Determinants of masticatory performance in dentate adults.

Masticatory performance results from a complex interplay of direct and indirect effects, yet most studies employ univariate models. This study tested a multivariate model of masticatory performance for dentate subjects. Explanatory variables included number of functional tooth units, bite force, sex, age, masseter cross-sectional area, presence of temporomandibular disorders, and presence of diabetes mellitus. The population-based sample consisted of 631 dentate subjects aged 37-80 years. Covariance structure analysis showed that 68% of the variability in masticatory performance could be explained by the combined effects of the explanatory variables. Age and sex did not show a strong effect on masticatory performance, either directly or indirectly through masseter cross-sectional area, temporomandibular disorders, and bite force. Number of functional tooth units and bite force were confirmed as the key determinants of masticatory performance, which suggests that their maintenance may be of major importance for promoting healthful functional status.

The role of dentistry in palliative care of the head and neck cancer patient.

Although palliative care for the terminally ill is based on a multidimensional philosophy to provide whole-person comfort care while maintaining optimal function, it does not usually include dentistry in its team approach. Dentists can have a significant role in the care of these patients by providing total, active comfort care of the oral cavity. The function of the oral cavity is essential to the patient's ability to thrive. Therefore, alleviation of pain and prevention of infection in the oral cavity should be a priority in providing total, active comfort for the patient. The oral problems experienced by the hospice head and neck patient clearly affect the quality of his or her remaining life. Through routine assessments and interventions by a dentist on the palliative care team (Figure 4), comfort care for the patient may be improved by the maintenance of oral hygiene and procedures to hydrate the oral mucosa. In addition, routine dental assessments may identify dental disease and facilitate dental interventions for caries, periodontal disease, oral mucosal problems or prosthetic needs. Attention to such detail may reduce not only the microbial load of the mouth but the risk for pain and oral infection as well. This multidisciplinary approach to palliative care, including a dentist, may reduce the oral debilities that influence the patient's ability to speak, eat or swallow. Not only does maintenance of oral health have impact on the quality of life, which is already challenged by the disease, but it also aids in the ability of patients to thrive for whatever precious time is left to them.

The most frequently prescribed medications in the elderly and their impact on dental treatment.

The high prevalence of multiple chronic medical conditions in the elderly and the likelihood of multiple drug therapies dramatically increase the chance of drug-specific adverse effects and drug-drug interactions. This article reviews the age-associated alterations in pharmacokinetics and pharmacodynamics along with the most frequently prescribed medications for the elderly. Adverse drug reactions, drug-drug interactions and oral side effects are reviewed along with the impact these medications may have on dental treatment planning and management.

Microbiologic contamination during dental radiographic film processing.

This study investigated microbiologic contamination of an automatic dental radiograph processor and daylight loader during a week of simulated clinical use. Pure cultures of Candida albicans, Streptococcus pneumoniae, Staphylococcus aureus, or Klebsiella pneumoniae were used to contaminate 320 vinyl intraoral radiograph packets. Each end of the films was deliberately contaminated during opening. These films and 24 uncontaminated control films were processed. Daylight loader ports, inlet and outlet rollers, fixer and developer samples, and 12 processed films were cultured daily. To simulate a weekend, the processor sites were cultured during 72 hours of inactivity after the contaminated runs. The results showed that contamination of the processor and daylight loader occurred and remained even after 48 hours of inactivity. Films remained contaminated after processing. In addition, cross-contamination of films occurred in the processor.