[International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Hebrew edition].

Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and follow up are important for improving a favorable outcome. Guidelines should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the best current evidence based on literature search and professional opinion. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented. The Hebrew Edition is part of the IADT global effort to provide accessibility to these guidelines worldwide.

[International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Hebrew edition].

Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth. The Hebrew Edition is part of the IADT global effort to provide a worldwide accessibility to these guidelines. This scond part of the guidelines will focus on avulsion of permanent teeth.

[International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Hebrew edition].

Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome. The Hebrew Edition is part of the IADT global effort to provide a worldwide accessibility to these guidelines. This third part will discuss injuries in the primary dentition.

A pilot study of the association between cariogenic oral bacteria and preterm birth.

OBJECTIVES: We examined the associations between preterm birth and low birth weight and maternal caries history, maternal periodontal status, and salivary levels of mutans streptococci and Lactobacilli. DESIGN: This study was a matched case-control study in women during their pregnancy or up to 8 weeks after delivery. SUBJECTS AND METHODS: Thirty-four women delivering before 37 weeks gestation were recruited along with 73 term controls matched for age and race/ethnicity. Demographic and obstetric information was collected from questionnaires and medical records and oral examinations along with commercial salivary tests were completed within the study groups. MAIN OUTCOME MEASURES: The main outcome variables were the preterm birth and low birth weight status. The independent variables measured were the salivary levels of Lactobacilli and mutans streptococci and the caries and periodontal status of the subjects. RESULTS: The odds ratio comparing low levels of bacteria in preterm mothers and controls was statistically significant for Lactobacilli (odds ratio (OR) = 3.45, 95% confidence interval (CI) = 1.27 to 10.00) and almost significant for mutans streptococci (OR = 2.63, 95% CI = 0.95 to 8.33). Clinical caries and periodontal disease measures did not differ significantly between groups. CONCLUSION: Within the limitation of our study, low levels of Lactobacilli in saliva were found to be associated with preterm birth.

Reattaching fractured tooth segments: an esthetic alternative.

Reattaching fractured tooth segments offers an esthetic transitional restorative alternative to bonded composite and full crowns. The authors review this technique and demonstrate its application.

Traumatic dental injuries: current treatment concepts.

In an overview of traumatic injuries in the permanent dentition, the authors describe the classification of, assessment of and treatment strategies for managing such injuries. They explore pulpal and periodontal considerations, as well as methods of minimizing complications. In addition, they suggest preventive strategies and future directions for trauma management.

Infection control practices of Minnesota dentists: changes during 1 year.

In 1986, a survey of all licensed Minnesota dentists (N = 2,752) was conducted to determine current infection control practices. In 1987, the survey was repeated with a 45% random sample of all Minnesota dentists (N = 1,357) to monitor changes in such practices during 1 year. The findings indicate that dentists made dramatic changes in their routine use of barrier techniques and also, that rates of vaccination against hepatitis B increased decidedly. Younger dentists had higher vaccination rates and use of routine barrier techniques. Although dentists' reluctance to treat patients with AIDS decreased in frequency, some dentists still refuse to treat these patients. However, a substantial majority will treat patients with other infectious diseases.

Professional self-regulation: peer review.

Dentistry, in fulfilling its responsibility for self-regulation, has established a highly specific and formalized method of peer review. Its primary purpose is to mediate problems between patients, dentists, and third parties relative to the quality of treatment and appropriateness of care. It is a confidential service provided to the public and profession at no cost and accomplished with the voluntary cooperation of all parties involved. Decisions of peer review committees are advisory in nature but offer an alternative to legal resolution of misunderstandings and problems in patient care. The profession, by continually refining peer review and by educating its members and the public to its function, is providing a unique and valuable service to patients, dentists, and third parties. The objective and consistent application of this self-monitoring process is but one mechanism by which dentistry seeks to serve the public and perpetuate its high standard of care.

Bonding of fractured tooth segments: a review of the past 20 years.

The technology of tooth-bonding materials has developed over the past 20 years to achieve results that are quick, minimally invasive and esthetically pleasing. The following paper is an overview of the advances in tooth-bonding technology over the past 20 years.

State dental boards and mandatory HIV testing.

Public and professional debate over what, if any, action should be taken by state regulatory agencies regarding AIDS and the HIV status of dentists has increased in recent months. To determine if state boards had workable policies in place or were considering such policies, a telephone survey of all state boards was undertaken. All boards participated, although three provided only limited information. As of early 1992, only two boards required evidence of immunity to HVB for relicensure and none require evidence of seronegativity to HIV for relicensure. Twelve percent of the boards anticipate such requirements within two years. None have mandatory HIV testing, but 13 percent anticipate such requirements in the near future. The authors conclude that while few agencies have taken more than tentative steps toward rigorous HIV testing or restrictions, most are aware of much closer public scrutiny. More restrictions seem likely as these agencies attempt to balance public and professional rights and responsibilities.