlands. Outcome was assessed in 341 patients in terms of dental anxiety after treatment (response 65%) and dental attendance one year later (response 74%). After treatment, patients treated with a behavioral management approach had lower dental anxiety scores than patients treated with intravenous sedation. Furthermore, one year after treatment 66.7% of the treated patients indicated to visit a general dental practitioner regularly. It is concluded that treatment was effective. However, it was felt that dental attendance level could be increased by a change in the referral procedure to general dental practitioners. It is recommended that a psychologist is involved in diagnosis and treatment planning in dental fear clinics.

Adolescent↗
PubMed2000

Dental anxiety reduction and dental attendance after treatment in a dental fear clinic: a follow-up study.

OBJECTIVES: The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to treatment outcome. METHODS: Questionnaires were sent to 280 patients treated with one of three treatment modes (i.e., behavioral management (BM), nitrous oxide sedation (NOS), and intravenous sedation (IVS)) at a dental fear clinic in The Netherlands. Dental anxiety before (T1) and after (T2) treatment was assessed using the Dental Anxiety Scale (DAS) and the Short version of the Dental Anxiety Inventory (S-DAI); the Symptom Checklist 90 (SCL-90) was used to assess general psychopathology. Dental anxiety was assessed again a year later and patients were questioned about their dental attendance pattern (T3). RESULTS: ANOVA showed that the DAS and S-DAI scores at T2 and T3 were statistically significant lower than the initial scores. In addition, IVS patients showed less anxiety reduction than BM patients at both T2 and T3. Of the 145 patients whose last visit to the clinic was at least one year ago, 62% had visited a GDP at T3. A regression analysis revealed that, beside treatment mode, somatization, number of visits to clinic for dental treatment, and number of months between first and last visit to the clinic predicted dental anxiety at follow-up. CONCLUSIONS: It is concluded that, although a reduction in dental anxiety level was present, a relatively large proportion of patients did not improve, in terms of both dental anxiety and dental attendance.

Adolescent↗