Biomedical subjects
Publications and source records attributed to J R Pinkham.
A general categorization of homebound patients is presented to aid the dentist in assessing their treatment needs and requirements. The importance of oral hygiene is shown, and modifications of oral hygiene appliances are presented. The role of the general dentist in the care of these patients is stressed.
A case of atlantoaxial subluxation accompanying pharyngitis is reported in a 4-year-old child. Diagnosis was made by examination and roentgenograms of the lateral cervical spine. Treatment consisted of halter traction and bracing. The patient responded well to treatment and is normal in all respects one year later. Atlantoaxial subluxation should be considered when treating pharyngitis, especially if the patient presents with torticollis.
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Using the information obtained from the Collegiate Patient Management System a comparison of average numbers of procedures performed by third year dental students from 1983/84 to 1996/97 was made. The data were grouped in order to compare Group I (1983/1989) to Group II (1990/1997). Student's t-tests were performed to determine significant differences between the groups for the various procedures. The number of new patients in Group I was only 8.2 compared to Group II--7.9 and the total number of new and recall patients seen by students was Group I--33.5 compared to Group II--29.9. Students in Group I performed 19.3 one-surface restorations compared to 11.8 (p = .0001) in the later group and 9.5 two-surface restorations compared to 6.0 (p = .0003) for the 1990's group. Stainless steel crowns, pulpotomies, extractions and sealants were also compared. The total numbers of patients visits was 66.8 in GRP I compared to 49.6 (p;eq.0001) in GRP II. There has been a decrease in most student experiences in the undergraduate pediatric dental clinic in the past 15 years.
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The role of the parent during their child's dental experience, in contemporary society, has changed during the past decade and should be addressed by pediatric dentists. Included in this matter are issues regarding risk management and practice management. Behavioral pediatric dentistry is in flux, much like the world that it serves; there appear to be schisms within the profession regarding one aspect of this: the presence of parents in the dental operatory. Presented here is an analysis of the paradigm-shifts in society since World War II, when a postfigurative parenting strategy was in vogue. An explication of noted anthropologist Margaret Mead's descriptions of this and two subsequent parenting styles, including configurative (or transitional) and prefigurative (contemporary) are presented. They are analyzed in terms of parental attitudes concerning trusting their child to authority figures, including the dental clinician. This emerging protective instinct is termed "social hypertrophy", based on social biologist Edward O. Wilson's work. Dentists are encouraged to understand parental attitudes and avoid unnecessary conflict.
In the last twenty years, nearly every aspect of American life has changed, with m any serious issues having influence on children. Since the late 1960s these changes have been fast and dramatic. So how dentists will, can, and do manage children has changed during these two decades. Social processes of paradigm shifting and parenting-strategy changes became perceptible in society about the time George Teuscher became editor of the Journal; diverse opinions seemed to explode and gain momentum as we watched them become today's realities for professionals, parents and their children. No issue was s pivotal to a successful dentistry-for-children movement in this country as was the ability of dentists to guide and manage the behavior of children through the dental appointment. Approximately 130 articles on behavioral topics have been published during Dr. Teuscher's editorship, a commitment upheld in the area of behavioral sciences in dentistry for children, in a time of society's rapid changes regarding children and their nonparental management.
Since the 1981-1982 academic year, the University of Iowa Department of Pediatric Dentistry had placed approximately 2000 composite/sealants or preventive resin restorations in children's molars. When these children appeared again for examination or treatment, their restorations were evaluated for retention, maintenance, and quality. Results were encouraging: more than 80 percent of the sealant material was "all present"; and more than 98 percent of the composite restorative material was rated quite satisfactory (the "Alfa" category).
In this paper, the fact that poor people, and specifically poor children, are a problem for our society was discussed. The eradication of poverty is a goal that our nation has not been able to achieve and probably will not reach in the foreseeable future. Data that are supportive of links between poverty and increased needs for dental treatment and difficulty in the acquisition of professional dental care for children were reviewed. Finally, it was pointed out that social consequences surrounding the environments of poor children and, in some instances, the manner in which these children are reared, are predictive of misbehavior at dental appointments, particularly in younger age-groups. Such misbehavior paired with the finding that these children often do need restorative and surgical care may present challenges in patient management. The most important conclusion of this paper is that the dentist must be sensitive to the problems of poor children, responsive to their psychological needs, and prepared to give the extra energy and time that may be needed in management before and during the dental appointment.
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The authors suggest the term implicit communication control more nearly describes the technique. In addition to the vocal element, the term includes the physical expressions of the face and hands.