AIDS and Infection Control: Amsterdam Dentists Surveyed

In March 1988 all Amsterdam dentists (N = 470) were sent a questionnaire to assess the extent of compliance with guidelines from the Health Council to prevent HIV transmission in dental practice. Response rate was 62 percent. Gloves, masks, and other protective garments were widely used. Other infection control procedures, like sterilizing instruments, were often not followed in ways recommended by the Health Council. To date, 60 percent of the respondents did not spend more than US$2,500 for protective garments or special equipment. Planned expenditure is substantially higher. One-quarter of the respondents were certain to have one or more HIV-seropositive patients, and 35 percent believed they did. When taking the medical history, almost one-third of the dentists ask questions to assess whether a patient is possibly HIV seropositive. Forty percent of the dentists hold the opinion that it is necessary for a dentist to know whether a patient is HIV seropositive. This is against Health Council views. Thirty percent of the respondents are definitely fearful of AIDS infection and want additional information or training on this topic.     

Mandibulofacial dysostosis. Case report

A case of mandibulofacial dysostosis (Treacher Collins syndrome) is presented. Clinical features and skull radiographs revealed typical anomalies associated with the syndrome. Cleft of the soft palate and unerupted multiple supernumerary teeth were present in this case. No haematological, biochemical or immunological abnormalities could be detected in the patient. Pedigree analysis showed an autosomal dominant mode of transmission of the disease. Chromosomal studies did not reveal any structural or numerical discrepancies.     

The Validity of Self-reported Oral Health Status in the Elderly

The validity of self-reported number of teeth was assessed in a random sample of 50 individuals aged 70+ by comparing self-reports in a telephone interview with results of a subsequent in-home examination by a dentist. There were no significant differences between self-report and examination data, nor was there any systematic under- or over-counting of teeth as the actual number of teeth increased. These data support the validity of self-reported dentition.     

The Oral Health Status, Treatment Needs, and Dental Utilization Patterns of Native American Elders

The purpose of this study was to evaluate the oral health status, treatment needs, and dental care utilization patterns of a Native American population aged 65-74 years. A random sample of 688 individuals was chosen and approached regarding participation in the study. Data were gathered through an interviewer-administered questionnaire and an oral examination. A total of 204 individuals completed all aspects of the study. Only one participant had all 28 natural teeth, while 58.3 percent were totally endentulous. Of the 85 dentate participants, almost 53 percent required at least one extraction. The average number of required extractions in the dentate subjects was three. Although 94 percent of the sample stated they had a usual source of dental care, 40.7 percent had not visited a dentist within the last five years. Multiple regression analyses were used to determine the factors associated with total number of teeth present among the dentate participants. Years of education and time since last dental visit were the two significant predictors (P less than .05) of number of teeth present. The higher the level of education, the greater the number of teeth in later life. The number of teeth present was inversely related to years since dental treatment. Compared to the results of the National Survey of Oral Health in US Employed Adults and Seniors, this Native American sample had a higher prevalence of endentulism and utilized dental services less often than a comparable age group in the US population as a whole.     

Modified Hygienic Epitec System Abutment for Magnetic Retention of Orbital Prostheses

Maintenance of healthy periimplant soft tissue is a significant problem for orbital prosthesis wearers. Two female patients with orbital defects after malignant tumor resection were treated using custom‐made retentive components of an individual magnet for an Epitec System orbital prosthesis. Freestanding hygienic retentive components for an individual magnet were fabricated. An abutment replica was trimmed and modified, and using pattern resin, a magnetic keeper was cast and soldered to the abutment. The patients could maintain good hygiene and healthy periimplant soft tissue. This type of freestanding retentive component may be advantageous for the hygiene maintenance of periimplant soft tissue.     

Combined mechanical and antibiotic periodontal therapy in a case of Papillon-Lefèvre syndrome

BACKGROUND: Papillon Lefèvre syndrome (PLS) is a rare entity and, as such, it is almost impossible to evaluate an effective therapy in a randomized controlled study. The amount of success reported after therapy for prepubertal periodontitis (PP) in PLS is highly variable from case to case. The goal of this case report is to evaluate the effects of a combined mechanical and antibiotic periodontal therapy regimen in the management of PLS. METHODS: A male patient was diagnosed as suffering from PP associated with PLS at the age of 7 years. He showed hyperkeratosis of the palms and soles, as well as advanced periodontal disease already affecting permanent teeth with maximal probing depth and vertical attachment loss of 12 mm and 11 mm, respectively. Subgingival debridement was performed with simultaneous administration of oral 250 mg amoxicillin 3 times daily and 250 mg metronidazole twice daily for one week. Clinical parameters were assessed and subgingival plaque was collected from all teeth prior to therapy and 7 and 26 months after treatment. Selective cultures for A. actinomycetemcomitans were incubated for each individual tooth and DNA probe analysis was performed for various periodontal pathogens. RESULTS: Prior to combined mechanical and antibiotic treatment, all teeth but one harbored Actinobacillus actinomycetemcomitans subgingivally. However, at 7 and 26 months after therapy A. actinomycetemcomitans could be detected neither by culture nor by DNA probes. Clinical parameters improved markedly and teeth erupting after therapy did not exhibit attachment loss of more than 1.5 mm during the observation period. CONCLUSIONS: Eradication (suppression beneath detection levels) of A. actinomycetemcomitans seems to play a significant role in the successful treatment of localized prepubertal periodontitis in PLS.     

Periodontal Attachment Loss in Independently Living Older Adults in Ontario, Canada

This paper describes the periodontal disease experience of a community-dwelling population aged 50 years and older, living in four communities in Ontario, Canada. The periodontal status of this population was assessed using attachment loss and the extent and severity index. Attachment loss was measured at two sites on each tooth using a pressure-sensitive periodontal probe. Complete periodontal data were obtained on 624 subjects. The mean number of sites per subject was 37.9. In line with recent US studies, the diagnostic threshold for a diseased or previously diseased site was set at 2 mm of loss. The overall mean attachment loss was 2.95 mm, with 19.7 percent of subjects having an overall mean attachment loss of 4.00 mm or more. The proportion of sites examined with loss of attachment of 2 mm or more was 77 percent. The severity of disease, defined as the average distance between the base of the sulcus or pocket and a point 1.00 mm apical to the cemento-enamel junction in sites with loss of 2 mm or more was 2.44 mm. These data indicate that the extent and severity of disease in this population were greater than that reported by some recent studies in the US. Taken together, the results of these studies suggest that there is some variation in the periodontal disease experience of population subgroups across North America.