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PubMed2002

Racial differences in orofacial pain.

This study investigated racial differences in the subjective report of orofacial pain in a stratified sample of adults dwelling in the community. The subjects were 724 participants in the Florida Dental Care Study, a longitudinal study of oral health among dentate adults aged 45 years and older at baseline. Pain prevalence and subjective ratings were assessed for a range of orofacial pain sites by means of a standardized telephone interview. The results suggest that white respondents were more likely to report painful oral sores than were black respondents (19.0% vs 6.3%). As was consistent with findings from patients seeking health care and laboratory-based experimental pain studies, a higher percentage of black subjects rated pain as severe enough to have an impact on behavior for temperature sensitivity (59.6% vs 30.3%), pain when chewing (70.0% vs 40.0%), and painful oral sores (53.8% vs 27.9%). These racial differences were most apparent within male sex for temperature sensitivity, pain when chewing, and toothache pain, with black men rating pain as more severe than white men. For jaw joint pain and painful oral sores, both black and white women rated pain as more severe than did white men. This study has documented race by sex interactions in the impact from orofacial pain across multiple symptoms in a community-based sample.

Journal Article↗
PubMed2003

Dental complaints in emergency departments: a national perspective.

STUDY OBJECTIVES: Using nationally representative data, we sought to describe the incidence of emergency department (ED) visits for dental-related complaints for children and adults in the United States. We hypothesized that dental-related ED visits were more likely than other ED visits to have Medicaid or no insurance as the payer. METHODS: We used data from the 1997 to 2000 National Hospital Ambulatory Medical Care Survey, a national probability sample survey of hospital ED visits that is conducted by the National Center for Health Statistics. From these data, all ED visits in which one of the reasons for the visit was toothache or tooth injury were compiled and used to determine national estimates of counts and rates of ED visits for dental-related complaints. Logistic regression analysis on the outcome variable, presentation to the ED with a dental complaint (versus other problem), was performed to determine the association with payer and other covariates. RESULTS: During the 4-year period from 1997 to 2000, there were an estimated 2.95 million ED visits in the United States for complaints of tooth pain or tooth injury, for an average of 738,000 visits annually. Population-based rates and proportion of all ED visits for dental complaints were highest in the 19- to 35-year-old group, accounting for 1.3% of all ED visits and 5.6 ED visits per 1,000 people in this age category. "Dental problem, not otherwise specified" was the most commonly assigned International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis. Multivariate logistic regression results indicated that the adjusted odds of presentation to the ED for a dental complaint compared with other problems were significantly elevated for visits in which Medicaid or self-pay was listed as the payer relative to those with private insurance. CONCLUSION: EDs are an important point of care for dental-related complaints, particularly for individuals who lack private insurance. ED providers should be equipped to triage, diagnose, provide basic treatment, and ensure appropriate follow-up care for dental problems, which may require enhancement of dental training for emergency medicine providers and improved dental care during and after ED visits.

Adolescent↗
PubMed2000

Familial hypophosphatemic vitamin D-resistant rickets: dental findings and histologic study of teeth.

A case of familial hypophosphatemic vitamin D-resistant rickets or X-linked hypophosphatemia (XLH) accompanied by specific systemic and dental findings is reported. A 15-year-old boy with XLH visited our facility complaining of a toothache in the left lower canine region. Two other family members of the patient, his younger sister and their mother, also had XLH, whereas the other 2 members, his younger brother and father, are healthy. Those with XLH show systemic signs of the disease, such as growth retardation, limb deformity, and spinal curvature disorders; however, these symptoms are more severe in the patient than in the others. The patient had multiple periodontal abscesses, but no evidence of dental caries, trauma, or periodontal disease on the corresponding teeth at the time of his oral examination. A radiographic examination showed root dysplasia and enlarged pulp chambers.A histologic examination of an extracted third molar showed marked globular dentin and an increased predentin width. The abscess was thought to be caused by pulpal infection, which came from bacterial invasion through enamel cracks and dentinal microcleavage of the teeth. The treatments provided in this case are discussed.

Adolescent↗
PubMed2005

Self-assessed dental health, oral health practices, and general health behaviors in Chinese urban adolescents.

The objectives of this study were: to describe perceived dental health status and oral health-related knowledge, attitudes, and behavior in Chinese urban adolescents; to assess the associations of oral health variables with socio-economic status and school performance; and to analyse the relative effect of socio-behavioral risk factors on perceived dental health, perceived need for dental care, and experience of dental symptoms. A cross-sectional survey of 2662 adolescents was conducted in eight capital cities in China; the response rate was 92%. The study population was chosen by multistage cluster sampling and covered three age groups: 11, 13, and 15 years. Data on dental and general health were collected by self-administered questionnaires. Self-assessment of dental health of Chinese adolescents was generally good, only 12% of the students answered that their teeth were "poor" or "very poor", and 9% claimed having "poor" or "very poor" gums. Eleven percent of participants said that other students made fun of their teeth; 24% of the respondents were dissatisfied with the appearance of their teeth, and 41% claimed that they had experienced toothache or symptoms during the previous 12 months. Positive attitudes towards dental care were found in all age groups; 67% of adolescents brushed their teeth at least twice a day and 48% of the students used fluoridated toothpaste. Only 26% of the students visited a dentist during the previous 12 months. In all, 6% of the adolescents had tried cigarette smoking at least once, while 41% reported having tasted alcohol drinks. Multivariate regression analyses showed that perceived dental health status and needs were associated with gender, age, unhealthy lifestyles, poor school performance, and socio-economic status. The establishment of school-based health promotion programs in China is urgently needed, and promotion of oral health lifestyles should be integrated with other general health actions.

Adolescent↗
PubMed2006

Nitric oxide levels in serum of patients with symptomatic irreversible pulpitis.

Nitric oxide (NO) affects both pain and inflammation in human tissues. Pharmacotherapy that decreases NO concentrations may have utility in treating inflammatory painful conditions. To determine the types of disorders in which such an approach should be studied, changes in NO serum levels before and after the painful inflammatory condition resolves would be helpful. This study compared the pre-treatment and post-treatment serum nitric oxide (NO) concentrations in irreversible pulpitis (inflammatory toothache). Thirty-two patients (16 males, 16 females) with irreversible pulpitis were included in this study. Before treatment, patients had severe symptoms of inflammation, but at the end of treatment no symptoms of inflammation were observed. NO concentrations were measured in serum of patients with irreversible pulpitis, before and after treatment. Differences in serum NO concentrations were not statistically significantly different before and after treatment.

Adolescent↗
PubMed2006

Streblus asper Lour. (Shakhotaka): A Review of its Chemical, Pharmacological and Ethnomedicinal Properties.

Streblus asper Lour is a small tree found in tropical countries, such as India, Sri Lanka, Malaysia, the Philippines and Thailand. Various parts of this plant are used in Ayurveda and other folk medicines for the treatment of different ailments such as filariasis, leprosy, toothache, diarrhea, dysentery and cancer. Research carried out using different in vitro and in vivo techniques of biological evaluation support most of these claims. This review presents the botany, chemistry, traditional uses and pharmacology of this medicinal plant.

Journal Article↗
PubMed1988

Horse pill ("bute") hemorrhage.

Phenylbutazone (PBZ) is a nonsteroidal antiinflammatory drug (NSAID) that is not commonly prescribed due to the high incidence of serious adverse reactions. However, it is still used extensively in equine medicine, and is readily available to those employed in the care and management of horses. Such persons may take the drug indiscriminately, without medical supervision. We present a 33-year-old male race horse track worker who took phenylbutazone horse pills for a chronic toothache and subsequently suffered a major hemorrhage from a gastric ulcer. Human use of phenylbutazone horse pills should be considered by physicians confronted with patients who have upper gastrointestinal symptoms and gastric injury and who belong to this select group.

Adult↗
PubMed2002

Lansoprazole in adolescents with gastroesophageal reflux disease: pharmacokinetics, pharmacodynamics, symptom relief efficacy, and tolerability.

OBJECTIVES: To evaluate the pharmacokinetics, pharmacodynamics, symptom relief efficacy, and tolerability of lansoprazole in adolescents between 12 and 17 years of age with gastroesophageal reflux disease (GERD). METHODS: Adolescents with symptomatic, endoscopically and/or histologically proven GERD were enrolled in this multicenter, double-blind trial and randomized to lansoprazole 15 mg or 30 mg once daily for 5 days. RESULTS: Sixty-three adolescents were enrolled in the study. After lansoprazole administration, T(max) occurred at 1.6 hours in those treated with lansoprazole 15 mg and at 1.7 hours in those treated with lansoprazole 30 mg. Dose-proportional increases in lansoprazole C(max) and AUC were observed in the treatment groups. Age, weight, and gender had no significant effect on T(max), C(max), or AUC. Lansoprazole produced significant increases (P < or = 0.05) in mean 24-hour intragastric pH and the percentages of time intragastric pH was above 3 and 4. The majority of adolescents treated with lansoprazole 15 mg (69%, 22/32) or lansoprazole 30 mg (74%, 23/31) demonstrated improvement in their reflux symptoms after 5 days of treatment. Adolescents in both dosage groups exhibited reductions from baseline in the percentage of days and nights with heartburn (or other predominant symptom of GERD), the severity of heartburn, the percentage of days antacids were used, and the number of antacid tablets used per day. Pharyngitis and headache were the most commonly reported side effects among adolescents treated with lansoprazole 15 mg and 30 mg, respectively. Five patients experienced adverse events considered to be possibly treatment-related. One patient with a history of environmental allergies experienced a mild allergic reaction after 3 days of treatment with lansoprazole 15 mg. Among those treated with lansoprazole 30 mg, 4 patients each reported one occurrence of pain (toothache), diarrhea, dizziness, and rash. CONCLUSION: The pharmacokinetic parameters of lansoprazole observed in this study of adolescents are similar to those observed in studies of healthy adults. Lansoprazole 15 mg or 30 mg once daily for 5 days produces significant increases in intragastric pH, effectively relieves symptoms of reflux disease, and is well tolerated in adolescents with GERD.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2006

Retrospective study of pediatric facial cellulitis of odontogenic origin.

OBJECTIVES: The aims of this retrospective study were to investigate the clinical characteristics of pediatric facial cellulitis of odontogenic origin and to compare the clinical differences between upper and lower facial infections and between genders. METHODS: Fifty-six children (28 boys and 28 girls) diagnosed with facial cellulitis of odontogenic origin during the year 2003 were selected for study. The average age was 5.72 +/- 2.70 years. Clinical investigations included sex, location of cellulitis, peak occurrence month, symptoms of infection, preference of first visit, hospitalization status, timing of surgical or dental interventions, need for incision and drainage, source of infection, and management of the primary odontogenic origin. Children were divided into upper face and lower face groups depending on the location of the infection. The chi and Student t tests were computed to assess the differences in the various study variables between upper and lower face infections and gender. RESULTS: Upper and lower face infections were reported in 57.1 and 42.9% of children, respectively. The source of infection was mostly from the deciduous posterior teeth. The clinical symptoms included a frequent toothache before swelling, and less commonly fever and trismus. Hospitalization was needed in 53.6% of the patients, and the mean length of hospitalization was 5.03 +/- 3.80 days. Surgical intervention such as incision and drainage was needed in only 25% of the cases. The majority of the patients had either surgical or dental interventions after subsidence of the swelling. The peak occurrence month was February. The source of infection in the upper face infections was significantly different from that of lower face infections (P < 0.01). Other study variables were not statistically significant for upper and lower face infections (P > 0.05). CONCLUSIONS: The differences in upper and lower face infections and differences in gender were not clinically significant. Surgical or dental interventions can be delayed through the proper use of antibiotics. With correct diagnosis, antibiotic treatment and appropriate timing for surgical or dental interventions, rapid resolution of the infection is expected.

Adolescent↗
PubMed1994

The dental caries experience, oral hygiene and dietary practices of preschool children of factory workers in Phnom Penh, Cambodia.

Two hundred and thirty-seven children attending four Ministry of Industry nursery schools in Phnom Penh, Cambodia, were examined. Dental caries experience, oral cleanliness and soft tissue abnormalities were determined. 149 mothers of these children were interviewed and information was gathered about infant-feeding practices, weaning age, diet after weaning, toothbrushing and dental attendance. Dental caries experience was high, and only 36% of children aged 1-4 years and 4% of those aged 5-6 years were caries free. Only 15% of mothers reported bottle-feeding, but 70% of these used sweetened canned milk in the bottle. Oral hygiene was rated as poor in 80% of children and only 10% were reported to use a toothbrush. 43% of children were reported to have experienced toothache, but only 5% had been to a dentist.

Bottle Feeding↗
PubMed1997

Dental attendance patterns and oral hygiene habits of 5-year-old children in Athens and in south London.

This study compared the dental attendance patterns and oral hygiene habits of 5-year-old children in the London boroughs of Lambeth, Lewisham and Southwark with those in the municipality of Athens in the light of differing provision of oral health education. Questionnaires were sent to the parents of 384 children in London and 318 children in Athens who took part in a survey of dental health. Response rates of 51% and 53% respectively were obtained. More children visit the dentist in South London than in Athens, the difference being highly significant. In South London the majority of children visit every 6 months, whereas in Athens they only visit when they have toothache. More London children brush their teeth than Athens children, the difference being significant. Of those brushing in London, most brush twice daily. The above findings indicate marked differences in dental attendance patterns and oral hygiene habits, and this may be partly attributable to differences in the delivery of dental care and oral health education in the two countries.

Chi-Square Distribution↗
PubMed2005

A case of Tourette syndrome presenting with oral self-injurious behaviour.

Self-injurious behaviour (SIB) is deliberate harm to the body without suicidal intent, and the condition occurs in a number of psychiatric, behavioural and developmental disorders. This case report describes a 4-year-old female with SIB who presented to a paediatric dentist after the self-extraction of teeth as a result of oral motor tics. The girl repetitively ground her teeth in a monophasic lateral motion that resulted in luxation of her maxillary right primary canine, and produced generalized oral and facial pain. The parents consulted the dentist about their child's complaint of toothache. The oral findings were unexcephonable except for a mobile primary canine, but there was a history of unusual behaviour including hyperactivity, and after multidisciplinary consultation and exclusion of other systemic diseases, the subject was diagnosed as suffering from Tourette syndrome (TS). Preventive treatment using a dental splint was provided. Noncontingent reinforcement therapy was successfully used to diminish the subject's SIB.

Behavior Therapy↗
PubMed2006

A comparison of oral health related quality of life between complete and partial removable denture-wearing older adults in Korea.

The purpose of this study was to compare the oral health related quality of life (OHRQoL) between older Korean adults with complete and partial removable dentures using oral health impact profile (OHIP). A pool of 4250 Korean older adults was identified by random stratification by area from the sample cohort of Korean National Survey of Oral Health in the year of 2000. Out of the potential pool, 445 subjects with removable partial dentures (RPDs) or complete dentures (CDs) agreed to be interviewed by telephone. Each question in the survey was about how frequently each event was experienced during the past 12 months. To analyse the association between OHIP scores and removable denture status, bivariable analysis and multiple linear regression analysis were used. RPD users showed higher scores on eight items than CD users. They were 'breath stale', 'food catching', 'sensitive teeth', 'toothache', 'tense', 'unable to brush teeth', 'less tolerant to family members' and 'irritable with others'. RPD users might be associated with higher scores of functional limitation, physical pain and psychological discomfort than CD users. RPD users had slight tendency to be associated with higher OHIP-49 score than CD users, but it was not statistically significant. The findings of the present study confirm that there is no general OHRQoL difference between RPD and CD users. But in the items and subscales of OHIP, RPD users might experience more impaired OHRQoL than CD users.

Age Distribution↗
PubMed1980

Malignant fibrous histiocytoma of the maxillary sinus.

A case of malignant fibrous histiocytoma arising primarily in the left maxillary sinus is described. The patient, a 39-year-old male, who had suffered from sinusitis for 20 years, began to have paresthesia or sharp pain of the left side of the face and toothaches of the left maxilla. At operation a white fibrous tumor developing extensively from the lateral wall to the upper and medial walls of the left maxillary sinus and into the ethmoidal sinus was noted. Following a gradual progression of dyspnea, he died approximately one year after the onset in spite of radiation therapy and anticancer chemotherapy. An autopsy revealed recurrence of the tumor in the left maxillary sinus with wide-spread metastases to the lungs, pleurae, pancreas, kidneys and bone marrows. The direct cause of death was respiratory failure due to extensive growths of the pulmonary and pleural metastases.

Adult↗
PubMed1990

Differences in health status between older and younger homeless adults.

The Institute of Medicine has placed a priority on determining the special health-care needs of elderly homeless persons. As part of a community-based study of 521 homeless adults in two beach communities of Los Angeles, we compared the demographic characteristics and health of older (age rangek 50-78, n = 61) and younger (age range, 18-49, n = 460) homeless individuals. Compared with younger adults, older adults were more likely to be white (85% versus 61%), veterans (59% versus 27%), retired (36% versus 3%), and living in a vehicle (21% versus 8%). Older adults were more likely to report having a chronic disease (69% versus 49%), functional disabilities, no informal social contacts during the previous month (49% versus 27%), observed high blood pressure (42% versus 22%), elevated creatinine (11% versus 2%), and elevated cholesterol (57% versus 36%). Older adults were less likely to have a toothache (3% versus 30%), report psychotic symptoms (25% versus 42%), and to be illegal drug users (15% versus 55%). Although they are chronologically younger, the constellation of health and functional problems of older homeless adults resemble those of geriatric persons in the general population. We suggest that geriatricians could play a significant role in training other primary-care providers to evaluate and treat socially isolated older homeless adults in a more comprehensive way than is currently standard in practice (e.g., interdisciplinary team care and emphasis on functional status, rehabilitative medicine, and assessment for sensory impairment).

Adolescent↗
PubMed1996

Community-wide emergency department visits by patients suspected of drug-seeking behavior.

OBJECTIVE: To measure community-wide ED use by patients at high risk for drug-seeking behavior. METHODS: A retrospective, observational study was performed to analyze a cohort of university hospital ED patients seen January 1 to June 30, 1990, for specific pain-related diagnoses (i.e., ureteral colic, toothache, back pain, abdominal pain, or headache) and either independently identified on at least one other local hospital's "patient alert" list or having a drug-related death during 1990. Patients with terminal illnesses were excluded. The frequency of ED (and affiliated urgent care clinic) visits and hospital admissions were determined for January 1 to December 31, 1990, at seven local hospitals. Detailed, supplemental chart review was performed for visits to three of these hospitals from 1990 to 1992. RESULTS: Thirty patients were identified as being at risk for drug-seeking behavior (mean age: 34.3 years; range: 21-55 years; 50% males). We identified 379 visits for this cohort (86% ED visits, 9.8% urgent care visits, 4.7% hospital admissions), for an average of 12.6 visits (range: 2-33) per patient per year. On average, each patient visited 4.1 (range: 1-7) different hospitals and used 2.2 (range: 1-6) different aliases. Two patients died of drug overdose. Supplemental chart review revealed 28 episodes (among 17 different patients) in which a patient was told that he or she "would receive no further 'narcotics'" from that facility; these patients subsequently received controlled substances from another hospital in 93% of these instances and from the same facility in 71%. CONCLUSIONS: Patients identified as being at high risk for drug-seeking behavior have high community-wide ED visit rates. Improving communication between and within hospitals may help identify patients who could benefit from more consistent community-wide care and appropriate treatment for addiction.

Adult↗
PubMed1983

Couvade.

In a prospective study a number of women and their husbands were interviewed early on in the pregnancy, in the week after delivery and again 4 months later. The couvade syndrome, in which the father-to-be suffers from somatic symptoms of psychogenic origin connected in some way with his wife's pregnancy, was investigated. Sixteen of the 81 men who participated in the study fulfilled the syndrome criteria. The most common symptoms were weight gain, toothache, loss of appetite, and "other aches". The men with the couvade syndrome had more mental symptoms during the pregnancy period. The syndrome had no relation to the somatic or mental symptoms of the women. It is proposed that the couvade syndrome might be a somatic expression of anxiety.

Adolescent↗
PubMed1980

Longitudinal study of oral hygiene and dietary habits among immigrant children in Sweden.

Families immigrating to Sweden from Finland and Southern Europe (Greece, Yugoslavia, and Turkey), as well as Swedish control families of the same social class, were interviewed twice on their children's oral hygiene and dietary habits and on the parents' knowledge of oral health. The first interview was made on the immigrants' arrival in Sweden and the second one 30 months later. The material comprised 35 Finnish, 23 South-European and 54 Swedish families. During the observation period more immigrant than control children had complained about toothache. The frequency of toothbrushing was lower among the immigrants than among the Swedes at both interviews. The frequency of sweets consumption was significantly higher among the immigrants. Fewer immigrant than Swedish children had been examined or treated by a dentist before the first interview. There was no difference between the immigrants and the controls in channels of information about oral hygiene, the schools and the dentists being the foremost source of information for both groups. The Swedish parents had a more competent knowledge of oral hygiene than the parents of the immigrant children. It was concluded that Finnish and South-European immigrant children definitely have a great need of preventive dentistry.

Adolescent↗