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Biomedical subjects

R C Oliver

Publications and source records attributed to R C Oliver.

At least 19 recordsLinked to original sources
PubMed2001

Beneficial effects of a hospital bereavement intervention program after traumatic childhood death.

PURPOSE: An investigation of the experiences of parents grieving the traumatic death of their child, the initiatives that helped, and common parental concerns that would benefit from improved education. METHODS: From January 1, 1995, to December 31, 1998, 81 of 3,501 children admitted to our pediatric trauma center died. An attempt was made to enroll all parents. Interactions included family contact at hospital, home/funeral home visit within 1 month of death, educational meeting with parents and 15 supporters at a restaurant within 2 months of death, follow-up survey to parents/supporters, and final interview/survey with parents in 1999-2000. RESULTS: Seventy-seven families were enrolled; 59 families completed the educational meeting with supporters, and 245 parental supporters returned surveys. Supporters were likely to use proposed interventions (82%), were more accepting of the duration of grief (94%), and interacted with parents more often after the death (78%). Parents (n = 44) felt the hospital staff was appropriately sensitive to their child (90%), themselves (93%) and prepared them for their child's death (81%). Parents (n = 54) on behalf of 37 children have completed the final interview. Poor conceptualization of aspects of the medical care and brain death, and delayed regret for missing the opportunity to donate organs, were recurring themes. CONCLUSION: We conclude that parents' unanswered questions or misconceptions regarding brain death, organ donation, and their child's medical care adversely affect their grief; that "normal life" for parents is challenged as they struggle to establish a new sense of normal; and that hospital and trauma service personnel can positively impact the grieving process with appropriate training.

Adult↗
PubMed1998

Periodontal diseases in the United States population.

Recent epidemiologic surveys and studies have provided important information on the prevalence, extent, and severity of periodontal diseases in the United States. Over 50% of adults had gingivitis on an average of 3 to 4 teeth. Subgingival calculus was present in 67% of the population. Adult periodontitis, measured by the presence of periodontal pockets > or = 4 mm, was found in about 30% of the population on an average of 3 to 4 teeth. Severe pockets > or = 6 mm were found in less than 5% of the population. Attachment loss > or = 3 mm was found in 40% of the population. Gingival recession accounted for a significant amount of attachment loss. The prevalence of early-onset periodontitis ranged from less than 1% in 14- to 17-year-olds to 3.6% in young adults aged 18 to 34. Extensive and severe periodontitis was much more prevalent in minorities, people with less than a high school education, and those who had seen a dentist infrequently and had subgingival calculus. Smoking and diabetes have been identified as risk factors, especially diabetics with poor metabolic control, a long duration of the disease, and extensive subgingival calculus. Under managed care, there has been an expansion of soft tissue management programs in the offices of general dentists and referral guidelines which limit referral of patients with moderate periodontitis. Quality-assurance mechanisms will be essential for the diagnosis and treatment of persons with periodontitis.

Adolescent↗
PubMed1995

Traumatic childhood death: how well do parents cope?

This study assessed effects of traumatic childhood death on parents. From July 1988 to September 1992, 48 of the 1,954 children admitted to our pediatric trauma center died. Interviews were requested with parents of children who died and were conducted by a chaplain in the homes of 29 parents (20 families). Interview assessments were based on Worden's "Mourning Tasks" and Demi and Miles's "Parameters of Normal Grief." Grieving was uncomplicated in seven parents (five families). Common elements included use of multifaceted non-family support networks to aid grieving, and no parents blamed themselves or God for the child's death. Grieving was pathologic in 22 parents (15 families). Dominant features included: (1) lack of a support network beyond the extended family; (2) an avoidant stance to grieving; and (3) view of God as distant and punitive. We provide nine indices that will enable hospital caregivers to anticipate the outcome of parental grieving, and offer suggestions for the physician who desires to be involved in parents' acute and rehabilitative grief recovery.

Attitude to Death↗
PubMed1994

Prevalence of periodontal pathogens with varying metabolic control of diabetes mellitus.

The purpose of this study was to determine the prevalence of 5 periodontal pathogens in individuals with diabetes mellitus. Subjects (n = 107) 20-70 years of age with type 1 (n = 60) or 2 (n = 47) diabetes mellitus were studied for the occurrence of the periodontal pathogens A. actinomycetemcomitans, F. nucleatum, E. corrodens, P. gingivalis and P. intermedia. Subgingival plaque was sampled in each subject from a single site exhibiting the greatest inflammation. The evaluation of selected periodontal bacterial pathogens was based on an immunoassay utilizing bacterial specific monoclonal antibodies. 35% of the sites harbored P. gingivalis, 28% F. nucleatum and 21% E. corrodens. A. actinomycetemcomitans and P. intermedia were found in less than 10% of the sites. Subjects for whom the probing depth at the sampled site was > or = 4 mm were more often found to have detectable pathogens than those with a probing depth < or = 3 mm. Diabetic factors such as duration, type and metabolic control of the disease had no statistically significant effect on the prevalence of these bacteria.

Adult↗
PubMed1994

Diabetes--a risk factor for periodontitis in adults?

With the increasing number of diabetics in an aging population and controversial research reports on the relationship of diabetes to periodontitis, clarification of diabetes as a risk factor for periodontitis would be helpful. This review notes variations in type, metabolic control, and duration of diabetes and highlights the results of studies that have considered these variations. Diabetics who maintained reasonably good metabolic control had not lost more teeth or experienced more periodontal attachment loss than non-diabetics, although they had more periodontal pockets. Poorly-controlled diabetics with extensive calculus on their teeth had more periodontitis and tooth loss than well-controlled diabetics or non-diabetics. Long-duration diabetics were also at greater risk for periodontitis. Mechanisms by which diabetes may contribute to periodontitis include vascular changes, neutrophil dysfunction, altered collagen synthesis, and genetic predisposition. Minimizing plaque and calculus in the oral cavity through careful self-care and regular professional care is important to reduce the risk of periodontitis in diabetics.

Adult↗
PubMed1993

Long-term control of diabetes mellitus and periodontitis.

The purpose of this study was to evaluate the association between long-term control of diabetes mellitus (DM) and periodontitis. A total of 75 diabetics (Type I or II) aged 20-70 years with long-term records of their diabetic control were selected for the study. The following periodontal variables were recorded in a randomized half-mouth examination: plaque, calculus (+/-), probing depth (pd) and attachment loss (al). The mean of glycosylated hemoglobin measurements (HbAlc) over the past 2-5 years was used to indicate the long-term control of DM. The study participants were divided into well-, moderately- and poorly-controlled diabetics. An increase in the prevalence, severity and extent of periodontitis with poorer control of diabetes was observed. The extent of calculus also increased with poorer control. In a multiple regression analysis, calculus and long-term control of diabetes were significant variables when pd > or = 4 mm was used as the dependent variable. Age was a significant predictor for al > or = 3 mm but not for pd > or = 4 mm. Sex, duration and type of DM were not significant variables in the regression models. Less than 2% of sites with no calculus demonstrated pd > or = 4 mm. When calculus was present, the frequency of pd > or = 4 mm increased from 6% in the well-controlled diabetics to 16% in the poorly-controlled ones. We conclude that periodontitis in diabetics is associated with long-term metabolic control and presence of calculus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Periodontitis and tooth loss: comparing diabetics with the general population.

People with diabetes may be at increased risk for periodontal disease. This study compared the periodontal health of diabetic and employed adults. While tooth loss and gingival attachment was similar for both groups, diabetics had a greater prevalence and extent of periodontal pockets. Diabetics with poor metabolic control and calculus also had more periodontitis.

Adult↗
PubMed1993

Enzyme activity in crevicular fluid in relation to metabolic control of diabetes and other periodontal risk factors.

Diabetics are generally considered at higher risk for periodontitis than non-diabetics. Among diabetics, those with poorer metabolic control have often been found to have more periodontitis. This study investigated the relationship between two crevicular fluid enzymes, beta-glucuronidase (beta G) and lactic dehydrogenase (LDH), and metabolic control in 93 adults with type 1 or 2 diabetes. Metabolic control was evaluated by glycosylated hemoglobin (HbA1c) levels. The most visibly inflamed site was sampled for crevicular fluid enzymes and plaque for microbial assessment. Plaque, calculus, and probing depth were also recorded. Beta-glucuronidase was found at significantly higher levels in patients with poorer diabetic control while LDH levels were not related to control. Using multiple regression analysis, good metabolic control was the only predicting variable for beta-glucuronidase when considered with microbes, probing depth, plaque, calculus, age, duration, and type of diabetes. If beta-glucuronidase is a predictor of periodontal disease activity, diabetics with poor metabolic control are at higher risk for periodontitis.

Adult↗
PubMed1991

Variations in the prevalence and extent of periodontitis.

A national survey of employed adults showed a decrease in the extent and severity of periodontal disease in comparison with findings from earlier studies. Using data from that survey, this report evaluates the association of socioeconomic factors--race, education, income and dental insurance, as well as most recent dental visit--with the prevalence and extent of periodontal disease. Periodontitis was more prevalent and usually more extensive in persons who are black, have less education or had not seen a dentist in three or more years. Having dental insurance was not associated with better periodontal health.

Adult↗
PubMed1990

Evaluating periodontal status of US employed adults.

A national survey of employed adults was conducted by the National Institute of Dental Research to provide more current epidemiologic information about dental disease. This report addresses one aspect of the survey's findings: periodontal status. Although almost all employed adults had experienced some loss of periodontal attachment, less than 13% had loss of attachment of 5 mm or greater. Gingival recession affected half of the population. The extent and severity of periodontal disease improved in comparison with findings from earlier studies.

Adolescent↗
PubMed1989

Periodontal diseases in the U.S. in 1981: prevalence, severity, extent, and role in tooth mortality.

Prevalence, severity, and extent of periodontal diseases as well as the role of periodontal diseases in tooth mortality are described for persons 19 years and older in the U.S. in 1981. The data were collected with a household probability sample of non-institutionalized persons living in the contiguous 48 states. Plaque and calculus scores were collected for six index teeth. All permanent teeth present and capable of being assessed were scored for gingivitis; pocket depths were measured on the mesial of each tooth with a periodontal probe. Examinations were conducted by trained dentists calibrated on specific criteria. Only 15% of persons in the U.S. in 1981 were free from any sign of periodontal diseases. Periodontitis (pockets greater than or equal to 4 mm) affected approximately 36% of the population. Advanced periodontitis (pockets greater than or equal to 6 mm) was present in 8% of the population and was usually found on only one or two teeth when present. End-stage periodontal destruction requiring extraction of teeth was found in only 4% of all persons while less than 20% of all missing teeth were listed as missing due to periodontal disease.

Adult↗
PubMed1989

An estimate of periodontal treatment needs in the U.S. based on epidemiologic data.

It has generally been assumed, based on previous epidemiologic and utilization studies as well as the increasing elderly population, that there would be an increasing need for periodontal treatment. Analysis of a more recent household epidemiologic survey conducted in 1981 indicates that the need for treatment of periodontitis is less than previous estimates. These epidemiologic data have been translated into treatment needs through a series of conversion rules derived from previous studies and current patterns of treatment, and applied to the 1985 U.S. population. The total periodontal services needed for scaling, surgery, and prophylaxes would require 120 to 133 million hours and $5 to $6 billion annually if the total population were treated for periodontitis over a 4-year period. Only 11% of the total hours needed would be for scaling and surgery whereas 89% would be needed for prophylaxes. Expenditures for periodontal treatment total approximately 10% of the amount being spent on dental care in 1985. On the basis of these data, it seems unlikely that there will be a substantial increase in the need for periodontal treatment in a growing and aging U.S. population. These figures represent the upper limits of treatment need and are reduced by factoring in current utilization of periodontal treatment.

Adult↗