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Biomedical subjects

J D Bader

Publications and source records attributed to J D Bader.

At least 73 records · Page 4Linked to original sources
PubMed1990

Evaluating and influencing periodontal diagnostic and treatment behaviors in general practice.

Providers' periodontal diagnostic and treatment behaviors were assessed in 34 practices in two North Carolina counties. Regularly attending patients had a low prevalence of gingival pocketing on index teeth, moderate attachment loss, and fairly prevalent bleeding and calculus. Treatment frequency and patient knowledge were generally adequate, but the notation of periodontal status in the patient record was insufficient. A continuing education intervention resulted in substantial and significant improvement in notation rates. Changes in rates with which services were provided, and changes in patient periodontal status were smaller and mixed. The study shows that continuing education can be effective in helping some but not all providers adopt needed, appropriate behaviors.

Attitude of Health Personnel↗
PubMed1989

Clinical evaluation of a samarium/aluminum compound filter.

Rare earth compound filters, which offer reduced patient exposure during intraoral radiography, have not been clinically evaluated for their effect on diagnostic yield. This clinical study was conducted to compare the diagnostic yield of bitewing radiographs exposed with a conventional aluminum filter with matched bitewing radiographs exposed with a samarium/aluminum compound filter. One hundred sixty-three pairs of bitewing radiographs were read independently by two reviewers for absence or presence and depth of proximal carious lesions. Degree of agreement between films was assessed by means of the kappa statistic. Results showed good agreement between the radiographs exposed with each filter type. Thus, x-ray machines modified with a samarium/aluminum rare earth compound filter produce bitewing radiographs of comparable diagnostic yield and lower dose when compared with radiographs exposed with a conventional aluminum filter.

Adult↗
PubMed1989

Dental patients' knowledge and beliefs about periodontal disease.

The knowledge and beliefs about periodontal disease of 1093 regularly attending patients in 36 North Carolina general dental practices were examined. Patients had a strong positive orientation toward keeping their teeth. Correct information concerning the signs, causes, prevention, and treatment of periodontal disease was widely held. Older patients were more knowledgeable about treatment and signs of periodontal disease, while younger patients expressed more positive beliefs about keeping their teeth for a lifetime. Although patients' knowledge was not perfect, it included few misperceptions that could threaten oral health. Additional education was most needed with respect to the significance of bleeding gums.

Adult↗
PubMed1989

Clinical periodontal status of regularly attending patients in general dental practices.

Periodontal status of regular patients of general practitioners in the United States is unknown. A project assessing the effectiveness of continuing professional education in altering provider behavior and patient periodontal health provided the opportunity to clinically examine 1092 patients in the offices of 36 general practitioners. These regularly attending patients were selected by a random start systematic sample of patient records. The examination included recording missing teeth and assessing plaque, gingivitis, calculus, probing depth, and attachment loss on the facial and facial-mesial surfaces of the Ramfjord teeth (PDI). The mean patient age was 48 years, and 63% were female. The mean number of missing teeth, not including third molars, was 3.9. Almost 78% of the patients had no sites with a P1I score greater than 1, but 52% of the patients had at least one site with bleeding. Calculus was present in 62% of the patients. Deepest pocket depth was 4 mm or greater in 9% of patients and 3.8% had sites with 4 mm or greater attachment loss. Mean attachment loss was 1.6 mm across all sites. Although the majority of these regular patients had plaque, calculus, and gingivitis, only a minority exhibited periodontitis at the index sites.

Adult↗
PubMed1988

Six-month effects of a sanguinarine dentifrice on plaque and gingivitis.

A six-month, double-blind clinical trial was conducted to determine the effectiveness of a sanguinarine-containing dentifrice in reducing plaque and gingival inflammation. One hundred twenty adult volunteers were randomly assigned to a control or experimental group. The test dentifrice contained 750 mcg/g of sanguinaria extract. A dentifrice of similar composition without sanguinarine was used as the placebo. Plaque and gingival inflammation scores were recorded for four surfaces on each of 12 index teeth at baseline, one-, three, and six-months. Matched pair t-test analyses showed no significant differences between experimental and control groups for mean six-month changes in plaque and gingival inflammation scores in analyses using all 48 sites per subject or in analyses of only the 24 interproximal sites. No long-term reduction was demonstrated in plaque or gingival inflammation with the use of a sanguinarine-containing dentifrice.

Adult↗
PubMed1988

Presence of periodontal data in patient records of general practitioners.

It has been reported that little diagnostic information concerning periodontal conditions is entered in patient records of general practitioners, but actual rates for such chart entries are unknown. Records of regular patients, seen at least annually, were randomly selected from the offices of 36 general practitioners in two North Carolina counties. In each office 80 records were selected for audit. After adjustment, the final sample consisted of 2488 audited records. Entries noting the presence or absence of 14 diagnostic conditions were identified for the five previous years and for the patient's most recent examination. The presence of a periodontal diagnosis or periodontal treatment plan was noted. The number of radiographic sets exposed in the previous five years and the age of the most recent set were determined for complete series/panoramic films and for bitewings. Across practices, the most frequent notations (20.5% within the past five years) concerned the presence of probing depths and calculus. Gingival bleeding (13%) and plaque (12%) were noted less frequently. A periodontal diagnosis was recorded in only 16.3% of the records. Annualized rates for radiographic sets were 0.09 for complete series/panoramic films and 0.50 for bitewings. These data suggest that, except for radiographs, the majority of patient records do not contain sufficient diagnostic information to describe patients' periodontal health.

Adult↗
PubMed1988

Periodontal status and treatment needs among regular dental patients.

A survey of periodontal status and treatment needs among dental patients was performed using the CPITN criteria, with the worst score per sextant being recorded, based on examination of all surfaces of all teeth. Regularly attending patients (n = 1092) from 36 general dental practices in two North Carolina counties were examined. The most frequently found worst conditions-per-patient across all ages were the presence of calculus (35 per cent) and the presence of 4-5 mm pockets (35 per cent). The most common worst condition-per-sextant was bleeding (32 per cent) followed by calculus (28 per cent). Less than a fifth of all sextants exhibited pocketing, although half of the patients had at least a 4-5 mm pocket. The mean amount of treatment time required for these conditions was 33 minutes, reflecting the general absence of the need for complex periodontal treatment.

Adult↗
PubMed1987

Estimates of the effects of a statewide sealant initiative on dentists' knowledge and attitudes.

The effects of a statewide initiative promoting the use of dental sealants were evaluated by assessing dentists' knowledge and attitudes before the initiative and 18 months later. Immediate changes also were determined for participants in continuing education (CE) sessions, a principal component of the initiative. Results of these assessments indicate that minor improvements in knowledge and attitudes occurred, that the effects were stronger but still modest for those dentists who participated in CE sessions, and that respondents believed the initiative had resulted in increased use of sealants. This evaluation highlights the need for controlled assessments of the effectiveness of future promotional campaigns.

Attitude to Health↗
PubMed1986

Identifying children who will experience high caries increments.

An 18-month longitudinal study of 197 5 to 18-yr-old children was conducted to assess the performance of multiple baseline variables in predicting which children would experience high increments of caries. Nine predictors were assessed; DMFS and defs scores, number of permanent teeth, indices of fissure retentiveness and occlusal morphology, S. mutans and lactobacilli levels, and sex and race. Discriminant analyses were applied to data for children in five age groups to identify the 30% who would have the largest 18-month DMFS increments. Prediction performance was assessed by comparisons with the actual high increment group, defined as those children with increments in the upper quartiles of the DMFS distributions within age groups. The analyses predicted between 56% and 91% of actual high increment children depending on age group. The children identified in the analyses experienced between 59% and 91% of the disease experienced by the actual high increment groups.

Adolescent↗
PubMed1986

Recent dental caries and treatment patterns in US children.

This report presents dental caries and treatment patterns found in a longitudinal study of US children between 1978 and 1982 who were geographically dispersed across several fluoridated and nonfluoridated sites. The analyses include first- and fifth-grade children examined annually for four years in the National Preventive Dentistry Demonstration Program and who did not receive effective preventive procedures. The results indicate that in association with the caries decline in US children, treatment ratios increased by over 20 percent during the study period. FS/DFS ratios averaged 79 percent for the four grade/fluoridation status cohorts analyzed and were significantly higher in fluoridated than in nonfluoridated sites. The single-fissured surface was the dominant treatment or disease area observed and these surfaces tended to be restored early. In assessing tooth-surface status changes annually, tooth surfaces were more than twice as likely to change from sound to filled than from sound to decayed between yearly examinations at fluoridated sites. The lower levels of decay and higher degree of restorative care observed were not observed in lower SES and black children nearly to the extent as those for higher SES and white children in the population. The dental profession should shift its emphasis from the early restoration of fissured-surface defects to an expanded use of sealants for those with reduced decay and focus resources on a minority of the population with high caries levels who receive limited care.

Black People↗
PubMed1985

Effect of secular decline in caries on the evaluation of preventive dentistry demonstrations.

Studies of dental preventive interventions often do not incorporate a concurrent, longitudinal control group in their study design. The existence of a secular decline in dental caries during the conduct of these studies may result in an overstatement of the effectiveness of the preventive intervention. Results of a recent large caries preventive study are analyzed using both a concurrent, longitudinal control group and an historical comparison group to demonstrate this effect. Differences in effectiveness of preventive procedures determined using the two types of control groups are sufficient to suggest a probable misinterpretation of results of studies using only historical comparisons.

Adolescent↗
PubMed1984

Production and economic contributions of dental hygienists.

Dental hygienists' contribution to total gross billings and production, measured in standard production minutes, was studied in 13 private practices that employed hygienists. Hygienists' treatment accounted for one fourth of total production and one eighth of all gross billings. These results, together with analyses of the use of available time, the range of procedures performed by hygienists, and the rate of return for these procedures, illustrate the utility of this type of information when assessing the possibility of changes in the dental hygiene profession. In the past five years, the literature concerning dental hygienists has included a number of contributions that focus on the status of and possible changes in the practice of dental hygiene. These contributions have discussed the general future of dental hygiene,1-3 and the specific issues of professionalism,4-6 advocacy,7-8 and legal and political activity and knowledge.9-11 In addition, several discussions of new forms of dental hygiene practice also have appeared in the hygiene literature, 12-17 as well as in the general dental literature.18-20 Finally, surveys of dental hygienists have been reported frequently.21-30 The content of this growing body of literature indicates that the profession of dental hygiene currently is undergoing an internal examination, and that several educators and practitioners are advocating the acceptance of increased responsibility by hygienists.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Hygienists↗
PubMed1984

Indications for sealant use in a community-based preventive dentistry program.

Dental caries is a disease that recently has undergone, and may still be undergoing, dramatic changes in distribution of incidence and prevalence. The most recent epidemiologic data available have been reviewed in this paper to illustrate that caries is becoming a disease primarily of pits and fissures, with less differentiation than previously acknowledged between fluoridated and fluoride-deficient areas. The present distribution of caries suggests that prevention may be accomplished more effectively through targeted sealant programs than through currently popular mass preventive programs. Existing information can be used to identify logical target groups for sealant programs, and age specific tooth eruption and caries attack information can be used to design delivery methods. Although the adoption of targeted sealant programs represents a departure from the traditional mass approach to prevention in dental programs, the present-day caries distribution requires that the initiation of such programs be given serious consideration. At the very least program administrators are encouraged to invoke the planning-implementation-evaluation process. Current programs should be evaluated carefully in view of today's disease patterns and the clinical significance of the results achieved. The content, design, and timing of future community-based programs should reflect individualized community diagnosis and the application of new epidemiologic data as well as a careful evaluation of the results achieved by current preventive procedures.

Adolescent↗
PubMed1984

Differences among entering dental classes in attitudes toward health care issues.

Attitudes toward social and professional issues in health care were examined for six successive entering classes in a single dental school. Attitudes were assessed on six scales derived by factor analysis of a larger set of questions presented to first-year students. The analyses focused on detection of annual variations and longer term differences in attitudes, and on associations between attitudes and students' background characteristics. Both annual variations and longer term differences were found, but no strong associations between students' characteristics and attitudes were noted. The finding that entering students' attitudes differ between classes can be of importance to educators' teaching strategies.

Adult↗
PubMed1983

Measurement of effects of a state dental practice act on potential delegation and production in general dental private practice.

Detailed treatment information was obtained on every procedure performed for all patients seen during a two-year period in 14 private dental practices in Kentucky. This information permitted the investigation of the effect of Kentucky's State Dental Practice Act on the amount of production that could have been legally delegated in the 14 practices. The development of a new measure called the Standard Production Minute (SPM) allowed for the examination of the relations between delegation and production by measuring the two variables in the same time-based units. Results of the study indicated: In 14 private dental practices in Kentucky, 58.7 percent of all production was legally delegable under the State Dental Practice Act. The three areas of operative, hygiene/prevention, and exam/diagnostic data accounted for 74.8 percent of overall production and 67 percent of the production in these areas was legally delegable to auxiliaries in Kentucky. Within individual areas of dentistry, the greatest potential delegation rates were found in these three areas. Given the procedure-mix for the 14 practices, 31 percent of all potential delegation was restricted to hygienists and 18 percent of all production was delegable only to the hygienist under the Kentucky State Dental Practice Act. If the delegation of placing and finishing restorations was restricted by the Kentucky State Dental Practice Act, the percentage of production that could be delegated in the operative area would have decreased from 53.1 percent to 20 percent. However, the percent of production that could be delegated across all areas would have decreased from 58.7 percent to 46 percent.

Delivery of Health Care↗