THE HSA: A FOCUS FOR ADVANCING PRIMARY PREVENTIVE DENTAL PROGRAMS

In conclusion, as community agencies under P.L. 93-641 embark upon the definition of health status goals, health system goals, and program implementation, dentists have the opportunity to clarify and assist in developing a vigorous approach to meeting dental health needs through primary prevention. Insofar as public health dentistry is able to provide technical assistance and leadership at the local HSA and SHPDA levels, the powerful tools for change embodied in this law can be a force for promoting the oral health of our population.     

The flow-rate-dependent excretion of ionized calcium in human parotid saliva.

The total calcium content of parotid saliva is increased in various diseases. Because of methodological difficulties, little is known about the ionized calcium fraction although it might be of importance for the secretion of fluid and proteins. Using a new method with calcium-selective disc electrodes, which gives an easy and exact estimation of ionized calcium, the Ca²⁺ activity in pilocarpine-stimulated parotid saliva of 10 healthy males was measured. With increasing flow-rate (0.1–0.6 ml/min), the concentration of ionized calcium rose exponentially from 1.13 ± 0.36 mequiv./litre (0.57 ± 0.18 mmol/litre) to 1.76 ± 0.21 mequiv./litre. At higher flow-rates (up to 2.5 ml/min), a plateau was observed. The total calcium concentration and the ionic calcium concentration were closely correlated (r = 0.93) and the ratio ionic/total remained nearly constant at 0.54 at all flow-rates.     

Stress analysis of disjunct removable partial dentures.

The (1) tooth-supported, (2) ridge-supported, and (3) tooth- and ridge-supported variations of the disjunct removable partial denture were studied. When testing loads were applied to three sites, bilaterally and unilaterally, it was found that the stresses were highest when the removable partial framework was tooth-support. No significant difference was recorded between the ridge-supported partial denture and the tooth- and ridge-supported partial framework. Further refinement of the pinsleeve mechanism may be necessary to effect better control over the distributions of the stresses.     

Follow-up investigation of reconstruction of the alveolar process in the atrophic mandible.

In this article the results are presented of the reconstruction of the alveolar process with iliac crest bone grafts in 14 patients. In all cases in a second operation a vestibuloplasty and a floor-of-mouth plasty was done. After an average follow-up period of 39 months, almost complete resorption of the bone grafts was observed. The clinical results varied. To obtain better results and avoid complications like pain at the donor and graft sites, mental nerve disturbances and other major problems associated with bone grafting, we prefer to perform the visor osteotomy in the future.     

Waste of dental pain.

The effects of dental disease on the population are difficult to describe to the lay public in terms which that public will appreciate. An attempt has been made to quantify the impairment of the quality of life which results from uncontrolled dental disease. Studies indicated that each person could have three to four days of dental pain a year which could be equivalent to 200 million days of toothache per year in the United Kingdom. Only 15 per cent of those who had toothache did seek dental advice for it. This represented a waste and an impairment in the quality of life. It is proposed that estimates of days of dental pain could prove an index of the quality of life of a population.