Biomedical subjects

Chris C L Wyatt

Publications and source records attributed to Chris C L Wyatt.

6 recordsLinked to original sources

PubMed2006

The development, implementation, utilization and outcomes of a comprehensive dental program for older adults residing in long-term care facilities.

This paper documents the experience of the University of British Columbia's Geriatric Dentistry Program (GDP) with emphasis on the dental treatment needs of patients during its first year of operation. The GDP provided access to dental care for residents of longterm care facilities, education for hospital staff concerning daily mouth care, education of dental students and an opportunity for research. The first year of clinical activity saw a small, yet significant, improvement in oral health for residents using the dental services. We hope that the outcomes of this new dental program for long-term care facilities will encourage dentists to provide care for this vulnerable population.

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PubMed2005

Insights from students following an educational rotation through dental geriatrics.

Little is known about how dental students respond to dental geriatrics. This article describes a qualitative analysis of reflective journals submitted over two years by ninety-two senior students who participated in a brief clinical rotation in long-term care facilities. We used an inductive interpretive approach to analyze the journals. Eight themes emerged from the analysis: 1) complexity of the institutional environment; 2) heterogeneity of the resident population; 3) multidisciplinary environment; 4) record keeping; 5) interactions with residents; 6) the difficulty of oral health care for frail residents; 7) bridging the gap between theory and practice; and 8) the emotional impact of the clinical experiences. Apparently, the students appreciated the opportunity to witness the complexity of care in a multidisciplinary context and to observe a practical program of oral health care. They described the rotations as unique and emotionally challenging but very worthwhile. Overall, they wrote positively about their experiences with the elderly residents, acknowledged the contribution of the rotation as important to their clinical maturation, and reported that the experience enhanced their appreciation of a dentist's professional responsibilities.

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PubMed2004

Caries management for institutionalized elders using fluoride and chlorhexidine mouthrinses.

OBJECTIVES: The effectiveness of either a 0.2% neutral sodium fluoride (NaF) solution or a 0.12% chlorhexidine (CHX) solution as a daily mouthrinse for controlling caries was tested against a placebo rinse in this 2-year randomized clinical trial among elders in long-term care (LTC) facilities. METHODS: At baseline, 369 recruits were examined clinically for caries and allocated randomly to one of the mouthrinse groups. RESULTS: After 2 years, 116 participants remained in the trial. The prevalence of caries and the dental status of the groups were similar at baseline and after 2 years. On average, each group lost less than one tooth per person, but the fluoride group compared with the others had significantly less caries and significantly more reversals from carious to sound dental surfaces at the end of the trial. CONCLUSIONS: We conclude that 0.2% neutral NaF mouthrinse every day does reduce the incidence of caries among elders in LTC facilities.

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PubMed2002

Bone level changes proximal to oral implants supporting fixed partial prostheses.

The success of oral implant treatment relies on the presence and maintenance of bone adjacent to implants. The monitoring of radiographic bone level changes provides valuable insight into the longevity of oral implants. The purpose of this study was to measure radiographic bone level changes proximal (mesial and distal) to Brånemark System) implants (Nobel Biocare AB, Göteborg, Sweden) supporting fixed partial prostheses. Measurements were used to determine mean bone loss for the first year of loading by the prosthesis and the mean annual bone loss for subsequent years. These results were then compared and contrasted with various characteristics of the individuals, treatment, and treatment outcomes. Fifty-five subjects with 69 fixed partial prostheses supported by 160 implants were followed over a 1 to 12-year period. A mean bone loss of 0.33 mm (SD 0.59) was measured for the first year of loading and a mean annual bone loss of 0.00 mm (SD 0.11) after the first year. The radiographic bone loss calculated for implants at the first year of loading was positively correlated with the mean annual bone loss thereafter. Males, younger individuals and those implants supporting distal extension prostheses lost significantly more bone in the first year of loading. Larger numbers of implants followed for longer periods of time are needed to further explore the effects of various aspects of treatment on bone loss.

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PubMed2002

Elderly Canadians residing in long-term care hospitals: Part I. Medical and dental status.

BACKGROUND: Oral diseases and conditions have been identified as a significant problem for elderly residents of long-term care (LTC) hospitals in developed countries, yet little recent information is available for the Canadian population. OBJECTIVE: To describe the medical, dietary, oral microbial, oral hygiene and dental status of elderly Canadians living in LTC hospitals in Vancouver and surrounding communities. METHODS: A sample of 369 elderly dentate hospital residents (mean age 83.9 years, 281 women [76.2%]) were examined, and their medical status and medications, oral status and type of hospital were documented. Oral hygiene practices and diet (specifically intake of refined carbohydrates) were evaluated. Subjects with xerostomia and subjects taking medications with hyposalivary side effects were identified, and salivary Streptococcus mutans and Lactobacillus were cultured. RESULTS: The mean plaque index was 1.3; men had a higher plaque index than women and residents of extended care hospitals had a higher plaque index than those in intermediate care hospitals. The mean bacterial score per millilitre of saliva was 9.7 105 colony-forming units (CFU) for Streptococcus mutans and 1.6 105 CFU for Lactobacillus. On average, each subject had 6.3 sound teeth, and 9.3 teeth had been restored. CONCLUSIONS: Although almost half of the subjects had visited a dental office in their community within the past 5 years, the elderly hospital residents in this study had few remaining teeth and suffered from poor oral hygiene. Prevention strategies (such as diet, oral hygiene and antimicrobial agents) rather than dental interventions (such as restorations and extractions) alone may be needed to control oral diseases in this susceptible population.

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PubMed2002

Elderly Canadians residing in long-term care hospitals: Part II. Dental caries status.

BACKGROUND: Dental caries has been identified as a significant problem for elderly residents of long-term care (LTC) hospitals in developed countries, yet little recent information is available for the Canadian population. OBJECTIVE: To document the caries status of elderly dentate residents of intermediate and extended LTC hospitals in Vancouver and surrounding communities. METHODS: A dentist examined the teeth of 369 elderly dentate hospital residents (coronal and root surfaces) for caries. The medical, dietary, oral microbial, oral hygiene and dental status of the same subjects are documented and discussed in a companion article. RESULTS: Two hundred and ninety (78.6%) of the subjects had at least one carious lesion; 186 (50.4%) had coronal caries and 254 (68.8%) had root caries. On average, each subject had 3.8 carious teeth. The residents of extended LTC hospitals had significantly more carious coronal surfaces. Lactobacillus scores were correlated with the DMFS (decayed, missing, filled surfaces), the number of carious coronal lesions, the number of carious surfaces and the plaque index, but Streptococcus mutans scores were correlated only with DMFT (decayed, missing, filled teeth). CONCLUSIONS: Overall, the prevalence of dental caries among the elderly residents of LTC hospitals in this study was high, although almost half of the subjects had visited community dentists within the previous 5 years. Caries prevention strategies (specifically diet, oral hygiene and antimicrobial agents) rather than treatment alone may be needed to control caries in this susceptible population.

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