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Effects of herbivorous snails and macroalgal canopy on recruitment and early survivorship of the barnacle Semibalanus balanoides (L.).

This study investigated the effects of grazing by the herbivorous snail Littorina littorea (L.) and the presence of a macroalgal canopy on recruitment and early survivorship of the barnacle Semibalanus balanoides (L.) at four sites of various distances from the mouth of Toothacher Cove on Swans Island in the Gulf of Maine in 1998. Recruitment plates were attached to the substrate at each site in all possible treatment combinations, including either presence of absence of macroalgal canopy, presence or absence of the herbivore, and presence or absence of a cage. Significant differences in recruitment were observed among sites in April and May, but not in June. The average number of recruits also varied significantly among herbivore treatments in May and June, and in the May macroalgaexherbivore interaction. Survivorship did not differ among sites, but did vary significantly among herbivore treatments. These differences were due almost entirely to consistently low recruitment and survival in the uncaged or open controls. Comparisons of the caged and open treatments explained between 88 and 99% of the variation in the respective main effects tests. The presence or absence of L. littorea or of macroalgal canopy had little effect on S. balanoides recruitment or survivorship. Results support previous conclusions that recruitment is greater on more exposed shores and suggest that exclusion cages may protect barnacle recruits from factors such as desiccation and the whiplash effect of macroalgal fronds.

Journal Article↗

[Mechanisms by which acute orofacial pain becomes chronic].

Pain is a complex, multidimensional experience encompassing sensory-discriminative, cognitive, emotional and motivational dimensions. These dimensions in the orofacial region have particular expression since the face and mouth have special biological, emotional and psychological meaning to each individual. Orofacial pain is frequent. Epidemiological studies reveal a high prevalence of severe pain in syndromes such as temporomandibular disorders (TMD), burning mouth syndrome and toothaches, as well as an important role of psychosocial influences, contributing to the persistence of these syndromes. Many of the difficulties experienced by clinicians with the diagnosis and management of acute and chronic orofacial pain stem from a lack of recognition and understanding of these complex conditions, the various intricate bio-psycho-social interactions and the neurobiology behind the chronicisation of acute pain. This text strives to review the important advances and insights into the peripheral processes by which noxious stimuli activates or modulates nociceptive afferent input into the brainstem, the neural pathways in the brainstem and higher levels of the trigeminal (V) somatosensory system and the mechanisms involved in the plasticity of nociceptive transmission. We shall link this knowledge to clinical correlates and suggest a therapeutic approach in acute orofacial pain, in the attempt to avoid the development of chronic pain.

Acute Disease↗

Effects of injury and inflammation on pulpal and periapical nerves.

Several studies dealing with the reactions of dental nerve fibers to injury and inflammation are reviewed in this article. The subgroup of dental nerve fibers that contains calcitonin gene-related peptide (CGRP) was examined by immunocytochemistry at various times (1 to 35 days) after one of three degrees of injury: (a) Mild: Four days after making shallow cavities into cervical dentin of first molars of anesthetized adult rats, we found that CGRP fibers had sprouted into the subjacent odontoblast layer and dentin, and then returned to normal by 3 wk. (b) Intermediate: If the cervical cavities were acid etched, we found damage to the odontoblast layer, microabscess formation, and sprouting of CGRP fibers near the abscess, with subsequent formation of reparative dentin and healing. (c) Severe: If the pulp was exposed, a variety of reactions could occur, the most prevalent of which was a severe necrosis leading to development of periapical lesions. Analysis of the progressive stages of pulpal abscess and necrosis showed sprouting CGRP nerve fibers (a) at the retreating interface between abscess and vital pulp; (b) in periapical areas during onset of lesions; and (c) around chronic abscesses in granulomatous periodontal tissues. These studies are discussed in relation to various dental clinical problems such as hypersensitive teeth, episodic toothache, early onset of periapical lesions, dental anesthesia, and possible roles for sensory fibers and neuropeptides in tissue defense and healing.

Animals↗

Poisoning with equine phenylbutazone in a racetrack worker.

Phenylbutazone is a potent nonsteroidal, anti-inflammatory drug often used by veterinarians to treat racetrack animals. Its use in human beings is limited because of significant adverse effects and the availability of newer, safer drugs. We report the case of a 24-year-old man who ingested 17 g of equine phenylbutazone over a 24-hour period to treat the pain of a toothache. He developed grand mal seizures, coma, hypotension, respiratory and renal failure, and hepatic injury. Serum phenylbutazone concentration obtained approximately eight hours after presentation was 900 micrograms/mL. The patient recovered during six weeks of intensive supportive care and repeated hemodialysis.

Acute Kidney Injury↗

Comparisons between inner-city and private school adolescents' perceptions of health problems.

A youth health survey was administered to 247 students in an inner-city ghetto high school and 404 students in a private boarding school. Significant differences between the two socioeconomic groups were found for responses about health information, health concerns and problems, and health status and service utilization. Sex-related issues were of greater concern to the private school youth and they desired more help with depression-sadness and birth control. Inner-city youth had more health worries and indicated a desire for more help with physical problems such as toothaches, headaches, and stomach aches, and social problems such as racial discrimination and parent relations. From a list of 22 health problems, the inner-city youth ranked dental problems, acne, and health worries highest while the private school youth ranked depression-sadness, tiredness, and acne highest. Regardless of social class, most adolescents perceived large gaps in their health education. One implication of our data is that the specific self-reported needs and concerns of adolescents should be considered in planning health services and education programs.

Adolescent↗

[The prevalence of caries and associated factors in children 2-5 years old from the Almanjáyar and Cartuja Health Centers of the capital Granada].

OBJECTIVE: To estimate caries prevalence and associated factors in children 2-5 years old in a deprived community. DESIGN: Transversal, cross-sectional study. SETTING: Paediatric services. Health centres of Almanjáyar and Cartuja in Granada (Spain). PATIENTS: 173 children attending to a pediatric revision. MEASUREMENTS: Children's odontological examination and revision of clinical records followed by structured interview with the mother or tutor. Target variables were caries, sociodemographic factors, nutritional habits, oral hygiene, medical antecedents, familiar experience of caries and use of dentistry services. RESULTS: Total prevalence of caries was 37%, but 29% among the majority population and 58% in the gipsy group. Statistically significant associated factors with caries were: increasing age (OR = 2.0, 95% CI = 1.2-3.2), father unemployment (OR = 3.1, 95% CI = 1.3-9.9), high consumption of sweets (OR = 3.3, 95% CI = 1.1-8.5), deficient oral hygiene (OR = 9.3, 95% CI = 3.4-24.7), mother's consultation for toothache or tooth extraction (OR = 2.9, 95% CI = 1.1-7.9) and not attendance to dentistry services due to high costs or fear (OR = 4.3, 95% CI = 1.5-12.4). CONCLUSIONS: The prevalence of caries in the gipsy population is very high, and it is probably associated with factors previously reported but not yet controlled. There is a need to initiate therapeutic and preventive measures in this community, and to detect barriers and facilitate the use of public dentistry services.

Analysis of Variance↗

Orofacial pain-related communication patterns: sex and residential setting differences among community-dwelling adults.

This study documented orofacial pain-related communication patterns among community-dwelling dentate adults, health care providers, and persons in the respondent's social network. We report communication patterns for orofacial pain by symptom (toothache pain, pain when chewing, temperature sensitivity of the teeth, painful oral sores, and jaw joint pain). The subjects for the study were 724 participants in the 42-month interview of the Florida Dental Care Study, a longitudinal study of oral health among dentate adults, age 45 and older at baseline. The data were collected using a standardized telephone interview. Pain was more likely to be discussed with a lay consultant (41-66% depending on the symptom) than a health care professional (21-62%). Consistent with studies that report females tend to rely on social networks to cope with pain, more female respondents than males reported having talked to a lay consultant about orofacial pain for most of the symptoms. We also found that rural Black adults were less likely to speak to a health care professional about their orofacial pain. The findings highlight the importance of family, friends, and neighbors within the lay consultation and support network for persons with pain. Recent interest in self-care and the use of complementary and alternative approaches to treatment suggest the importance of considering influences acting within the environment of persons with pain.

Aged↗

Some herbal remedies from Manzini region of Swaziland.

In this paper, recipes for 41 herbal remedies used for treating 25 illnesses in traditional medicine in Swaziland are reported. Preparation of the herbal remedies involved the use of different parts of 47 species from 32 families, some of which have never been described previously in the flora of Swaziland. Descriptions of the plants used, the preparation of each remedy, dosage, route of administration and medical uses are reported. Some of the diseases the remedies are used to treat include asthma, backache, candidiasis, cardiac problems, cough, diarrhoea, dizziness, eye problems, constipation, menorrhagia, painful shoulders, scabies, threatened abortion, toothache, ulcers and vomiting among others. The remedies were obtained from traditional medical practitioners (TMPs) in an ethnomedical survey carried out in the Manzini region of Swaziland. Voucher samples of the plants used for the remedies were collected, identified and deposited in the National Herbarium of Swaziland.

Eswatini↗

In vitro neuropharmacological evaluation of piperovatine, an isobutylamide from Piper piscatorum (Piperaceae).

Piperovatine, a sialogogic, piscicidal, and buccal local anesthesia producing isobutyl amide from the amazonian piscicidal and toothache-relieving plant, Piper piscatorum Trelease et Yuncker (Piperaceae), was evaluated for its ability to induce changes in neuronal intracellular calcium concentration. Ratiometric calcium imaging of Periplaneta americana neuronal cell cultures upon piperovatine application revealed that this compound induced dramatic increases in intracellular calcium concentration. Calcium flux was not affected by co-application of the muscarinic acetylcholine receptor antagonist, atropine, indicating that the parasympathomimetic system was not involved in piperovatine's sialogogic actions. Calcium flux was, however, totally eliminated by co-application of the voltage-gated sodium channel blocker, tetrodotoxin (TTX). This, in conjunction with the repetitive calcium spikes observed in the assay and previous radioligand binding studies on the chemical class, strongly suggest that activation of voltage-gated sodium channels characterizes piperovatine's mode of action

Animals↗

Retrospective denial of emergency department payments is inappropriate.

Third-party payers typically use patients' discharge diagnoses to determine "appropriate" Emergency Department (ED) usage. This analysis compared the resource intensity involved in ED evaluation for "inappropriate" and all other ED visits. In this retrospective database review, 11 discharge diagnoses (DX11) (chronic nasopharyngitis; chronic sinusitis; chronic pharyngitis; rhinitis; constipation; head cold; hemorrhoids; toothache; flu; headache; and tension headache) were identified by a third party payor as being "inappropriate" for ED evaluation. The chief complaints of all patients seen in 1994 and 1995 with one of the DX11 were identified along with their E & M billing level, ED length of stay (LOS), and the frequency of consultation. In this urban, university trauma center, 1994 and 1995 visits totaled 120,402. Eighty-two different chief complaints were associated with a final diagnosis of DX11; 79% of all ED patients presented with one of the chief complaints (AllCC). Four percent of patients with DX11 were admitted, and the AllCC group had comparable resource utilization to the entire ED population. Patients' presenting complaints are incapable of predicting diagnosis or disposition. Retrospective denial of payment by discharge diagnosis is inappropriate.

Emergency Service, Hospital↗

Mandibular pain as the leading clinical symptom for metastatic disease: nine cases and review of the literature.

BACKGROUND: Metastases to the jaws are a rare phenomenon. Nevertheless, the appearance of non-specific symptoms such as toothache can signal the onset of neoplastic disease in some patients. PATIENTS: In this article, we present details of a 74-year-old patient with a history of breast cancer to illustrate this point. Retrospectively, covering a time span of one year, we could identify nine patients (1.2%) with metastatic disease to the mandible out of a total of 763 patients referred to our Maxillofacial Surgery department with non-specific jaw pain. RESULTS: Four patients were subsequently diagnosed as having breast cancer, two had lung cancer, one prostate cancer, one renal cell carcinoma and one adenocarcinoma of unknown primary site. Only three of these patients had documented tumor spread to bones before the onset of jaw pain. In the other patients, the dental symptoms were either the first sign of a generalized neoplastic disease, or indicated relapse of disease after long term disease free interval. However, further work up disclosed generalized tumor spread with additional organ- or bone-lesions in all patients, and the median survival was only six months (range 3.5(-)+22) from diagnosis. CONCLUSION: Pain of uncertain origin in the jaws should alert clinicians to the potential of metastatic disease in patients with a history of cancer and a bone scintigraphy should be done to rule out metastatic involvement. Although metastatic lesions in this area usually herald generalized neoplastic spread according to our experience, prompt diagnosis nevertheless can lead to useful palliation and an enhanced quality of life.

Aged↗

Chronic oral disadvantage, a measure of long-term decrements in oral health-related quality of life.

UNLABELLED: Few studies have investigated the relation between oral health-related quality of life (HRQL) and key demographic, socioeconomic, and oral health decrements. METHODS: Data were taken from 873 participants from the Florida Dental Care Study. Chronic oral disadvantage was defined from incident oral disadvantage, a measure of oral HRQL, reported for a minimum of two consecutive 6-month intervals. Patterns of chronic oral disadvantage over the 24-month period were described. Associations between the dependent variable, chronic oral disadvantage, and demographic variables, socioeconomic variables, oral health decrements, and dental services were evaluated. RESULTS: During 24 months of follow-up, 30% of subjects reported chronic oral disadvantage. Chronic oral disadvantage was significantly associated with approach to dental care, area of residence, situation if faced with an unexpected dollars 500 dental bill, teeth that are stained or look bad, cavities, sore or infected gums, loose tooth or cap, toothache or abscess, dental sensitivity, and chewing difficulty. A recent dental visit was associated with reduced progression to chronic oral disadvantage. CONCLUSION: A large proportion of subjects avoided certain daily activities due to oral health decrements for longer than 6 months. Recent dental visits were significantly associated with limitation of long-term progression of oral disadvantage.

Aged↗

An assessment of oral self-care level among Japanese dental hygiene students and general nursing students using the Hiroshima University--Dental Behavioural Inventory (HU-DBI): surveys in 1990/1999.

PURPOSE: The purpose of this study was to determine the differences in oral self-care levels between Japanese dental hygiene students and general nursing students in 1999, and compare them with a similar study in 1990. METHODS: The examination was mainly based upon responses to a questionnaire titled "Hiroshima University--Dental Behavioural Inventory (HU-DBI)". Higher scores of the HU-DBI indicate better oral health attitudes/behaviour. RESULTS: The mean HU-DBI score of the 2nd-year dental hygiene students was significantly greater than that of the 2nd-year nursing students (9.56 and 6.65, respectively; p<0.001), and much higher than those of the 1st-year students at each course (dental hygiene course; 6.30, nursing course; 5.88). Except for the 2nd-year dental hygiene class, there were no significant differences in the HU-DBI score between the 1990 and 1999 subgroups of each class. About 1/3 of the 2nd-year nursing students reported a belief that they may eventually require false teeth, while 6% of the 2nd-year dental hygiene students held this belief. More than 60% of this study sample stated that they put off going to the dentist until they had toothache. The 2nd-year dental hygiene students were more likely to have this attitude than their 1990 peers. Flossing was not popular among the nursing students in either 1990 or 1999. CONCLUSION: Although the difference in the HU-DBI score across time was not major, the variation in HU-DBI and the favourable attitudes/behaviour toward oral health appeared to reflect the differences in schooling between student hygienists and student nurses.

Adolescent↗

Shining teeth in prosperous Germany.

Healthy teeth are very important in the RAF as a nagging toothache could jeopardise a crucial mission. Air force DSAs stationed in Germany are trained to sit the UK National Certificate. Examinations take place twice a year, and last November Michael Austin flew out to test nine hopeful candidates.

Educational Measurement↗

Dental treatment in Anglo-Saxon England.

Anglo-Saxon medical literature suggests that care of the teeth was largely limited to non-invasive treatment. Cures, mainly for toothache, were based on herbal remedies, charms and amulets. Herbal potions also treated oral problems as diverse as caries and facial deformities. However, surgical intervention for cleft lip is mentioned in the later documents. Skeletal evidence confirms that cleft lip and palate was definitely known to the Anglo-Saxons. A possible dentist's grave has been identified.

Cleft Lip↗

Oral health behaviour of 12-year-old children in Kuwait.

OBJECTIVES: The objectives of the study were: (1) to describe the pattern of oral health behaviour of 12-year-old children in Kuwait, (2) to analyse this in relation to parental education, dental visiting habits and location, and (3) to establish a baseline for planning and evaluation of an oral health care programme for secondary schoolchildren. DESIGN: Cross-sectional, interviews with children in 1995. SAMPLE AND METHODS: The sample included 500 12-year-old schoolchildren (250 boys and 250 girls) selected from schools in Kuwait. All the children agreed to take part. Interviews with the children were carried out in the schools by four trained and calibrated Arabic speaking interviewers. RESULTS: During the previous 12 months, 28% of the children had experienced oral health problems--toothache (10%), or had felt discomfort (18%) either often or occassionally. The children reported that they needed oral hygiene instruction (71%), fillings (32%) and tooth extraction (23%). For 53% of the children the reason for the most recent visit to a dentist was pain or problems with teeth or gums. At their last dental visit 26% of the children had undergone a tooth extraction. The consumption of sugary foods and drinks was extremely high. Children who had visited a dentist within the last 12 months and children whose parents had higher education levels more often claimed frequent toothbrushing than those with no previous dental visiting experience and those whose parents had a low level of education. CONCLUSIONS: Oral health education and oral health care programmes should be established in secondary schools in Kuwait to influence the oral health behaviour of the children and to avoid further deterioration in their oral health.

Child↗

Phantom tooth pain: a new look at an old dilemma.

UNLABELLED: The aim of this paper is to review the current knowledge of phantom tooth pain, a neuropathic facial pain disorder, thought to result from peripheral nerve injury. Phantom tooth pain is a deafferentation pain disorder of persistent toothache in teeth that have been denervated (usually by root canal treatment) or pain in the area formerly occupied by teeth prior to their extraction. The pain usually extends to the facial structures adjacent to tissues that have undergone deafferentation. The clinical characteristics, differential diagnosis, epidemiology, and treatment of phantom tooth pain are reviewed. Suggestions for further research include the need for controlled treatment trials and modification of current criteria. CONCLUSIONS: Phantom tooth pain has much in common with other phantom pain disorders. In the absence of controlled clinical trials specifically directed to phantom tooth pain, treatment should be guided by standards used for other neuropathic pain disorders. Revised diagnostic criteria for phantom tooth pain are proposed.

Journal Article↗

Necrotizing fasciitis of odontogenic origin in Ibadan, Nigeria.

We reviewed eight patients with necrotizing fasciitis of odontogenic origin. There were three women and five men, mean age 58 (range 46-72), and none had any associated medical condition such as diabetes. All cases had symptoms of toothache for a mean duration of 34 days (range 26-42) before they sought treatment. Infection originated in the molar teeth region, and initially presented as an odontogenic or periodontal abscess. The clinical features of necrotizing fasciitis became apparent only after the superficial fascia had been invaded. The transient unusually reddish hue for a dark skin might be explained by the fact the deep fascia and muscles were affected before the superficial fascia and skin. Necrosis of the skin began in the submandibular region and progressed downwards. The necrotic area was less than the extent of infection. Antimicrobial treatment, debridement, and fasciotomy improved healing. Delay before appropriate treatment had an adverse affect on outcome, and one patient died.

Aged↗