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Biomedical subjects

M J Rudolph

Publications and source records attributed to M J Rudolph.

At least 37 records · Page 2Linked to original sources
PubMed1999

Utilisation of oral health services, oral health needs and oral health status in a peri-urban informal settlement.

Interviews were conducted with 294 black residents (155 females and 138 males) of a peri-urban informal settlement in Gauteng to ascertain utilisation of oral health services, oral health needs and oral health status. Only 37 per cent of the sample had consulted a dentist or medical practitioner, usually for extractions. Teenagers and employed persons were significantly less likely to utilise dentists than the older age groups and unemployed persons. Forty per cent were currently experiencing oral health problems such as a sore mouth, tooth decay and bleeding/painful gums. Two hundred and twelve (73 per cent) interviewees wanted dental treatment or advice. Residents who rated their oral health status as fair or poor appeared to have the greatest need for oral health services. The use of interviews appears to be a cost-effective method of determining oral morbidity.

Adolescent↗
PubMed1999

Oral health care--the perceptions and self-reported practices of nurses.

A structured, 40-item, self-administered questionnaire was distributed to 290 nurses attending an international health care conference held in Pretoria, South Africa. The questionnaire focused on; personal and demographic details of the respondents, history of dental disease and dental attendance, exposure to oral health during and after basic nurse training, opinions on oral health and the nursing curriculum, perceptions on the relationship between nurses and oral health personnel, perceived ability to promote oral health and self-reported contributions to oral health. The 153 respondents were predominantly female (140, 93.3%) with a mean age (+/- Standard deviation) of 43.0 +/- 7.5 years. One hundred and twenty one (79.1%) had previously visited a dental clinic for personal care and 105 (68.6%) had suffered from dental disease, dental pain, bleeding gums or bad breadth. Only 71 (46.4%) were exposed to experiences in assessing and caring for clients with oral disease during their training. Significant positive correlation were found between exposure (during training) to experiences in assessing and caring for clients with oral diseases and some factors. One hundred and forty-eight (96.7%) agreed oral health should be integrated into the nursing curriculum. Forty-one (26.8%) indicated they have not been contributing to the oral health of their clients or community while 92 (60.1%) described their personal contributions as fair. One hundred and thirty six respondents (88.9%) wished to be able to do more for their clients in the area of oral health.

Adult↗
PubMed1999

HIV infection and oral health care in South Africa.

This study determined the knowledge, attitude and practice of oral health care workers in public clinics in South Africa towards HIV/AIDS and investigated the implementation of infection control measures. A total of 727 questionnaires were distributed to dentists, dental therapists, oral hygienists and chairside assistants in the public dental clinics of 9 provinces, of which 276 were returned from 8 provinces, giving a response rate of 38%. The questionnaire covered demographic factors and assessed issues such as knowledge, infection control practices, continuing education, legal, ethical and psychosocial issues and available support for HIV/AIDS. The common oral manifestations seen by respondents were candidiasis, acute necrotising ulcerative gingivitis (ANUG), hairy leukoplakia and Kaposi's sarcoma. Of the 174 who had a previous HIV test, 48% were for insurance purposes and 21% for post-needle-stick injury. Over 10% of the respondents indicated that gloves were not available at all, that there was an inadequate supply of water, and that there was no autoclave in their clinic. Nearly 50% of the clinicians had not had hepatitis B vaccination in the last 3 years. Fifteen respondents (5.4%) were not willing to treat HIV-positive patients. Only 48% had access to a written post-exposure management protocol and post-exposure medication was available to only 36.6%. The vast majority of the respondents clearly expressed a need for additional education on HIV/AIDS. The study demonstrated a need to add knowledge, enhance personal skills and improve the application of universal precautions.

AIDS Serodiagnosis↗
PubMed1996

The effectiveness of a school-based fluoride mouth rinse programme.

The objective of this study was to determine the effectiveness of unsupervised weekly fluoride mouth rinsing (FMR) with 10 mls of 0.2 per cent sodium fluoride on the caries increment of permanent teeth in schoolchildren aged 6-12 years over a 3 year period. Caries was assessed using DMFT and DMFS indices (WHO, 1987). Over 2000 children from 4 schools in the Johannesburg area were selected at baseline. For analysis purposes pupils were pooled into 2 groups, those who received and those who did not receive the FMR. There were significant differences in mean decayed scores after 3 years. The percentage caries reduction achieved with the FMR was approximately 15 per cent. Reductions of up to 30 per cent have been recorded in previous studies of this nature. The overall caries reduction for this study period can be considered low.

Analysis of Variance↗
PubMed1995

Private dental practitioners--perceptions of needs and barriers to dental care.

The purpose of this paper was to examine needs and barriers to dental care as perceived by private dental practitioners in South Africa. In 1988/89 a National Oral Health survey was conducted. This included a questionnaire sent to 3200 dental practitioners. The items examined in this paper were part of this questionnaire. Fifty six and 29 per cent of practitioners considered that there was a shortage of dentists for black and coloured persons respectively and only 4 per cent perceived a shortage for whites. Twenty two per cent of respondents believed that there was no shortage of dentists for black patients. There was however, a high percentage of "don't know" responses. An analysis of the type of treatment provided indicated that 60 per cent of dentists spend more than 60 per cent of their time on performing extractions for black patients and minimal time on prevention. The main barriers to dental care were seen as attitudinal, structural and dentist-related. Dentist perceptions of these barriers highlight the role non-dental factors play in dentistry and oral health. These factors need to be seriously considered in order to improve the nature and quality of, and accessibility to dental care.

Black or African American↗
PubMed1995

Private dental practitioners in South Africa--a professional profile.

A questionnaire submitted to dentists in private practice was part of the first National Oral Health Survey 1988/89. The questionnaire investigated demographic and professional characteristics. Completed questionnaires were returned by 2224 dentists (69.5 per cent). Most respondents were located in the 5 main metropolitan areas. There was a paucity of Black and Coloured dentists. Male dentists dominated the profession with almost 74 per cent under 50 years of age. General practitioners made up over 90 per cent of the profession and orthodontists were the largest group of specialists. Conservation was ranked as the most frequently practised service and preventive procedures were ranked low. Medical aid systems were seen to have some disadvantages. Fees and working conditions were felt to be better in private practice than in the public sector.

Adult↗
PubMed1995

A profile of South African orthodontists: NOHS 1988/89.

The response by orthodontists to a 1988/89 National Oral Health Survey questionnaire is reported. The 54 predominantly white male respondents reflected a balanced age distribution. The majority were in solo private practice. Almost half employed oral hygienists, 96 per cent worked between 40 and 49 weeks per year and 61 per cent worked between 35 and 44 hours per week. Half were satisfied with their busyness and the remainder were evenly divided between being too busy or not busy enough. The majority of patients were white. It is recommended that imbalances in race and gender amongst orthodontists be redressed.

Adult↗
PubMed1994

Oral health, oral health care and dental services--the consumer perspective.

As part of a National Oral Health Survey conducted in 1988/89, community knowledge of and attitudes towards oral health and oral health care were examined in the various population groups in South Africa. A wide range of issues were explored. These included amongst others, help-seeking and oral health behaviour, sources of health information and attitudes to dentists and dental care. Given the major political change that has recently occurred in the country, the results of the survey suggest that these findings could profitably be used in future dental personnel planning as well as in the re-structuring of the health services that is currently taking place.

Attitude to Health↗
PubMed1994

The impact of a mobile dental system on a school community. Part I--Oral health status of schoolchildren.

This cross-sectional study was designed to compare the caries status of children 8-10 and 11-13 years of age, at schools visited by and schools not visited by the Mobile Dental System (MDS). A total of 918 children from six primary schools participated in the study. For the experimental schools, Noordgesig and Cavendish were paired in Group 1 (curative services and brushing programmes), while Riverlea and Wilhelmina Hoskins were combined in Group 2 (curative services and weekly fluoride mouthrinse programmes). Kliptown II and Ernest Hobbs were grouped together as the control schools (Group 3) where no services were provided by the MDS. Dental caries examinations were conducted using the WHO criteria (1987). Statistical analysis was done using chi-square tests, ANOVA and pairwise t-tests. A comparison of mean DMFT scores revealed differences between the control and both experimental groups in the 11-13 year old age group that were significant. The filled and missing components of the DMFT differed significantly for both age groups when experimental and control schools were compared, which clearly showed the impact of the service provided by the MDS. There were however, no differences in the decayed component indicating the limitations of the system in preventing or controlling the development of new carious lesions.

Adolescent↗
PubMed1994

The impact of a mobile dental system on a school community. Part II--Responses of recipients and providers of care.

This paper is concerned with the impact of a Mobile Dental System (MDS) on the providers and recipients of oral health care. It focuses more specifically on children as patients of the MDS and MDS personnel as clinicians and oral health educators. Data, which were quantitative and qualitative in nature were collected from children and MDS members by means of questionnaires and interviews. Results indicate that the children had acquired some oral health information from the MDS, but many were fearful of clinical procedures. MDS personnel were gratified that they were able to provide a service to an otherwise underserved community, but also considered themselves inadequate child managers and oral health educators. The lack of a permanent career structure created feelings of insecurity amongst MDS staff. Recommendations arising from this investigation are the need for permanent and comprehensive services for all members of the community, and improved working conditions and continuing education courses for MDS personnel.

Adolescent↗
PubMed1994

The impact of a mobile dental system on a school community. Part III--Teachers and parents response to a mobile dental system at school.

According to the principles of the Primary Health Care Approach, planning and implementation of community health programmes should be carried out with the full participation of the community concerned (WHO, 1978). The introduction of the Mobile Dental System to the school environment is an example of a "Community health care/technology approach" where the programme was determined by the professionals for the community and not by the community for itself. Teachers play an important role in the implementation of oral health care programmes in the school, while parents provide the vital and appropriate context and continuity for the success of such programmes. This paper, therefore, deals with the responses of teachers and parents to an introduction of a mobile dental system at their school. A self-administered mostly open-ended questionnaire was distributed to all teachers in the four schools that participated in preventive programmes and were served by the Mobile Dental System. Based on the results it seems that both the teachers and the parents were apathetic in their commitment to the programme although they were quite willing to participate. Their participation was confined to compliance with instructions or suggestions given by the health professionals. It is clear that under these conditions the potential to sustain the momentum created by the introduction of the MDS is limited. It seems that only if the community is involved in the determination of their preferential needs, planning of the appropriate programme and playing an active role in its implementation, will the programme have a chance of long term success.

Adolescent↗
PubMed1993

Dental caries experience and periodontal disease in institutionalised male psychiatric patients.

The prevalence of caries and the periodontal disease in 240 adult male psychiatric patients was determined in order to recommend appropriate treatment strategies. Twenty seven per cent of the sample were fully dentate and 12 per cent were caries free. The mean DMFT was 7.92 with the D component reflecting many untreated carious teeth. All age groups require simple restorative care for the treatment of dental caries. None of the subjects were totally free from periodontal disease. Calculus and moderate periodontal pocket formation was the most common manifestation. Seventeen per cent of the sample needed complex periodontal care. Health education aimed at professional and lay staff, the implementation of a suitable plaque removal regimen and the removal of subgingival calculus by auxiliary personnel were seen as important therapeutic measures to enhance the oral health of this population.

Adult↗
PubMed1992

A mobile dental system in southern Africa.

Recent studies indicate a great need for dental treatment and preventive services in dentally underserved communities in southern Africa. Geographic inaccessibility, limited financial resources, and a maldistribution of dental personnel are the main barriers to oral health care. This project describes the evolution and utilization of a unique, purpose-built, mobile dental unit (MDU). From a compact 2 x 2.5 meter box trailer, an enclosed area of 8 x 9 meters is formed by deploying a cover system housed on top of the trailer. Once deployed, the unit becomes four fully equipped dental operatories and a combined waiting and educational area, with all-weather protection. Comprehensive care is provided by dental auxiliaries. The underlying philosophy of the service is based on the primary oral health care approach. To date, the MDU has visited a wide variety of rural and urban communities where several thousand patients have been examined and treated. Assessment of the MDU indicates that it is an effective and viable alternative oral health delivery system.

Adolescent↗
PubMed1991

Evaluation of stannous fluoride and chlorhexidine sprays on plaque and gingivitis in handicapped children.

The objective of this study was to evaluate the effect of twice-daily oral sprays of 2 ml chlorhexidine (0.2%) and 2 ml stannous fluoride (0.2%) as the sole oral hygiene measure on plaque and gingivitis in handicapped children. 52 institutionalized mentally handicapped individuals (aged 10-26 years) were divided into 4 groups to participate in a 9-week, double-blind, randomized clinically controlled trial, which included a cross-over. For the first 3 weeks, groups 3 and 2 had their mouths sprayed with chlorhexidine and stannous fluoride, respectively. Following a 3-week wash-out interval, groups 1 and 4 were sprayed with chlorhexidine and stannous fluoride, respectively. The alternate groups received a placebo, water. Plaque (PI) and gingival indices (GI) were recorded. Subgingival plaque samples were collected and counts of spirochaetes, motile rods and cocci were taken using darkfield microscopy. By the 9th week of trial, the PI and GI were reduced by 48% and 52% for the stannous fluoride group. In the chlorhexidine group, reductions of 75% (PI) and 78% (GI) were achieved. Pair-wise comparisons of placebo, stannous fluoride and chlorhexidine using the U-test of Mann-Whitney revealed significant (p less than 0.05) differences for both PI and GI scores in the placebo/stannous fluoride and placebo/chlorhexidine pair by the 9th week of the trial. In the stannous fluoride/chlorhexidine pair, only the PI was significantly reduced for those on chlorhexidine. Coccoid cells were more dominant at sites with low PI and GI scores (stannous fluoride and chlorhexidine groups), while spirochaetes and motile rods were more frequent at sites with high PI and GI scores (placebo group).

Adolescent↗