The mouth and the quality of life.
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Biomedical subjects
Publications and source records attributed to D B Giddon.
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Consumers, dentists, dental students, dental assistants, dental hygienists, dental assistant trainees, and dental hygiene students in Massachusetts were surveyed for their attitudes toward the concept of expanded-duties auxiliaries. The Osgood sematic differential technique was used, in which study participants were asked to respond to line drawings of a dentist or an auxiliary performing each of three different procedures: cutting tooth structure, placing a restoration, and taking radiographs. The results indicate that most of the groups perceived significant differences between cavity preparation by the dentist and by the auxiliary: they were modierately positive toward the former, near neutral toward the latter. Groups were more positive toward cavity restoration, generally perceiving fewer, but still significant, differences between the dentist and auxiliary as operatiors. All groups were most positive toward taking radiographs and perceived no difference between the two operators. Of all groups, the dentists perceived the greatest difference between operators; dental hygienists and dental hygiene students were the most positive and saw the least differences between operators. Consumers were the least positive to all procedures and perveived only modirate differences between the two operators. In other words, the consumers did not seem overly concerned with who provided the dental care; they just did not like the services themselves. In the study, the consumer was more concerned with the procedure than with the different operators, whereas the dentist was more concerned about the operator.
In general, plaque and gingivitis scores were correlated negatively with the manual parameters and positively with the academic and mental parameters studied. Plaque showed significant negative correlations with the manual average and the carving test. Gingivitis also demonstrated a negative correlation, just short of significance, with the manual average, but virtually no correlation existed between gingivitis and the carving test. Gingivitis displayed a significant positive correlation with the academic average, and plaque exhibited a nonsignificant positive correlation with the academic average. Relationships between these parameters may help determine what segments of the population are more susceptible to plaque accumulation and gingivitis and may suggest possible new approaches to the adoption of preventive measures. Finally, in view of the statistically significant but relatively low correlation found between manual dexterity and oral health, further investigations are indicated to establish the validity of the relationship.
A new approach to the teaching of behavioral sciences has been evaluated with one class of dental students. The findings suggest that educational environment and perceived qualities of instructor supportiveness are essential to the effectiveness of a socially oriented educational program.
This paper describes a taxonomy proposed for use by dental school faculties as an aid in specifying their course objectives in behavioral terms. This taxonomy, developed and tried at the Harvard School of Dental Medicine, is simpler than taxonomies previously proposed because it reduces the number of categories. In addition, the categories themselves are designed to communicate to and be interpreted by dental educators. The six categories are (1) knowledge of facts, concepts, and principles; (2) comprehension; (3) perceptual ability; (4) diagnosis and treatment planning skills; (5) motor skills; and (6) interactive skills. Each category is briefly defined and illustrated with two samples from operative dentistry.
There is increasing concern about the difficulty encountered by handicapped patients in obtaining adequate dental health care. In addition to the problems of availability and accessibility of dental care there are social and psychological problems affecting the acceptability of dental health care. To overcome these difficulties the dentist must understand the bases of his own perceptions as well as those of his patients which interact in the dentist-patient treatment situation. Although many of the physical problems can be solved by such measures as wheel chair ramps, the major difficulty is the social acceptability of the handicapped. The same degree of handicap may cause different problems depending on the way in which the individual adjusts to it. Orofacial defects cause particular difficulties because they cannot be hidden in the same way as, for example, a missing or deformed limb. Often the relatively minor defects encountered in dental practice may cause greater problems than a more major deformity, since the near normal person strives harder to be considered as normal. Studies of babies' responses to normal and abnormal facial appearances have demonstrated the tremendous importance of the facial area in communication. Smiling responses were common with a normal face whereas grotesque faces induced anxiety in children. In later life facial abnormalities tend to evoke both aesthetic and sexual aversion so interfering with the process of social interaction. The dentist must become more aware of the psychological state of physically handicapped patients and of his own reaction to them.
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Using intravital microscopy, topically applied amide-type local anesthetics suppressed the adherence of leukocytes to the venular endothelium within surgical defects in the hamster cheek pouch. The response was reversible with physiologic saline and was localized to venules within the defect. Quantitation in terms of the percent of initially adhering leukocytes remaining in place on the venule wall at each minute following application of lidocaine and physiologic saline, respectively, revealed the suppression to be reliably related to the concentration, viz: 20.0 >10.0 >5.0 >0.0 mg ml of commercially available Xylocaine(R) (lidocaine) HCl.
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