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If the symptoms for which dental extraction is performed do not rapidly resolve, or if the tooth socket fails to heal, it is likely that there is further pathology in the alveolus or gingiva. A series of four cases is presented, in which, following dental extraction, a tumour was found to be the cause of the original symptoms.
The dental health of 457 5-year-old children who have lived continuously in fluoridated (at 1.0 mg F/litre) Newcastle and 370 children of the same age in non-fluoridated (less than 0.1 mg F/litre) South Northumberland has been reported. This paper examines in detail the caries prevalence in social class groups I + II, III, IV + V, and the social class/fluoridation relationship in 1987. The prevalence of dental caries in the three social class groupings I + II, III, and IV + V (and the mean dmft), respectively, was 35% (1.1), 46% (1.7) and 67% (2.4) in the fluoridated area, and 59% (2.2), 67% (3.7) and 77% (5.0) in the non-fluoridated area. Fluoridation was effective in all social class groupings and, because caries levels were higher in social classes IV + V, fluoridation brought about greater savings for these children than for those in social classes I + II. Fluoridation reduces but does not eliminate social inequalities, leaving social disadvantage/social background/social class as the major factors in caries prevalence for this age group. Further research into the fluoridation/social class relationship is required, particularly since the understanding of occupational class, now considered an imperfect representation of social class, is being superseded by other criteria which have stronger associations with measures of poor health.
In the light of recent warnings on the hazards of aspirin administration to children, a survey amongst the parents of 361 randomly selected child dental out-patients, aged 11.99 years and under, was undertaken to determine their analgesic of choice for the relief of dental pain. A significant number of parents are continuing to administer aspirin to children under 12 years of age, contrary to medical advice. The choice of a suitable alternative analgesic is discussed.
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The effectiveness of pain relieving treatments given for acute dental pain has been evaluated after 24 hours in 172 patients who presented to a dental hospital emergency department. Patients were contacted by telephone the day after attendance and graded their pain on a scale from 1 (no pain) to 5 (pain much worse). The mean pain scores for each diagnosis of cause of pain were calculated and related to the treatment given. Some 76% of patients were in pain due to the ravages of dental caries of periodontal disease. Overall, 87% received marked or total pain relief and this appeared to depend upon decompression of inflamed tissue. Oral administration of antimicrobial drugs alone produced little or no pain relief within 24 hours and anti-inflammatory analgesics offer poor pain control in these circumstances.
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To determine the pattern of antibiotic prescribing (source and type) for acute dental conditions in the emergency setting, a prospective cross-sectional study was undertaken of 500 consecutive new patients attending the examination and emergency clinic of the Cardiff Dental Hospital in May 1994. The source and type of antibiotics prescribed, the nature of complaint and type of antibiotic prescribed in the primary care and dental hospital setting were recorded. Antibiotic prescription was a feature of the treatment of 30% (149/500) of patients. The 60 patients who had received emergency treatment prior to attending the hospital emergency clinic had been prescribed a total of 14 different types of antibiotics; 41% of these patients had sought treatment from general medical practitioners. Antibiotics were frequently prescribed without generally accepted criteria and there was wide variation in prescribing. Overall, only seven different types of antibiotics were prescribed in the dental hospital setting. The use of second generation antibiotics was more common in general practice than in the dental hospital. The results suggest that many patients with dental pain may seek treatment from medical practitioners, prior to, or in place of, definitive dental treatment. In summary, rationalisation of antibiotic prescription and the provision of emergency dental treatment is needed.
It was no accident that Warren Harvey's paper on 'Tooth temperature with reference to dental pain while flying' was published during the Second World War, as Harvey was given the opportunity to investigate this subject after aircrew reported dental problems during flight. Group Captain Peter Richardson of the RAF Institute of Dental Health and Training reviews the paper.
Scuba diving is one of the fastest growing sports in the world. It is inevitable that the general dental practitioner (GDP) will have patients who participate in this sport and they should be aware of a number of problems that a diver can experience that are associated with the teeth and related structures. The aim of this article is to introduce the GDP to the dental problems associated with diving and make recommendations on dental care for scuba divers.
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In Prehistoric and Mediaeval times few dentitions in this country remained intact much after the age of 40-45 years. The point is made that dental caries and periodontal disease played little part in this early disintegration and it is unlikely that the population of this time suffered severely with their teeth. A change in dietary habits in the late seventeenth and early eighteenth century measurably increased the lifespan of the dentition, but also radically altered the prevalence of caries. This change is likely to have been responsible for a vast increase in dentally-related pain and suffering which was only capable of being tackled as a social problem by the advent of modern dentistry.
OBJECTIVE: Acupuncture is frequently advocated as an effective treatment of dental pain. The question whether or not it is effective for this indication remains controversial. The aim of this systematic review therefore was to assess the effectiveness of acupuncture in dental pain. DATA SOURCES: Four electronic databases were searched: Medline, Embase, CISCOM, and the Cochrane Library. Only controlled trials were included in this review. DATA EXTRACTION: Information was extracted from included studies and entered on standard forms independently by both authors. Methodological quality was assessed using the Jadad score. MAIN RESULTS: 16 such studies were located. The majority of these trials imply that acupuncture is effective in dental analgesia. However, important questions remain unanswered. CONCLUSION: It is concluded that acupuncture can alleviate dental pain and that future investigations should define the optimal acupuncture technique and its relative efficacy compared with conventional methods of analgesia.