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Biomedical subjects

M W Heft

Publications and source records attributed to M W Heft.

At least 37 records · Page 2Linked to original sources
PubMed1993

Parallels between properties of high-threshold mechanoreceptors of the goat oral mucosa and human pain report.

In the following experiments, we examined parallels between properties of A-delta high-threshold mechanoreceptors (HTMs; mechanonociceptors, MN, and intense pressure receptors, IPR) innervating the goat mucosa and human mucosal pain report. As suggested in previous studies, activation thresholds of afferents which are generally considered to be mechanical nociceptors are far below mechanical pain thresholds. It was determined that classification of nociceptors by frequency thresholds, i.e., the pressure at which HTMs maintained a minimum frequency (97 g/mm2 and 117 g/mm2 for IPRs and MNs respectively) brings afferent reactivity into alignment with perceptual events. The range of reactivity of the nociceptor pool paralleled pain report from "faint-weak" (142 g/mm2) to "strong-intense" (277 g/mm2). It is suggested that coding of intense mechanical pain from compressive forces is likely to arise from both individual afferents, whose reactivity spanned the range, and from recruitment of afferent populations with progressively higher thresholds.

Afferent Pathways↗
PubMed1993

Attitudinal and behavioral characteristics of older Floridians with tooth loss.

In this cross-sectional study of Floridians aged 65 yr or older, 600 persons were interviewed to identify the characteristics of individuals who survived into old age with an intact or nearly intact dentition. Persons with total or partial tooth loss reported less frequent dental care, less ability to pay dental care fees, less frequent dental hygiene, and were more likely to have been smokers or diabetic. Persons with tooth loss also had less positive attitudes toward dentists and dental care. These cross-sectional findings are consistent with tooth loss being the result of disease-, behavior-, and attitude-related causes, and/or their interactions. Tobacco use, diabetes, and infrequent oral hygiene and dental care may increase risk for dental disease; decreased ability to pay for dental treatment may impair utilization of non-extraction treatment options, and negative attitudes toward dental treatment may influence the desire for non-extraction treatment options. Research targeted toward modifying attitudes toward dental treatment may be useful in preventing or delaying tooth loss, and measurement of attitudes may be a useful way to identify individuals at the greatest risk for tooth loss for intervention studies.

Aged↗
PubMed1993

Mouth dryness as reported by older Floridians.

Thirty-nine percent of 600 community-dwelling older Floridians (mean age of 78 yr) reported having mouth dryness. Seventy-nine percent of respondents reported at least one medical condition, 57% were taking at least one prescribed or over-the-counter medication, and 33% were taking at least one potentially xerostomic medication. Reported mouth dryness was highly associated with the number of potentially xerostomic medications. After stratification by medication usage, age, diabetes, arthritis, perceived medical health, and dependence in physical functioning were significantly associated with mouth dryness. Persons with dry mouth were also more likely to have reported dental symptoms, signs of dental disease, sensory changes, and other oral symptoms. Ten percent of those who reported mouth dryness also said that their mouths felt dry when eating a meal, 10% said that they had difficulties swallowing foods, and 15% of persons with dry mouth also said that the amount of saliva in their mouths was too little. Sixty-five percent of persons with dry mouth reported doing one or more dryness-related behaviors. These results suggest that the prevalence of xerostomia was high, and the impact of dry mouth on individuals' daily behaviors was significant.

Aged↗
PubMed1993

Oral signs, symptoms, and behaviors in older Floridians.

Six hundred community-dwelling older Floridians were interviewed regarding the presence of reported signs of dental conditions, dental and oral symptoms, behavioral impact from dental conditions, and orofacial sensory changes. The prevalence of any single oral sign, symptom, or behavioral impact was generally low. A notable exception was the 39 percent prevalence of dry mouth. However, from 10 percent to 29 percent of persons had at least one of these dental signs, dental symptoms, dental behavioral impacts, or sensory changes. These findings are consistent with a noteworthy burden from nonoptimal oral health status, and these burdens were significantly more prevalent in irregular dental attenders, persons with lower household incomes, and persons who reported poorer general health. Inclusion of these non-disease items in an assessment of oral health status seems warranted, and would allow a broader evaluation of oral health outcomes.

Aged↗
PubMed1992

Longitudinal study of signs of temporomandibular disorders (TMD) in orthodontically treated and nontreated groups.

This study measured the prevalence and incidence of signs of temporomandibular (TM) disorders in both a group undergoing orthodontic treatment in the University of Florida graduate orthodontic program and a control group. A questionnaire pertaining to the patients' reports of signs and symptoms of TM disorder and a clinical examination were administered by a trained dental examiner. Data collection sessions occurred at baseline (before treatment) and at 12-month intervals to 24 months. Data were also collected for the control group at the same time intervals. There were 102 patients (43 boys, 59 girls) mean age 15.3 years. An untreated control group of 41 nonorthodontically treated subjects mean age 16.2 years was used. The incidence of TM signs for the treatment group and control group were not significantly different. Preliminary results are in agreement with the contention that orthodontically treated patients are not more likely to develop TM signs while undergoing treatment. Results underscore the changing, inconstant, and ephemeral nature of TM signs in many persons over the course of time.

Adolescent↗
PubMed1992

Periodontal status of older Floridians attending senior activity centers.

Older adults attending senior activity centers in Florida cooperated for a questionnaire and an oral examination. The 671 ambulatory dentate seniors in this report had a mean of 17.0 teeth. The mean attachment loss was 3.5 mm from the cementoenamel junction (CEJ), and the mean pocket depth was 2.1 mm. 24% of the sample had at least 1 site with attachment loss of 7 or more mm; the majority of these persons had only 1 or 2 severely-involved sites. The extent and severity index of attachment loss (2 mm or more threshold) was (88%, 3.7 mm). Use of pocket depths alone would have substantially underestimated prevalence of periodontitis in this older sample. Sites with severe attachment loss were typically not accompanied by severe pockets. Evidence of a history of moderate disease in this cross-sectional study was prevalent (62% of persons had a maximum attachment loss of 4-6 mm), as was evidence of a history of severe disease (24% had at least 1 site with attachment loss of 7 mm or more).

Aged↗
PubMed1992

Orofacial pain.

Orofacial pain is an area of considerable interest in aging. Orofacial nociceptive pain arises mainly from injury or disease afflicting the teeth or the supporting structures of the teeth (periodontium); however it may arise from other intraoral or nonintraoral structures. Because of the rich innervation of the orofacial complex, pain may be referred to remote sites. Neuropathic pains, such as trigeminal neuralgia and postherpetic neuralgia, result from nerve injury and are usually seen only in older adults. Establishment of the source and cause of the pain results in effective pain management.

Aged↗
PubMed1991

Relationship between gingival inflammation and painfulness of periodontal probing.

The relationship of gingival inflammation to the pain associated with periodontal probing was assessed at baseline (B), and 1 month (1M) and 3 months (3M) later in 46 subjects. At each of the 3 sessions, clinical measures of gingival inflammation included an observational gingival index and bleeding score. In addition, periodontal probings of all existing teeth was performed with a constant force probe (25 g). Following completion of the probing at each session, subjects rated the global painfulness of the probing using a visual analog scale for pain. Results of this study showed that judged painfulness of probing was related to clinical inflammation (bleeding score) at baseline and 1 month and suggest that the degree of periodontal inflammation is related to the pain and discomfort associated with periodontal probing.

Adult↗
PubMed1991

Tooth loss and caries prevalence in older Floridians attending senior activity centers.

Older adults attending 14 senior activity centers in six countries of Florida cooperated for a questionnaire and an oral examination. The mean age was 76.5 yr, and about one-third were 80 yr or older. One-third of the dentate persons had dental caries. Most of the carious lesions were on the crown, not the root, and most of the decay was primary, not recurrent. Most of the persons with a need for caries treatment were likely to seek dental care; however, the majority of carious surfaces were in persons who reported being infrequent users of care. These results from ambulatory older adults suggest that older adults have significant caries treatment needs, and provide support for the view that the treatment of older U.S. adults may grow in the coming decades.

Aged↗
PubMed1991

Comparison of self-instruction methods for teaching diagnostic testing.

In a randomized controlled trial, self-teaching booklets and computer media were evaluated for teaching diagnostic testing to dental students as a foundation for further development of clinical decision making skills. Effectiveness was assessed by pre- and post-tests. Reliability of these test instruments was examined by analyzing the pre- and post-test scores of 49 first year dental students who received no instruction. Forty-one second year dental students were exposed to clinical epidemiological principles applied to endodontic diagnosis through either self-teaching booklets or computer media. No statistically significant difference was found between the mean test scores of the students through self-teaching booklets and computer media. Although first and second year students showed a statistically significant improvement between the pre-test and post-test, the improvement in the second year class was greater. An addendum was later made to the main trial to compare the self-teaching booklet to the traditional lecture format in teaching endodontic diagnosis. Seventy-one third year dental students were exposed to these same materials through either a lecture or the self-teaching booklet and then similarly tested. There was no significant difference between the self-teaching booklet and traditional lecture for the third year students.

Computer-Assisted Instruction↗
PubMed1990

Arthroscopic lavage and lysis of the temporomandibular joint: a change in perspective.

Arthroscopic surgery was applied to correct various disorders of the temporomandibular joint (TMJ). Lysis and lavage of the upper TMJ compartment proved of value in patients with anterior disc displacement without reduction ("closed lock"), because it increased the range of mouth motion and alleviated pain in the TMJ. Because this beneficial arthroscopic intervention did not encompass repositioning the disc, its surgical relocation when attempting to overcome dysfunction and pain in the TMJ is questioned.

Adult↗
PubMed1990

Economic impact of dental service utilization by older adults.

A total of 747 general dental practitioners--in Arizona, Colorado, Connecticut, Florida, and Minnesota--responded to a questionnaire in 1988 by completing a detailed productivity report of patient services performed during a specified period. The results, based on 11,909 patient visits and 22,712 dental procedures, indicated that stereotypes of older adults as underutilizers of dental care are incorrect. This finding and others, detailed within this article, indicate that older adults make up a substantial portion of regular patients and that their utilization of dental services should increase throughout 1990.

Adolescent↗
PubMed1987

Secretion of antimicrobial proteins from the parotid glands of different aged healthy persons.

The secretion of three antimicrobial proteins from the parotid glands of 82 generally healthy men and women, 22 to 81 years in age, was examined. No change was observed in the levels of secretory IgA, but statistically significant, modest elevations (approximately 50 to 100%) of lactoferrin, in both unstimulated and stimulated secretions, and lysozyme, in unstimulated secretions, were detected when results were expressed as mg antimicrobial protein/100 ml saliva. However, these alterations were not observed if data were expressed as mg antimicrobial protein/g total protein. Also, no change was detected in an acinar cell exocrine product, the anionic proline-rich proteins, as reported previously by our laboratory. The data are consistent with a maintenance of protective functions in parotid saliva during aging.

Adult↗
PubMed1985

Does the Illness Behavior Questionnaire measure abnormal illness behavior?

Abnormal illness behavior (AIB) has been proposed as a construct measuring the inappropriate or maladaptive modes of responding to one's state of health, and the Illness Behavior Questionnaire (BQ; Pilowsky, 1975) was designed to measure this construct. Previous studies using small samples have failed to agree on the factor structure of this questionnaire. The present paper examines the factor structure of the Illness Behavior Questionnaire and critically evaluates the interpretation of its dimensions as well as the construct of AIB. A factor analysis of responses from 1,061 health care and nonhealth care seeking subjects yielded six interpretable factors which substantially replicated Pilowsky's previous results. Six scales were calculated and correlated with several personality measures. The results indicated that the Illness Behavior Questionnaire is saturated with neuroticism, a dimension known to be related to excessive medical complaints. But excessive medical complaints cannot be equated with hypochondriasis or AIB in the absence of objective medical information. In the absence of evidence for the discriminant validity of the IBQ, its use as a diagnostic device is unwarranted. Treating elevated IBQ scores as indicators of abnormal illness behavior without corroborating medical information may be more misleading than accepting patients' symptom reports at face value.

Adult↗
PubMed1984

An experimental basis for revising the graphic rating scale for pain.

Seven subjects judged the differences between electrocutaneous shocks and words from two category rating lists describing those sensations in each of two differences estimation experiments. The electrocutaneous shocks used for the two experiments were 10 suprathreshold shock intensities determined separately for each subject. There were two distinct 7-word category rating lists. Both lists shared 6 common words; however, the seventh word made the rational ordering of the two lists different. Magnitude scales of meaning for the category rating words and sensory scales for the electrocutaneous shock intensities were determined for each of the two experiments for each subject using conjoint measurement analysis. Comparisons of the sensory scales for electrocutaneous shock between the two difference estimation experiments for each subject showed that they judged the electrocutaneous shocks similarly with the two words lists. This allowed for comparisons between the scales of meaning for the words from the category rating lists. The two word lists were not equivalent. There was substantial agreement among the subjects on characteristic spacings of quantitative values for the category rating items. These results suggest that clinical ratings scales used for analgesimetry should not assume homogeneity of spacing of category items. A scale incorporating our subjects' common understanding is presented.

Adult↗
PubMed1984

Nitrous oxide analgesia: a psychophysical evaluation using verbal descriptor scaling.

The effect of 33% nitrous oxide/67% oxygen was compared with 100% oxygen and air on verbal reports of either sensory intensity or unpleasantness of sensations associated with painful electrical tooth pulp stimulation. Forty-eight subjects used words describing the sensory intensity (i.e., weak, mild, strong) or degree of unpleasantness (i.e., annoying, unpleasant, distressing) to assess the sensations produced by a broad range of tooth pulp stimuli. Within the experimental session, a given subject assessed the painful sensations under all three treatments delivered through a nasal inhaler in a double-blind manner. The incorporation of within-subject placebo (nasal inhaler + air) and active placebo (nasal inhaler + oxygen) controls allowed for rigorous assessment of the components of nitrous oxide analgesia. The results of this study suggest that 33% nitrous oxide analgesia reduces the intensity but not the unpleasantness of painful tooth pulp sensations. Further, 100% oxygen provides no analgesic effect.

Anesthesia, Dental↗