Native Language Spoken as a Risk Marker for Tooth Decay.

OBJECTIVE: The purpose of this study was to assess dmft, the number of decayed, missing (due to caries), and/ or filled primary teeth, of English-speaking and non-English speaking patients of a hospital based pediatric dental clinic under the age of 72 months to determine if native language is a risk marker for tooth decay. STUDY DESIGN: Records from an outpatient dental clinic which met the inclusion criteria were reviewed. Patient demographics and dmft score were recorded, and the patients were separated into three groups by the native language spoken by their parents: English, Spanish and all other languages. RESULTS: A total of 419 charts were assessed: 253 English-speaking, 126 Spanish-speaking, and 40 other native languages. After accounting for patient characteristics, dmft was significantly higher for the other language group than for the English-speaking (p<0.001) and Spanish-speaking groups (p<0.05), however the English-speaking and Spanish-speaking groups were not different from each other (p>0.05). CONCLUSIONS: Those patients under 72 months of age whose parents' native language is not English or Spanish, have the highest risk for increased dmft when compared to English and Spanish speaking patients. Providers should consider taking additional time to educate patients and their parents, in their native language, on the importance of routine dental care and oral hygiene.

Managing patients who have seizure disorders: dental and medical issues.

Some dental professionals may have concerns about treating patients who have seizure disorders. The authors contend that increased knowledge about seizures and how to manage them may make dental professionals more comfortable. This article reviews the various seizure types, discusses commonly used anticonvulsants and their side effects and outlines some special concerns dentists may have in providing care to these patients.

Rett syndrome--a rare and often misdiagnosed syndrome: case report.

Rett syndrome is a recently discovered, progressive neurological disorder that occurs exclusively in females early in life. Females with this rare and often misdiagnosed clinical entity have unusual but distinctive oral/digital habits. Dentists aware of Rett syndrome and its distinct manifestations will be able to aid in early diagnosis and treatment of those afflicted. A case report of a 4-year, 3-month-old white female with Rett syndrome and review of pertinent literature are presented. The previously reported oral/digital habits and oral manifestations of Rett syndrome are listed along with other unreported oral findings. Many of these oral manifestations are not unique to Rett syndrome. There is a likelihood that they may be related to trauma secondary to the excessive oral/digital habits, poor gait, and seizure activity.

Oral management of a patient with a plasminogen activator inhibitor (PAI-1) deficiency: case report.

Plasminogen activator inhibitor-1 (PAI-1) deficiency causes a rare bleeding disorder by allowing excessive fibrinolysis to occur. Knowledge of the specific type and severity of the bleeding disorder is crucial in planning a safe and appropriate treatment sequence in conjunction with a hemophilia team. This article reports the oral management of a 9-year-old female with PAI-1 inhibitor deficiency using tranexamic acid (Cyclokapron).

Dental office access for patients with disabling conditions.

Today's professional health care centers are becoming more accessible to patients with handicapping conditions each year. The increase in numbers of these persons in society, along with their desire to be treated locally, will result in a much higher influx of persons with disabling conditions seeking professional services. Dental professionals should be aware and make appropriate responses to the needs of these special patients. State codes for facilities access vary widely, but are clearly becoming more defined as federal legislation and federal regulations continue to support the rights of persons with disabling conditions to access work, study, leisure, and services. The dental profession has an opportunity to demonstrate leadership in handicapped access in both the private and public professional sectors without direct governmental mandates. The American Dental Association and constituent state associations can further accomplish this by setting accessibility guidelines for the dental environment.

Baby bottle tooth decay: a concern for all mothers.

Health care professionals often inappropriately separate dental health from other health functions. Baby bottle tooth decay (BBTD) should be a concern for all professionals who work with expectant or new mothers and very young children. Research indicates that even though many mothers are aware of the etiology of the condition, they continue to allow prolonged nursing with milk or liquids other than water. Nurses can help promote good oral health for children by educating and training expectant and new mothers, children, and others who work with mothers and children in preventing BBTD.

Incidence and indications for surgical management of phenytoin-induced gingival overgrowth in a cerebral palsy population.

Phenytoin-induced gingival overgrowth (PIGO) is a recognized side effect in many cerebral palsy patients using diphenylhydantoin (Dph) for the control of seizures. Severe degrees of gingival overgrowth can affect the patient's dentition by: 1) interference with normal masticatory function to the point of documented weight loss, 2) producing an ectopically erupting dentition to the point of poor occlusal development, and 3) producing an unattractive appearance, in those patients who appreciate their esthetics, to the point of lessened self-concept. The purpose of this investigation was to evaluate the management of a group of 142 patients, with various cerebral palsy diagnoses, as to the use of diphenylhydantoin for the control of seizures. If diphenylhydantoin was used, the presence, degree, and surgical management of PIGO was documented. Additionally, if surgical treatment was employed for removal of hyperplastic gingiva, the indications for outpatient treatment (no use of general anesthetic) or inpatient (hospital admission and use of a general anesthetic) were identified. A discussion of major indications of surgery and postoperative complications of all surgical procedures is provided.