Substance use and dependence education in predoctoral dental curricula: results of a survey of U.S. and Canadian dental schools.

The purpose of this study was to obtain information about education in substance use and dependence that appears in the predoctoral curricula of U.S. and Canadian dental schools. Sixty-eight deans were sent a twenty-item survey requesting information about when in the curriculum these subjects were taught, what instructional methods were used, and whether behavior change instruction was included to address these issues in clinical interactions. The survey had an 81 percent response rate. The topics of alcohol use and dependence, tobacco use and dependence, and prescription drug misuse and abuse were reported in over 90 percent (N=55) of responding schools' predoctoral curricula. The topic of other substance use and dependence was reported in only 72.7 percent (N=40) of these schools. The primary instructional method reported was the use of lecture. Less frequently used methods included small-group instruction, instruction in school-based clinic, community-based extramural settings, and independent study. As future health professionals, dental students are an important source for patients concerning substance use, abuse, and treatment. Our investigation confirmed that alcohol, tobacco, and prescription drug abuse is addressed widely in predoctoral dental curricula, but other substance use and dependence are less frequently addressed.

A survey of pharmacy students' experiences with gambling.

OBJECTIVES: To assess gambling among pharmacy students using the South Oaks Gambling Screen (SOGS). METHODS: Six hundred fifty-eight pharmacy students enrolled at Creighton University were surveyed to determine the extent and characteristics of their gambling. RESULTS: Four hundred eighty-eight students (74.2%) participated (mean age was 26.6 years and 63.4% were female). Almost two-thirds (63.1%) gambled at least once during the past 12 months. Slightly more than 16% (80) of students were identified as "at-risk" (SOGS scores of 1 to 2). Another 5% (24) were likely to be problem gamblers (SOGS scores of 3 to 4), while 1% of students were identified as probable pathological gamblers (SOGS scores > or = 5). Students who gambled were significantly more likely than non-gamblers to be single males. Gamblers with a score > or = 1were significantly more likely to report gambling had affected their relationships with others, compared to casual gamblers. CONCLUSIONS: Gambling is a common activity among pharmacy students. While the incidence of problem gambling is relatively small, the percentage of our students who may be at-risk for gambling-related problems is noteworthy.

Dental student experiences with gambling: a survey of attitudes, exposure, and impact.

The aim of this study is to assess the extent and characteristics of gambling among dental students. Three hundred sixteen dental students enrolled at a private midwestern dental school accessed the twenty-six-item modified South Oaks Gambling Screen (SOGS) as an online survey. Students were advised of the anonymity and confidentiality of the survey results. Student characteristics are presented as descriptive data. One hundred eighty-six students (58.9 percent) responded. Nearly two-thirds (61.3 percent) of the respondents reported having gambled at least once during the past twelve months. Using the SOGS score, six students can be considered problem gamblers with a value of 3 but <5, and three students can be considered as pathological gamblers with a score of >or=5. Gambling is a common activity among dental students and should be considered a possible factor for students who develop academic or social difficulties. Students do not appear to have a realistic perception of what constitutes problem or pathological gambling and may benefit from programs that address this issue.

In vitro caries formation in primary tooth enamel: role of argon laser irradiation and remineralizing solution treatment.

BACKGROUND: The authors evaluated the effects of argon laser (AL) diation and remineralizing solution (RS) treatment alone and in combination on carieslike lesion formation in primary tooth enamel in an in vitro study. MATERIALS AND METHODS: The authors divided 10 caries free primary tooth enamel surfaces into four segments and assigned them to one of four treatment groups: no treatment control, AL irradiation alone at 13.5 joules per square centimeters (0.270 watts, 5-millimeter beam, 10 seconds), RS treatment alone for two minutes and AL irradiation before RS treatment. The authors created in vitro caries using a modified ten Cate solution. They evaluated longitudinal sections (three per tooth segment, 30 per treatment group) for mean lesion depth. RESULTS: After lesion formation, mean lesion depths (+/- standard deviation) were 179 +/- 16 micrometers for the no treatment controls, 137 +/- 19 microm for AL irradiation alone, 87 +/- 9 microm for RS treatment alone and 68 +/- 12 microm for AL irradiation before RS treatment. All treatment groups had mean lesion depths that were significantly less than those for the matched no-treatment control group (analysis of variance [ANOVA], Duncan multiple range [DMR] test, P < .05). AL irradiation before RS treatment significantly reduced lesion depth compared with AL irradiation alone or RS treatment alone (ANOVA, DMR test, P < .05). CONCLUSIONS: The maximum reduction in lesion depth in primary tooth enamel was achieved when the RS--which contained calcium, phosphate and fluoride in a carbopol base--was combined with AL irradiation. CLINICAL IMPLICATIONS: It would appear that to improve clinical caries resistance to enamel dissolution, AL irradiation before RS treatment could be used.

Argon laser irradiation and fluoride treatment effects on caries-like enamel lesion formation in primary teeth: an in vitro study.

PURPOSE: To evaluate topical acidulated phosphate fluoride (APF) and low fluence argon laser (Ar) treatment effects on in vitro caries formation in primary tooth enamel. METHODS: 20 extracted or exfoliated primary teeth with sound buccal and lingual surfaces underwent soft tissue debridement and a fluoride-free prophylaxis. Treatment groups were: (1) Control [n=5]; (2) Ar [231mW, 10 seconds, 11.5J/cm2; n=5], (3) 1.23% APF for 4 minutes before Ar [n=5]; (4) Ar before APF [n=5]. Buccal and lingual enamel surfaces were treated, and then rinsed in deionized,distilled water (24 hours). An acid-resistant coating was applied leaving buccal and lingual sound enamel windows exposed. In vitro enamel caries was created (2.2 mM calcium, 2.2 mM phosphate, 5.0 mM fluoride, pH 3.90, 10 days). Following longitudinal sectioning, two lesions per primary tooth (10 lesions total) with each group were evaluated for lesion depth (polarized light, water imbibition) and compared (ANOVA, Duncan's Multiple Range). RESULTS: Argon laser irradiation alone provided a 41% reduction in lesion depth (176 +/- 21 microm, P< 0.05) when compared with that for the no treatment controls (297 +/- 31 microm). The combination of argon laser irradiation with APF treatment resulted in lesion depth decreases of slightly over 50% (140 +/- 23 microm for APF before ArTx; 124 +/- 17 microm for ArTx before APF, P< 0.05) compared with control lesion depths, and 20 to 30% over that for argon laser treatment alone (P< 0.05). There was no statistical difference in lesion depth regardless of whether fluoride treatment occurred before or after laser irradiation (P> 0.05).

Aberrant root formation: review of root genesis and three case reports.

The mechanism of root formation and tooth eruption is a complex process which is not fully understood. Prior to a tooth emerging into the oral cavity, root genesis is initiated by derivatives of the enamel organ. The dental follicle mediates an eruption pathway allowing for movement of the developing tooth in a coronal direction. As the tooth moves towards the oral cavity, root formation occurs passively in the resulting space. Failure of the enamel organ and dental follicle to properly coordinate may result in complications in the eruption process. This clinical report presents 3 cases of isolated, unerupted teeth with dysmorphology of the roots. The process of root development and tooth eruption is also briefly reviewed.

In vitro enamel caries formation: argon laser, light-emitting diode and APF treatment effect.

PURPOSE: To evaluate argon laser irradiation (AL), light-emitting diode exposure (LED), and acidulated phosphate fluoride treatment (APF) in vitro effects on caries-like enamel caries formation. METHODS: Sound teeth (n = 18) were divided into four tooth quarters and coated with an acid-resistant varnish, leaving an enamel window exposed per tooth quarter. The tooth quarters were assigned to: (1) no treatment (control, mesiobuccal); (2) 1.23% APF (4 minutes, distolingual); (3) LED (Ultradent Ultra-Lume LED2 20 seconds, mesiolingual); and (4) AL (HGM Model 8, 11.5 J/cm2, 231 mW, 5mm beam size, 10 seconds, distobuccal). Following caries-like lesion formation (modified ten Cate solution), longitudinal sections (three per tooth quarter, 54 lesions per group) were obtained and evaluated for mean lesion depths (water imbibition, polarized light microscopy, ANOVA, DMR). RESULTS: Mean lesion depths were: 198 +/- 21 microm for controls; 186 +/- 17 microm for LED; 117 +/- 19 microm for AL; and 104 +/- 23 microm for APF. Lesion depths were statistically significantly decreased for AL (41%) and APF (47%) groups (P < 0.05), compared with controls. A slight lesion depth reduction for LED (6%) was present compared with controls; however this was not statistically significantly different (P > 0.05).

An in vitro study of enamel surface microhardness following argon laser irradiation and acidulated phosphate fluoride treatment.

PURPOSE: The purpose of this in vitro study was to evaluate the effect of low-fluence argon laser (AL) irradiation and acidulated phosphate fluoride (APF) gel treatment on enamel microhardness. METHODS: Twelve mandibular permanent molars were selected for this study. The teeth were sectioned generating 4 flat enamel surfaces per tooth. The flattened enamel tooth surfaces were randomly assigned to 1 of 4 treatment groups: (1) no treatment (control); (2) the enamel surface was exposed to a 4-minute, 1.23% APF gel treatment; (3) the enamel surface was exposed to AL irradiation of 11.5 J/cm2 (0.23 1-W, 5-mm beam size, 10 seconds); and (4) the enamel surface was exposed to the same AL irradiation followed by an APF gel treatment. Using a Buehler Micromet II Digital Microhardness Tester, Knoop hardness was determined using a 1,000-gram load and a dwell time of 12 seconds. Five hardness values were recorded for each enamel surface. Data were analyzed using ANOVA and Fisher's least significant difference post-hoc test. RESULTS: Mean surface hardness values (+/-SD) were 298+/-37 Knoop hardness (HK) for the no treatment (control), 270+/-70 HK for the APF-only group, 316+/-5 HK for the AL-only group, and 317+/-25 HK for the AL-before-APF group. The AL-only and AL-before-APF groups had significantly higher (P<.05) surface hardness values vs the APF-only group. CONCLUSIONS: Enamel surface microhardness is higher when exposed to low AL irradiation only or AL before APF vs a no treatment (control) enamel surface.

Enamel caries initiation and progression after argon laser irradiation: in vitro argon laser systems comparison.

OBJECTIVE: The purpose of this in vitro laboratory study was to determine the effect of low-fluence argon laser (AL) irradiation delivered from two different argon laser systems on enamel caries-like lesion initiation and progression. BACKGROUND DATA: Previous in vitro investigations and a recent in vivo pilot study have shown that AL irradiation of enamel provided a protective effect against in vitro and in vivo cariogenic challenges. MATERIALS AND METHODS: Twenty extracted human molars were selected, and 10 teeth were assigned to the HGM argon laser group and 10 were assigned to the LaserMed argon laser group. The exposed buccal windows of sound enamel were exposed to low-fluence irradiation, while the lingual windows of enamel were not exposed to laser irradiation and served as the no-treatment (control) group. Enamel caries-like lesions were created using an acidified gel. Two longitudinal sections were taken per sample (n = 20 lesions per group) and evaluated by polarized light microscopy for body of the lesion depths after lesion initiation (8 weeks) and progression (12 weeks) periods. RESULTS: After lesion initiation and progression, the body of lesion depths were similar for both argon-irradiated groups (p > 0.05). With the no-treatment (control) group, there were significant increases in lesion depth with a 61-78% increase for the lesion initiation period and a 50-69% increase for the lesion progression period when compared with the argon laser-treated groups. CONCLUSION: Argon laser irradiation provides a certain degree of protection against in vitro enamel caries initiation and progression. Resistance to a continuous caries challenge was similar with either argon laser delivery systems (HGM and LaserMed). Argon laser irradiation may prove to be beneficial in reducing the caries susceptibility of sound enamel and white spot lesions in the clinical environment.