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PubMed1992

[Fetal toxicity of non-steroidal anti-inflammatory agents].

All non-steroidal anti-inflammatory drugs (NSAIDs) are prostaglandin inhibitors, which explains their foetal toxicity. So far, no epidemiological study of their cardiopulmonary and renal effects has been carried out, but case-reports have been published. The cardiopulmonary effects of NSAIDs include closure of the ductus arteriosus, pulmonary hypertension cardiopathy and tricuspid valve insufficiency. They were responsible for 31 neonatal accidents, 8 of which were fatal (for 22 pregnant women, 7 bearing twins, 1 bearing triplets). The renal effects of NSAIDs consisted of acute renal failure with oedema, oliguria, hyponatraemia and marked hyperkalaemia. They affected 23 neonates, 8 of whom died (for 17 pregnant women, 4 bearing twins, 1 bearing triplets). A few epidemiological studies have reported foetal haemorrhages when aspirin was used by the mother as anti-inflammatory agent. In comparative trials of indomethacin as short treatment of premature labour and polyhydramnios the drug proved to be effective. In obstetrical tocolysis NSAIDs can be given in the absence of alternative therapy with beta-adrenergic agents, and their risk can be minimized by ultrasonographic examination and monitoring of foetal cardiac function and diuresis. In the field of rheumatology, corticosteroids would be a good alternative to NSAIDs for rheumatic diseases, but using NSAIDs for low back pain, sciatica, haemorrhoids, toothaches, sinusitis, etc., would not be justified in pregnant women. Self medication must be discouraged.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2003

Dentistry in the British Isles.

This wide-ranging and in-depth study of dental practice in the British Isles reveals the origins and education of practitioners in the context of the political and economic background and that of their medical colleagues. The nature and costs of treatments offered are examined, as well as the marketing of other products such as toothache cures and mouthwashes. The significance of advertising, especially in connection with the need for migration and mobility of practitioners to secure a living is discussed. The second half of the chapter looks at individual practitioners in selected areas of England, Scotland and Ireland, the types of treatment they offered and their professional travels.

Dentists↗
PubMed1992

Histiocytosis X with thyroid involvement: report of a case.

Histiocytosis X is a disease of histiocyte proliferation in response to some unknown etiology. Thyroid involvement is extremely rare in the literature. In this paper, we present an 18-year-old female with histiocytosis X with thyroid involvement. This patient had had a goiter with normal thyroid function since 12 years of age. A thyroidectomy was done under the suspicion of thyroid cancer. Pathology revealed histiocytosis X. Hypoparathyroidism and hypothyroidism were noted after the operation and were treated with thyroid hormone, vitamin D and calcium carbonate. This patient also had lesions on the left side of mandible, in the suprasellar region and possibly in the right mastoid. A curettage biopsy of her mandibular lesion was also compatible with histiocytosis X. She was proven to have hypothalamic and pituitary dysfunction including hypogonadism and hypoadrenalism. Her thyroid lesion did not recur after the thyroidectomy. The toothache that she had also experienced subsided after the curettage biopsy of the mandibular lesion. Hypothalamic and pituitary dysfunction were controlled by hormone replacement. Because her disease had been running a benign clinical course, no chemotherapy was given.

Adolescent↗
PubMed1992

[A case of acetaminophen-induced pneumonitis].

A 20-year-old woman took 1.2 g of acetaminophen for toothache. She subsequently developed a dry cough, pyrexia, and dyspnea. Chest X-ray revealed diffuse reticulo-nodular shadows in both lung fields. Broncho-alveolar lavage examination showed a marked increase in the total cell number and an increase in the percentage of eosinophils, neutrophils, and lymphocytes. Because drug-induced pneumonitis was suspected, all drugs were stopped and she was administered methylprednisolone. Consequently her symptoms resolved, and pulmonary function and chest X-ray findings improved remarkably. The lymphocyte stimulation test was positive for Norshin and its acetaminophen element. Based on these findings, the diagnosis of acetaminophen-induced pneumonitis was made. Acetaminophen intoxication is well-known, but to our knowledge this is the first reported case of acetaminophen-induced allergic pneumonitis in Japan.

Acetaminophen↗
PubMed2003

[Pain management after third molar extraction. Observations of the use of mefenamic acid and rofecoxib in the treatment of postoperative pain in the dental office].

Pain monitoring is often inadequate in the ambulant field to assure therapy results. Today NSAID take the centre in acute pain and inflammation control in dental interventions. Compared to conventional non-selective NSAID modern selective Cyclooxygenase-2 inhibitors (COX-2) provide the potential for improved compatibility and simplified medication with heightened effectiveness in acute postoperative toothaches. The aim of this study was to compare the effect of selective COX-2 inhibitors with NSAID after operative wisdom tooth extraction in 30 ambulant patients. The pain curve under mefenamine acid showed a significant increase during the first 48 hours after extraction. With rofecoxib a continuous pain decrease with the lowest stand 48 hours after intervention was registered. One week after extraction the patient's satisfaction was in favour of rofecoxib, which showed a clearly prolonged analgetic effect over 24 hours. Additionally rofecoxib as a COX-2 selective inhibitor doesn't bear the risk for severe non-anticipatable gastrointestinal side effects or prolonged bleeding after surgical intervention.

Adult↗
PubMed2003

The knowledge and practices of oral hygiene methods and attendance pattern among school teachers in Riyadh, Saudi Arabia.

OBJECTIVE: The aim of this study was to find out the knowledge and practices of oral hygiene methods among primary and secondary school teachers in Riyadh, Kingdom of Saudi Arabia (KSA). METHODS: The study was carried out using a self-administered questionnaire. Four hundred and seventy teachers, male 236 (50.2%) and female 234 (48.8%) responded with a response rate of 85.5%. The study was conducted during October to December 2001 at primary and secondary schools in Riyadh City, KSA. RESULTS: Almost 86% of male and 90% of female teachers felt that dental caries is due to the wrong method of tooth brushing, while sugar and sugary drinks were considered the main factor by 90% of male and 98% of female teachers. Seventy-five percent of male and 72% of female teachers considered irregular tooth brushing a cause of gums disease with 32% of male and 39% of female teachers not knowing details with regards to microbial relationship of gum disease. Tooth brushing preference was common among 45% male and 49% female teachers due to perceived effect of better cleaning, while almost an equal percentage of male and females (62%) used miswak due to Sunnah. Thirty-three point five percent of female teachers brushed 3 times a day as compared to 19% male teachers. On daily basis brushing 3 times, a day was common among >5000 SR monthly income group. Male teachers preferred horizontal tooth brushing (40%) while female teachers preferred circular tooth brushing (45%). Miswak was more commonly used by male teachers as compared to female teachers. Female school teachers had a higher income as compared to male schoolteachers. Thirty-two percent of females and 28% of male teachers were regular attendees to the dentist. Males were more satisfied by their oral health as compared to female teachers and 56% of male and 63% of female teachers visited the dentist only on having pain (toothache). CONCLUSION: It is concluded that there is much resemblance in knowledge and practice of oral hygiene habits among male and female schoolteachers and there is a need to enhance their knowledge regarding oral health and disease. Both need more awareness regarding oral health promotion to have a positive role in school oral health education for their students in collaboration with oral health care workers.

Faculty↗
PubMedDate not supplied

Oral health care practice and socio-demographic findings among the physicians in Ilorin, Nigeria.

BACKGROUND: In most developing countries, physicians attend to patients with oral health problems more than dentists usually because physicians are easily available. The aim of this study is to assess the level of practice of oral health care by physicians and make recommendations on how oral health care practice can be improved among the physicians. METHODS: This is a descriptive cross-sectional study carried out among 173 physicians who were randomly selected using their various health facilities. The study was carried out in Ilorin, the capital of Kwara State, Nigeria, over a period of six months. A well-structured questionnaire served as data collection tool while EPI-INFO version 6 software packages were used for analyzing data after being coded. RESULTS: There was a high level (74.1%) of practice of oral health care among the physicians and the major reasons for this were limited number of qualified dentists in the study area as well as lack of awareness by the patients concerning the treatment of oral health problems by dentists. Toothache and trauma were the most (68.2%) and least (2.3%) prevalent oral health problems respectively seen by physicians in this study. Antibiotics and analgesics were the medications used by the majority (58.1%) of the physicians to treat oral health problems. Almost all (97.7%) the respondents referred oral health problems to dentists while only 2.3% claimed never referred patients to a dentist. CONCLUSION: The available dental services in the study area cannot meet the oral health needs of the populace considering the fact that there are fewer dentists than physicians. Since this study showed a high level of practice of oral health care among the physicians, it is therefore necessary to include dentistry in the curricular of all medical schools in Nigeria and such curricula need to place more emphasis on promotive and preventive aspects of oral health as well as community participation.

Adult↗
PubMed2004

["Molar-incisor hypomineralization"].

Hypocalcification of the enamel is the most common developmental disorder observed in teeth. The prevalence of this kind of hypomineralisation is about 10-19%. These molars are often referred to as cheese molars, because the lesions clinically resemble cheese in color and consistency. Other descriptions are: idiopathic enamel hypomineralisation in the permanent first molars, idiopathic enamel opacities in the permanent first molars, non fluoride enamel hypomineralisation in the permanent first molars, non-endemic mottling of enamel in the permanent first molars. Molar-Incisor Hypomineralisation is today the proposed expression for this disease. Occlusal surfaces of the first permanent molar are most commonly affected. The lesions are more frequent in the upper jaw than in the lower jaw. The incisors are affected to a lesser degree than the molars. Several aetiological factors can cause these defects. Some studies show a relation between intake of dioxins via mother's milk after prolonged breast feeding and developmental defects of the child's teeth. Because the ameloblasts are very sensitive to oxygen supply, complications involving oxygen shortages during birth or respiratory diseases such as asthma or bronchitis and pneumonia are discussed as further aetiological factors. Renal insufficiency, hypoparothyroidism, diarrhoea, malabsorption and malnutrition and high-fever diseases can be other reasons for the occurrence of these defects. Defective enamel can be a locus of lowered resistance for caries. Histologically there are areas of porosity of varying degrees. The affected teeth can be very sensitive to air, cold, warm and mechanical stimuli. Toothbrushing may create toothache in these teeth. We therefore suggest that these patients receive intensified prevention with fluoride varnish, a fissure sealing, GIZ, composits, stainless steel crowns or implants. In some cases an interdisciplinary approach with an orthodontist can result in the extraction of the molars in the age of 8 to 10 years.

Calcium↗
PubMedDate not supplied

Dental care needs and demands in patients attending the dental hospital of the Obafemi Awolowo University Teaching Hospital's Complex Ile-Ife, Nigeria.

BACKGROUND: To compare the pattern of need and demand for dental care in settings where services are paid for through government sponsored insurance programs and out of pocket by individuals. METHODS: Study consisted of first visit patients attending the Dental Hospital. The assessment of normative treatment needs was done. The tooth based treatment needs were assessed by the WHO basic methods and the periodontal needs were assessed by the periodontal need systems PTNS. RESULTS: More males had sought treatment than females. In both sexes, most of the patients demanding treatment belonged to the 17-34 year age group. There was no statistically significant difference between age groups (P = 0.65). 55.4, 8.1 and 1.4 percents sought care for toothache, caries without concomitant pain and dental check-up respectively. Oral surgical care was considered necessary for the main complaint in 50.1% of cases. However, the age group 17-34 year old needed more restorative care than periodontal and the > 65 age group requested more extractions. CONCLUSION: The expressed need or demand for dental care falls short of the normative need. It should therefore be the aspiration of appropriate government ministry and health care providers to attempt converting normative needs into demand for care.

Adult↗
PubMed2004

Dental writings in a medical self-help book of 1650.

Only one copy exists of the very first medical self-help book written in the Yiddish language. The author, a well respected. barber-surgeon in Prague, states that he wrote the book for those too poor to consult a physician. Physicians were not as knowledgable or experienced as the barber-surgeons who were the principal providers of medical care for the masses. The book follows the format of discussing illnesses from head to toe, and includes numerous prescriptions for toothache, loose teeth, foul mouth and sore tongue. We derive an interesting picture of what dental treatment was like in the mid-seventeenth century.

Barber Surgeons↗
PubMed1992

The difficult differential diagnosis.

The mere complaint of "toothache" pain does not always indicate the need for endodontic treatment. As pointed out in this paper, there are many entities, both odontogenic and nonodontogenic, that can give rise to or mimic pulpal-periapical pain. Conventional and appropriate diagnostic tests should be performed routinely no matter how obvious the preliminary diagnosis may seem. This habit of gathering all pertinent data provides the foundation for accurate diagnosis and avoids the embarrassment and unnecessary treatment associated with a quick, presumptive, and at times, incorrect diagnosis.

Dental Pulp Diseases↗
PubMed2004

Canadian and American self-treatment of pain: a comparison study.

INTRODUCTION: Adults frequently rely on self-treatment modalities to relieve pain that exceeds everyday kinds of pain, such as minor headaches and toothaches. Examples of self-treatment modalities include doctor-prescribed analgesics, non-prescribed over-the counter medications, herbal substances and treatments, and non-drug treatments such as heat, cold and exercise. Self-treatment is often associated with adverse affects related to the improper use of self-treatment substances and the adverse interactions they may produce when combined with other prescribed or non-prescription treatments for pain control. Many adults also use a variety of self-treatment modalities without informing their health care providers. OBJECTIVES: To explore the occurrence of pain and identify pain self-treatment modalities used by members (n = 105) of rural communities from two eastern Canadian provinces. Results of this study were compared with a rural American cohort study in order to explore similarities/differences in patterns of self-treatment of pain between the two countries. METHODS: This descriptive-exploratory study was conducted using a survey method. The design followed that used in a US study by Vallerand, Fouladbakhsh and Templin. Investigators used self-report questionnaires to identify pain self-treatment modalities, pain intensity ratings, pain interference, and the percentage of pain relief in a convenience sample of 105 participants recruited from two Canadian rural communities. Differences in mean scores between Canadian and US data were determined through t-tests. Difference between Canadian and US pain self-treatment modalities were determined using chi2 tests for significance. RESULTS: Canadians reported choosing significantly more non-pharmacological self-treatment modalities of pain control such as heat, cold, exercise/stretching, and massage than did their US counterparts (chi2 = 7.6, p = .006). US participants reported significantly higher percentages of pharmacologic modalities than Canadian participants, ie prescription medications (chi2 = 4.8, p = .03), and over-the counter medications (chi2 = 8.14, p = .004). There was no significant difference between the two countries in the number of herbal supplements taken for pain relief (chi2 = 2.47, p = .12). Canadian participants reported having significantly less pain relief from their current self-treatment regimen than US participants, (t = 13.77, p = .00). In addition, 33% of Canadian participants and 20% of US participants had not informed their primary care practitioner of their self-treatment choices. CONCLUSIONS: This study demonstrates that pain is a common experience for many North American individuals living in rural communities. Comparison of results between Canadian and US cohort studies indicate that rural Canadians may benefit from increasing their knowledge about self-treatment options of pain control. Findings showed that rural Canadians choose more non-pharmacologic self-treatment modalities and have less pain relief than rural US participants by their self-treatment choices. In addition, a significant number of Canadian and US participants had not informed their primary care provider of their self-treatment practices. Community healthcare agencies may need to improve the dissemination of information on how to combine both pharmacologic and non-pharmacologic modalities into self-treatment regimens in order to facilitate more effective pain control for some rural communities. Further study is indicated to examine how the differences found in self-treatment practices between Canadian and US cohort studies relate to the differences between Canadian and US culture and healthcare payment systems.

Journal Article↗
PubMed2005

[Pain during and after root canal treatment].

Toothache can be prevented or remedied with a root canal treatment. Unfortunately a root canal treatment can also be the cause of pain. During a root canal treatment pain can be suppressed by local anesthesia, the use of the airotor, the attitude of the dentist and his communication with the patient. Afterpain has three causes: damage and iatrogenic apical periodontitis, pulpitis and continuing apical periodontitis. In this article the possible treatment of pain by a root canal treatment are extensively discussed.

Analgesics↗
PubMed2006

Oral health attitudes, knowledge, and behavior among school children in North Jordan.

The aim of this study was to assess the knowledge, attitude, and behavior of school children towards oral health and dental care as well as to evaluate the factors that determine these variables. School children (n=557) of an average age of 13.5 years attending public schools in North Jordan were recruited into this study. The subjects completed a questionnaire that aimed to evaluate young school children's behavior, knowledge, and perception of their oral health and dental treatment. The participants' oral hygiene habits (such as tooth brushing) were found to be irregular, and parents' role in the oral hygiene habits of their children was limited. The study population showed higher awareness of caries than periodontal conditions. Irregular visits to the dentist were found to be common, and toothache was the major driving factor for dental visits. Children had positive attitudes toward their dentists; nevertheless, they indicated that they feared dental treatment. The children in this study also recognized the importance of oral health to the well-being of the rest of the body. Parents were not proactive in making sure that their children received regular dental care. Parents' knowledge and attitudes about the importance of oral health care and their fears about dental treatment influenced their children's dental care. The results of this study indicate that children's and parents' attitudes toward oral health and dental care need to be improved. Comprehensive oral health educational programs for both children and their parents are required to achieve this goal.

Adolescent↗
PubMed2006

Dental health attitudes and behaviour among dental students in Jordan.

OBJECTIVE: Examine and compare differences in oral health attitudes and behaviour among Jordanian dental students. BASIC RESEARCH DESIGN AND PARTICIPANTS: Cross-sectional study of 314 dental students was conducted to compare differences in oral health behaviour and attitudes among these students in different levels of academic education. SETTING: Jordan University of Science and Technology. METHODS: Subjects were surveyed using a modified version of the Hiroshima University Dental Behavior Inventory (HU-DBI) questionnaire (20 Items). Multivariate binary and polytomous logistic regression analyses were performed in order to study change of patterns of statements during preclinical and clinical, and year of study, respectively. RESULTS: The percentage of students claiming to brush their teeth twice daily or more often was four times higher amongst clinical students than amongst pre-clinical students.. The odds of visiting a dentist only in case of toothache was reduced by a factor of more than three among clinical year students (OR 0.30, 95% CI 0.15-0.61). Clinical year students rarely complained of bleeding gums after toothbrushing (OR 0.10, 95% CI 0.03-0.27). On the other hand, a number of items regarding use of dental floss and tooth paste, bad breath, colour and appearance of teeth, and cigarette smoking was similar between preclinical and clinical students. Evaluation of trends during dental studies employing polytomous multivariate logistic regression analysis revealed an abrupt change at the end of preclinical studies for items characterizing professional attitude. CONCLUSIONS: With advancement in dental school, dental student's oral health awareness and attitudes improved in some aspects. Preventive dentistry courses should be taught early in the dental curriculum of the pre-clinical years.

Attitude of Health Personnel↗
PubMed1991

[Stomatological problems related to pregnancy. A statistical study].

Pregnancy is related to particular dental issues, such as the increased incidence of diseases( gingivitis, caries, epulis), the fluoride supplementation, and the limits of diagnostics and therapy. Moreover, the mysterious halo surrounding pregnancy often makes the dentist uneasy. In order to objectively evaluate the implications of pregnancy in dentistry, we distributed a form to 100 pregnant women. The results of the form showed that 53 of them had gingival bleeding, 22 had toothache, 19 had caries but that just 12 of them had gone to the dentist because of dental troubles while 54 had not gone at all. Among the pluri-gravidae, all the women with dental diseases in their previous pregnancies had them again in their current pregnancy but nonetheless only some had undergone a dental check-up. The dentists did not show any uneasiness, as they performed tooth extractions in 5 women, endodontics in 2 women and fillings in 11 women. Just 4 out of 100 women had taken a fluoride supplementation. We deem advisable a stronger collaboration between physician, gynecologist and dentist in order to resolve specialist problems and to make pregnant women more aware of the need for dental follow-ups and fluoride supplementations.

Adult↗
PubMed1991

A report on the feasibility of establishing a paediatric emergency dental service at Glasgow Dental Hospital.

A six-month pilot emergency service for children was established at Glasgow Dental Hospital to provide care for patients in pain, offer preventive advice and ensure ongoing dental care. The service was staffed by experienced community dental officers. In the main study period 2965 patients were seen. The majority (54 per cent) were referred from general dental practitioners; however, 27 per cent came directly to the hospital without seeking dental advice in their locality. The most common problems were toothache (55 per cent), occasional pain (28 per cent) and swelling (14 per cent). Eighty per cent of the patients were directed to oral surgery for extractions under general anaesthesia and six per cent for extractions under local anaesthesia. Dental caries still causes pain and distress to a large number of Glasgow school children. Clearly water fluoridation would greatly improve dental health and in so doing reduce the proportion of children requiring extractions under a general anaesthetic. The emergency service is currently being reorganised so as to place more emphasis on following up those patients who do not have a dentist, or who presented for care without a referral letter.

Adolescent↗
PubMed1990

[3 cases of food-dependent exercise-induced anaphylaxis in which aspirin intake exacerbated anaphylactic symptoms].

Exercise-induced anaphylaxis (EIAn) is a distinct form of physical allergy. As one of the predisposing factors of EIAn, food intake is often cited, and such cases are classified as food-dependent EIAn. Another factor reported is the administration of drugs. Recently we had 3 patients with food-dependent EIAn who showed more severe symptoms when they took aspirin orally. None of them had shown symptoms when they took aspirin alone. Symptoms were provoked only when they took aspirin for common cold, headache or toothache followed by certain foods and exercise. Two out of the 3 patients had experienced food-dependent EIAn before. However, after taking aspirin, their anaphylactic symptoms were more severe with more slight degree of exercise. Results of exercise challenge by treadmill showed that exercise alone induced an increase in plasma histamine concentrations in 2 out of the 3 patients 5 to 15 minutes after the challenge. These data suggest the possibility that our patients have an increased histamine releasability from mast cells responding to exercise, and that aspirin intake might enhance the process.

Adult↗