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Biomedical subjects

P Milgrom

Publications and source records attributed to P Milgrom.

At least 145 records · Page 8Linked to original sources
PubMed1975

Dental auxiliaries, universities, and academic freedom.

The practicing dental profession lately has asked questions regarding the propriety of research programs designed to investigate the use of expanded duty dental auxiliaries. The dental schools see paraprofessional research as socially responsive. Dental societies recognize the usefulness of auxiliaries but feel their responsibilities should be limited. This paper examines the status of dental auxiliaries, universities, and academic freedom.

Allied Health Personnel↗
PubMed1975

Patient consent procedures for dental care.

Informed consent is a poorly developed concept in dentistry. The dentist should initiate discussion on the information reasonable patients may need to make a decision on a specific treatment or on whether they will accept treatment from that particular dentist. As a minimum, dentists should be required to explain the treatment, benefits, and probable complications as well as possible alternatives. Increasingly, malpractice actions are being decided on these grounds and, thus far, little guidance is available to conscientious dental practitioner.

Delivery of Health Care↗
PubMedDate not supplied

Psychiatric diagnoses among self-referred dental injection phobics.

In order to determine the psychiatric characteristics of people with dental injection phobia. 118 dental injection phobics were systematically assessed using a structured clinical interview and a written questionnaire. Fifty-four percent of subjects had a current Axis I diagnosis other than dental injection phobia, mainly anxiety, mood or adjustment disorder, and 68.6% of subjects had an additional lifetime Axis I diagnosis. Subjects with additional current Axis I diagnoses reported higher dental anxiety, greater severity of injection fear cognitions, and poorer relationships with dental professionals, than did subjects without any or with past Axis I diagnoses. Further investigation is needed to explore the treatment possibilities for patients with and without additional current diagnoses.

Adolescent↗
PubMedDate not supplied

A community strategy for Medicaid child dental services.

OBJECTIVES: The authors present second-year utilization data and first- and second-year cost data for a community-based program in Spokane County, Washington, designed to increase access to dental care for Medicaid-enrolled children from birth to 60 months of age. METHODS: The authors used Medicaid eligibility and claims data for 18,727 children 5 years of age and younger to determine utilization of dental care from January 15, 1996, through January 15, 1997. They also used accounting records from the agencies involved to calculate the first- and second-year costs of the program. RESULTS: A child in the ABCD program was 7.2 times as likely to have at least one dental visit as a Medicaid-enrolled child not in the program. Estimated costs per child with at least one dental visit (in 1995 dollars) were $54.30 for the first year and $44.38 for the second year, or $20.09 per enrolled child for the first year and $18.77 for the second year. CONCLUSION: Public-private joint efforts are effective in improving access to dental care for Medicaid-enrolled children.

Child↗
PubMedDate not supplied

Treatment outcomes for specific subtypes of dental fear: preliminary clinical findings.

In order to examine the clinical treatment outcome for dental fears, we examined 111 active patient records retrospectively using an 80-item structured format. Subjects were from three fear subtypes: needle phobic (N = 15), gagger (N = 11), and non-specific dental fear (N = 85). Mean subtype Dental Fear Survey scores ranged from 72.3 to 81.0. Patients received either behavioral therapy alone (N = 85) or behavioral therapy with a nitrous oxide or IV sedation adjunct (N = 26). Mean psychological treatment time was 3.9 hours (SD = 2.8 h) and did not differ by fear subtype (p > 0.05). All patients successfully completed initial dental treatment. Relapse of fear requiring additional psychological treatment occurred only in the non-specific fear subtype (rate = 11.2%). Patients receiving pharmacologic adjuncts to behavior therapy (nitrous oxide) experienced less relapse.

Adult↗
PubMedDate not supplied

Dental fear treatment outcomes for substance use disorder patients.

In order to examine the clinical treatment outcome for dental fears, we compared the records of 18 phobics who had co-morbid substance use disorder (SUD) with those of 27 subjects who were phobic without concomitant SUD. Outcomes were determined by calculation of changes in the Dental Fear Survey (DFS) score. Subjects were classified by the Structured Clinical Interview for DSM-III-R. All subjects received exposure-based behavioral therapy with or without pharmacological adjuncts. All 27 subjects in the non-SUD group and 15 of 18 (83.3%) of subjects in the SUD group improved. Non-SUD subjects improved more than SUD's on the avoidance and specific fear, but not on the physiological upset, dimensions of the DFS.

Adult↗
PubMedDate not supplied

Side effects of triazolam in children.

PURPOSE: This study examined the incidence of side effects occurring with three doses of orally administered triazolam in children undergoing restorative dental procedures. METHODS: Thirty children, aged 39-81 months, participated in the study. The children were pretested for gait ataxia, amnesia, visual acuity, stereoscopic depth perception, and diplopia during a screening session. In a subsequent appointment, children received one of three triazolam dosages (0.005, 0.015, and 0.030 mg/kg) prior to dental treatment. Dosage assignment was random and double blind. Each child received a single triazolam dosage. Tests for gait ataxia, amnesia, and visual disturbances were repeated following drug administration. RESULTS: The proportion of children experiencing ataxia, amnesia, and diplopia increased with increasing triazolam dosages. The 0.030-mg/kg triazolam dosage impaired visual acuity and stereoscopic depth perception. CONCLUSION: Triazolam produces ataxia, amnesia, and diplopia in a dose-dependent manner in children.

Administration, Oral↗
PubMedDate not supplied

Taking bitewing radiographs in preschoolers using behavior management techniques.

Radiographs are essential diagnostic tools to enable dentists to make adequate decisions and treatment plans. Treatment plans for young children, however, are quite often based on no or less than ideal radiographs. Getting successful bitewing radiographs from young children demands both behavior management techniques and adequate equipment. This report reviews the literature, and presents a modified technique of taking radiographs in young children. The technique was successfully used with 156 three-to-five-year-old children from Yakima County, Washington. Behavioral management of the children employed several techniques: building rapport, tell-show-do, modeling, positive reinforcement and increasing the child's sense of control. The equipment and placement technique were designed to be as atraumatic as possible. Positive experiences in the dental office often enhance a child's future cooperation. The techniques presented are simple to learn and use in treating very young children.

Behavior Therapy↗
PubMedDate not supplied

Dentist participation in a public-private partnership to increase Medicaid participation and access for children from low income families.

The purpose of this research is to solicit feedback from dental society members involved in a program (Access to Baby and Child Dentistry, ABCD) to provide care for children receiving Medicaid benefits, and to gain an understanding of dentist participation. We investigated whether general dentists who were participants in ABCD were more fully integrated into the dental society profession and community, and whether they demonstrated greater interest in children. Dentists were stratified regarding ABCD participation and randomly selected to be interviewed (N = 40). The majority thought it appropriate for general dentists to care for very young children. Participants found fewer problems in fee levels in Medicaid, but there was no difference in an index of fees between the groups. Participants were no more active in the dental society, and few differences existed between the groups regarding other aspects of personal or professional life. Dentists participating in ABCD to improve access had a good experience and have positive views of the program. This may encourage other nonspecialist colleagues to participate in programs for children.

Attitude of Health Personnel↗