Rationale for using single-use disposable air/water syringe tips.

The research discussed in this article was conducted to study the inaccessible lumen surfaces of used and unused metal tips of air/water syringes using a light and a scanning electron microscope. Factors affecting the selection of air/water syringe tips were enumerated and compared. Patient and dentist acceptance of reusable and single-use air/water syringe tips for use in the oral cavity was evaluated. Although heat sterilization may destroy microbial organisms, the internal surfaces of metal tips were found to be rough, making them the focus of mineral and bioburden deposits. With regard to cleaning and sterilization, disposable tips were found to be more acceptable in clinical use than metal tips.

Hepatitis B virus infection. Current status in dentistry.

HBV is a serious threat to members of the dental team. Dental personnel who are carriers of HBV, many of whom may not be aware of their status, are also at risk for hepatitis delta infection. In 1991, the Occupational Safety and Health Administration issued an instruction (in the Federal Register Part II, 29 CFR Part 1910.1030, 56-235)64175-64182) on Occupational Exposure to Bloodborne Pathogens--Final Rule, mandating that HBV vaccine be offered by employers free of charge to all at-risk employees. From a public and professional health perspective, such a mandate was a significant step forward. It is hoped that this update will assist employers to understand better their role in providing HBV vaccine and will assist employees in understanding why acceptance of vaccination is of prime importance to practitioners and staff, their families, and their patients.

Evaluation of medical consultations in a predoctoral dental clinic.

OBJECTIVE: A patient's medical condition can affect the delivery of dental care. Medical consultation is indicated for dental patients whose medical history is uncertain or when physical assessment may indicate an untreated medical problem. The aims of this study were to evaluate the use of medical consultation and determine how it affects dental treatment plans in a predoctoral dental clinic program. STUDY DESIGN: Reviews of 147 medical consultation requests were performed. RESULTS: The main reasons for medical consultations were cardiovascular assessment (51.5%) and diabetic status determination (12.6%). In the cardiovascular assessment category, hypertension (48.1%) and heart murmur (17.9%) were primary concerns. Main dental concerns were the need for preoperative antibiotic prophylaxis (33.3%) and the use of vasoconstrictors (20.4%). Overall, 32.1% of medical consultations resulted in an alteration in dental treatment plans. As a result of medical consultations, 8% commenced their medical management. CONCLUSIONS: These results indicated that medical consultations could reduce the medical risk associated with dental procedures and unnecessary antibiotic prophylaxis. Therefore for many dental patients, good communication between dentists and physicians is essential for adequate care.

The basic principles of infectious diseases as related to dental practice.

A variety of bacterial, viral, fungal, and protozoan microbes may present hazards to the dental team and to patients. After contamination with a microbe, three major factors determine if an infectious disease results: (1) virulence of the microbe, (2) the dose or number of microbial cells that contaminate the body, and (3) the resistance of the body to the microbe. Because nothing can be done about microbial virulence, prevention of infectious diseases involves decreasing the dose and increasing body resistance, coupled with education about disease spread and modes of prevention. The steps in the development of an infectious disease are (1) source of the microbe, (2) escape of the microbe from the source, (3) spread of the microbe to a new person, (4) entry of the microbe into the new person, and (5) infection and damage. The prevention of infectious disease can be accomplished by interfering with any of the above steps.

Documenting medication use in adult dental patients: 1987-1991.

The authors surveyed 5,002 dental outpatients to determine the prevalence and patterns of drug use. They found that drug use increased significantly with age and that a significant number of patients took medications that had potential for adverse dental effects. Thus, dentists should be aware of patient medications and the effects those drugs have on dental treatment.

Morphometric analysis of the dental pulp chamber as a method of age determination in humans.

Eighty bite-wing radiographs from 40 female and 40 male patients were selected from the patient record system at the University of Texas Dental School at San Antonio, Texas. All samples were equally divided into four age groups, with a range from 15 to 55 years of age. The lower right first permanent molar tooth was chosen as the representative tooth for measuring the maximum height and width of the pulp chamber. The reproducibility of the method was checked by repeating all measurements on two different occasions. Regression analysis indicates that the height and width of the pulp chamber were negatively correlated with age (height r = -0.376 and width r = -0.125). The coefficient of determination (r2) for pulp chamber height and width were 0.123 and 0.058, respectively. This indicates that although there appears to be a definite relationship between the age of an individual and the height and width of the dental pulp chamber, these measures cannot be used as a reliable method of age determination.

State-of-the-art infection control in dentistry.

This paper defines infection control in dentistry as it exists in 1991 and makes some predictions about the future of this area. A total of 21 items form the basis of a comprehensive infection control program.

The global challenge of hepatitis B: implications for dentistry.

Hepatitis B remains a serious threat to non-immune members of the dental team. Dental personnel who are hepatitis B virus (HBV) carriers, many of whom may not be aware of their status, are also at risk of superinfection with hepatitis delta virus. It is hoped that this paper will assist dentists to understand better their role in preventing HBV infection and for dental staff to understand why acceptance of vaccine is so important to them, their families and their patients.

Hepatitis B. Current status in dentistry.

Hepatitis B is the target disease whenever one considers the scientific basis for the procedures to prevent cross contamination between patients. Thus, hepatitis B is the infectious disease that health care workers must review (occasionally) to remain current in the recognition and prevention of infection. This article provides a review and the latest information on non-A, non-B hepatitis (hepatitis C and hepatitis E) and hepatitis B vaccines.

Disinfection/sterilization protocols recommended by manufacturers of impression materials.

A survey of six companies manufacturing 12 commonly used impression materials was conducted to determine current recommended impression disinfection techniques. Only one company provided a protocol based on studies of its own product, and only two chemical disinfectants were evaluated, with little test information provided. It was concluded that none of the six impression manufacturers had an appropriate, complete disinfectant protocol.