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Biomedical subjects

D J Stiefel

Publications and source records attributed to D J Stiefel.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Chlorhexidine swabbing applications under various conditions of use in preventive oral care for persons with disabilities.

A sample of 44 adults with severe disabilities completed a randomized single-blind cross-over study testing chlorhexidine swabbing under various conditions: with/without prior dental prophylaxis, reduced frequency of application (2 vs. 5 times per week), and prolonged use (42 weeks). All subjects received therapeutic doses of 10 mL 0.12% chlorhexidine gluconate (Peridex, Procter & Gamble) and 10 mL 0.05% NaF applied with a Toothette (Sage Products). Clinical effectiveness of chlorhexidine swabbing compared with placebo was previously reported. In the present study, while initial benefits were observed to be independent of dental prophylaxis, significant reductions in periodontal scores were sustained by a combination of dental prophylaxis and swabbing protocol, at reduced frequency of application and over prolonged time. High levels of acceptance and compliance by subjects/caregivers were maintained. Subjects/caregivers reported improvements in dental health as well as in attitude, quality of life, and smile. Chlorhexidine swabbing at maintenance frequency, combined with periodic dental prophylaxis, may offer an effective and pragmatic long-term preventive regimen for persons with disabilities.

Adult↗
PubMedDate not supplied

Comparison of incoming dental school patients with and without disabilities.

A survey of incoming dental school patients compared 64 adult patients (DECOD) and 73 patients without disability (ND), regarding past dental experience, current needs, and basis for selecting the school's clinics. The responses indicated that, for DECOD patients, clinic selection was based largely on Medicaid acceptance, staff experience, and inability of other dentists to manage their disability; for ND patients, selection was based on lower fee structure. Both groups expressed high treatment need, but the rate was lower for DECOD than for ND patients. More DECOD patients reported severe dental anxiety and adverse effects of dental problems on general health. Chart records revealed that clinical findings exceeded perceived need for both DECOD and ND patients. While both groups had high periodontal disease rates (91%), DECOD patients had significantly poorer oral hygiene and less restorative need than ND patients. The findings suggest differences between persons with disabilities and other patient groups in difficulty of access to dental services in the community, reasons for entering the dental school system, and in presenting treatment need and/or treatment planning.

Adult↗
PubMedDate not supplied

Characteristics of dental emergency clinic patients with and without disabilities.

This study compared oral health and demographic characteristics of patients with and without disabilities at a dental school emergency clinic. Of 407 consecutive patients surveyed, 20.4% reported disabilities. Two groups matched by age and gender, those with disabilities (DIS, n = 79) and those without disabilities (ND, n = 177), were compared on questionnaire responses; two subgroups, DIS (n = 38) and ND (n = 44), were assessed clinically. The mean ages of the DIS and ND groups were 44.0 years (SD +/- 11.6) and 43.0 years (SD +/- 12.3), respectively. By chi-squared analysis, DIS vs. ND subjects had significantly lower levels of education, employment, income, and dental insurance, and greater dependence on Government funding. In the DIS group, 79.5% were not working, while 6.4% did work regularly. In the ND group, the corresponding values were 30.9% and 46.9%, respectively. In the DIS group, 51.9% identified Medicaid acceptance as the reason they sought care at the clinic, while 62.7% of the subjects in the ND group identified the lower fee structure as the reason for clinic selection. More DIS than ND subjects reported dentists' unavailability and inability to manage the disability, lack of transportation, effect of dental problems on health, and referral by a health professional. DIS vs. ND subjects had significantly fewer sound teeth and more missing teeth. The results suggest that one in five dental school emergency clinic patients has disabilities.

Adult↗
PubMedDate not supplied

Characteristics of an in vitro dental pellicle.

Procedures developed for in vitro pellicle formation in intact enamel proved useful for relating qualitiative characteristics of dental pellicle to a number of factors. Coronal surfaces of extracted human molars from experimental and control groups were pumiced, sterilized, and incubated for two hours at 37 C in parotid saliva and distilled water, respectively. Pellicle proteins were desorbed sequentially with water and 0.2 M sodium phosphate, with a pH of 7.0. Polyacrylamide disc electrophoresis of the desorbates yielded distinct patterns, indicating selective adsorption of proteins from saliva, varying affinity to enamel, and the presence of proteins not acquired in vitro from saliva. Certain pellicle components, including amylase and IgA, showed a relatively weak affinity for enamel and were eluted in part by water; other proteins were desorbed only by phosphate buffer. Anionic electropherograms of the phosphate desorbates showed an increase in the two most anodic proteins relative to corresponding salivary bands. An intense anodic protein and two minor bands were eluted by water or buffer from the surface of control as well as experimental teeth but not from teeth coated with sealants. Serum albumin and alkaline phosphatase were identified as components of the extra-salivary material. Further investigation of the sources and functions of the constituents of the protein layer generally considered as "acquired" dental pellicle appears warranted.

Amino Acids↗