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[Self-reported dental experience and dental anxiety among school children in a rural district of Norway].

The article deals with the relationships between previous dental experience (STE in text and table) and self-reported dental anxiety (CDAS) and clinical anxiety (KAB). 155 children aged 10-13 from a rural district in Norway participated in the investigation. Previous dental experience was decided on the basis of three questions related to extraction, fillings, and toothache. With No/Yes as alternative answers the STE scale scores 3-6. There was a weak, but significant correlation between experience and self-reported dental anxiety. No significant correlation was found between experience and clinical anxiety. However, as a group, children with the broader experience (STE = 5-6) demonstrated a significantly higher level of clinical anxiety than children with lesser experience (STE = 3-4).

Adolescent↗

[Caries prevalence and dental hygiene in a group of school-age children].

The results of a cross-sectional study of the prevalence of caries in a sample of 3,237 children aged 5 to 21 are described in relation to some objectives of the WHO program. The prevalence of caries is high in the sample: 1. 31.5% of the children aged 5 to 6 are free of caries (according to the WHO objectives, 50% of the children aged 5 to 6 should have no caries), 2. the mean number of decayed, missing and filled permanent teeth (DMF/T index) in children aged 11 to 12 is 6.6 (The DMF/T should be less than or equal to 3). The frequency of toothbrushing is distributed as follows: 23% of the children brush their teeth once a week or less, 46% brush their teeth once a day, and 31% brush their teeth twice a day or more. The purpose and the frequency of the consultations at the dentist's office have been examined: 15% of the children never consult the dentist, 44% consult the dentist in case of toothache, and 41% go to the dentist's office for screening or control. Only 3.2% of the children use regularly and appropriately fluoride tablets. Since the variance of the results is large, it is difficult to distinguish explaining variables or determinants. However, the data indicate that social groups show differences in DMF indices as well as in the behaviors associated with dental hygiene and prevention.

Adolescent↗

[Studies on the chemical constituents of Piper macropodum C.DC].

Piper macropodum is used in Chinese folk medicine for the treatment of rheumatism, toothache, epilepsy and stomach ache. From the ethanolic extract of the viny stem of this plant five components were isolated, a new compound and four known compounds. On the basis of spectroscopic analysis (IR, UV, MS, 1HNMR and 13CNMR) the structure of this new compound was elucidated as (2E,4E)-N-isobutyl-2,4-icosadienamide (I). The other four compounds were identified as piperine (II), piperyline (III), daucosterol (IV) and beta-sitosterol (V). All of them were isolated from this species for the first time.

Chemical Phenomena↗

[A case of medullary infarction presented lateral medullary syndrome and respiratory arrest after ataxic respiration].

We reported a 71-year-old male with lateral medullary syndrome presented acute respiratory arrest after ataxic respiration. The patient had experienced transient diplopia repeatedly for about 2 weeks and then the developed persistent diplopia and vertigo. On the third day he was admitted to our hospital because of neurological deterioration and aspiration pneumonia. He showed left Horner's sign and double vision. And he had sensory disturbances of pain and temperature in the left face and the right side of the body, left limb ataxia and truncal ataxia. He showed dysarthria, severe dysphagia and left mild central facial paresis, but no hemiparesis. This case was clinically considered to be a typical case of left lateral medullary syndrome. When he was admitted to our hospital, he showed hypoxia with hypercapnea in spite of no history of chronic obstructive pulmonary disease. This condition was considered to be a central alveolar hypoventilation. He had two episodes of sudden-onset respiratory arrest following ataxic respiration on the 4th and 5th days, but no cardiac arrest. He was supported his respiration by mechanical ventilation until he was able to breathe spontaneously on the 29th day. The 22nd day MRI disclosed high intensity area in the left lateral and dorso-medial medulla in T2-weighted image, and this lesion was 1.5 cm in length. Therefore this case was diagnosed medullary infarction. This case developed ipsilateral facial pain in chronic stage. Pain existed around the eye and in the cheek, and pain was like toothache and unbearable like thalamic pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

An allergy to local anesthetics? The consequences of a misdiagnosis.

In this case, inappropriately labeling the child as "allergic to local anesthetics", resulted in her inability to receive appropriate dental care. It was a major disservice to her and led to the potentially serious consequences of neglecting the dental disease present. The small caries lesions that would have required amalgam restorations at five years of age progressed to painful toothaches requiring stainless steel crowns and pulpal treatment. Although adverse reactions to local anesthetics are uncommon, most dentists can anticipate encountering a patient who will have an adverse reaction to a local anesthetic. This case ilustrates the need for dentists to be knowledgeable regarding the signs and symptoms of the potential adverse reactions and their appropriate management. Most importantly, prevention is based upon knowledge of anatomy, dose determination, and the use of proper armamentarium and technique, which are key factors in making a safe and effective drug even safer.

Anesthesia, Dental↗

[Therapeutic considerations in maxillofacial neuralgia].

In the presence of idiopathic and neuralgiform pain in the trigeminal area, differential diagnosis will have to eliminate sinus disturbances, toothache, TMJ trouble and neuromuscular spasms derived thereof. Neuralgias unconnected to these causes are treated by electrobiological testing of the neurotoxins. Symptomatic immediate treatment was formerly done by enneural injection. Now, a special technique of auriculoacupuncture has been successful for some time.

Acupuncture Therapy↗

[Concepts and findings in dentistry in medical dissertations from the 16th, 17th and 18th centuries].

This historical paper deals with medical dissertations from the second half of the 18th century which deal with stomatology. 30 of the 100 consulted dissertations were translated from latin with great differences in scientific content and style, because they dated from the 16th to the 18th century. The views of normal anatomy and physiology of that time are described. Strange views were held on the embryological development. Apart from toothache, dentitio difficilis in children, aphtous stomatitis, cleft palates and the respective therapies were described. The scientific content of those dissertations was way backward when compared to contemporary text book literature.

Academic Dissertations as Topic↗

[Jean-Baptiste Van Helmont (1579-1644), the baroque and teeth].

J. B. Van Helmont has been qualified as a medical exponent of the baroque spirit. This affirmation can only be accepted in the following sense: as Harvey, but in an other way. Van Helmont has prepared modern medicine notwithstanding their fidelity to the philosophy of nature (aristotelism or irrationalism) of the sixteenth century. Van Helmont, who believed in the occult forces of the teeth, was also the first to denounce the catarrhe as a cause of toothache.

Belgium↗

The problem of anorexia nervosa.

In anorexia nervosa the pain of hunger or, alternatively (in bulemia), of glut recalls Freud's aphorism that the man with toothache cannot fall in love. But object longing remains and stimulates such envy that the anorectic must project her wishes; she is not be found wanting. The use of projection, in turn, complicates self-other boundaries, with the result that she experiences not only people but even food as overpowering. This, then, excites more envy, indeed an envy so ruinous that self-starvation or compulsive evacuations are employed additionally to make reparation. Because all of this condenses into Less is More, the anorexic poses particular problems for analytic treatment, which is the subject of a companion paper.

Anorexia Nervosa↗

Oral health status and traditions in the Philippines.

With an annual population growth of 2.71 per cent per year the government is harnessing all available resources so that every Filipino can enjoy a decent way of life. Since the majority of the population is in the rural areas, priority health services are directed towards this particular segment. Because of meagre income among the rural population all health services are given free, except for major operations, medicines and dental procedures such as the construction of partial and full dentures, porcelain restorations, root canal therapy and major oral surgery. Older people in the rural areas still adhere to their beliefs and traditions to alleviate the pain of toothache, particularly in the areas which cannot be reached by dentists. Because their fees are minimal the services of quack doctors/dentists and faith healers are still sought. In the Philippines, although dental health services have been given a low priority by the government, preventive dental health programmes are being implemented throughout the country. These include mouthrinsing with sodium fluoride solutions, supervised toothbrushing with fluoride toothpaste and the use of fluoride-containing varnish and fluoride tablets. Water fluoridation exists in two pilot areas and there is an intensive dental health education campaign. Indigenous health workers augment the inadequate dental manpower in attempting to attain and maintain the global indicator for oral health, which is 3 DMFT on average for age 12 years old.

Adolescent↗

Acute sinusitis.

Acute sinusitis is one of the most commonly observed entities in clinical practice. Despite the frequency of the disease, diagnosis and therapy often remain empiric. Most cases are secondary to sinus ostia obstruction associated with the common cold or allergies. Maxillary sinusitis is most common. Because of the proximity of vital anatomic structures and venous drainage systems, serious complications frequently arise from sphenoid, frontal, and ethmoid sinusitis. Clinical signs and symptoms most helpful in the diagnosis of maxillary sinusitis are the presence of a maxillary toothache, lack of improvement with decongestants, a purulent nasal discharge, cough, purulent secretions observed on nasal examination, abnormal transillumination, and sinus tenderness. Plain film radiographs are helpful, but do not adequately visualize the anterior ethmoid sinuses. Computed tomography provides superior visualization, but cost remains prohibitive for routine cases. Most maxillary sinusitis in adults is secondary to Streptococcus pneumoniae or Hemophilus influenzae. Moroxella catarrhalis is common in children. Staphylococcus aureus is observed more frequently in frontal or sphenoid disease. Most patients with acute sinusitis are treated without microbiological diagnosis and respond well to commonly used oral antimicrobials with activity against the usual pathogens. Complications of sinusitis include meningitis, periorbital infections, subdural empyema, epidural abscess, brains abscess, cavernous sinus thrombosis, and osteomyelitis.

Acute Disease↗

Utilisation of dental services in Cambodia and the role of traditional dentists.

Cambodia has a small, but growing number of qualified dentists, as well as about 300 traditional dentists. This study describes the current level of utilisation of dental services in Cambodia in Phnom Penh and in 6 provincial areas. 548 adults aged 35-45 and 60-80 years of age were interviewed concerning previous dental attendance, type of service used and preference for qualified or traditional practitioner services. Only 38 per cent had ever had dental treatment, with 87 per cent of attenders last visiting the dentist because of toothache. Although 34 per cent of attenders received their last course of treatment from a traditional dentist, 77 per cent of all subjects said they would prefer to visit a qualified dentist if they had the choice. The role of traditional practitioners may therefore diminish as numbers of qualified dentists increase.

Adult↗

The relationship between tooth brushing frequency and personal hygiene habits in teenagers.

A survey of 904, 14-17 year old school children from secondary schools around Nairobi was done to find out if there was any relationship between toothbrushing frequency and personal hygiene habits. The students completed a questionnaire anonymously in class. Female students brushed their teeth more often than the male students. 62.2% of the females and 50.1% of the males brushed their teeth more than once a day. Of those students who brushed their teeth more than once a day, 52% bathed daily, 22% used perfumes/deodorants daily and 50.1% always washed their hands after visiting the lavatory. No relationship was found between washing of hair and toothbrushing frequency. 69.7% males and 53.2% females gave toothache and tooth decay as the main reasons for mouth care. Those who brushed their teeth more frequently also visited the medical doctor regularly for routine check-ups. These findings indicated that toothbrushing was closely related to personal hygiene habits.

Adolescent↗

[Chondrosarcoma of the maxilla. A clinical case report].

Chondrosarcoma are malignant tumour originating in cartilaginous cells which tend to preserve their essentially cartilaginous nature throughout their evolution. They are rare at the level of the maxilla and mandibular. When localized in facial bone, chondrosarcoma follow a more aggressive pattern compared to those localized in long bones. They mainly affect individuals aged between 30 and 60 and show no sexual preference. In the majority of cases, chondrosarcoma have a relatively slow rate of growth. The only valid treatment is radical surgical removal. In overall terms, the prognosis in these patients is not good since the 5-year survival rate is less than 40%. During the period 1980-1992 only 5 cases of chondrosarcoma were diagnosed by the Division of Maxillo-Facial Surgery of the University of Turin. The authors considered it worthwhile to report the last case observed in a premaxillary localization given the advanced age of onset and the typical course of the pathology and treatment received. CASE REPORT. A male 83-year-old patient was referred to use due to a slow growing neoformation in the premaxillary region which had appeared approximately 5-6 months earlier. The patient had previously undergone the avulsion of residual upper teeth due to suspected "toothache". The neoformation filled the premaxilla, deforming the anterior middle portion of the palate and spreading towards the floor of the anterior nasal cavity. The gingiva of the upper alveolar crest presented ulceration with irregular edges and sanious bottom. On palpation the consistency was hard-ligneous and swelling, in continuity with the bone, was slightly painful. Incisional biopsy enabled the diagnosis of chondrosarcoma to be confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Importance of dental problems according to 12- to 16-year-old children.

The willingness to take preventive action is partly determined by the perceived importance of the disease. The purpose of this study was to investigate the relationship of age, sex, education, and ethnicity to the importance of dental and other health problems by 12- to 16-year-old children. The children (361 boys, 272 girls) attending Dutch schools were asked a series of questions requiring a choice by students as to the more important problems in a given pair of conditions. Conditions included systemic, dental, and psychological problems. Nervousness was the least important problem and hearing disability the most of the nine ranked. Having full dentures was ranked third, bad teeth fifth, and toothache sixth of the nine from least (first) to most important (ninth). Age, sex, education, and ethnicity showed no relationship to importance of problems alone or in aggregate.

Abdominal Pain↗

Temporomandibular disorders: a critical review of the nature of pain and its assessment.

Temporomandibular disorders is a common form of chronic pain affecting the head, face, and jaw. The distinguishing symptoms of this disorder include pain and impairment of the masticatory function, and frequent display of symptoms, ranging from aches in the head, neck, ears, and eyes, to atypical toothaches, throat symptoms, and occlusal changes. It is recognized that pain is a complex, multifactorial experience including not only sensory dimensions, but also affective and cognitive factors. Recent recommendations regard temporomandibular disorders as a dual-axis disorder with physical and psychologic dimensions, but little research has incorporated measures of multidimensional pain characteristics in the assessment of temporomandibular disorders. This article is a review of the literature on the psychophysiologic factors contributing to temporomandibular disorders and its limitations. Recommendations for future research are also given.

Afferent Pathways↗

[A case of pulmonary tuberculosis complicated with gingival lesions].

A case of secondary gingival tuberculosis is presented. The case is 51 year-old male who had been suffering from undetected pulmonary tuberculosis visited a dentist because of chronic periodontal inflammation around the gingiva of the right upper and left lower molar teeth lasting for one year. The lesions remained unchanged and painful granulomatous swelling sustained in spite of the conservative treatment. The case was treated with the extraction of six teeth due to continued toothache. By pathohistological examination of gingiva and chest X-ray examination, the case was diagnosed as tuberculosis. Chest roentgenogram showed active pulmonary tuberculosis, and bacteriological examination of sputum showed tubercle bacilli. The administration of INH, RFP and EB was started, and the response to the treatment was good and the pain in the gingiva disappeared within three weeks. Secondary gingival tuberculosis is manifested as local granulomatous lesions with severe pain. The incidence of gingival tuberculosis is very rare, but we have to keep in mind that the oral tuberculosis secondary to pulmonary tuberculosis could occur.

Gingival Diseases↗

A practical guide for the diagnosis and treatment of acute sinusitis.

OBJECTIVE: To develop guidelines for the diagnosis and management of acute sinusitis. OPTIONS: Diagnostic clinical criteria and imaging techniques, the role of antimicrobial therapy and duration of treatment, and the role of adjunct therapy, including decongestants, glucocorticosteroids and nasal irrigation. OUTCOMES: Improved accuracy of clinical diagnosis, better utilization of imaging techniques and rational use of antimicrobial therapy. EVIDENCE: A MEDLINE search for relevant articles published from 1980 to 1996 using the MeSH terms "sinusitis," "acute sinusitis," "respiratory infections," "upper respiratory infections," "sinusitis" and "diagnosis," "sinusitis" and "therapy," "sinusitis" and "etiology," and "antimicrobial resistance" and search for additional articles from the reference lists of retrieved articles. Papers referring to chronic sinusitis, sinusitis in compromised patients and documented nonbacterial sinusitis were excluded. The evidence was evaluated by participants at the Canadian Sinusitis Symposium, field in Toronto on April 26-27, 1996. VALUES: A hierarchical evaluation of the strength of evidence modified from the methods of the Canadian Task Force on the Periodic Health Examination was used. Strategies were identified to deal with problems for which no adequate clinical data were available. Recommendations arrived at by consensus of the symposium participants were included. BENEFITS, HARMS AND COSTS: Increased awareness of acute sinusitis, accurate diagnosis and prompt treatment should reduce costs related to unnecessary investigations, time lost from work and complications due to inappropriate treatment. As well, physicians will be better able to decide which patients will not require antimicrobial therapy, thus saving the patient the cost and potential side effects of treatment. RECOMMENDATIONS: Clinical diagnosis can usually be made from the patient's history and findings on physical examination only. Five clinical findings comprising 3 symptoms (maxillary toothache, poor response to decongestants and a history of coloured nasal discharge) and 2 signs (purulent nasal secretion and abnormal transillumination result) are the best predictors of acute bacterial sinusitis (level I evidence). Transillumination is a useful technique in the hands of experienced personnel, but only negative findings are useful (level III evidence). Radiography is not warranted when the likelihood of acute sinusitis is high or low but is useful when the diagnosis is in doubt (level III evidence). First-line therapy should be a 10-day course of amoxicillin (trimethoprim-sulfamethoxazole should be given to patients allergic to penicillin) (level I evidence) and a decongestant (level III evidence). Patients allergic to amoxicillin and those not responding to first-line therapy should be switched to a second-line agent. As well, patients with recurrent episodes of acute sinusitis who have been assessed and found not to have anatomic anomalies may also benefit from second-line therapy (level III evidence). VALIDATION: The recommendations are based on consensus of Canadian and American experts in infectious diseases, microbiology, otolaryngology and family medicine. The guidelines were reviewed independently for the advisory committee by 2 external experts. Previous guidelines did not exist in Canada.

Acute Disease↗