Biomedical subjects

Walter J Psoter

Publications and source records attributed to Walter J Psoter.

17 recordsLinked to original sources

PubMed2006

Associations of ethnicity/race and socioeconomic status with early childhood caries patterns.

OBJECTIVES: The purpose of this project was to evaluate ethnicity/race, household income and caregiver education level as predictors of (1) any early childhood caries, and (2) each of four proposed patterns of primary dentition caries. METHODS: Between February 1994 and September 1995, five examiners visually examined Arizona pre-school children ages 5-59 months old. Self-reported demographic information including family income, caregiver education level and ethnicity/race were obtained at the time of examination. Multivariate analyses were conducted to assess the association of income, education and ethnicity/race with a child having any caries and with each of the proposed caries patterns seen in 3850 examinations. RESULTS: Income and education were inversely associated with: (1) any early childhood caries, and (2) the maxillary incisor caries pattern. A positive association between these caries patterns and minority ethnicity/race status was also identified. Three additional caries intraoral patterns demonstrated more varied associations with socioeconomic status (SES), ethnicity/race and income and education. CONCLUSIONS: This study supports the association of both ethnicity/race and social status with any early childhood caries. The patterns of caries were each found to be associated with specific and different socioeconomic-demographic indicators. The practical importance of these findings is that global measurement of ECC, without regard to specific caries pattern, leads to the potential for substantial non-differential misclassification of disease. The consequence of this is the potential for important ECC-SES-ethnicity/race associations to be masked. This, in turn, decreases the ability of surveys and investigations to accurately identify sub-groups of the population at greatest risk of developing ECC.

Arizona↗

PubMed2006

The Medical Reserve Corps. an opportunity for dentists to serve.

The response to the events of Sept. 11, 2001, relied on local resources and personnel. Aware of how important their contribution could be, many people are now inspired to volunteer during times of crisis. The Medical Reserve Corps is a community-based volunteer network of health professionals that trains to respond to large-scale emergencies.

Civil Defense↗

PubMed2006

Proposed educational objectives for hospital-based dentists during catastrophic events and disaster response.

The purpose of this project was to define education and training requirements for hospital-based dentists to efficiently and meaningfully participate in a hospital disaster response. Eight dental faculty with hospital-based training and/or military command and CBRNE (chemical, biological, radiological, nuclear, and explosive) expertise were recruited as an expert panel. A consensus set of recommended educational objectives for hospital-based dentists was established using the following process: 1) identify assumptions supported by all expert panelists, 2) determine current advanced dental educational training requirements, and 3) conduct additional training and literature review by various panelists and discussions with other content and systems experts. Using this three-step process, educational objectives that the development group believed necessary for hospital-based dentists to be effective in treatment or management roles in times of a catastrophic event were established. These educational objectives are categorized into five thematic areas: 1) disaster systems, 2) triage/medical assessment, 3) blast and burn injuries, 4) chemical agents, and 5) biological agents. Creation of training programs to help dentists acquire these educational objectives would benefit hospital-based dental training programs and strengthen hospital surge manpower needs. The proposed educational objectives are designed to stimulate discussion and debate among dental, medical, and public health professionals about the roles of dentists in meeting hospital surge manpower needs.

Bioterrorism↗

PubMed2006

The prevalence of pit and fissure sealants among twelve year olds living in Puerto Rico during 1997.

OBJECTIVE: to estimate the prevalence of pit and fissure sealants on first permanent molars in twelve year olds living in Puerto Rico and to further evaluate dental sealant prevalence by (1) urban/rural and public/private school status as well as (2) gender; DESIGN: population-based, cross-sectional study. SETTING: public and private schools encompassing the 11 health regions of Puerto Rico. SUBJECTS: a probabilistic sample of 12-year old school attendees in Puerto Rico representing a population of approximately 70,000. METHOD: during April through December 1997, the first permanent molars of 1435 subjects were evaluated by visual and tactile methods for the presence of dental sealants. RESULTS: the data collected revealed that 4.3% of 12 years olds presented at least one permanent first molar sealed. A statistically significant difference (p = 0.01) between urban-public (2.5%), rural-public (3.39%) and urban-private (11.0%) schools was observed. The prevalence of sealants was higher in males (5.5%) than females (2.9%); (p = 0.02). CONCLUSIONS: the prevalence of dental sealants in the first permanent molars of 12-year olds living in Puerto Rico during 1997 (4.3%) is lower than that reported in the United States (18.5%). Sealant prevalence was higher in males and students attending (urban) private schools.

Age Factors↗

PubMed2005

Sociodemographic risk indicators for depressive symptoms among persons with oral cancer or oral epithelial dysplasia.

PURPOSE: We report findings from a study that measured associations between sociodemographic risk indicators and depressive symptoms among individuals diagnosed with either oral cancer or a premalignant lesion. MATERIALS AND METHODS: Incident cases of oral cancer and oral epithelial dysplasia (OED) were identified by reviewing pathology reports generated by 3 oral pathology laboratories serving primarily community-based oral and maxillofacial surgeons. Subjects were interviewed by telephone to collect information on sociodemographic characteristics, depressive symptoms using the Center for Epidemiologic Studies-Depression (CES-D) Scale, and social support using the Berkman Social Network Inventory. RESULTS: The analysis included 167 oral cancer and 234 OED cases. Nineteen percent of the subjects had a CES-D score indicative of clinical depression (CES-D > or =16). Forward and backward stepwise logistic regression identified diagnosis (cancer/OED), age, social support, employment status, and gender as sociodemographic indicators of CES-D scores of 16+. In the final model, which also controlled for smoking and drinking, the odds of having elevated CES-D scores (16+) were 79% higher among oral cancer relative to OED cases. The odds of high CES-D scores were significantly reduced in persons over the age of 50 compared with those aged 50 years and younger as well as in persons with higher, relative to low, levels of social support and in persons employed outside the home compared with those who were not. Although not statistically significant, men were more likely to have CES-D scores indicative of clinical depression. CONCLUSIONS: Knowledge of sociodemographic characteristics may assist the clinician in identifying those individuals with an elevated risk of concomitant depressive symptoms.

Adult↗

PubMed2005

Dental caries in twelve- and fifteen-year-olds: results from the basic oral health survey in Haiti.

OBJECTIVE: Reports on oral health investigations in Haiti are sparse. There are only three peer-reviewed published articles on oral health in Haiti. In order to construct a national dataset useful for public health planning, a representative dental caries survey of Haitian school attending children was conducted in 1999. METHODS: This survey was conducted using a modified version of the World Health Organization (WHO) Basic Oral Health Survey (BOHS) pathfinder method. Children ages 12 and 15 years old attending public or private schools in both rural and urban regions were targeted in seven of the nine geographic Departments of Haiti: each Department constituted a strata that was further stratified into the major urban center and one or more rural towns. Four trained examiners, calibrated to WHO caries criteria, conducted the survey RESULTS: Of the total 1,218 examined 12- and 15-year-olds, 31% of the 12-year-olds and 46% of the 15-year-olds had a DMFS of 1 or more, i.e., these percentages are the simple prevalence levels of dental caries for those age groups in Haiti. Mean DMFS scores were 1.01 (SE 0.09) and 2.52 (SE 0.02) for the 12- and 15-year-olds, respectively. No difference was observed between gender, while differences were found by geographical classification. Less than 1% of the children had any dental restorations. CONCLUSIONS: The findings from this investigation suggest that at the population level, permanent dentition caries in early adolescence is a minimal health problem, relative to dental caries in other neighboring Caribbean countries, as well as to other health conditions in Haiti. However, at the individual level, those children afflicted with decay are without dental services for all practical purposes.

Adolescent↗

PubMed2004

Emergency preparedness in the dental office.

BACKGROUND: Terrorist activities now can be added to the list of possible man-made and nature-induced health and safety disasters that can affect a community. There are two basic responses that people can choose to protect themselves during these events. One is to evacuate the area, the other is to shelter in place. CONCLUSIONS: The authors provide an overview of the issues, present basic principles and increase the awareness of the dental profession to the various responses available in an emergency. The key issue is that families, dental offices and communities should plan ahead. Dentists should be cognizant of their professional role and help educate the public in regard to emergency issues. PRACTICE IMPLICATIONS: The uncertainties and stress of a potential terrorist attack can be mitigated somewhat by planning. These plans can be fairly basic, involving minimum equipment and supplies; however, they may go a long way to protect dental staff members, patients and families.

Communication↗

PubMed2004

Meeting a disaster's medical surge demand: can dentists help?

No one can deny that these are extraordinary times in world affairs. This is true not because there is turmoil in the world, which tends to be the norm, but because the problems in the world are dominated not by countries or religions, but by individuals and radical sects for whom life seems far too expendable. It is a time for each of us to determine how to respond to help protect our families. It is also a time for dentists to assess how they should respond to meet the additional demands placed upon them by way of their professional licenses and underlying responsibility to society. This article frames a set of commitments that the profession should consider assuming. It is related from the perspective of an institution that has taken an active role in societal protection from before Sept. 11, 2001, to the present. The discussion includes a description of the nature of medical surge demand and why the dental profession is uniquely positioned to assist in meeting this demand. The skill set of the dentist is highlighted in terms of triage ability, a role in bio-surveillance, the capacity to calm the "worried well," and community responsiveness. In addition, concepts like shelter in place and the Medical Reserve Corps are explained, and valuable reference sources and websites are provided.

Dentists↗

PubMed2003

Classification of dental caries patterns in the primary dentition: a multidimensional scaling analysis.

OBJECTIVE: Clinical patterns of early childhood caries (ECC) encompassing specific teeth or surfaces have been previously proposed on an a priori basis and have been used as case definitions. The underlying assumption is that the patterns result from different host response and environmental conditions. Identifying caries patterns has utility in refining case definitions of ECC. Well-defined caries patterns should enhance the ability of an analysis to identify meaningful associations between suspected risk factors and ECC. The purpose of this project was to identify patterns of caries in the dentition of preschool children using multidimensional scaling without a priori pattern delineation. METHODS: Between February 1994 and September 1995, five examiners visually examined 5171 Arizona preschool children aged 5-59 months old. Multidimensional scaling (MDS) was used as a classification/taxonomy technique to identify any underlying structure of the caries data. MDS provided a classification scheme for individual tooth surfaces based on the dissimilarity measures of squared Euclidean distance and of variance using an alscal analysis. Both two- and three-dimensional solutions were pursued; s-stress, stress, R-square and residual patterns were assessed in determining the best dimensional model, with the resulting quadrant positions of the tooth surfaces suggesting potential caries patterns. RESULTS: All models demonstrated excellent fit. Two- and three-dimensional solutions suggested four caries patterns: (i) any maxillary incisor surfaces, (ii) first molar occlusal surfaces, (iii) second molar pit and fissure surfaces, and (iv) any smooth surfaces, excluding the maxillary incisor surfaces. CONCLUSIONS: This is the first delineation of primary dentition caries patterns produced by a classification analysis without a priori pattern definitions. The identified caries patterns may arise from specific risk factors and/or be a function of the timing of various risk factor exposures. Use of these patterns as case definitions should enhance the ability to identify associations between suspected risk factors and ECC.

Child, Preschool↗

PubMed2003

Bioterrorism and catastrophe response: a quick-reference guide to resources.

BACKGROUND: Dentists' responses to catastrophe have been redefined by bioterrorism. Informed response requires accurate information about agents and diseases that have the potential to be used as weapons. METHODS: The authors reviewed information about the most probable bioterrorist weapons (those from the Center for Disease Control and Prevention's Category A) from the World Wide Web and print journals and distilled it into a resource list that is current, relevant to dentistry and noncommercial. The Web sites cited include those sponsored by federal agencies, academic institutions and professional organizations. The articles cited include those published in English within the last six years in refereed journals that are available in most higher education institutions. RESULTS: The authors present the information in a table that provides a quick-reference guide to resources describing agents and diseases with the greatest potential for use as weapons: anthrax, botulism, plague, smallpox, tularemia and viral hemorrhagic fevers. This article presents Web site and journal citations for background and patient-oriented information (fact sheets), signs and symptoms, and prophylactic measures and treatment for each of the agents and diseases. The table facilitates quick access to this information, especially in an emergency. This article also points out guidelines for response should a suspected attack occur. CONCLUSIONS: Armed with information about biological weapons, dentists can provide faster diagnosis, inform their patients about risks, prophylaxis or treatment and rethink their own role in terrorism response. CLINICAL IMPLICATIONS: Fast, accurate diagnosis limits the spread of exceptionally contagious diseases. Providing accurate information to patients minimizes misinformation and the associated public fear and panic that, unchecked, could overwhelm health care systems.

Anthrax↗

PubMed2003

Enhancing medical and public health capabilities during times of crisis.

Terrorist attacks and other catastrophic events will create demands that severely challenge the capacity of the medical/public health system. To meet the surge, a cadre of professionals should be trained to operate around the nucleus of medical/public health officials. At New York University, an inter-institutional team is considering specific roles for and an approach to training dentists to enable these health care professionals to supplement medical/public surge needs based upon informatics systems that provide critical information.

Delivery of Health Care↗

PubMed2003

Dental caries prevalence of twelve year olds in Puerto Rico.

OBJECTIVE: To assess the prevalence of dental caries amongst twelve-year old Puerto Ricans. DESIGN: Population-based, cross-sectional study. SETTING: Public and private schools in the 11 health regions of Puerto Rico. SUBJECTS: A probabilistic sample of 12-year old school attendees in Puerto Rico. METHOD: One thousand four hundred and thirty-five subjects were evaluated following NIDCR criteria and methodology for DMFS and DMFT indicators from a population of approximately 70,000 12-year olds during April through December 1997. RESULTS: The overall mean DMFS was 6.5 (SE 0.38) and ranged from 9.2 in the Central Region to 5.3 in the Metropolitan and West Regions. The mean DMFT was 3.8 (SE 0.18). The decayed component comprised 42% of the DMFS; caries prevalence for the population was 81%. CONCLUSION: The mean DMFS for twelve year olds is higher than the mean DMFS of 4.2 to 4.7, reported for 12 to 17 years olds in the USA. Dental caries is a highly prevalent disease amongst 12-year olds in Puerto Rico.

Child↗

PubMedDate not supplied

Removal torques of conical, tapered implant abutments: the effects of anodization and reduction of surface area.

PURPOSE: To examine the effects of anodization (surface coating) and reduction of internal Morse taper surface area on the reversal torque values of Straumann ITI dental implants and abutments. MATERIALS AND METHODS: Eighty ITI solid screw implants were mated with corresponding 5.5-mm solid abutments. The assemblies were divided into 4 test groups of 20 specimens. All abutments were torque tightened into the implant to 35 Ncm. Half of the abutments were anodized and half were in their as-machined state. Each of these 2 groups included half of the implants with the standard internal Morse taper configuration and half with the synOcta (Straumann USA, Waltham, MA) internal positioning interface (indexed). Torque removal testing was then performed on the assemblies. The 4 groups were compared statistically to examine the effect of the 2 variables (anodization and reduction in surface area). Scheffe's test for multiple comparisons was used to compare groups at an adjusted significance level of < or = .05. RESULTS: Torque removal of all specimens revealed that the indexed implant with the non-anodized abutment demonstrated superior removal torque. DISCUSSION: The indexed and standard implants with anodized abutments, and the standard implant with the non-anodized abutment had lower reversal torque values. CONCLUSION: The addition of the indexed internal surface to the ITI implant did not have deleterious effect on the resistance to loosening of standard solid abutments.

Coated Materials, Biocompatible↗

PubMedDate not supplied

Patient self-reported satisfaction with maxillary anterior dental implant treatment.

PURPOSE: Dental implants are accepted as a successful alternative to conventional fixed and removable prostheses for the treatment of partial or complete edentulism. However, there have been few studies of the success of implants from the patients' perspective. The purpose of this study was to assess patient overall satisfaction with the outcome of treatment with maxillary anterior implants. MATERIALS AND METHODS: A self-administered mailed questionnaire, which was developed for this project, and a data abstraction form, which was designed based on information available from the corresponding dental records of 123 eligible subjects, were utilized to survey implant patients. RESULTS: Seventy-eight of 123 eligible subjects responded to the mailed, self-administered, structured questionnaire. Twelve of the 24 questionnaire variables demonstrated statistically significant bivariate associations with the dependent variable "overall patient satisfaction." Five variables--implant position, definitive restoration shape, appearance, effect on speech, and chewing capacity--were strongly associated with overall satisfaction. No demographic or treatment-related, dental record-abstracted variable, of the 25 that were examined, was statistically significant. DISCUSSION: The practitioner who provides implant restorations should be aware of the multidimensional aspects of patient satisfaction with implant treatment. This study suggests that patient satisfaction with key elements influences the overall acceptance of maxillary anterior implant prostheses, which are esthetically critical. Communication between dentist and patient is important to achieve optimal results that will be satisfactory to both. Discussion of treatment limitations may also help patients to develop realistic expectations of the final result. CONCLUSIONS: In this limited investigation, patient satisfaction with implant position, restoration shape, overall appearance, effect on speech, and chewing capacity were critical for patient overall acceptance of the dental implant treatment.

Adolescent↗

PubMedDate not supplied

Median ages of eruption of the primary teeth in white and Hispanic children from Arizona.

PURPOSE: The purpose of this project was to establish median eruption ages of primary teeth and evaluate eruption differences between contralateral teeth by gender, ethnicity, and household income. Data was derived from a caries study of preschool children. METHODS: A total of 4,277 white (non-Hispanic) and Hispanic preschool children from Arizona were visually examined for caries and tooth eruption status by 5 examiners between February 1994 and September 1995. Analyses of eruption status were conducted using logistic regression to produce an eruption probability distribution from which median eruption ages for the primary teeth were determined. Possible differences in eruption timing between contralateral teeth by gender, ethnicity, and household income were examined. RESULTS: Eruption status of 1 tooth was significantly predictive of the pair-matched tooth for all pairs. Differences were found for the maxillary central incisor (gender) and the mandibular second molar (ethnicity). Eruption ages did not vary by household income. Median eruption ages for each of the 10 primary teeth are presented. CONCLUSIONS: This study provides contemporary median eruption ages for primary teeth.

Age Factors↗

PubMedDate not supplied

Preparing for a terrorist event: a scenario-driven approach.

Since September 11, 2001, government agencies on all levels have focused on planning and preparing to respond to another possible terrorist attack. In addition to emergency and medical issues, these agencies must be concerned about the public's behavior and psychological response when they plan the management of a bioterrorist event. We present readers with one such possible incident, a radiological bomb scenario, with the aim of educating dentists and communicating the risks involved.

Disaster Planning↗

PubMedDate not supplied

Historical evolution of primary dentition caries pattern definitions.

A variety of dental caries patterns encompassing differing teeth have been proposed, and their use may have utility in Early Childhood Caries (ECC) investigations by minimizing case misclassification. Recent reports have proposed multiple pattern schemes. The purpose of this paper was to review the historical evolution of ECC patterns to assist the clinician and researcher in understanding the strengths and limitations of contemporary caries pattern definition(s).

Dental Caries↗