Biomedical subjects

David G Gillam

Publications and source records attributed to David G Gillam.

4 recordsLinked to original sources

PubMed2006

The assessment and implementation of mouth care in palliative care: a review.

AIM: From a review of the literature it is evident that the importance and maintenance of oral health for patients with cancer is recognised as an integral part of basic nursing care and yet from practical observation in the hospital environment together with reviewing the published literature it is clear that there appears to be limited evidence of regular assessment of the mouth or implementation of oral protocols on the ward. Furthermore there is a lack of adequate training in the assessment and implementation of mouth care by nurses during their general nurse training. The aim of the present study was to review existing literature published between 1995 and 1999 to determine whether mouth care was effectively assessed and implemented in the palliative care setting. METHOD AND RESULTS: Relevant articles selected from the 1995-1999 period highlighted the lack of published research in this very important aspect of care. Results from these published articles raised concern about the lack of training and education among nurses in the assessment of mouth care as well as the need to rationalise the assessment tools used on the ward or hospice. Furthermore, while it was recognised in palliative care that a multiprofessional approach was beneficial, in practice this did not appear to apply to mouth care with a few notable exceptions. CONCLUSION: This review has highlighted a number of inconsistencies in both the knowledge of mouth care and its implementation by nursing staff. The importance of establishing protocols and setting standards of care was also indicated in this review. It is clear that without effective assessment of the mouth, the appropriate implementation of care will not be delivered. The implementation of mouth care should not be anecdotal in nature but based on research (evidence-based) and this in turn will enable nurses to embrace an evidence-based practice (which will benefit their patients) that can be effectively audited.

England↗

PubMed2006

Managing dentin hypersensitivity.

BACKGROUND: The objective of this review is to inform practitioners about dentin hypersensitivity (DH) and its management. This clinical information is described in the context of the underlying biology. TYPES OF STUDIES REVIEWED: The authors used MEDLINE to find relevant English-language literature published in the period 1999 to 2005. They used combinations of the search terms "dentin*," "tooth," "teeth," "hypersensit*," "desensiti*" and "desensitiz*." They read abstracts and then full articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action. RESULTS: The prevalence of DH varies widely, depending on the mode of investigation. Potassium-containing toothpastes are the most widely used at-home treatments. Most in-office treatments employ some form of "barrier," either a topical solution or gel or an adhesive restorative material. The reported efficacy of these treatments varies, with some having no better efficacy than the control treatments. Possible reasons for this variability are discussed. A flowchart summarizes the various treatment strategies. CLINICAL IMPLICATIONS: DH is diagnosed after elimination of other possible causes of the pain. Desensitizing treatment should be delivered systematically, beginning with prevention and at-home treatments. The latter may be supplemented with in-office modalities.

Adhesives↗

PubMed2005

Effect of desensitizing agents on the hydraulic conductance of human dentin subjected to different surface pre-treatments--an in vitro study.

OBJECTIVES: The aim of this study was to evaluate the variation of fluid filtration across dentin treated with different formulations of potassium oxalate gels and one gel of acidified sodium fluorophosphate, under five different pre-conditioned dentin surfaces. METHODS: The methodology used for the measurement of hydraulic conductance of dentin in the present study was based on the model suggested by Pashley, Stewart and Galloway [Arch Oral Biol 29 (1984)379]. Two hundred dentin discs 1 mm in thickness, obtained from human extracted third molars, were divided into 20 groups of ten specimens each. The groups corresponded to the following experimental materials: 3% potassium oxalate gel-pH 4; 6% potassium oxalate gel-pH 4; 3% potassium oxalate gel-pH 2.5 and 1.23% fluoride gel (APF gel)-pH 3.6-3.9, applied to dentin under the following surface conditions: air-dried, blot-dried, wet, EDTA air-dried; EDTA blot-dried. General MANOVA and post-hoc Duncan tests were performed on the data. RESULTS: Regardless of surface pre-treatment the 3% potassium oxalate gel-pH 2.5 produced the greatest reduction in dentinal filtration (p<0.05) even after citric acid challenge. In general, air-drying the dentin was the best surface pre-treatment (p<0.05). The interaction between the material and surface pre-treatment showed values of hydraulic conductance similar for most of the combinations, but the 3% potassium oxalate gel-pH 2.5 under wet conditions produced the largest reduction in hydraulic conductance. The APF gel produced the smallest reduction in hydraulic conductance when compared with the other materials, regardless of surface pre-treatment. SIGNIFICANCE: the potassium oxalate gels studied in this investigation have a great potential for tubule occlusion and, consequently, should be effective treatments of dentinal hypersensitivity, regardless of dentin wetness.

Acidulated Phosphate Fluoride↗

PubMed2004

A preliminary investigation into the ultrastructure of dental calculus and associated bacteria.

INTRODUCTION: Though dental calculus is generally recognised as comprising mineralised bacteria, areas of non-mineralised bacteria may be present. AIM: To investigate the ultrastructure of non-decalcified young and mature supragingival calculus and subgingival calculus, and the possible presence of internal viable bacteria. MATERIALS AND METHODS: Supragingival calculus was harvested from five patients, 9-10 weeks after scaling and root debridement. Five samples of mature supragingival and subgingival calculus were taken from patients presenting with adult periodontitis. Specimens were fixed and embedded for transmission electron microscopy. RESULTS: The ultrastructure of young and mature supragingival calculus was similar with various large and small crystal types. Non-mineralised channels were observed extending into the calculus, often joining extensive lacunae, both containing intact non-mineralised coccoid and rod-shaped microorganisms. Subgingival calculus possessed more uniform mineralisation without non-mineralised channels and lacunae. CONCLUSION: Supragingival calculus contains non-mineralised areas which contain bacteria and other debris. The viability of the bacteria, and their identification could not be determined in this preliminary investigation. As viable bacteria within these lacunae may provide a source of re-infection, further work needs to be done to identify the bacteria in the lacunae, and to determine their viability.

Adult↗