Tobacco use in a dental school patient population

A retrospective study was performed to determine the incidence of tobacco usage and cessation in a dental school patient population. The study was conducted to assess the magnitude of the tobacco problem in a dental school patient population and determine patients' interest and success in cessation. The study reviewed 1,030 randomly selected charts of patients who were seen during 2004. Of these surveys, 1,025 met the study criteria: a medical history form with completed questions concerning tobacco usage. Of the 1,025 surveys reviewed, 565 patients (55%) had used tobacco and 219 (39%) continued to use tobacco products, including 25 current users whose attempts to quit had failed. Surprisingly, 32% of the 219 tobacco users were not interested in quitting. Patients in the 20-29 age group had the highest prevalence of current tobacco users. Tobacco cessation increased steadily with age; the cessation trend was 21% in patients aged 20-29, increasing steadily to 100% prevalence among patients 90 or older. Tobacco usage also was found to be more prevalent among men than among women. Of the total patient population, 25% were current smokers, a percentage well above the national health goal to reduce tobacco usage to 12% by 2010. Dental care providers must work to reduce the percentage of tobacco-using patients by providing cessation information and support.     

Medical profile of a dental school patient population

Advances in health care and pharmacotherapeutics have led to a growing aging population living with complex medical conditions. These changes are apparent in patients presenting for treatment at dental schools. This study assessed the medical profile of patients seeking treatment at the School of Dental Medicine, State University of New York at Buffalo. Medical records of 1,041 consecutive patients who presented for comprehensive dental care at the school were retrospectively reviewed. The demographic data, medical status, and use of medications from the charts were analyzed. The mean age of the patients was 52 (SD+/-18), and the female to male ratio was 1.2:1. More than half of the patients had one or more systemic illnesses or were taking medication. The results of this study reflect the medical complexity of the growing aging population. The dental school curriculum should address the needs for management of the growing number of medically complex patients.     

The presence of anti-HBc in a dental school patient population

Testing for three serum markers in screening for hepatitis B disclosed 34 of 292 patients testing positive to anti-HBc. Responses to the medical history alone disclosed only one patient with a history of hepatitis. Seroanalysis, plus a complete history, yields the most reliable results.     

The prevalence of hypertension in a dental school patient population.

OBJECTIVE: A study of the prevalence of hypertension in the patient population was conducted at the University of Mississippi, School of Dentistry. METHOD AND MATERIALS: The 3,665 records reviewed represented patients treated by undergraduate dental students from 1993 through 1997. Inclusion criteria were diagnosis of hypertension by a physician or presentation with a systolic reading of greater than 140 mm Hg or a diastolic reading of greater than 90 mm Hg. RESULTS: Of the 1,021 subjects who met the criteria, 609 were previously diagnosed with hypertension and 412 exhibited elevated blood pressure. The prevalence of diagnosed hypertension in the study population was 16.6%. When the 412 subjects who exhibited elevated blood pressure were included, the prevalence of hypertension was 27.9%. At the initial screening, 32.2% of diagnosed adults and 27.0% of undiagnosed adults exhibited a systolic reading of 160 mm Hg or greater or a diastolic reading of 100 mm Hg or greater. For all age groups, there were no statistically significant differences in race, sex, educational level, or occupation between the diagnosed and undiagnosed groups. CONCLUSION: The prevalence of hypertension, often undiagnosed or uncontrolled, justifies routine blood pressure screening of dental patients.     

Implications of the changing medical profile of a dental school patient population

Representative adult patient populations seeking treatment at a dental school in 1976 and 1986 were analyzed for the prevalence and the characteristics of medical conditions. Patients' records (N = 3,000) were randomly selected from the examination clinics and reviewed for the presence and types of compromising medical conditions. The results indicated a significant increase in the percentage of dental patients who had medical conditions in 1986 as compared with 1976 (P less than .001), as well as significant changes in the types of medical conditions present. These data indicate an increase in the number of patients with medical problems in the general dental school patient population.     

Self-reported mental illness in a dental school clinic population

The purpose of this study is to assess the prevalence of mental illness in a university-based dental clinic population. Dentists routinely review the patient's medical history to identify any physical disease or condition that may impact dental treatment. Mental illness may also affect dental treatment and patient management. This study examined the degree to which patients seeking routine dental care report these diagnoses. Data was gathered from records of 508 consecutive new patients whose treatment plans were submitted for faculty approval. The patient's self-reported mental illness was obtained from the patient questionnaire and physical evaluation forms of the dental record. One hundred thirty-six patients (26.77 percent) reported at least one mental illness. Of all diseases and disorders recorded in the medical history, self-reported depression was second only to hypertension in frequency. Substance abuse, anxiety, anorexia, bulimia, insomnia, bipolar disorder, and post-traumatic stress disorder were also common findings. This study establishes the need for training of dental students to recognize and manage psychologically compromised patients. The dental curriculum must address these issues.     

Control of a rubella outbreak in a dental school population

This study traces the development of a rubella outbreak; 16 clinical and one sub-clinical case were detected. Overall, the incidence of infection was higher for males than females. Susceptibility rates determined by the absence of primarily IgG antibodies indicated that class association, social contact, and preexisting susceptibility patterns influenced the differences in attack rates seen among the classes. In spite of a higher susceptibility caused in part by the number of foreign students enrolled, no infections occurred in the graduate student population. Concern for the spread of rubella to susceptible students and personnel within the dental school, among adjunct dental assistant and hygiene programs and others at the adjacent medical school and hospitals, led to a comprehensive immunization policy. All dental and medical personnel, regardless of clinical contact, must present proof of immunity or be immunized.     

Survival analysis of complete veneer crowns vs. multisurface restorations: a dental school patient population

The purpose of this study was to compare the longevity of crowns versus large multisurface restorations in posterior teeth. The investigation used the treatment database at Virginia Commonwealth University School of Dentistry. The inclusion criteria for the final data set used for analysis were: only one restored tooth per patient, premolars with three or more restored surfaces, molars with four or more restored surfaces, molars and premolars restored with complete veneer metal crowns, or crowns veneered with metal and porcelain. The Kaplan-Meier approach was used to visualize the survival curves, and the Cox proportional hazards model was used for analysis of predictor variables. The investigation indicates crowns survive longer than large restorations and premolar restorations survive longer than molar restorations. The median survival for crowns exceeded 16.6 years, with the median survival of premolar restorations being 4.4 years and molar restorations 1.3 years. An interaction between age and treatment was discovered, with overall survival decreasing as patient age increases. The doctor supervising the treatment also affected survival with treatment supervised by specialists lasting longer than treatment supervised by nonspecialists.     

Seropositivity of the rapid plasma reagin (RPR) test in a dental school patient population: a retrospective study

OBJECTIVES: The purpose of this retrospective study was to determine the seropositivity of the rapid plasma reagin (RPR) in a dental school patient population. METHODS: Blood was drawn on 20,844 subjects registering for treatment at the Louisiana State University School of Dentistry. All subjects who are admitted to the dental school are submitted to RPR screening (Macro-Vue-RPR Card, Becton Dickinson), blood indices, and serum chemistries. Venereal Disease Research Laboratory (VDRL), microhemagglutination assay for Treponema pallidum (MHA-TP) and/or fluorescent treponemal absorption test for Treponema pallidum (FTA-ABS) were also run on the positive RPR results. RESULTS: Two hundred seventy-nine (1.34%) of the 20,844 were RPR-positive. Sixty-two subjects (0.30%) of this total population from the RPR-positive findings were nonreactive (biological false positives or BFP) to the MHA-TP and FTA-ABS. This left 217 (1.04%) subjects of the 20,844 screened who were seropositive on both the RPR and the FTA-ABS or MHA-TP. CONCLUSIONS: Since this study has not been performed in a dental school patient population setting, comparison with other institutions is difficult. The authors agree that routine RPR testing is helpful and cost effective to detect patients possibly infected with Treponema pallidum in a large patient population.     

Detecting diabetes in an elderly dental patient population

The prevalence of both diagnosed and undiagnosed diabetes, a disease which has a significant impact on dental care delivery, increases with age. Because of these two factors, the dental practitioner must pay special attention to the detection of diabetes in this age group. This paper describes a study that validates the use of a simple blood test in conjunction with a questionnaire as a method to detect undiagnosed diabetes in an elderly dental patient population.