The use of a neoprene "thumb-sock" to prevent trauma in a thumb-sucking child with intractable epilepsy

A nine-year-old girl with spastic quadripiegia, mental retardation, poor vision, a gastrostomy, and intractable epilepsy was referred by her pediatrician for a dental assessment with a view to extracting her anterior teeth as a means of preventing repeated damage to the skin over the proximal phalanx of her left thumb, which she sucked at night. This was the time of day when the frequency of her epileptic seizures was highest. A simple solution to the problem was developed by a dentist and an occupational therapist In which nylon-coated 3-mm neoprene sheeting (wet-suit material) was formed into a "thumb-sock" with a simple Velcro fastening around the wrist. No trauma to the thumb from epileptic seizures has occurred since the "thumb-sock" was fitted 24 months ago .     

The oral health of older people: general dental practitioners' beliefs and treatment experience

The purpose of this study was to examine New Zealand general dentists' beliefs about older people's oral health and to identify the important barriers that prevent dentists from treating institutionalized older adults. A postal survey was distributed nationwide to a representative sample of 700 dentists (response rate 64.5%). Dentists' beliefs were mostly consistent with current epidemiological knowledge, although most (81.5%) mistakenly believed that the root surface caries increment was greater than that for coronal caries. One in four had visited a long‐term care (LTC) facility during the previous 2 years. Over threequarters cited the inconvenience of leaving their practices as a barrier, and the lack of a financial incentive was cited by almost half. The results suggested that the areas most in need of attention were the LTC staff's oral health knowledge and attitudes, as well as government policies. Although dentists' beliefs, practices, and attitudes occasion some optimism, the increase in the dentate older population means that policymakers will need to examine efficient, dentist‐acceptable ways of delivering care. The profession will need to develop and sustain an appropriate workforce.     

An epidemiological comparison of Dean's index and the Developmental Defects of Enamel (DDE) index

Objectives: To compare the Dean's and DDE indices in examining dental fluorosis and diffuse opacities. Methods: Survey of a random sample of 9‐year‐old children in Southland, New Zealand. Dental fluorosis was measured using Dean's index. Enamel defects were recorded using the DDE index. Results: A total of 436 children (74.5 percent) were examined: 24.1 percent had diffuse opacities, and 10.8 percent of children had fluorosis (P < 0.001). At tooth level (using the score for the same tooth), the indices were more similar, but 9 percent of the 33 with diffuse opacities showed no visible signs of fluorosis. Conclusions: We found relatively little concordance between the DDE and Dean's indices in determining person prevalence of defects among children. At the tooth level, concordance between the two was greater, and suggests that little may be lost in fluorosis studies which use the DDE index, particularly as it enables collection of a wider and more comprehensive range of information. Although the use of Dean's index is important for historical comparisons, investigators should appreciate its limitations.     

The occurrence of xerostomia and salivary gland hypofunction in a population-based sample of older South Australians

This paper examines the prevalence of and concurrence between the symptoms of dry mouth (xerostomia) and reduced salivary flow (SGH) among a population-based sample of older South Australians. Participants in a longitudinal dental study of older people were asked a global question about their experience of dry mouth (“How often does your mouth feel dry?”), and those who responded “Always” or “Frequently” were categorized as xerostomic. Unstimulated whole salivary flow rate was measured, and individuals whose flow rate was less than 0.1 mL/min were categorized as SGH cases. Saliva samples were collected from 700 individuals, of whom 683 (97.7%) answered the dry-mouth question. The mean unstimulated salivary flow rate was 0.27 mL/min (SD 0.22). The prevalence of SGH was 22.1%, and the prevalence of xerostomia was 20.5%, but only 5.7% of participants had both conditions. Almost two-thirds of the sample had neither condition. Males and females differed in the degree of concurrence between the two conditions. It appears that, in the group studied, xerostomia and SGH were largely discrete conditions, supporting the assertion by other workers that low salivary flow may not be the key factor in the etiology of xerostomia among older people.