Prevalence of oral lesions in the dental office.

Comprehensive head and neck examinations provide the best opportunity to carefully evaluate the oral cavity for the presence of disease. For this study, 40 dental professionals in 20 dental offices in Northern Ohio received a three-hour standardization course on oral pathology, performed head and neck examinations on all adult patients over a three-week period, and recorded the presumptive identification of all observed oral lesions. Lesion-positive and lesion-negative patients were compared on patient age, gender, tobacco usage, denture status, and the type of provider (dentist or hygienist) making the observations. Providers performed head and neck examinations on 3,182 adults, 847 (26.7%) of whom had 1,073 lesions. Lesion-positive and negative patients were similar in terms of age and gender, although patients with lesions were almost twice as likely to use tobacco and more than 2.5 times as likely to wear dentures. Most lesions were classified as white (36.6%), followed by red (17%), ulcerated (14%), pigmented (14%), and soft tissue enlargements (12%). Leukoplakia and erythroplakia were observed in 1% of the screened adults, although patients were not aware of the presence of these conditions. Overall, the prevalence of lesions in dental patients (26.7%) was similar to national estimates (27.9%), but the prevalence of some specific lesions varied.

Prevalence and etiology of erythema migrans among children in northeast Ohio.

OBJECTIVE: To determine the prevalence of erythema migrans (EM) in northeast Ohio; to identify demographic, health, and dental characteristics associated with this condition in patients aged 1 to 15 years; and to investigate the possibility that EM is a marker for children with multiple medications and certain systemic conditions. METHOD AND MATERIALS: In this retrospective chart review study, 1,900 charts were reviewed at 2 separate offices. One thousand were analyzed at a hospital dental clinic in Cleveland, Ohio, and 900 at a private pediatric dental office in a Cleveland suburb. Data were collected from each chart by 1 investigator and recorded in a database to be statistically analyzed. Nonparametric measures of association and logistic regression were used to determine differences between the presence of EM and the study variables and odds for EM. Significance level was set at P = .05. RESULTS: Seventy-two subjects (3.8%) were found to have EM. The more medications patients were taking, either prescription or over-the-counter, the greater the likelihood of EM (P <.001). Similarly, there was increased likelihood of EM with increasing numbers of medical diagnoses. Gender, oral hygiene, and behavioral status were not found to be statistically significant in the presence of EM. CONCLUSION: Erythema migrans was found in the records of 3.8% of children in 2 clinical facilities in the Midwest. Also, increased prevalence was found among patients with multiple health conditions in conjunction with multiple medication use.

The angle of the articular eminence in modern dentate African-Americans and European-Americans.

The purpose of this study was to determine if there were differences in the angle of eminentia of two 20th century populations based on race, age, gender, and number of teeth and whether there was asymmetry of the angles of eminentia. The sample included dry skulls from the Hamann-Todd Osteological collection as follows: 80 African-Americans (AA, 53 males and 27 females) and 62 European-Americans (EA, 49 males and 13 females), ranging in age from 16-77 years. The lateral, central, and medial aspects of the right and left slopes of the articular eminence were measured in a parasagittal plane. Independent t-tests, paired t-tests, and Pearson correlation coefficients were computed. For the AA population, the right central, lateral, and medial angles of eminentia were steeper than the corresponding left angles (paired t-test, p<0.05); for the AE males only the right lateral and medial angles were significantly steeper than the corresponding left angles (paired t-test, p<0.05). There were no significant relationships between age or number of teeth and the angle of eminentia measurements, nor were there differences in angle of eminentia by gender. There were two differences by race: the EA males had steeper left central and left medial angles than the AA males (independent t-test, p<0.05). The central angle of eminentia was consistently steeper than the medial angle (paired t-test, p<0.01), and the lateral was generally steeper than the medial.

Nursing home executive directors' perception of oral care in long-term care facilities.

Oral health in long-term care (LTC) facilities has been repeatedly documented as less than ideal. The complex nature of this environment has made it difficult to understand and improve the oral health status of residents through education and training. The purpose of the study was to investigate how the executive directors (EDs) of LTC facilities value oral health and to determine facility variables, which may influence how oral care is delivered. A mail survey of the EDs of all LTC facilities in Ohio (n = 1018) was conducted with 338 responses received after secondary follow-up (33.2% response rate). The 30-item survey included information concerning the nursing facility, the EDs, the EDs' perception of the level of oral health care, and value statements rated on a Likert-like scale. The results of the survey showed that more than two-thirds of the EDs were female and that most facilities were proprietary (70.3%). ED gender was not statistically associated with any of the oral health variables. Fifty-three percent of the EDs rated their residents' oral health as fair or poor but were still satisfied with the oral care provided at their facilities. The apparent discontinuity between perceived levels of oral health and satisfaction with oral care suggests that EDs are distanced from the oral care of their residents or they do not acknowledge oral health care needs. While the survey results revealed important facility characteristics and administrators' perceptions about oral health, the most important aspect of this project was the low response rate despite secondary follow-up. That, coupled with the negativity expressed upon follow-up, suggests a larger issue that may affect oral health in nursing facilities: oral health continues to have a low priority in this setting. Continuing efforts to improve oral health and educate LTC professionals about oral health's influence on general health is critical for managing the oral health of future generations of aging adults.