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Biomedical subjects

S M Nainar

Publications and source records attributed to S M Nainar.

At least 19 recordsLinked to original sources
PubMed2001

Dental management of children with latex allergy.

This paper reviews the aetiology, epidemiology and dental management of children with latex allergy. The issue of latex allergy has serious consequences for the dental management of children with one or more of the following risk factors: spina bifida, atopy, first surgery before one year of age, history of multiple surgical procedures, congenital urologic abnormalities, gastrointestinal malformations, hydrocephalus internus, ventriculo-peritoneal shunts, spinal cord injuries, and family history of atopy. Management of latex allergy is based upon the diligent avoidance of latex exposure. Universal use of powder-free low-allergen latex gloves is recommended.

Child↗
PubMed1994

Fluoride profile in mature unerupted enamel following removal of surface organic material.

The aim of the present study was to determine fluoride profiles in mature unerupted enamel following removal of the surface organic material. Thirty teeth were randomly allocated into three groups. The surface organic material (Nasmyth's membrane) was left intact in group I; it was removed by tooth-brushing in group II, and in group III the surface organic layer was removed along with subsurface organic material by deproteinizing. Each tooth was then sectioned into halves and a standardized biopsy area was created. Initially alkali-soluble fluoride was extracted with 1M KOH followed by acid etch analysis to measure the remaining fluoride. No difference was seen in the alkali-soluble fluoride levels but residual fluoride concentrations were significantly reduced (p < 0.05) after deproteinizing but not after toothbrushing. It would appear that a substantial amount of fluoride (approximately 25%) in mature enamel from unerupted teeth can be removed by a deproteinizing agent, which may suggest an association of this fluoride with subsurface organic material.

Acid Etching, Dental↗
PubMed1989

Incidence and etiology of midline diastema in a population in south India (Madras).

In a cross-sectional study of midline diastemas in a South Indian (Madras) population, 9,774 patients aged 13-35 years were screened. True midline diastema was defined as one without periodontal/periapical involvement and with the presence of all anterior teeth in the arch. Sample purification resulted in a research sample of 166 patients with true midline diastemas. The incidence of true maxillary midline diastema (160/9774-1.6%) was greater than that of true mandibular midline diastemas (31/9774-0.3%). No direct etiologic factor for the midline diastemas was noted. Spacing in the anterior region was the most significant factor associated with the midline diastema.

Adolescent↗
PubMedDate not supplied

Pediatric dental practice: reconstruction or disintermediation.

The objective of this study was to evaluate ongoing changes in contemporary pediatric dental practice. The impact of demographics, gender, generational values and debt load of the 1990s practitioner is reviewed. The role of overhead expenses, third party payers, business practices, dental management service organizations and business training of practitioners are analyzed. The influence of technological changes on clinical practice is described. In conclusion, there is a need for zero-basing and reconstructing pediatric dental practices.

Career Choice↗
PubMedDate not supplied

Web site setup for pediatric dentists: a framework.

The objective of this paper is to describe a framework for the development of a simple web site for pediatric dentists. The four steps--domain name registration, web site hosting, web site design and web site publishing--are detailed. A pediatric dental web site can be created and maintained for less than $300 per annum.

Humans↗
PubMedDate not supplied

Profile of Journal of Dentistry for Children and Pediatric Dentistry journal articles by evidence typology: thirty-year time trends (1969-1998) and implications.

PURPOSE: This study was performed to assess the profile of Journal of Dentistry for Children and Pediatric Dentistry journal articles by evidence typology and measure their changes over a thirty-year period (1969-1998). METHODS: All issues of both journals during the study period (1969-98) were manually reviewed. The publications were ranked by the quality of the evidence. Editorials, letters to the editor, abstracts, and organization-related communications were excluded from consideration. The publications were analyzed by journal and also by decade of publication, i.e., 1969-78, 1979-88 or 1989-98. RESULTS: There were 2848 publications included in the data set with descriptive studies, case reports, etc. comprising the majority (71%). No distinctive trends in the evidence typology were detected over the decades in either journal. CONCLUSION: There is a need to improve the quality of the evidence in the two pediatric dental journals reviewed.

Case-Control Studies↗
PubMedDate not supplied

Dentists' ranking of Medicaid reimbursement rates as a measure of their pediatric Medicaid participation.

The objective of the study was to determine the usefulness of dentists' ranking of Medicaid reimbursement rates as a measure of their participation in the Medicaid program for children. Data were obtained from two mail-in questionnaire surveys of Connecticut dentists, before and after an increase in Medicaid reimbursement rates for children. Dentists ranked acceptability of Medicaid reimbursement rates on a seven-point index, while their participation in the Medicaid program was assessed by whether they acknowledged treating Medicaid children and were currently accepting new Medicaid children into their practices. There was a significant difference (p < 0.0001) in the dentists' ranking of Medicaid reimbursement rates following the rate increase indicating that the index was responsive. Acceptance of new Medicaid children into dental practices was a better measure of active participation in the Medicaid program. Following the increase in Medicaid reimbursement rates, dentists ranking it as acceptable/equivocal were more likely (p < 0.02) to accept new Medicaid children into their practices. In conclusion, the index of dentists' ranking of Medicaid reimbursement rates was a responsive and valid measure of their participation in the Medicaid program.

Attitude of Health Personnel↗
PubMedDate not supplied

Economic implications of evidence-based caries prevention in pediatric dental practice: a model-based approach.

OBJECTIVES: This paper presents an economic model which can be used to assess the potential implications of evidence-based caries prevention in pediatric dental practice. METHODS: Assessment of the evidence indicated that most children in the United States were likely to experience dental caries, though the severity of the disease would be minimal in most of them. Based on the evidence, it was concluded that annual recall examination and topical fluoride application would suffice as the norm for caries prevention. A model was developed to estimate the extent and cost of caries prevention in a traditional and an evidence-based pediatric dental practice. RESULTS: The model showed that evidence-based caries prevention resulted in a one-third decline in the number of recall examination visits provided, while the ensuing patient revenues from recall appointments declined by two-thirds in a calendar year. CONCLUSIONS: Evidence-based caries prevention will likely result in a significant decline in preventive services revenues and create additional capacity in pediatric dental practices. This economic impact will likely be absorbed by the current undersupply of pediatric dentists and by the reformulation of practice revenue streams.

Appointments and Schedules↗
PubMedDate not supplied

Profile of pediatric dental literature: thirty-year time trends (1969-1998).

The objectives of this study were to determine the importance of the various areas of research interest in the pediatric dental literature and to measure their changes over a thirty-year period (1969-98). The Journal of Dentistry for Children and Pediatric Dentistry were reviewed by direct physical reference review and the publications categorized by research area. Frequency distribution and time series analyses were performed. There were 2.848 publications included in the study. Oral medicine, pathology and surgery remained the largest research area throughout the study period accounting for one-third of the publications. Time trends showed an increase in the following research areas: health services research; and pharmacologic behavior management; and an decrease in the following research areas: child behavior and nonpharmacologic behavior management; dental trauma; growth and development and orthodontics; and pulp therapy and medicaments. Time series analysis showed a strong negative correlation between the proportion of publications listed under pharmacologic behavior management, and child behavior and nonpharmacologic behavior management. In conclusion, pediatric dental literature reflected the trends in clinical practice.

Dental Research↗
PubMedDate not supplied

Child patient behavior: a new perspective.

All behavior depends on responses of the nervous system (Shepherd 1988). Alkon demonstrated physical changes in the nervous systems of Hermissenda crassicornis and rabbits at the molecular level following behavioral conditioning. This physical change resulted in a reduced flow of potassium ions across the neuronal cell membrane for some time, with resultant enhanced excitability during this period. It is suggested that behavioral deterioration in children during sequential dental visits might be the result of a reduced potassium ion flow across the neuronal cell membrane, with resultant enhanced excitability during this period. Alkon also reported that in a "conditioned" stimulus, information flows along a "collateral pathway" formed in the course of the learning experience. It is hypothesized that behavioral improvement in children following positive dental experiences (model learning and desensitization) may be due to the information of the "conditioned" dental stimulus flowing along a "collateral pathway" formed in the course of the learning experience.

Child↗
PubMedDate not supplied

Caries experience in inner-city preschoolers at the time of their initial dental visit.

This retrospective study examined caries experience in a population of inner-city preschoolers at their initial dental visit. Clinical and sociodemographic data for 103 patients aged five years and under at the time of their first dental visit were obtained from the dental records of an inner-city community health center clinic located in a fluoridated area. The sample consisted of fifty-eight males and forty-five females who were seen during a continuous six-month period in 1991. The mean age of the subjects was 44.1 months (S.D. +/- 10.5 months). Sixty-seven percent of the children in the sample were found to have caries. The mean number of decayed surfaces (ds) was 6.54 (+/- 7.16), with the following distribution by surface type: occlusal--2.89 (+/- 3.15); proximal--1.75 (+/- 2.91); buccal/lingual--1.90 (+/- 2.73). Caries prevalence and severity increased with age. Findings from this sample demonstrate that dental caries remains a significant problem in inner-city preschoolers, thereby underscoring the importance of early intervention programs.

Age Factors↗