Practical clinical applications of sports dentistry in private practice.

Preparing a practice to become "trauma-ready" involves more than educating the dentist and the staff in the proper management of dentofacial trauma. All members of the office should understand their roles in preventing and treating trauma. They must be willing to provide care after hours when called upon to do so. Dentists who want to be more involved might wish to volunteer their services as sports dentists for local school or recreational league teams. The dentist who is conscious of his or her patients who are at risk for sports-related trauma will also find others in the practice who might benefit from many of the same protective devices that are being constructed for athletes. These include children involved in higher-risk activities, developmentally disabled patients, patients undergoing general anesthesia, and others. Being trauma-ready may open up several rewarding activities for the practice because of the many spin-off applications. The trauma-ready practice must also be cognizant of the some-times perplexing legal and insurance issues with regard to preventing and treating sport-related injuries. In addition to lowering the risk exposure to the practice, the dentist can help ensure the maximum third-party benefits for the patient.

Fluoride uptake into demineralized primary enamel from fluoride-impregnated dental floss in vitro.

Fluoridated mouthrinses are not advised for preschool children who may swallow much of the agent. An alternate method of delivering topical fluoride to the interproximal tooth surfaces in these young patients may be fluoridated dental floss. The purpose of this study was to determine the fluoride levels of demineralized primary enamel both before and after the use of a commercially available dental floss impregnated with commercially available fluoride-containing products. The results showed that demineralized primary tooth surfaces treated with fluoride-impregnated dental floss exhibited significantly higher fluoride levels than those surfaces treated by immersion in a fluoridated mouthrinse or deionized water.

Monitoring of sedated pediatric dental patients.

The results of this study showed that children sedated with 50 mg/kg chloral hydrate and 25 mg hydroxyzine in conjunction with 40 percent nitrous oxide and 60 percent oxygen may have respiratory difficulties which are not detected by the traditional monitoring of blood pressure, pulse, respiratory rate and skin color. The use of a pulse oximeter that noninvasively measures oxygen saturation of hemoglobin (SaO2) allowed earlier detection of respiratory distress, when correction was a relatively simple matter of readjusting head position. This combination of sedative agents was effective in managing two-thirds of the patients originally classified in a behavioral category of definitely negative. No children sedated with only 40 percent nitrous oxide and 60 percent oxygen exhibited respiratory problems, and over 80 percent of the patients classified in behavioral category of negative were managed effectively with this technique.

Dimensional stability of alginate impressions immersed in disinfecting solutions.

The stability of full-arch alginate impressions that had been immersed in one of two disinfecting solutions was assessed by measuring stone casts poured from the alginate impressions. Statistically significant dimensional changes occurred, when compared with master casts, but only by 1 mm or less, a clinically insignificant amount.

A study of plaque accumulation and gingival health surrounding stainless steel crowns.

From the findings of the present study the following can be stated: The degree of gingivitis surrounding teeth restored with nonideal stainless steel crowns was significantly higher than that of the entire mouth; however, the gingival status of the crowned teeth was not significantly different from that of unrestored contralateral control teeth. The amount of clinically detectable plaque associated with teeth restored with nonideal stainless steel crowns was not significantly different from that of the entire mouth or that of unrestored contralateral control teeth. A moderate positive correlation existed between the plaque index and the gingival index of teeth restored with nonideal stainless steel crowns; strong positive correlations between the same factors existed for the entire mouth and for the unrestored contralateral control teeth. The majority of stainless steel crowns placed by undergraduate dental students were judged as clinically acceptable. Nevertheless, most exhibited one or more observable defects: errors in marginal crimp and length were most common. In view of the association between nonideal stainless steel crowns and gingivitis, the operator must be meticulous in the placement of stainless steel crowns. Errors in adaptation must be avoided in order to minimize irritating factors and to preserve the health of the gingival tissues.

Early diagnosis and successful management of periodontosis.

A brief review of the literature regarding the recognition, causes, and different therapeutic approaches of periodontosis was presented. Two cases of periodontosis in the early stages were reported, and a successful treatment plan using modalities similar to those used for other forms of periodontitis was described. Early diagnosis of the condition was critical to the success of both cases. Both patients were taught good oral hygiene, which, along with scaling, root planning, and conservative periodontal surgery, not only resulted in arresting the disease process, but also encouraged osseous regeneration. These examples emphasize the necessity of routine periodontal examinations for all children, especially at the circumpubertal period because periodontosis is often passed unnoticed until there has been massive periodontal destruction. The management of the advanced conditions is more challenging and seldom successful.

Clinical significance of taurodontism.

In an attempt to determine the clinical significance of taurodontism, two reports of cases of patients with the anomaly have been presented. It seems that the taurodont form does not interfere with routine operative procedures, but it is suggested that the morphology might hamper the location of orifices and could create difficulties in instrumentation and obturation in endodontic treatment. It is hoped that other cases involving the treatment of taurodont teeth will be reported to aid in determining the clinical significance of the anomaly for other areas of dentistry.